The Healthy Working Lives Group has undertaken a sustained programme of clinically focused research to improve the quality, consistency and effectiveness of occupational health practice.
Alongside our academic research, practising occupational health physicians within the group have conducted work focused on clinical decision-making, competency assessment, consultation quality, clinical assessment, report writing and the growing complexity of occupational health practice.
About this work
Occupational health practice involves complex clinical, legal, ethical and workplace decisions. Good occupational health advice must be clinically sound, clearly communicated and useful to workers, employers and organisations.
Our work has focused on improving the quality of occupational health practice by developing practical methods for clinical decision support, peer review, audit and professional reflection.
This includes the development of the first clinical algorithms in occupational health practice, designed to support consistent, evidence-informed decision-making in everyday occupational health settings.
Clinical algorithms in occupational health
The group developed and implemented clinical algorithms to support occupational health clinicians in managing common and complex clinical scenarios.
This work recognised that occupational health practice is shaped by clinical evidence, employment context, legislation, ethics, workplace hazards and communication with multiple stakeholders.
The clinical algorithms were designed to support consistency, transparency and quality in occupational health decision-making.
Peer review and report quality
Occupational health reports are one of the main ways occupational health professionals communicate clinical advice to employers, workers and organisations.
The Healthy Working Lives Group has published a series of peer-reviewed audit studies examining the quality of occupational health reports.
This work has explored:
- the process and outcomes of peer review audit;
- whether peer review improves occupational health report quality;
- how report quality can be assessed and improved;
- the quality of reports produced by specialist and non-specialist occupational physicians;
- how audit and feedback can support clinical governance in occupational health practice.
Understanding complexity in OH practice
More recent work has examined clinical case complexity in occupational health.
Occupational health consultations often involve overlapping health, workplace, legal, psychosocial and organisational factors. This means that apparently simple cases may become complex when work demands, employer expectations, worker vulnerability, disability, safety, communication and return-to-work decisions intersect.
Understanding this complexity is essential for training, service quality, clinical governance and workforce planning in occupational health.
Why this matters
Quality improvement in occupational health is not just about better paperwork. It affects the quality of advice given to workers and employers, the fairness of workplace decisions, and the ability of occupational health services to support safe, sustainable work.
Clear, high-quality occupational health reports can improve communication, reduce misunderstanding and support better decision-making.
Clinical algorithms, peer review audit and complexity research all help strengthen occupational health practice by making clinical reasoning more consistent, transparent and evidence-informed.
Key themes
- Quality improvement in occupational health practice
- Clinical decision-making
- Clinical algorithms
- Occupational health report quality
- Peer review audit
- Clinical governance
- Competency assessment
- Specialist and non-specialist occupational physician practice
- Consultation quality
- Clinical case complexity
- Evidence-informed occupational health practice
Selected publications
- Development and implementation of clinical algorithms in occupational health practice
Ghafur, I., Lalloo, D., Macdonald, E.B. and Menon, M. (2013). Journal of Occupational and Environmental Medicine, 55(12), pp. 1443–1448.
https://pubmed.ncbi.nlm.nih.gov/24270296/ - Peer review audit of occupational health reports: process and outcomes
Lalloo, D., Ghafur, I. and Macdonald, E.B. (2012). Occupational Medicine, 62(1), pp. 54–56.
https://eprints.gla.ac.uk/120812/ - Impact of peer review audit on occupational health report quality
Lalloo, D., Demou, E. and Macdonald, E.B. (2015). Occupational Medicine, 65(6), pp. 440–443.
https://eprints.gla.ac.uk/105427/ - Peer review audit of non-specialist occupational physician reports
Lalloo, D., Gallagher, J., Macdonald, E.B., McDonnell, C. and Vargas-Prada Figueroa, S. (2020). Occupational Medicine, 70(7), pp. 503–506.
https://pubmed.ncbi.nlm.nih.gov/32804206/ - Understanding clinical case complexity in occupational health
Lalloo, D. and Macdonald, E. (2022). Occupational Medicine, 72(5), pp. 283–285.
https://eprints.gla.ac.uk/275273/
Healthy Working Lives Group 