Fitness for safety critical work, UK wide
Safety Critical Medicals and Drug and Alcohol Testing
No United Kingdom statute obliges a general employer to run drug and alcohol testing or to send people for safety critical medicals, which is exactly why so many programmes fall over when challenged. AL23 Safety builds the risk case that justifies testing, writes the policy that makes it defensible and manages the clinical work through occupational health specialists, for clients UK wide.
What is a safety critical medical?
A fitness decision about one specific task, not a general health check
A safety critical medical asks a narrow question. Can this person perform this defined task safely today, given the consequences of sudden incapacity or impairment while performing it. It is not a wellbeing benefit and it is not a health screen.
Drug and alcohol testing sits alongside the medical as a separate control on impairment. The two are often bought together and they answer different questions. A medical addresses capacity and underlying health. A test addresses the presence of a substance at the point the sample was taken.
The output your managers receive is a fitness statement, worded as fit, fit with restrictions, temporarily unfit or unfit. Clinical detail stays with the occupational health provider and does not come to you.
Who needs one
The trigger is the consequence of failure, not the job title
There is no statutory list of safety critical roles for general industry. The honest test is whether sudden incapacity or impairment in that role could cause serious harm to the worker or to somebody else before anyone could intervene.
- Rail work in a safety critical capacity, where the operator relies on a due diligence position under the Transport and Works Act 1992
- Aviation and maritime roles governed by the Railways and Transport Safety Act 2003 and by medical certification regimes such as ENG1 for seafarers and UK Civil Aviation Authority Part-MED for aircrew
- Large goods vehicle and passenger carrying vehicle drivers, assessed against the Driver and Vehicle Licensing Agency Group 2 medical standards
- Entry into confined spaces under the Confined Spaces Regulations 1997 and work under the Work in Compressed Air Regulations 1996, where an appointed doctor is required
- Classified persons under the Ionising Radiations Regulations 2017
- Plant, crane, forklift, high voltage switching, working at height and process operating roles where your own risk assessment identifies impairment as a material risk
Where the risk sits in vehicle movements rather than in the person, the sharper control is often a review of workplace transport safety rather than a medical programme.
The regulations that apply
Your legal framework, in plain terms
The duty comes from the general law and from your own risk assessment, not from a testing statute. The Health and Safety at Work etc. Act 1974 requires you to control risk so far as is reasonably practicable. The Management of Health and Safety at Work Regulations 1999 require you to assess it. Where impairment in a safety critical task is a foreseeable and material risk, a policy that includes testing becomes a reasonably practicable control. Sector statutes then add hard obligations in rail, aviation, maritime and road transport.
HSWA 1974 section 2(1)
Duty to ensure the health, safety and welfare at work of employees so far as is reasonably practicable.
HSWA 1974 section 3(1)
Duty to conduct the undertaking so that people who are not employees are not exposed to risk, which is the limb that bites where your workers affect the public.
HSWA 1974 section 7
Duty on the employee to take reasonable care and to co-operate, the hook that makes a policy obligation enforceable against an individual.
MHSWR 1999 regulation 3
Suitable and sufficient risk assessment. This is where a testing regime is justified or is shown to be disproportionate.
Transport and Works Act 1992, Part II
Creates offences of being unfit through drink or drugs while carrying out safety critical work on a transport system. It also creates a separate operator offence with a due diligence defence. That defence is why a rail testing programme is effectively compulsory in practice.
Misuse of Drugs Act 1971 section 8
Narrower than most policies claim. It makes it an offence for an occupier or manager of premises to knowingly permit the production or supply of a controlled drug, the preparation of opium for smoking or the smoking of cannabis, cannabis resin or prepared opium.
Read that last point carefully. Section 8 does not make it an offence to permit an employee to be under the influence on your premises. It does not cover simple possession or consumption either. We remove that overstatement wherever we find it in a client policy.
What the service covers
From the risk case to accredited clinical delivery
- A written justification for testing, drawn from your risk assessment, naming the roles in scope and the reason each one is in scope
- Policy drafting covering substances tested, cut-off levels, triggers, sampling method, consequences, appeals and the support route
- The contractual basis for testing, either an express term, incorporation by reference or a properly consulted variation for existing staff
- Pre-employment and pre-engagement screening design, including what a positive result may and may not be used for
- With cause testing, built on a documented reasonable suspicion process that supervisors can actually apply under pressure
- Post incident testing, tied to defined incident thresholds and to your incident investigation procedure so that the sample is taken before the evidence decays
- Random unannounced testing, with a stated selection percentage, an auditable selection method and a record proving the selection was genuinely random
- Return to work and transfer testing after a positive result or a move into a safety critical role
- The medical battery itself, typically medical history and medication review, vision, hearing, cardiovascular assessment, musculoskeletal function, plus fatigue and obstructive sleep apnoea screening using tools such as the Epworth scale
- Chain of custody design, with tamper evident kits, split samples sealed in the donor's presence and a laboratory accredited to ISO/IEC 17025 for the specific toxicology methods
- Confirmation testing by gas chromatography mass spectrometry or liquid chromatography tandem mass spectrometry before any action is taken on a screening positive
- Medical review of every confirmed positive by an occupational health doctor, to exclude a legitimate prescribed or over the counter explanation
- The UK GDPR position, covering the Article 9 condition, the appropriate policy document where one is needed, the data protection impact assessment and the arrangement with your provider
Our process
Justify the scope before anyone is tested
- 01
Risk case first
We work through the roles you believe are safety critical and test each one against the consequence of impairment. Some come out of scope. That reduction is part of the value.
- 02
Policy and contract
We draft the policy, set the triggers and cut-off levels with the provider and identify how the policy becomes contractually binding on existing staff without provoking a constructive dismissal argument.
- 03
Provider appointment
We scope the work, appoint the right specialist, interpret the results and turn them into an action plan you can actually deliver. That includes the laboratory accreditation check and the chain of custody paperwork.
- 04
Data protection build
We settle the Article 9 condition, produce or review the appropriate policy document, run the impact assessment and fix the controller position with the provider in writing.
- 05
Launch, brief and review
We brief managers on the with cause conversation, publish the amnesty and self-declaration route, then review the programme against outcomes rather than against test volumes.
What you get
Policy, procedure and a defensible data position
- A safety critical role schedule with the risk justification for each role recorded against it
- A drug and alcohol policy in plain English, covering triggers, cut-offs, refusal, adulteration, appeals, re-test and rehabilitation
- A manager procedure for reasonable suspicion, with the observation record and the removal from duty script
- A random selection protocol with the selection method and the retention rules that prove it was random
- A data protection pack containing the Article 9 analysis, an appropriate policy document where you rely on it and a completed impact assessment
- A controller to controller schedule with your occupational health provider, covering record transfer on termination of the contract
What we need from you
Your assessments, policies and provider details
- Your current risk assessments and the role descriptions for the posts you consider safety critical
- Any existing policy, contract wording and staff handbook clauses on drugs, alcohol and medical examination
- Details of your current occupational health provider and the testing laboratory behind it
- Incident records where impairment was suspected, raised or discounted
- Recognition or consultation arrangements, since a policy imposed without consultation is the one most likely to be challenged
Why AL23 Safety
One point of contact across three specialists
Accountable
When something is non-compliant, we say so clearly and set out the fix. If your policy overstates the Misuse of Drugs Act or treats refusal as a deemed positive without saying so, the report says so.
Expert and chartered
Chartered Building Engineer and Health and Safety Professional leadership, working to current standards and legislation.
Practical, not just compliant
We scope the work, appoint the right specialist, interpret the results and turn them into an action plan you can actually deliver. You keep one point of contact rather than managing a clinician, a laboratory and a lawyer separately.
UK wide
We run medical and testing programmes for single sites and for multi-site operations across the UK from our Manchester base.
Talk to us about fitness for work
Straight answers before you commit to a programme
If you are not sure whether your roles justify testing at all, a short call usually settles it faster than a proposal does. No obligation and no pressure.
Common questions
Answers, up front
Cannot see your question? Get in touch and we will answer it directly.
Contact usNot safely. There is no general employer right to test. You need a lawful contractual basis, a policy communicated in advance and consent at the point of the test. Testing people outside safety critical roles, with no risk justification, is the single most common weakness we find.
No. Any policy that says otherwise is overreaching. A screen detects the presence of a substance or its metabolites above a cut-off level. It does not establish impairment at the moment of the task. That is why cut-off levels, confirmation testing and medical review matter. It is also why testing is one control among supervision, competence assurance and fatigue management rather than a substitute for them.
It can be, where the roles are genuinely safety critical, the policy is contractual and the selection is genuinely random and documented as such. The limits are proportionality and evidence. Random testing across an entire workforce including office staff is very hard to defend. A selection process that quietly targets individuals is not random at all.
Health data is special category data under Article 9(1), which means you need an Article 6 basis and an Article 9 condition together. For safety critical medicals and for the clinical work the usual condition is Article 9(2)(h), occupational medicine and assessment of working capacity, which requires the processing to be under the responsibility of a professional bound by confidentiality. Explicit consent under Article 9(2)(a) is a weak basis in employment because the power imbalance undermines genuine choice. Treat the signed consent form as clinical consent to the procedure rather than as your data protection condition.
Cost is driven by the number of roles in scope, the medical battery each role needs, the testing frequency, the number of sites and whether sampling is on site or at a clinic. Policy and risk work is a one-off. Clinical delivery is a recurring cost per person per year. Tell us the headcount, the roles and the sites and we will quote against that. The advisory element can sit inside a retained support arrangement.
They point in opposite directions. Health surveillance looks for early signs of ill health caused by your work, which means it checks whether your controls are working. A safety critical medical checks whether the person is fit to do the work. Different legal basis, different frequency, different report.
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