Why is health surveillance important and how is it different from fit-to-work medicals?

Health surveillance plays a crucial role in ensuring the health and safety of employees in the workplace. It involves systematically monitoring workers for signs of work-related ill health, caused by workplace hazards, allowing for early intervention and prevention of potential health issues. Whether you’re in construction, manufacturing, transportation, rail, or utilities and energy, you have a legal duty of care to your employees, so it’s important to understand your responsibilities.  

Why is health surveillance important for companies?

One of the main reasons why health surveillance is important is its ability to identify and manage the workplace health risks which may affect an employee. By regularly monitoring employees, any potential health risks can be identified and addressed before they become serious health concerns. This not only protects employees, but also ensures that employers fulfil their legal duty of care.

Health surveillance is critical in workplaces where employees may be exposed to specific hazards such as noise, vibration, and hazardous substances. Prolonged exposure to high noise levels can lead to hearing loss, while regular use of vibrating tools or machinery may cause conditions like hand-arm vibration syndrome (HAVS). Additionally, working with or around hazardous substances poses risks of respiratory conditions, skin disorders, or other long-term health complications.

By identifying these risks through effective health surveillance, employers can implement targeted controls and safety measures to minimise exposure and protect worker health.

How can health surveillance support employee wellbeing?

Health surveillance also plays an important role in supporting employee wellbeing. It demonstrates that an employer values their health and safety, fostering a positive workplace environment. By prioritising health surveillance, companies can reduce absenteeism, improve productivity, and promote a culture of care and responsibility. Consistent health monitoring ensures that issues are addressed promptly, demonstrating a proactive approach to employee health, as well as compliance with UK health and safety law.

Beyond regulatory compliance, investing in health surveillance has long-term advantages for both an organisation and its employees. By identifying potential health risks early, companies can implement preventative measures, reducing the likelihood of workplace injuries or illnesses.

Employees feel valued when their wellbeing is prioritised, leading to improved morale, job satisfaction, and retention rates. As well as this, fostering a healthy workforce contributes to a positive corporate image - strengthening relationships with clients, stakeholders, and the wider community. These collective benefits underscore the importance of integrating health surveillance into everyday business practices.

How should a business implement health surveillance?

Implementing health surveillance effectively requires a structured and proactive approach. Businesses should begin by conducting a thorough risk assessment to identify potential hazards and the specific health risks faced by employees. This process involves evaluating the workplace environment, mitigating any identified hazards where possible, understanding job roles, and consulting with employees to gather insights.

Once risks are identified, appropriate monitoring programmes can be established, tailored to the unique needs of each individual. As a starting point, an employee would normally undergo a baseline assessment with a clinician. After this, regular medical assessments ensure that employees are monitored for any changes to their health which may be related to their working environment.

Clear communication and training are vital to ensure employees understand the purpose of health surveillance and their own role in maintaining a safe and healthy working environment. By fostering collaboration and ongoing education, businesses can create a culture of health and safety that benefits everyone involved. 

Is health surveillance a legal requirement?

Health surveillance is a legal requirement in workplaces where employees are exposed to specific health risks, such as hazardous substances, noise, or vibration. For example, The Health and Safety at Work Act 1974 places a general duty on employers to ensure the health, safety, and welfare of their employees. Compliance ensures not only the wellbeing of employees but also helps businesses avoid legal penalties and maintain a responsible reputation.

More specifically, the Management of Health and Safety at Work Regulations 1999 require employers to assess and manage risks, including implementing health surveillance where risks are identified. Additionally, the Control of Substances Hazardous to Health Regulations 2002 (COSHH), the Control of Noise at Work Regulations 2005, and the Control of Vibration at Work Regulations 2005 explicitly mandate health surveillance for workers exposed to hazardous substances, excessive noise, or vibration.

What's the difference between health surveillance and fit-to-work medicals?

While both health surveillance and fit-to-work medicals focus on employee wellbeing, they serve different purposes within workplace health management. Health surveillance is a requirement for monitoring the health of employees who are exposed to specific workplace hazards and involves periodic assessments to detect early signs of work-related illnesses. This is to ensure preventive measures are effective.

On the other hand, a fit-to-work medical assesses whether a person is medically capable of performing a specific job role without risk to themselves or others. While health surveillance focuses on ongoing monitoring related to workplace hazards, fit-to-work medicals are about determining suitability for a job, particularly for roles involving safety-critical tasks. Both processes are vital but address different aspects of occupational health.

How can we optimise our health surveillance programme?

A well-run health surveillance programme doesn’t just tick a compliance box, it helps you spot early signs of work-related ill health, protect your team, and create a safer, healthier workplace. Here are some practical ways to make yours more effective:

Using data to guide action – Analyse health surveillance results over time to spot patterns or emerging risks, and use that insight to inform risk management.

Tailoring surveillance to actual exposures – Align the type and frequency of health checks with the specific risks employees face, based on up-to-date risk assessments.

Ensuring clinical follow-up – Make sure any flagged concerns lead to timely medical advice, support, or workplace adjustments.

Integrating with wider health systems – Link health surveillance with occupational health records, absence data, and wellbeing initiatives for a more joined-up approach.

Auditing and improving – Regularly review the surveillance process itself, are you using the right tests, reaching the right people, and acting on results?

Conclusion

Health surveillance is a vital component of workplace safety, as it enables the ongoing monitoring of the health of individual employees to identify potential health risks at an early stage. Unlike fit-to-work medicals, which assess whether an employee is medically capable of performing their specific role, health surveillance focuses on detecting any adverse effects caused by workplace hazards over time.

This proactive approach not only helps protect employees from long-term health issues but also ensures compliance with legal regulations and supports a culture of care within the organisation.

At Express Medicals, we bring decades of experience working collaboratively with health and safety teams across a wide range of industries. Our deep understanding of workplace risks, combined with our clinical expertise, allows us to deliver tailored health surveillance solutions that are not only compliant with regulatory guidelines but also aligned with the specific needs of your workforce.

But it’s not just about ticking boxes, our approach is about helping you spot early signs of work-related ill health, support your employees proactively, and reduce the risk of long-term issues that could impact both wellbeing and productivity.

By partnering with us, you’ll benefit from a robust health surveillance programme that empowers your business to stay ahead of regulatory requirements while building a safer, healthier workplace.

Sources

For more information on workplace health and safety, visit the Health and Safety Executive (HSE) website: https://www.hse.gov.uk