Hi Sharon

This employee is probably disabled under the Equality Act, so your employers walk a tightrope between avoiding unlawful discrimination and reasonable adjustments and running the operation properly.

The employee doesn’t have immunity though from even capability dismissal , with the enormous proviso that you have to be very careful to get it right.

You might be well advised to place it on record in a written communication, that you’re anxious to make all possible workplace adjustments to facilitate and continue return etc and are sorry that she’s chosen not to attend two successive OH appointments to this end, at a cost of £400 already. And that you won’t be making another appointment unless you can be reasonable certain she will attend and so won’t be able to access expert medical opinions about adjusting to her conditions and will therefore have to work the best you can without this information.

Then, if absence or capability at work continues at unacceptably high level, hold a formal Hearing to consider all the aspects and her and any companions side of the story and maybe offer OH yet again but only if employee commits to attending. Try to explain ( without threatening in any way ) that you as her employers have a right ultimately to dismiss in these unfortunate circumstances, provided you follow a fair process and this is the first step.

Is she a trade union member? - assume not, but if she is, a quiet word with the TU rep might be useful to have.

It’s a strange OH Provider that charges such big money for missed appointments - I’d be looking at changing mine if they persisted in doing this, or at least trying to get them to arrange yet another consultation without or with reduced cancellation fee in view of what had gone before.

In reply to David:

Thank you David for your sound advice as usual. I too am disappointed with the lack of support from our OH providers particularly as the owner is the Chair of Govenors. I know, it is unbelievable, but very true.

I will write to employee with your advice as to how it is difficult to support if we are not fully informed of her conditions by OH. I don’t think we can make any further appointments until we are sure that she will attend.

In reply to Sharon :

All Best with coping with it all, Sharon: sounds like a Titanic conflict of interest facing you there.....

We have an employee who has resisted to attend OH appointments for months, things improved, then went downhill leading in a longer absence than I suspect she would have had anyway. On speaking to her, she was just worried. She was worried what OH would share about her medical history, worried as she had never been in that situation before, worried we would change her job role.
We have worked hard to improve the perception of OH and now she has her appointment imminently.
Could it be that your employee doesn't fully understand the role of OH?

In reply to Alex:

Really good point, Alexandra.

I do sometimes wonder how common this perception might be.

Has anyone else experienced this?

In reply to Steve Bridger:

interestingly we have had this very situation in a previous case where the individual would not attend her appointment and I have been mindful of this with new cases of OH referrals. It is a good point though and I do think assumptions are made as to the employee's understanding of what the OH appointment is for. Thank you

In reply to Sharon :

Something for all of us to note... and think about, I think.