The National Transport Commission (NTC) leads reforms in land transport across Australia, working with all levels of government to enhance safety, efficiency, productivity, and environmental outcomes. As a major contributor to national transport reform, the NTC is accountable to Australian transport ministers through the Infrastructure and Transport Minister’s Meeting and its advisory body, the Infrastructure and Transport Senior Officials’ Committee. The NTC released an updated version of the National Standard for Health Assessment of Rail Safety, and as of 11 November 2024, is now in effect. Supporting Australia’s Essential Rail Safety Workers: Rail workers are essential to the safe operation of Australia’s rail network. The updated Standard helps rail operators and rail safety workers effectively manage health-related risks. The NTC reviews the National Standard for Health Assessment of Rail Safety every three years, collaborating with governments, health experts, rail unions, safety regulators, and industry stakeholders to ensure it reflects the latest knowledge and best practices. Key Changes And How They Impact Rail Operators: From 11 November 2024, all health assessments conducted for the purpose of determining the fitness for duty of rail safety workers must be conducted according to the new edition of the Standard. Periodic Health Assessments for rail safety workers do not need to be brought forward. They should be conducted as scheduled. All Triggered Health Assessments, including those associated with Fit for Duty Subject to Review determinations, should be conducted according to the 2024 edition of the Standard from the 11 November 2024. Authorised Health Professionals (AHP) must meet specific selection criteria which focus on the health professional’s knowledge and understanding of the rail occupational environment. Only Authorised Health Professionals trained in the new Standards and registered as Authorised Health Professionals with the AHP Program may conduct assessments under the Standard. Important changes to Forms: The professionally designed forms are included as fillable PDFs on the NTC website. The NTC strongly encourages all stakeholders to use the new suite of forms to promote consistency in reporting outcomes and address quality issues identified during the review. As the key form for communicating the requirements of the assessment to the Authorised Health Professional and the result of the assessment to the transport operator, the Request and Report Form is of vital importance. The revised form reflects the simplified outcome categories and other requirements identified by stakeholders. The Report Form (Part B) no longer includes the worker’s consent for portability of the assessment due to concerns about worker’s not receiving adequate information about the implications of consenting to portability. Consent for portability is now included in Part A of the form and rail transport operators should facilitate informed consent of this process. Under the new standard, WHA clients will be required to complete Part A. Request for Health Assessment for all Rail medicals. If the completed form is not attached at the time of the booking request, delays may occur to confirm the booking. Notifying Rail Employees About Health Assessments: The updated standard requires rail operators to provide employees with a minimum of 10 working days’ notice for non-urgent health assessments, such as routine periodic health checks, unless both parties agree to a shorter timeframe. In contrast, urgent health assessments triggered by sudden health issues, such as a loss of consciousness, must be arranged and conducted without delay. Key Changes To Health Assessments: It is important to note that there are some changes to the medical standards that will be applied to rail employees during their health assessments. Please see below for an overview of the key changes to assessments: Health assessment outcome categories: Drawing on developments in other health assessment standards for safety critical workers, Section 2.3, of the Standard, has been amended to limit the fitness for duty outcome categories to four: Fit for Duty Unconditional Fit for Duty Subject to Review (this category encompasses requirements for job modification) Temporarily Unfit for Duty Permanently Unfit for Duty. Fit for Duty Conditional is no longer a formal category, as it relates to a narrow range of circumstances involving the wearing of aids such as corrective lenses and hearing aids. Workers who are required to wear these aids will have this requirement identified independent of their main category. In-person assessments: New standards state that except in very limited circumstances health assessments for rail safety workers must be conducted in person, not via telemedicine/telehealth. The Standard states that telehealth may be used to facilitate access to specialist opinion for Fit for Duty Subject to Review assessments and for hearing testing and assessment when face-to-face services are limited. Cardiovascular Examinations: Fasting is no longer required for pathology testing. Calculation of the cardiac risk score is required for Category 1 Safety Critical Workers 30 years and over. Workers younger than 30 do not require a cardiac risk score. They require monitoring of individual risk factors including cholesterol, diabetes and blood pressure, with due consideration of the specific needs of First Nations people. Workers found to be at high risk based on their score will be referred for cardiologist assessment and management. Investigations will be directed by the cardiologist and only repeated if clinically indicated. Cardiac stress testing is no longer required to be routinely requested unless recommended by a cardiologist. Diabetes Testing: Fasting is not required for pathology testing. A urine glucose test has been introduced for Category 2 Safety Critical Workers to improve identification of Diabetes in this group of workers, who are subject to the same fitness for duty criteria as Category 1 workers. The urine test can be conducted at the time of the appointment, with a positive result requiring a follow up blood test. New Section for Neurodevelopmental disorders: A new section for Neurodevelopmental disorders has been introduced, which include conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). These were previously covered by the criteria for ‘Other neurological conditions’. Sleep Disorders: A new screening tool, the STOP-Bang questionnaire has been included to improve the assessment obstructive sleep apnoea (OSA) risk. WHA’s Commitment to Supporting Rail Safety Workers: Since 2004, Workforce Health Assessors (WHA) has been a trusted leader in providing workforce medical services, including pre-employment assessments, ongoing health monitoring, and related testing services. With a network of 82 WHA clinics and access to over 300 partner clinics across Australia and New Zealand, WHA offers comprehensive coverage and convenience for businesses and their workforce. We appreciate the ongoing support of our valued clients and remain dedicated to meeting your rail medical assessment needs. If you have any questions or require further information about these changes, please don’t hesitate to get in touch with our team here. For further information please refer to the: National Standard for Health Assessment of Rail Safety Workers | National Transport Commission