Allied Health Professional (AHP) Health and Work Report

6.1 Fractured right humerus example: Completed report

See this example of how the AHP Report has been completed View Case History

Example Condition: Fractured right humerus

Jenny Kowalski is full-time receptionist. She travels to work by two buses. She has a history of anxiety. She has fractured her right humerus and is being treated with a sling and home exercises.

She is right handed. Her GP has signed her as ‘not fit’ for work. Her fit note expires on 14th February but she is making a good recovery apart from some reduction in shoulder adduction and abduction, and repetitive movements are still uncomfortable.

She is keen to return to work, but anxious and concerned about frequent use of the mouse, and telephone, travelling in the rush hour, and standing for long periods at the reception desk as her shoulder muscles tire after 20 minutes. You think she may be able to return to work now if she

works from 9.30am to 3.30pm initially to avoid the rush hour to regain her confidence
builds in additional breaks of 15 minutes at three points during the working day to allow a change of position and carry out some simple exercises
and is temporarily provided with a stool to perch on.

She should be able to return to full hours and duties within four weeks, but it would be helpful if her progress is monitored and progressed by her line manager. You have given her an open appointment until the end of September and agree to send a copy of the report to her GP.

Listen to the case history

Allied Health Professions
Advisory Fitness for Work Report

1 Patient's name: Jenny Kowalski

Date of birth: 19/07/1994

I advise that:

1a you are not fit for work.

1b you may be fit for work taking account of advice below

2 This form has been completed by a:
Physiotherapist / Occupational Therapist / Podiatrist / Other

Practitioner's name: Your Name

HCPC registration number: OT XXXXX

Organisation/Service: Name of your service / department / unit

Contact details (email/ tel no.): Your work email address

Date assessment completed: 23/01/2019

4 AHP Advisory Fitness for Work Report issued for period from 23/01/2019 to 20/02/2019

A follow up review is / is not required* has been made for dd/mm/yyyy *delete as appropriate

5 With your employer's agreement you may benefit from these or more options:

a phased return to work

amended duties

altered hours

a workplace assessment

6 Patient-reported work-relevant difficulty, recommendations and goals:

Difficulty	Recommendations / goals
Fracture to upper right arm. Healed but shoulder muscles weak. Difficulty with activities that require moving arm away from body e.g. computer mouse and landline phone.	Build in three extra 15 minute breaks in working day to allow change of positions and carry out slmple exercises.
Shoulder feels tired and uncomfortable after standing for more than 20 minutes.	Temporary use of high stool to perch on, to allow breaks from standing.
Anxious about travelling by bus during rush hour.	Return to work initially 9.30 - 3.30 until more confident.

7 Comments

Fit note expires 24th Feb however in my opinion she could return now if these modifications are made. Should be able to return to full hours and duties in 4 weeks. It would be helpful if her line manager could check on her progress until then. Copy of this report to be sent to GP. Ms Kowalski has an open appointment with our service until the end of February 2019.

8 Additional information is provided on 0 accompanying sheets

9 Signature: Your signature

AHPs: please follow the guidance held on the website of your professional body when filling out this form and always attach the information sheet for employees, employers and doctors. Employees, employers and doctors: please read information attached or log on to: www.ahpf.org.uk