On 3 July 2026, the HSE announced landmark enforcement action against an occupational health service provider – its first ever Prohibition Notice served on a provider of occupational health services, followed by an Improvement Notice covering the provider’s wider health surveillance arrangements. For UK employers who rely on an external provider for workplace health surveillance – for risks such as wood dust, hazardous substances and noise – this is a significant development. This article explains what happened, why this HSE occupational health enforcement action matters for your business, what the health surveillance requirements are, and the practical questions every employer should now be asking their occupational health provider.
HSE inspectors found that an occupational health service provider was delivering health surveillance through personnel who were inadequately trained, unqualified and unsupervised. Because the surveillance was ineffective, early signs of serious occupational diseases – including occupational asthma, dermatitis and noise-induced hearing loss – were at risk of going undetected, leaving workers exposed to wood dust and noise without appropriate intervention. HSE issued a Prohibition Notice to stop the activity, on the grounds that it created a risk of serious personal injury. It later issued an Improvement Notice after finding that the provider’s health surveillance arrangements were fundamentally unsuitable: inspectors identified a lack of competent occupational health oversight, inadequate clinical governance, no quality assurance processes, and no clear procedures for escalating adverse findings or reviewing workplace controls. This is the first time HSE has taken enforcement action of this kind against an occupational health provider – and the regulator has been clear that it did not do so lightly.
Health surveillance is a legal requirement for many employers, under regulations including the Control of Substances Hazardous to Health Regulations 2002 (COSHH) and the Control of Noise at Work Regulations 2005. If your business exposes people to wood dust, other hazardous substances or noise – common in manufacturing, woodworking, engineering, warehousing and construction – there is a good chance health surveillance applies to you. And it is not a paperwork exercise. Health surveillance exists to identify the early signs of work-related ill health – occupational asthma, dermatitis, noise-induced hearing loss – so that action can be taken to protect the affected worker and everyone else exposed to the same risks. This case confirms two things. First, occupational health providers are not exempt from regulatory scrutiny. Second, appointing a provider does not discharge your duties: HSE expects employers to satisfy themselves that the occupational health providers they appoint are capable of delivering services that meet legal requirements and help protect workers from preventable occupational disease.
Perhaps the most important line in the press release came from HSE Occupational Health Inspector Julie Wood: “When it is carried out poorly, employers are given false assurance and workers are left unknowingly at risk.” That is the real danger here. If health surveillance is carried out by people who are not suitably trained, qualified, supervised or clinically governed, the early signs of occupational disease may simply be missed – while everything appears to be in order. The visits happen, the certificates arrive, the files fill up. Meanwhile, a worker developing occupational asthma from wood dust, dermatitis from skin contact with hazardous substances, or noise-induced hearing loss on a loud production line continues to be exposed, and nobody intervenes. In that sense, poor health surveillance can be worse than none at all, because it actively reassures an employer that a problem does not exist. Good occupational health governance – competent people, clinical oversight, quality assurance and clear escalation routes – is what turns a testing programme into genuine protection.
You do not need to be an occupational health expert to act on this. The practical learning points for employers are:
Whether you are appointing a new provider or reviewing an existing one, these questions will quickly tell you how well governed the service is – and a good provider will have ready answers:
Two types of enforcement notice were used in this case, and it is worth understanding the difference. A Prohibition Notice requires an activity to stop where an HSE inspector believes it involves a risk of serious personal injury or ill health – it is the stronger of the two, used where continuing would put people in harm’s way. An Improvement Notice requires specific remedial action to be taken within a set timescale to address a contravention of health and safety law. Both are formal enforcement action, both can be appealed, and both appear on HSE’s public enforcement register (notices are published five weeks after they are served, to allow for the appeals process). Insurers, clients and procurement teams routinely check the register, so a notice has commercial consequences well beyond the remedial work itself.
None of this should be read as a criticism of occupational health providers in general. Good occupational health provision is extremely valuable: it catches disease early, keeps people in work, supports sensible decisions about fitness for work and absence, and gives employers reliable evidence that their controls are working. HSE itself says that supporting employers to access competent occupational health services is a key part of its strategy to reduce work-related ill health. The lesson from this case is not to avoid occupational health – it is to appoint carefully. Choose a competent occupational health provider that can demonstrate clinical governance, quality assurance and clear escalation processes, and that connects what it finds in the medical room to what happens on your shop floor. Reputable providers will welcome the questions listed above, because they can answer them.
If you take one thing from this landmark HSE occupational health enforcement case, make it this: check, do not assume. In practical terms:
Health surveillance is a system of ongoing health checks – such as lung function tests, skin checks and hearing tests – used where workers remain exposed to a residual health risk after controls are in place. It is legally required under a range of regulations, including COSHH 2002 and the Control of Noise at Work Regulations 2005, where your risk assessment identifies a relevant exposure.
A Prohibition Notice stops an activity where there is a risk of serious personal injury or ill health. An Improvement Notice requires remedial action within a set timescale to address a breach of health and safety law.
Size does not exempt you. If your risk assessment identifies relevant exposure – for example wood dust (a cause of occupational asthma) or daily noise exposure at levels that put hearing at risk – health surveillance requirements apply to SMEs just as they do to larger businesses.
Ask about clinical responsibility, staff qualifications and experience, quality assurance and audit, and how abnormal results are reviewed and escalated. A competent, well-governed provider will answer readily; hesitation on these basics is a warning sign.
No. Health surveillance is a back-stop that checks whether your controls are working. Controlling exposure at source – extraction, enclosure, quieter equipment, safer substances – always comes first.
Under the Management of Health and Safety at Work Regulations 1999, every employer must appoint one or more competent persons to help meet their health and safety duties. Judging whether health surveillance is required, whether your provider’s arrangements stand up to scrutiny, and whether occupational health findings are properly connected to your risk assessments is exactly the kind of area where experienced support pays for itself. As your appointed competent person, we help you work out what health surveillance your business actually needs, prepare the right questions for your provider, and close the loop between occupational health findings and workplace controls. Our wider health and safety consultancy services include risk assessment support written with you on site, and our free CoSHH Essentials E-Tool is a good starting point for assessing hazardous substances.
This case is a timely prompt to look again at how workplace health risks are managed in your business. TIPS Consultancy Ltd helps SMEs review workplace risk assessments, COSHH assessments, noise controls and health surveillance action plans – and, crucially, whether the recommendations coming back from your occupational health provider are properly linked to the risks and controls in your workplace. Clients on our 12-month Competent Person Service receive ongoing support with risk assessments, safe systems of work and health and safety documentation, all proportionate to the size and nature of their business.
TIPS Consultancy Ltd provides straightforward, experienced health and safety support for small and medium-sized businesses across manufacturing, woodworking, engineering, warehousing and construction. Whether you need help with a one-off review of your health surveillance arrangements or year-round competent person support, get in touch to find out how we help businesses across the East Midlands and beyond protect their people from preventable occupational disease – and demonstrate it.
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