Rail Health Assessment

A brief overview of the National Standard for Health Assessment of Rail Safety Workers

Updated over a week ago

Scheme Overview

National Standard for Health Assessment of Rail Safety Workers

  • All health assessments of rail safety workers in Australia are conducted in line with the current edition of the National Standard for Health Assessment of Rail Safety Workers (the Standard).

  • The Standard was developed in consultation with industry, rail unions, rail safety regulators and health professionals to provide practical guidance for rail transport operators for managing the risks posed by the ill health of rail safety workers.

  • NTC review’s the National Standard for Health Assessment of Rail Safety Workers every three years.

Purpose of Rail Workers Health Assessments

  • Under the Rail Safety National Law (RSNL), rail transport operators are required to manage the risks posed by the ill-health of rail safety workers. This National Standard for Health Assessment of Rail Safety Workers (the Standard) provides practical guidance for rail transport operators to meet these obligations. This responsibility is an essential part of an operator’s rail safety management system, which aims to minimise risks and protect the safety of:

    • the public

    • rail safety workers and their fellow workers

    • the environment.

Safety Critical Work/Workers

  • These are workers whose action or inaction may lead directly to a serious incident affecting the public or the rail network. Their vigilance and attentiveness to their job is crucial, and they are therefore the main focus of this Standard. These workers require health assessments to ensure ill health does not affect their vigilance and attentiveness to the job, and therefore the safety of the public or the rail network. Safety Critical Workers’ tasks are distinguished from tasks that affect only individual worker safety.

Non-Safety Critical Work/Workers

  • These are workers whose action or inaction will not lead directly to a serious incident affecting the public or the rail network. These workers require health assessments to ensure their own safety while working in or around the network.

Category 1 Safety Critical Work/Workers

  • Category 1 workers are the highest level of Safety Critical Worker. These are workers who require high levels of attentiveness to their task and for whom sudden incapacity or collapse (e.g. from a heart attack or blackout) may result in a serious incident affecting the public or the rail network. Single-operator train driving on the commercial network is an example of a Category 1 task

Category 2 Safety Critical Work/Workers

  • Category 2 workers are those whose work also requires high levels of attentiveness, but for whom fail-safe mechanisms or the nature of their duties ensure sudden incapacity or collapse does not affect safety of the rail network. For example, in many cases signallers are classified as Category 2 because fail-safe signal control systems protect the safety of the network in case of worker incapacity.

Category 3 Non-safety Critical Worker

  • The Track Safety Health Assessment for ATTP (Category 3) focuses on medical conditions that could impact on a worker’s ability to detect and react quickly to an oncoming train or warnings. The assessment comprises eyesight and hearing tests, and an assessment to ensure safe mobility around the track, as well as a questionnaire to help identify any other serious conditions that could affect safety around the track.

Frequency of Health Assessments

Pre-placement or change-of-risk-category health assessments

  • Rail safety workers classified in Categories 1, 2 and 3 require health assessments at pre-placement and before changing to a position involving tasks of a higher risk category.

Periodic health assessments

  • Category 1 and 2: Safety Critical Workers

    • At time of commencement (pre-placement, as above)

    • every 5 years to age 50, then

    • every 2 years to age 60, then

    • every year

  • Category 3: Around the Track Personnel in an Uncontrolled Environment

    • At time of commencement (pre-placement, as above), then

    • every 5 years from the age of 40 years.

Depending on the needs of the worker, Authorised Health Professionals may also recommend more frequent assessments for health surveillance.

For Category 1 and Category 2 Safety Critical Workers, despite anything to the contrary in the list, the worker must have a health assessment conducted within 2 years after turning 50 years of age, and within 1 year after turning 60 years of age.

Triggered Health Assessments

  • Triggered health assessments overlay the scheduled periodic health assessments and enable early intervention, appropriate management and timely monitoring of health problems that are likely to affect safety.

  • Referral for a triggered health assessment may be prompted by a number of different circumstances. In turn, these circumstances will determine the nature and extent of the health assessment required.

Example: “A worker presents to work after being hospitalised over the weekend with chest pain. They report they are fine and want to be at work, but you can see they look unwell.”

Part B

  • The Part B certificate is completed by the AHP (or CMO) and summarises relevant clinical findings, actions and defines the workers overall fitness for duty classification:

Fit for Duty Unconditional

  • This indicates the worker meets all criteria in the Standard and is to be reviewed in line with the normal periodic health assessment schedule.

Temporarily Unfit for Duty

  • This indicates that the worker does not meet the criteria for Fit for Duty Unconditional and cannot presently perform current rail safety duties. Their health situation is such that they may pose a risk to safety and therefore should not continue current rail safety duties. They must undergo prompt assessment to determine their ongoing status and be definitively classified. Temporarily Unfit for Duty may also be applied in situations where a clear diagnosis has not been made—for example, in the case of an undifferentiated illness where a worker is being investigated for blackouts. The worker may be assessed as fit for alternative duties.

Fit for Duty Conditional

  • This indicates that the person meets all criteria in the Standard provided that they wear appropriate aids (e.g. corrective lenses, hearing aids, prostheses).

Fit for Duty Subject to Review

  • This indicates the worker does not meet the criteria for Fit for Duty Unconditional; however, the condition is sufficiently controlled to permit current rail safety duties. Continuation of normal duties is conditional on the worker being reviewed more frequently than the periodic health assessment schedule. The review period is specified by the Authorised Health Professional. This classification may also apply as a provisional classification for a newly diagnosed condition which does not pose an immediate risk to safety but requires further investigation. In this situation, workers must undergo prompt assessment to determine their ongoing status and be definitively classified.

Fit for Duty Subject to Job Modification

  • This indicates the worker does not meet the criteria for Fit for Duty Unconditional, but could perform current rail safety duties if suitable modifications were made to the job. These modifications may include: modification of physical equipment, roster changes, or worker supervision. Job modifications may not be practicable in various areas of rail safety work. The worker may also be classified Fit Subject to Review if more frequent review of their condition is required.

Permanently Unfit for Duty

  • This indicates that the worker does not meet the criteria for Fit for Duty Unconditional or Fit for Duty Subject to Review (or any other conditional category). Their condition is permanent (defined as unfit for 12 months or more) and they will not be able to perform current rail safety duties in the foreseeable future. Normal company policies such as redeployment may be considered.

Health Assessment Database

  • The rail transport operator should establish an appropriate database to help administer health assessments. The database should identify all of the following:

    • each rail safety worker’s risk category, and the assessment required

    • the due date for each worker’s assessment

    • any restrictions or conditions on the worker’s fitness for duty.

    • It should be managed so that timely reminders to supervisors and workers are issued and followed up.

Privacy / Information Disclosure

  • Health information should be reported on a need-to-know basis from a doctor to a rail transport operator.

  • The Authorised Health Professional must not disclose the worker’s clinical records to the rail transport operator.

  • The rail transport operator needs to know fitness for duty (or any restrictions), not the underlying medical conditions.

  • Worker/patient consent must be obtained to disclose any health information to a third party, unless permitted by law as with workers’ compensation.

  • However, a doctor is not prohibited from giving the rail transport operator general advice about fitness for duty provided the doctor does not refer to the worker’s medical details.

  • Where a rail transport operator employs the services of a CMO, the rail transport operator’s CMO may request a copy of the Health Assessment Record, the Safety Critical Worker health questionnaire and/or other supporting clinical records from the Authorised Health Professional to ensure consistency and quality of health assessments for rail safety workers or to assist management of a particular worker. Where such records are accessed or retained by the CMO, their confidentiality must be assured and systems must be in place to ensure records are not accessed by other personnel within the rail transport operator. This is consistent with privacy provisions.

Role of the CMO

The CMO is an individual that is appointed by a company such as UGL to use the Authority under the National Rail Medical standards to manage workers.

  • The CMO has the authority to delegate a further level of authority to the KINNECT AHP Doctors to assist with reviewing workers ensuring they are fit for their safety critical roles.

  • KINNECT does not hold the authority.

  • The CMO will also case manage identified rail workers who require referral to specialist and are temporarily / conditionally unfit for rail work.

In the absence of this model, the examining AHP would be required to do this and we have seen very mixed results with their ability to do this / access to them (i.e. left the business, only work 2 days per week, too busy with GP appointments etc.) / their ability to communicate what is required to the rail worker and the workplace.

Part B Extensions

  • Extensions can only be provided when there has been a concerted effort to obtain information by the worker. The CMO will review the request based on whether the worker has attempted to organise the reports, whether they are being complaint with their Dr or specialist treatment management plans (previous history) and what impact it could have on UGL operations.

  • Part B extensions cannot be provided past the final review date as RIW will not accept these. In this case the worker could not be on site.

  • Please ensure that any requests for extension are received by KINNECT 5 workings days prior to the expiry to allow for processing.

Medication Reviews

  • Medication declarations are the responsibility of the worker. Under the standard they are required to report any new medication or change in medication which may impact their ability to perform the safety critical role.

  • The CMO can provide advice on whether medication will impact the worker and the risk so that UGL can decide on next steps.

  • The best outcome is when KINNECT has a detailed understanding of what has been prescribed and why i.e Name of medication, dose and frequency and who has prescribed the medication – GP or specialist, condition requiring the medication and safety critical role requirements.

  • The CMO will discuss the outcome with the Rail Operator and provide a report.

Obtaining further medical information from treating GP/health professional

  • The CMO will prepare a letter outlining what information is requested from the workers GP/Health Professional

  • KINNECT will contact the worker and explain what information is requested and how to submit that back

  • It is the workers responsibility to arrange and fund the appointments required to obtain the requested information

  • Failure to do so, will result in their Part B expiring

  • The Rail Operator can play a role in following up the worker to ensure they have completed what has been asked of them and not just relying on KINNECT to persuade the worker to do what has been asked – sometimes, they just don’t listen to us

  • Once information has been supplied, the CMO will do a review of the information and issue a new Part B

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