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Implementation – interim guidance Job-Related Fitness Tests for the Police Service of England and Wales September 2013 Winsor Recommendation 33

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Page 1: Job-Related Fitness Tests for the Police Service of ... · marketing@college.pnn.police.uk All other enquiries about this publication should be addressed to the College (0800 496

Implementation – interim guidance

Job-Related Fitness Tests for the Police Service of England and Wales

September 2013Winsor Recommendation 33

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This document can be provided in alternative formats. Please email [email protected]

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Publication date: September 2013

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Contents1 Introduction 5

2 Fitness testing – police staff 6

3 Health and safety compliance 6

4 Job-related fitness test (JRFT) standards 6

4.1 In-service JRFT – introduction 6

4.2 JRFT standards – application note 7

4.3 JRFT familiarisation 7

4.4 JRFT protocols 8

4.5 JRFT referral and support process 8

4.6 JRFT occupational health referral 8

4.7 JRFT failure 8

5 Equality and diversity 8

6 Delivery 9

6.1 Health and safety 9

6.2 Staffing 9

6.3 Medical screening 9

7 Data collection 10

Tables

1 Recommended Winsor recommendation (33) JRFT standard 6

Appendices

1 Home Office Circular 43/2004 (relevant section) 11

2 JRFT (5:4) – risk assessment 12

3 Equality impact assessment 16

4 JRFT medical questionnaire 20

5 Health declaration 21

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Potential for legal challenge

This guidance has been produced by the Police Advisory Board for England and Wales Fitness Testing Working Group to support the assessment and validation process concerning the introduction of the job-related fitness test for serving police officers. Police forces that implement these standards will be able to cite them as being assessed as reasonable and appropriate under the Equality Act 2010 and the Health and Safety at Work etc. Act 1974 (as amended). Any derogation from these standards carries a risk of legal challenge from an officer disadvantaged by the implementation of a higher or a lower standard, any additional standards or a different method of assessment than those recommended in this guidance.

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1 Introduction The Home Secretary accepted the recommendation of the Police Advisory Board for

England and Wales (PABEW) to introduce, in part, the recommendation made in the Winsor Review (Part 2 report) for annual fitness testing of serving police officers.

The initial recommendation (33) to implement fitness testing made in Winsor (Part 2) states:

A fitness test should be introduced in September 2013 for all police officers and staff required to undertake personal safety training. Participants should be required to attain level 5:4 on a 15-metre shuttle run. From September 2014, those who fail the test three times should be subject to the appropriate disciplinary procedures.

PABEW reconsidered the part of the recommendation stating that officers who fail the test on three occasions should be subject to appropriate disciplinary procedures. They recommended instead that forces provide supportive action through force performance procedures to officers who fail the test.

It should be noted that while the Winsor Review made other recommendations linked to in-service fitness testing, these are still the subject of on-going negotiations.

The Home Secretary accepted Winsor recommendation 33 subject to the caveat, proposed by PABEW. PABEW tasked the National Fitness Testing Working Group with developing guidance for forces on the implementation of annual fitness testing in the short term, and assessing the likely impact of the tests in the longer term.

This guidance sets out how forces should implement the new arrangements. This will enable the Fitness Testing Working Group to make longer-term recommendations to ensure that the fitness tests do not unlawfully discriminate against officers because of their disability, gender or age. The Working Group also seeks to reduce the risk of a legislative breach of health and safety law and subsequent challenge due to injury or illness suffered by an officer, and maximise resources for operational policing.

Police forces in England and Wales need to interpret this guidance in accordance with local management and organisational structures.

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2 Fitness testing – police staff No decision has been made with respect to fitness testing for police staff. Winsor

recommendation 33, as it relates to these employees, remains outstanding. It is anticipated that the PABEW Fitness Testing Working Group will now address this in partnership with the Police Staff Council.

3 Health and safety compliance This guidance will help police forces ensure job-related fitness test (JRFT) standards comply

with the Health and Safety at Work etc. Act 1974 (HSWA) and the Police (Health and Safety) Act 1997. This guidance complies with the Health and Safety Executive’s (HSE) guidance on successful health and safety management in the workplace – HSG65.

4 Job-related fitness test (JRFT) standards The JRFT purely measures endurance. It is based on scientific research to match the

physical demands of officer safety training (OST), and it is this basis that gives the test legitimacy and relevance. The JRFT standard is the same as that used in recruiting officers.

Table 1: Recommended Winsor recommendation (33) JRFT standard

Candidate Recommended endurance standard(level:shuttle)

Police officer 5:4

*Note – the upper body strength test is not included in these standards

4.1 In-service JRFT – introduction

In order to facilitate implementation of the JRFT for in-service fitness testing, PABEW has accepted that in the first year (from September 2013 to September 2014) there should be no sanction applied to those officers who fail the fitness test or who are unable to take it because of a medical reason. The reason provided should be assessed by the force occupational health provider.

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It is important that there is diversity monitoring in force of those officers who pass, fail or are unable to take the test, and that this is shared with the Fitness Testing Working Group to allow national assessment of adverse impact. This will also enable the Working Group to assess future requirements and establish whether an appropriate alternative test should be developed, in line with Winsor’s recommendation.

Some forces have already implemented alternative tests and it is important to highlight that this approach may bring certain risks. The 5:4 shuttle run testing can be justified as equivalent to the levels of aerobic activity reached in personal safety training (defined in terms of VO2 max uptake). The risk with an alternative is that it may not be adequately validated against national standards and could have an adverse impact on officers from some of the protected groups, which forces may not be able to justify if challenged. The National Fitness Testing Working Group has commenced work to establish the need for an alternative test and, if one is required, what that test should be. Forces will be updated once the Working Group has finalised consultation on a validated alternative.

4.2 JRFT standards – application note

The Fitness Testing Working Group proposes that this pass standard is implemented as a pre-selection process for police officers undertaking OST and is subject to an annual retesting regime. All officers tested should wear appropriate physical training clothing and footwear, not operational police uniform and/or equipment.

It is advised that the testing is undertaken in an indoor facility with suitable flooring and floor markings. It is important to ensure that the recording of the 15-metre multi-stage fitness test can be heard clearly from all parts of the facility where the testing is being undertaken. The suitability of the facility must be addressed in the risk assessment (see Appendix 2).

The National Fitness Testing Working Group recognises that some forces have moved away from annual OST. These forces should consider how the objective behind this policy can best be achieved.

4.3 JRFT familiarisation

A familiarisation system should be established which allows officers to become familiar with the JRFT test and, if necessary, attempt an informal test. It may be helpful to run open days targeted at certain groups, in a non-threatening environment, as a positive action measure. This may reassure anyone particularly anxious about testing of the level of physical competence required. All health and safety criteria must apply to ensure that no candidate’s safety is compromised as a result of practice tests. This also gives each candidate the opportunity to receive advice on how to improve their fitness (if required) from the appropriately trained specialist administering the test.

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4.4 JRFT protocols

The delivery criteria of the JRFT must be consistent with good 15-metre multi-stage fitness practice with an appropriate warm up undertaken as per Home Office Circular 43/2004 – see Appendix 1. The test must be delivered to the minimum standard only (5:4). Undertaking this test with candidates of differing fitness standards to a maximal level of physical exertion may carry a degree of risk detrimental to the health and well-being of the candidate.

4.5 JRFT referral and support process

Positive action should be considered for groups of officers who may find the test more challenging. This can be achieved by delivering familiarisation sessions (see paragraph 4.3) to specific groups of individuals only (eg, females). In addition, support processes for all must be considered to help candidates pass the JRFT on their first attempt or develop them after they have recorded a fail.

4.6 JRFT occupational health referral

If a candidate cannot pass the medical screening element of the JRFT or records a fail due to an inadequate physical fitness standard, musculo-skeletal complaint or ill health, a structured referral process must be implemented (including occupational health). The referral process should include a documented action plan to give the candidate a realistic time-bound target to make appropriate improvements to undertake the JRFT successfully.

4.7 JRFT failure

If an officer cannot pass the JRFT, forces may wish to consider whether the officer should be permitted to go on to undertake OST. The aerobic demands in the JRFT are equivalent to those in OST. Consequently, it may not be a defensible position to allow participation in OST following a JRFT failure, which could render the force legally liable if an injury occurs.

5 Equality and diversity In the context of work the Equality Act 2010 requires that there is no unlawful discrimination

because of age, disability, gender reassignment, marriage or civil partnership, pregnancy or maternity, race, religion or belief, sex or sexual orientation. The law also requires public sector employers to promote equality for all people from the protected groups (except, in some respects, marriage and civil partnership). See the Equality and Human Rights Commission website for more information. An initial equality impact assessment (EIA) of the tests has been conducted (see Appendix 3). Forces should ensure that this EIA is reviewed and amended in the light of their own practices and arrangements.

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Forces need to complete the online data collection survey so that the Fitness Testing Working Group can complete a proper evaluation of equality impact at regular intervals during the first year of implementation. The Working Group will make recommendations as to whether the process needs to be amended based on the outcome of the full EIA.

6 Delivery It is accepted that the training structure and facilities in each police force will dictate how

a testing regime is delivered and at what cost.

6.1 Health and safety

A specific risk assessment for the JRFT must be completed by a suitably experienced person in line with the HSE’s ‘5-step risk assessment’ template. It is advised that the risk assessment is reviewed by a designated health and safety adviser/officer periodically, or in the event of significant injury/illness to a participant, or if an organisational restructure affects JRFT delivery. An example (only) of an appropriate risk assessment is shown at Appendix 2; other local force considerations may be needed to add or influence the scoring or content of the risk assessment.

6.2 Staffing

Forces must be satisfied that staff members delivering the JRFT test are competent to do so as well as first aid certified. The qualification/certification must be recorded within the risk assessment.

6.3 Medical screening

All candidates should complete a medical screening questionnaire prior to undertaking the JRFT (an example questionnaire is attached at Appendix 4). The screening questionnaire must be part of the risk assessment and approved by an occupational health specialist. It is advised that the medical screening questionnaire is reviewed by a designated occupational health specialist periodically or in the event of significant injury/illness to a participant. This questionnaire should be completed as part of the pre-join instructions for undertaking the fitness test. It will identify the requirement for a referral to a specialist for further assessment and determine suitability for the individual to participate in the JRFT. On the day of the test, a further health declaration (see Appendix 5) should be completed by participants confirming there has been no change in their personal circumstance in the intervening period. This process is already in place in many forces with regard to OST.

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7 Data collection At this early stage it is important to audit the number of passes and failures and understand

how specific groups of individuals (eg, of specific age and gender) are performing. Each force is required to collect results from their testing regime and supply them via an online survey provided by the College of Policing. Results will be requested on a date to be notified.

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Appendix 1 Home Office Circular 43/2004 (relevant section)

Test elements and standards

The test administrator must ensure that all candidates are sufficiently warmed up for the test. This should involve some whole body activity such as jogging followed by appropriate stretching exercises, particularly of the leg muscles. It would be useful to familiarise candidates with the test by taking them to level 3 as part of the warm up followed by basic mobility stretching activities.

Page 2, paragraph 4, Home Office Circular 43/2004

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Appendix 2 JRFT (5:4) – risk assessmentRisk to the participants undertaking JRFT

Activity/task assessed: Name of assessor: Assessment no.: Type of assessment: Specific

Date implemented: Date of last assessment: Review date:

No. Activity/workplace

Hazards Persons at risk1

Severity of

hazard2

Likelihood of risk2

Overall risk

level2

H, M, L

Control measures/ comments

Revised risk

level2

Further action

required? (Y/N)

1 Pre-JRFT (screening and pre-test)

a. serious illness or fatality

P, PS 5 2 10 (M) • Implement positive action/familiarisation of testing regime in respect of all potential participants.

• Informed consent and health screening questionnaire to be completed prior to the JRFT.

• Questionnaire to be reviewed by appropriate person.

• Do not test any staff identifying medical problems on the questionnaire.

• Occupational health referral for any potential problems identified on the questionnaire.

• Instructors must be trained in basic first aid (consider the access to, and training needs for, a defibrillator).

• Comply with JRFT Standard Operating Procedure (HO Circ 43/2004).

5 (L)

1Persons at risk include: participant (P), instructor (I), police service (PS)2See the risk estimator matrix

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Risk to the participants undertaking JRFT (continued)

Activity/task assessed: Name of assessor: Assessment no.: Type of assessment: Specific

Date implemented: Date of last assessment: Review date:

No. Activity/workplace

Hazards Persons at risk1

Severity of

hazard2

Likelihood of risk2

Overall risk

level2

H, M, L

Control measures/ comments

Revised risk

level2

Further action

required? (Y/N)

b. slipping or tripping

P 3 3 9 (M) • The floor surface should be of a suitable gymnasium standard.

• The floor surface must be clear, clean, clearly marked and maintained.

• Candidates must be wearing appropriate footwear.

• Instructors must be trained in basic first aid.

• Compliant with all relevant Health and Safety Executive Approved Codes of Practice (HSE ACOPs).

4 (L)

c. musculo-skeletal injury

P 3 3 9 (M) • Candidates must not run beyond 5:4.

• Comply with JRFT Standard Operating Procedure (HO Circ 43/2004).

• Candidates must be clearly briefed.

• Candidates must declare any current musculo-skeletal injury which they feel may deteriorate as a result of undertaking the JRFT.

• Candidates must be afforded appropriate time to warm up before the JRFT (preferably delivered by a qualified instructor).

• Instructors must be trained in basic first aid.

4 (L)

1Persons at risk include: participant (P), instructor (I), police service (PS)2See the risk estimator matrix

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Risk to the participants undertaking JRFT (continued)

Activity/task assessed: Name of assessor: Assessment no.: Type of assessment: Specific

Date implemented: Date of last assessment: Review date:

No. Activity/workplace

Hazards Persons at risk1

Severity of

hazard2

Likelihood of risk2

Overall risk

level2

H, M, L

Control measures/ comments

Revised risk

level2

Further action

required? (Y/N)

d. injury, illness or fatality due to general use of the fitness testing facility

P, I, PS 5 2 10 (M) • Candidates must not run beyond 5:4.

• Comply with JRFT Standard Operating Procedure (HO Circ 43/2004).

• Candidates must be clearly briefed on the facilities (ie, fire evacuation procedures).

• Candidates must declare any current musculo-skeletal injury which they feel may deteriorate as a result of undertaking the JRFT.

• Candidates must be afforded appropriate time to warm up before the JRFT (preferably delivered by a qualified instructor).

• Instructors must be trained in basic first aid.

• Compliant with all relevant HSE ACOPs.

5 (L)

1Persons at risk include: participant (P), instructor (I), police service (PS)2See the risk estimator matrix

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Risk estimator matrix

Severity

LikelihoodNo injury First aid

injuryLost time

(over 3 days)

Major injury or disabling

diseaseDeath

Improbable 1 2 3 4 5

Remote 2 4 6 8 10

Possible 3 6 9 12 15

Probable 4 8 12 16 20

Very likely to occur 5 10 15 20 25

Warning – health & safety

It is advised that all officers undertaking the standards are not run beyond the endurance pass standards outlined in Table 1 (page 6).

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Appendix 3 Equality impact assessment

Title of policy: Initial implementation of in-service fitness tests Date: 7 June 2013

1: Identify the aims and purpose of the policyThis should identify the ‘legitimate aim‘ of the policy (there may be more than one).

To ensure that fitness testing for serving police officers is carried out consistently across forces and are non-discriminatory.

2: Identify the individuals and organisations likely to have an interest in, or be affected by, the policyThis should identify the persons/organisations who may need to be consulted about the policy or procedure and its outcomes (there may be more than one).

In 2003 the Police Advisory Board of England and Wales (PABEW) expressed concerns about the potential for unlawful discrimination in certain fitness standards operated by forces. They commissioned the Fitness Testing Working Group to make recommendations for:

1. an interim solution as to the type and level of fitness required at recruitment on the best evidence currently available, based on an assessment of job and competency requirements;

2. how the recruitment fitness test (based on the interim solution at bullet point 1 above) should be conducted fairly and consistently and what the response should be to those who do not meet the standard;

3. further work (with timetable to progress) that will be needed to (a) assess fully, and validate, the required standards and test, (b) establish the type and level of job- and competence-related fitness required for specialist roles and how to test fairly and effectively for them, and (c) establish the possible needs for, and forms of, on-going support and assessment of the fitness and health of police officers.

PABEW commissioned the Fitness Testing Working Group to develop guidance in this area. By 2011 the Working Group had completed the work identified at items 1, 2, 3(a) and 3(b).

In 2012 the Winsor Review of Police Officer and staff remuneration and conditions recommended that:

’A fitness test should be introduced in September 2013 for all police officers and staff required to undertaken personal safety training. Participants should be required to attain level 5:4 on a 15-metre shuttle run.’

This recommendation was accepted in part by PABEW who agreed that an annual fitness test of 5:4 on a 15-metre shuttle run should be introduced for serving officers who are required to undertake officer safety training (OST). Their recommendation was accepted by the Home Secretary. PABEW commissioned the Fitness Testing Working Group to develop this proposal for implementation.

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3. Consultation Who was consulted and how? (This should include reference to people and organisations identified in section 2.)

The Fitness Testing Working Group was comprised of representatives of the organisations on PABEW whose members would be interested in, and affected by, the policy. The Working Group commissioned an external agency, Lilleshall Consultancy Services, to develop appropriate fitness standards and validate those standards.

4: ResearchSummarise the findings of any research you have considered regarding this policy. This could include quantitative data and qualitative information; anything you have obtained from other sources.

Lilleshall Consultancy Services developed the job-related fitness test (JRFT) for recruits to the Police Service in 2004. A comprehensive review of the literature relating to functional fitness tests in working environments was undertaken as part of that project. By measuring the ‘real time’ physiological demands of OST Lilleshall Consultancy Services recommended that level 5:4 on a 15-metre shuttle run was an appropriate level to replicate the demands of OST. Operational officers are required to undertake OST on a regular basis.

The Working Group reviewed the equality legislation and case law in this area. They identified the potential for unlawful sex and age discrimination to occur in applying in-service fitness testing.

A test that is part of a selection process for a job comes under the requirements of the employment provisions of the equality legislation. A fitness test has the potential to discriminate unlawfully both directly and indirectly. Direct discrimination occurs if someone is treated less favourably because of a protected characteristic. Indirect discrimination occurs if a provision criterion or practice (in this case, the fitness test) puts someone from a protected group at a disadvantage, and which is unable to be justified as being a proportionate means of achieving a legitimate aim.

1. Sex discriminationA lower pass mark for women than for men would result in unlawful direct discrimination against men who are denied a job if they passed the women’s pass mark, but not the man’s; see Allcock v Chief Constable of Hampshire Constabulary. Direct sex discrimination cannot be justified in law. A fitness test which has the same pass mark for men and women but which fewer women than men are able to pass, could indirectly discriminate against women if it does not accurately reflect the requirements of the role; see Dougan v Chief Constable of the Royal Ulster Constabulary and Bamber v Chief Constable of Greater Manchester Police.

2. Age discriminationA lower pass mark for older people would result in direct discrimination against younger people denied a job if they passed the older person’s pass mark, but not the one for younger people. Unlike direct sex discrimination, direct age discrimination may be justified in law. A higher standard for younger people would, therefore, have to be justified if it is a proportionate means of achieving a legitimate aim.

A fitness test which has the same pass mark for all age groups but which fewer older people can pass, could indirectly discriminate against older people if it does not accurately reflect the requirements of the role; see Bamber v Greater Manchester Police.

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3. Disability discriminationThe Equality Act 2010 requires that reasonable adjustments are made for disabled people in employment if a provision, criterion or practice (such as a fitness test) puts them at a substantial disadvantage compared to non-disabled people.

The Winsor Review policy equality statement recognised that ’Forces should take care to treat appropriately those who are assessed as unable to pass the test because of a health condition or problem. It could be as a result of a disability under the Equality Act 2010‘. The Review postulated that ’officers and staff with a hearing impairment, or another medical reason which would prevent them from running the shuttle run test, would need to have an appropriate alternative provided... Those who are unable to take the test for reasons of illness, injury or disability would also be referred to occupational health departments for advice and assistance or further action’.

5. MonitoringSummarise the findings of any monitoring data you have considered regarding this policy. This could include data which shows whether the policy is having the desired outcomes and also its impact on members of different equality groups.

The Working Group was mindful of the data presented in the Winsor Review from Hampshire Constabulary where an in-service fitness test operated between June 2010 and July 2011. This showed disproportionate impact on the grounds of age and sex. While 20% of eligible officers did not attend the test, 97% of those who took the test passed. However, 0.6% of male officers failed the test compared to 5.3% of females. The average age of females who failed the test was 42, while their average age was 35. The average age of males who failed the test was 47, while their average age was 38.

The Working Group was also mindful of the disproportionate impact because of sex and age identified in the validation of the JRFT for recruits and for specialist posts; see relevant equality impact assessments.

6. Conclusions Taking into account the results of the monitoring, research and consultation, set out how the policy impacts, or could impact, on people from the following protected groups (include positive and/or negative impacts).

6.1 AgeThere is likely to be adverse impact on older officers.

6.2 Disability There is likely to be adverse impact on officers with certain disabilities.

6.3 Gender There is likely to be adverse impact on women officers. No difference in impact is anticipated due to gender reassignment.

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6.4 RaceNo difference in impact is anticipated.

6.5 Religion or beliefNo difference in impact is anticipated.

6.6 Sexual orientationNo difference in impact is anticipated.

7. DecisionsIf the policy will have a negative impact on members of one or more of the protected groups, explain how the policy will change or why it is to continue in the same way.

If no changes are proposed, the policy needs to be objectively justified as being an appropriate and necessary means of achieving the legitimate aim set out in section 1.

The Fitness Testing Working Group has proposed that the first year of implementation is monitored for disproportionate impact because of age, sex and disability. The results will be analysed by the Working Group and, if necessary and appropriate, changes will be proposed to the College of Policing that reduce or remove any unjustifiable adverse impact.

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Appendix 4 JRFT medical questionnaireName Date

Work location Contact telephone no. Warrant/pay

The purpose of this questionnaire is to ensure that your health is not placed at risk when you perform the JRFT. The questionnaire is intended to screen for pregnancy and cardiovascular disease risk factors. If no positive answers are given to any questions from 1 to 8 you may take the JRFT. Please pass your completed questionnaire to the PT staff administering the JRFT. If a positive answer is given to question 1 you cannot take the JRFT.

If a positive answer is given to question 2 your blood pressure will have to be measured within three days of your JRFT and if the reading is high (systolic >160 and/or diastolic >100) you will not be able to take the JRFT. Your BP can be measured by your GP or a qualified nurse. A date, signature and name must be provided in the appropriate area. Your BP can also be measured on the day of the test by one of the PT staff. Please contact the PT staff prior to your JRFT if you anticipate you will need a BP test on the day of your JRFT.

If a positive answer is given to any questions from 3 to 8 you will not be able to take the JRFT. If a positive answer is given to any of questions 3 to 7, go to question 8. Answer ‘No’, if you personally or a close relative have had no diabetic or cardiac event in the past 12 months, and you have taken the JRFT within the same period. If a ‘No’ is given to Q8 you can take the JRFT. If a positive answer is given to questions 3 to 8 on the day of your JRFT, or if prior to attending your JRFT you feel a positive answer will be given to a question which may prevent you taking the test, please contact the PT staff.

Please tick Yes No

1. Are you pregnant or have you given birth within 7 months of today’s date?

2. Are you currently taking medication for high blood pressure? Blood Pressure Measurement Recorded / Signature and name of GP or qualified nurse Date

3. Do you suffer from diabetes?

4. To the best of your knowledge have you ever suffered from any of the conditions listed below? Heart attack or heart disease? Cardiomyopathy (enlargement of the heart)? Myocarditis or pericarditis (inflammation of the heart)? A heart murmur or heart valve problem?

5. Have you ever attended your GP or a specialist complaining of chest pain?

6. Are you currently having investigations or treatment for a heart problem?

7. Has any close relative, eg, father, mother, brother or sister had a heart attack at a young age (eg, between 35 and 60)?

Complete Q8 if you have previously given a ‘Yes’ to any of questions 3 to 7 and taken the JRFT within the last 12 months. If you answer ‘No’ to Q8 you CAN take the JRFT.

8. In the past 12 months have you experienced a diabetic or cardiac event and/or has a close relative experienced a cardiac related incident?

Signature

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NOT PROTECTIVELY MARKEDJRFT Guidance

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Page 21 of 21

Appendix 5 JRFT health declaration

I am/I am not at present undergoing treatment/taking medication under the direction of a medical practitioner (including physiotherapy). I have the following injury/medical condition(s) outlined below.

(Enter details in comment box below or strike through as appropriate.)

Comments:

I understand that failure to disclose any existing medical or physiological condition may affect any future claim for loss or injury as a result of this training or undertaking the job-related fitness test.

Date:

Signed:

Print name:

Warrant/employee no.:

Trainer’s comments (confirm with individual if they have undertaken an occupational health assessment concerning their suitability to undertake JRFT, and if any of the conditions have arisen subsequent to that assessment):

This form may be forwarded to Occupational Health if required