The National Transport Commission (NTC) has introduced a new edition of the National Standard for Health Assessment of Rail Safety Workers. These changes, effective from 11th November 2024, will impact how rail operators and health professionals manage the health assessments of rail safety workers. This guide will walk you through the main changes and what they mean for rail operators, health professionals, and workers.
Why the Update?
The National Standard is reviewed regularly to ensure it aligns with advancements in medical practice, health management, and evolving safety needs in the rail environment. The latest 2024 update reflects feedback from stakeholders, including rail operators, unions, medical experts, and government bodies. The changes are designed to simplify processes, clarify roles, and improve safety outcomes for rail workers.
Key Changes to the Health Assessment Standard
Simplified Fitness for Duty Categories
The fitness for duty categories have been streamlined into four main outcomes:
Fit for Duty Unconditional: Worker meets all health standards without restrictions.
Fit for Duty Subject to Review: Worker is fit but requires ongoing monitoring.
Temporarily Unfit for Duty: Worker is temporarily unfit due to a treatable or short-term condition.
Permanently Unfit for Duty: Worker is permanently unfit for duty due to a progressive or permanent condition.
The former category “Fit for Duty Conditional” has been removed. Workers needing corrective aids (such as glasses or hearing aids) will have this noted separately from their primary fitness category.
Enhanced Health Assessments for Medical Conditions
Cardiovascular Conditions:
A new Australian Cardiovascular Risk Calculator, specific to Australian data, will be used for Category 1 Safety Critical Workers aged 30 and over.
Cardiac stress testing is no longer a routine requirement unless recommended by a cardiologist.
Diabetes Management:
Workers no longer need to fast for pathology testing.
A simpler urine glucose test will be used for diabetes screening in Category 2 workers.
Ongoing reviews may now be managed by the worker’s general practitioner if diabetes is well-controlled.
Hearing and Vision Assessments:
Workers with hearing loss will be automatically referred to the rail transport operator’s hearing conservation program.
Workers with stable vision conditions will be categorised as “Fit for Duty Unconditional” while those with progressive vision issues will be categorised as “Fit for Duty Subject to Review” for ongoing monitoring.
Triggered Health Assessments: More Clarity and Flexibility
Triggered health assessments will now be conducted in three scenarios:
Monitoring an existing medical condition (Fit for Duty Subject to Review).
Investigating a newly identified condition.
When there is a concern raised by the worker or employer.
For triggered assessments, the standard now includes clearer timeframes and the use of “interim” reports if results are pending.
Neurodevelopmental Disorders Now Considered
Conditions such as autism spectrum disorder (ASD) and ADHD are now specifically addressed in the Health Questionnaire and categorised based on their impact on safety rather than diagnosis alone.
Workers with these conditions will be assessed individually to determine the effect on their safety and work capacity.
Sleep Disorder Screening Expanded
The STOP-Bang questionnaire has been introduced to provide a more comprehensive assessment of obstructive sleep apnoea risk in Category 1 and 2 workers.
This is in addition to the Epworth Sleepiness Scale, which measures actual sleepiness experienced by the worker.
If a worker is found to be at risk, they will be referred for a sleep study.
Clear Prohibition of Medicinal Cannabis and Other Drugs
The Standard has clarified that medicinal cannabis and other drugs, such as methamphetamine and MDMA, are banned for rail safety workers, even if they are legally prescribed.
Enhanced Management of Health Data and Privacy
The privacy of workers’ health information is emphasised, ensuring that only fitness-for-duty results are shared with operators, while detailed health data remains confidential.
Operators must develop processes to notify workers of any data breaches and ensure compliance with privacy laws.
What This Means for Rail Operators
From 11th November 2024, all rail health assessments must follow the updated guidelines. Here’s how these changes will impact rail operators:
Notifying Workers About Health Assessments
Rail operators must give workers at least 10 working days’ notice for non-urgent health assessments (e.g., periodic health checks), unless mutually agreed otherwise.
Urgent health assessments due to sudden health concerns, such as sudden loss of consciousness, must be conducted as soon as possible.
Revised Health Assessment Forms
All forms used for health assessments have been updated to align with the new standard. KINNECT has implemented the new paperwork requirements within its carelever platform, ensuring that they continue to be completed electronically via Carelever forms. Changes include:
New fields for assessing cardiac and sleep disorder risks.
Additional questions to capture neurodevelopmental conditions.
Revised consent procedures for sharing health information.
Clearer Guidance for Authorised Health Professionals
All Authorised Health Professionals (AHPs) must complete updated training and be re-registered under the revised AHP Program to conduct rail health assessments.
Operators must ensure that only certified AHPs are used for health assessments. For remote or difficult-to-access areas, a temporary approval process is available, but must be managed on a case-by-case basis.
KINNECT is working with its AHP network to ensure they participate in the required training and maintain their AHP registration.
How to Prepare
Review Your Internal Procedures: Ensure that your procedures and documentation are updated to reflect the 2024 Standard.
Communicate with Workers: Provide clear and concise information to your workers about what the changes mean for them and their health assessments.
Update Data Management Practices: Develop and implement clear policies for handling health information, ensuring compliance with the updated privacy guidelines.
Additional Resources and Support
For more information and resources, you can access the NTC’s website here.
By staying informed and aligned with these changes, rail operators and workers can continue to ensure the safety and wellbeing of all rail safety workers. If you have further questions or need guidance on implementing these updates, feel free to reach out to us at KINNECT.