What to Expect at your Medical Appointment

To give you the best opportunity of passing your medical ‘first time’, without unnecessary delays, ARC Medicals Ltd (ARC) has created this step-by-step guide to help you prepare for your examination in advance.

We will need you to arrive 15 minutes prior to your allocated appointment time, in order to complete the necessary paperwork in readiness for your medical. If you have not arrived on time for your appointment you may have to rebook and come back another time. If you do arrive late, we will fit you in IF we can – BUT – you will have to wait until an appointment becomes free.

This bit is very important so, please ensure that you bring the following essential items to your medical:

• Photo ID (Passport or Driver’s Licence, CSCS or Sentinel Card) – this must be valid (in-date)
• National Insurance Number
• Name and address of your GP
• Glasses (if worn for distance vision/at work)
• List of any medication

This information applies to a range of medicals that we conduct, which include:

• Personal Track Safety (PTS)
• Fit to Work (FtW)
• Safety Critical (S/C) Medicals

** Your medical examination will not involve us taking any blood, or the use of any needles **

Vision Test

A Snellen Vision Chart is used to measure your visual acuity for both eyes together, the left eye individually and the right eye individually.

To meet the required Standards, your distance vision must be at least 6/9 in the better eye and 6/12 in the other eye, with spectacles or contacts if worn.

If you wear glasses or contact lenses, please ensure you have had your eyes tested recently with your optician to ensure your prescription is still satisfactory. If you think your eyesight has deteriorated since your last medical, make an appointment with your optician for a vision examination prior to your medical.

Hearing Test

Amplivox hearing machines with suction head cups and audio booths are used. The booth is used to reduce any background noise. Hearing loss should not exceed 30dB averaged over the frequencies 0.5, 1 and 2kHz in either ear.

Hearing aids cannot be used to meet the Standards.

If you think your hearing has deteriorated since your last medical, please make an appointment with your GP for an ear examination. Your ears may need to be syringed in order for you to meet the Standards.

Colour Vision Test

Ishihara Colour Plates test which uses cards showing patterns and numbers made up by coloured dots are used. Normal colour vision is not required for certification in PTS, but it is a requirement of certain tasks undertaken on or near the line to which other, job specific requirements apply.

General Health

During your medical you will be asked for information regarding your general health. In line with the Standards, a person shall not be permitted to go on or near the line if they are suffering from medical conditions or taking medical treatment, likely to cause sudden loss of consciousness, impairment of awareness or concentration, sudden incapacity, visual impairment of a temporary or transient nature, impairment of balance or co-ordination, or a significant limitation of mobility. This will apply to all other medicals that we offer, as your work safety is paramount.

If you suffer with a medical condition that may have an impact on the above, please bring the full details from your GP to your appointment with you as this will help to speed up the process. Examples of these conditions will include Epilepsy, Diabetes, etc. Whilst your condition may not necessarily result in a failed medical, we are likely to require additional information before we are able to issue your certificate.

Blood Pressure

The blood pressure checks will be performed using an electronic blood pressure machine.

If you know that you suffer from raised blood pressure, please ensure you have visited your GP or Practice Nurse to ensure that it is currently at an acceptable level. In addition, if you are currently on medication to control your blood pressure, please bring the full name and dosage of your medication to the medical in order that this may be noted on your assessment.

Protein & Glucose in Urine Test

A dipstick test will be placed in a sample of your urine and assessed on the spot for the presence of glucose and protein.

Diabetes

If you are diabetic, please make an appointment with your GP or Practice Nurse prior to your medical and ask for written confirmation of the following:

In the past twelve months have you:

• Attended a diabetes clinic at your GP surgery or at a hospital?
• Had a full eye examination to check for diabetic complications at the back of the eye?
• Had difficulty keeping your diabetes under control?
• Suffered from hypoglycaemic attacks (hypos), blackouts or impaired concentration?
• Been admitted to hospital because of your diabetes or a medical condition related to it?
• Taken time off work because of your diabetes or a medical condition related to it?

If you fail to bring this information with you, it may delay you returning to work.

Also, please bring along your diabetic diary. This information is vital for ARC to make a decision regarding fitness or potential onward referral to an Occupational Health Physician.

N.B. The above information is required by your employer’s Occupational Health Provider to ensure you can continue working in the same capacity – ensure that you explain this fully to your GP.

Balance and Mobility

A series of assessments will be carried out including; squat tests, upper body twist, point to point and heal-to-toe walking – ensuring that your balance, mobility and co-ordination can be maintained at all times.

Height & Weight

Performed using modern scales and height chart/measuring stick.

BMI – Body Mass Index Calculation

Your body mass index is a calculation of your body weight in relation to your height. A healthy BMI is 18 – 25. Here is a guide to body mass index:

BMI Range

Ideal Weight – 18.5 to 25

Overweight – 25 to 30

Obese – 30 to 40

Very Obese More than 40

If you are overweight, it would be advisable to make a conscious effort to exercise and eat a sensible balanced diet.

Important: You may be asked to attend an appointment with your GP for additional information. We may then need to send that information to our consultant doctor for determination. If our doctor is unable to provide a medical level, you may be referred onward to an Occupational Health Physician if you have a condition which is more serious and may require ongoing assessment.

Medicals we conduct include Personal Track Safety (PTS), Constructing Better Health (CBH), Fit to Work (FtW) and Safety Critical (S/C) Medicals.

Drugs & Alcohol Screening

To give you the best opportunity of passing your drug & alcohol screen ARC has put together some useful information to help you prepare for the sample collection. Safety is Network Rail’s first priority, so it is important that everyone behaves in a safe and responsible manner. Drugs and Alcohol can seriously affect your ability to work safely.

The drug and alcohol policy is designed to ensure safety by placing and enforcing strict limits regarding the use of alcohol or drugs. The policy applies to all holders of Sentinel competence cards along with any employee who works for any company with a valid policy.

Standard policy requirements usually include:

You must not:

• Report for duty, or attempt to report for duty, having recently consumed alcohol
• Report for duty, or attempt to report for duty, in an unfit state due to consumption of alcohol or use of any drug
• Be in possession of, or supply any drug of abuse in the workplace or whilst on duty
• Consume drugs of abuse or alcohol in the workplace or whilst on duty

You must:

• Submit to an alcohol and drugs test if requested to do so
• Declare any alcohol or drugs related problem which you have or suspect you may be developing
• Report any prescription or over the counter medication which may affect your ability to undertake your normal duties

As part of your periodic medical, a urine sample will be taken and sent to a laboratory for analysis for drugs and alcohol, as per the Network Rail Group Standard. Some of the drug groups listed in the panel are also found in medications. Some of these medications can be prescribed by your GP or purchased from a pharmacist, they are:

Benzodiazepines – Tranquillisers or sleeping pills

Opiates – Pain killing drugs

Propoxyphene – Cough and cold remedies

During the urine collection you will be asked to provide details of any medication you have taken in the last 14 days. If you take medication on a regular basis, please ensure you take the full name of the medication(s) including dosage for consideration by the laboratory when analysing the sample.

If you do not take medication but have suffered from illness resulting in you taking medicines it is extremely important that you keep a record of the name of the medication taken. Some trigger questions for you:

Have you recently taken any drugs for the following conditions?

• Cough cold remedies

• Headache tablets

• Strong pain killing drugs

Have you recently undertaken?

• Dental surgery or procedures

• Minor surgery with your GP

• Major surgery

You will also be asked to provide a sample of breath for an evidential breath alcohol reading. An unfit state through alcohol means more than 13 micrograms of alcohol per 100ml of breath. It is important that you do not eat, drink, smoke or vape for 20 minutes prior to your appointment – also, you will need to avoid mouthwash and chewing gum.

The above may result in a positive drugs or alcohol test. All positive results are reported to Sentinel and to your employer.

If your positive result is due to an illegal substance or alcohol, your Sentinel card or job application will be suspended. The suspension of a Sentinel card due to drugs or alcohol currently lasts for a period of 5 years. You will not be allowed to perform any duties on the railway infrastructure during this time period.

** Please Note **

Please allow up to two/three working days for the results to come back from the Laboratory. Usually (in 99% of our screenings) the results arrive the next working day, allowing us to report quickly. However, we cannot and do not guarantee that your result will be with us the next day. If the Lab detects traces of any substance, the sample will be resubmitted for further analysis – this will delay the confirmation of the result by a few extra days.

Medical Rooms

ARC has carefully selected our rooms to carry out medicals and Drug & Alcohol screenings. These rooms have been chosen for your convenience in offices within easy reach of road, train and bus routes. Nurses are fully trained professionals in their field. All facilities and equipment have been checked and passed as fit for purpose. Facilities and equipment are subject to internal audits and audits under the requirements of Link Up (Rail Supplier Scheme) and ISO certifications (Quality Accreditation).

South Wales Office

Units 4/5 Centre Court, Treforest – CF37 5YR

London Office

1^st Floor, City View House, Stratford – E15 1BZ

If you have any queries or require clarification, please do not hesitate to contact your HR Department or ARC directly on 01443 303 003.