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Hospital Return To Work Form Template for England and Wales

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Key Requirements PROMPT example:

Hospital Return To Work Form

"I need a Hospital Return To Work Form for a senior nurse returning from a three-month sick leave in March 2025, including provisions for a phased return and specific workplace adjustments due to mobility issues."

Document background
The Hospital Return To Work Form is a crucial document in the healthcare sector across England and Wales, designed to manage the safe and effective return of employees following medical absence. This form became particularly significant following the implementation of stricter health and safety protocols in healthcare settings and the need for comprehensive documentation of workplace returns. It incorporates requirements from various legislative frameworks including the Health and Safety at Work Act 1974, Equality Act 2010, and Data Protection Act 2018. The form typically includes medical clearance, risk assessments, and any required workplace adjustments, ensuring both legal compliance and employee wellbeing.
Suggested Sections

1. Employee Information: Basic personal and employment details including name, employee ID, department, role

2. Absence Details: Dates of absence, reason for absence, any hospital treatment received

3. Medical Clearance: Confirmation of fitness to return to work from medical professional

4. Work Capability Assessment: Assessment of current capability to perform regular duties

5. Return Date: Confirmed date of return to work

Optional Sections

1. Phased Return Plan: Details of graduated return to work schedule, used when employee requires gradual reintegration following extended absence or complex medical conditions

2. Workplace Adjustments: Specific modifications needed to accommodate medical condition, required when reasonable adjustments are necessary under Equality Act

3. Occupational Health Referral: Details of referral to occupational health services, used for complex cases requiring specialist assessment

Suggested Schedules

1. Medical Certificate: Copies of relevant medical certificates or fit notes

2. Risk Assessment: Workplace risk assessment related to return to work

3. Adjustment Plan: Detailed plan of workplace modifications if required

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈ˰æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions

























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Relevant Industries
Relevant Teams
Relevant Roles
Industries

Health and Safety at Work etc. Act 1974: Primary legislation establishing employer duties for ensuring employee health, safety, and welfare, including risk assessment requirements for returning workers

Equality Act 2010: Legislation protecting against discrimination for employees with disabilities or health conditions, requiring reasonable adjustments and ensuring protection against discrimination related to medical conditions

Data Protection Act 2018 and UK GDPR: Regulations governing the processing, confidentiality, storage and handling of sensitive personal medical information and health data

Access to Medical Reports Act 1988: Legislation covering requirements for obtaining medical information, employee consent, and rights to view medical reports

Management of Health and Safety at Work Regulations 1999: Regulations detailing risk assessment requirements and special considerations for vulnerable workers

The Working Time Regulations 1998: Legislation governing working hours, patterns, rest break requirements, and night work restrictions

Fit Note (Med3) Regulations: Guidelines for integration with GP fit notes and consideration of GP recommendations

NHS Guidelines and Protocols: Healthcare-specific requirements covering infection control measures, public health requirements, and occupational health recommendations

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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