In-house doctor

Investment in employee health

Facilitating easy access to a doctor with minimal waiting times can be experienced by staff as a highly regarded benefit. As an employer, you can demonstrate your commitment to staff health and wellbeing. At the same time, it provides an opportunity for preventing or reducing absence from work, as health problems are addressed early and supporting an effective return to work.

Dialogue and partnership

Grespi’s in-house doctor works to a clear understanding of HR expectations regarding fitness to work, attendance of employment-related meetings and reasonable adjustments. HR has access to a direct referral mechanism to obtain timely opinions and information, and clarification of letters or reports where needed.


Clear, employment-focused reports provided with employee consent and in line with GMC Good Medical Practice guidelines.

Records screening

Grespi’s in-house doctor may, with the employee’s consent, obtain and review the employee’s medical records.

The aim of the records review is to form an overview of current health concerns and treatments and advise on next steps including any specialist assessment required in order to address questions about fitness to work, support and reasonable adjustments.

Mode of operation

Grespi’s in-house doctor offers consultations by online video, followed up by a succinct report stating the nature of presenting issues, clinical recommendations, guidance to HR if any workplace adjustments may be necessary, and/or a view of return to work prospects.

Unlike most occupational health service providers, Grespi’s services are delivered by its in-house team and are not outsourced to third-party service suppliers.

Specialist mental health backup

About 50 per cent of occupational health difficulties are related to mental health problems. For employees requiring a specialist with occupational mental health opinion, Grespi’s in-house doctor can arrange a consultation with one of our consultant psychiatrists without the need for onward referral.

Mental health evaluation


Few problems can be resolved if they are inaccurately understood. Grespi therefore places the highest priority on the triage, assessment and diagnosis of presenting problems.

The triage and assessment process takes place at the outset of any assignment, and ensures that as senior HR professional you remain in the driving seat of the process. We start with a phone conversation with one of our senior consultants. A typical conversation will take about 20 minutes, and allows for the problem to be clarified and an initial understanding to be formed. This provides you with clarity on your overall approach for managing the problem and for the most effective next steps to be put into place.

The triage call may be followed as appropriate by a face-to-face assessment and a report that includes a diagnostic formulation of the problem(s) and recommendations as to any action required.

Effective triage means that the right pathway is identified early, and the right processes are followed.

To arrange a triage conversation within three hours, click here.

Occupational mental health assessment

Psychological conditions may raise complex questions regarding fitness for work:

  • Whether a GP’s sick note for ‘stress’ is sufficient to determine how mentally unwell and unfit for work an employee is
  • If, when and how an employee may become fit again to return to work
  • If, when and how a return to work process could take place
  • Who in the organisation should take the lead in facilitating a return to work process
  • Whether the employee is psychologically fit to attend employment-related meetings
  • How to address a request for reasonable adjustments in the workplace on mental health grounds
  • How to support an employee who has been through difficult life experiences, such as the death of a child/spouse or their involvement in a serious accident
  • How to manage an employee with difficult personality traits
  • Whether an under-performing employee has the capacity to benefit from a performance improvement programme
  • Whether a performance improvement or disciplinary process may risk descending into an employee signing off sick with ‘stress’ and/or bringing a claim
  • How to address a claim of disability on mental health grounds

Addressing these questions is difficult, particularly when an employee’s GP provides a non-specific sick note citing a nebulous problem such as ‘stress’ or ‘anxiety’.

Grespi offers specialist occupational mental health assessments that provide a clinically and medico-legally sound picture of the situation, clarify the likely nature, sources and dynamics of the presenting problems, and make well thought-out and commercially appropriate recommendations as to how to address them.

The mental health assessment for fitness for work comprises a detailed face-to-face consultation by a Grespi consultant psychiatrist. This is followed by report tailored to your fitness to work questions, which is usually completed within a week following the assessment consultation.

Which type of report?

Our 1-2 hour initial consultation can lead to one of three types of report:

Occupational Mental Health Report (25-30 pages)

For significant clinical complexity; or differing views on diagnosis; or tortuous employment-related dynamics; and/or a high potential for litigation.

General Psychiatric Report (5-7 pages)

For addressing more general questions, for example regarding diagnosis, prognosis, fitness to work/to attend employment-related meetings, reasonable adjustments, and treatment recommendations. Not appropriate for cases that raise the type of medico-legal concerns mentioned in occupational mental health report.

Brief Psychiatric Report (1-2 pages)

Suitable when an employer would like to provide the employee with the opportunity to discuss with a psychiatric specialist diagnosis, prognosis and recommendations for medical and psychological treatment. Not appropriate when there are serious concerns about the employee’s fitness for work, return to work process, reasonable adjustments and other factors listed under the other two types of report.

Following face-to-face consultation with the employee, we let the employer know about our recommendation regarding the type of report and ask them to confirm their funding authorisation.

If you think an occupational mental health consultation may be needed for an employee, the first step is to request a triage telephone call with us.

Telephone consultation on complex situations

Grespi offers a telephone or Skype consultation service for complex work-related situations. These typically involve discussions between a Grespi consultant and senior HR personnel and/or departmental directors on the management of individuals, or groups of employees, or dysfunctional organisational issues. These consultations are normally pre-booked. Grespi guarantees that consultations of 60 to 90 minutes will be available within 48 hours. The first step is to arrange a triage phone call to identify the problem and agree the way forward.



In cases where an initial occupational mental health assessment with one of our consultant psychiatrists has identified a mental health condition, we provide a diagnostic and psychological formulation, prognosis, review of treatments to date, and recommendations on optimal treatment. Treatment may include psychological and pharmacological approaches. In complex cases, we provide follow-up consultations to monitor treatment and progress.

Clinical psychology

An initial consultation may identify the need for clinical psychology. Clinical psychologists use a psychological formulation (or way of understanding difficulties) to address symptoms and suffering or promote personal development. They may use a range of psychotherapeutic techniques and support in order to help the individual put themselves on firmer psychological footing and work towards achieving personal goals. Where there is a specific need, they may also carry out psychometric testing. Grespi psychologists are accredited with the Health and Care Professions Council (HCPC) and are skilled in working in tandem with our psychiatrists.

Occupational therapy in mental health

An initial consultation may lead to a recommendation for occupational therapy. Occupational therapists (OTs) in mental health help individuals to optimise their engagement in meaningful and productive roles. The individual is helped to identify their goals, translate these into realistic objectives and to stay on task in working towards these objectives within an agreed timeframe. Such help is particularly important for those individuals who may need to make a significant recalibration in their lives or reintegrate in work following a period of illness. Grespi OTs are registered with the Health and Care Professions Council (HCPC) and are skilled in working in tandem with our psychiatrists.


An initial consultation may identify a need for psychotherapy. This is an introspective type of talking treatment, which is mindful of the individual’s strengths and which seeks to link the individual’s difficulties in the present situation with their origins in childhood. By using the treatment relationship with the therapist to understand and resolve these difficulties, the individual can move from a somewhat stuck psychological position into a freer one, and apply their strengths to more adaptive ways of dealing with problems and relationships. Grespi’s psychotherapists are recognised by the main umbrella organisations for psychotherapy in the UK (the BPC, the UKCP and BACP) and are skilled in working in tandem with our psychiatrists.

Cognitive behavioural therapy (CBT)

An initial consultation may identify a need for CBT. This is a type of talking treatment that helps the individual identify their typical ways of thinking and behaving, and link this with their feelings and symptoms. By strengthening helpful thoughts strategies, while challenging unhelpful ones, the individual and their therapist work towards goals by setting exercises which the individual then carries out in a supported way. Grespi’s CBT therapists are recognised by the BABCP, the main accreditation body for CBT in the UK, and are skilled in working in tandem with our psychiatrists.


An initial occupational mental health consultation may lead to a course of counselling. Counselling aims at helping individuals broaden their awareness of their psychological difficulties, and how these affect their everyday life. It is however important to differentiate counselling from psychotherapy, in that psychotherapy aims at fostering significant psychological changes and help individuals settle on a healthier and permanent mental health plateau.

It should also be noted that EAPs (employee assistance programmes) typically offer ‘generic counselling’ as a general opportunity to ‘talk things through’. In contrast, counsellors with NHS experience and additional training in occupational mental health are better placed to provide effective help to employees experiencing psychological difficulties also in relation to their employment role and duties. All Grespi counsellors have accumulated years of NHS experience and obtained additional training in occupational mental health. They hold registrations with the professional bodies for counselling and psychotherapy in the UK, such as the BACP, the BPC and the UKCP. Grespi counsellors are skilled in working in parallel with our psychiatrists and other mental health clinicians.

Screening and individual optimisation

Role screening

The recruitment process presents employers, and in particular HR, with a number of challenges, including:

  • Spotting hidden psychological problems when reading application forms or CVs, or meeting with applicants face-to-face.
  • Ensuring that lateral hires, particularly to senior or executive positions, are mentally able to cope with high levels of responsibility and pressure.
  • Identifying candidates with adequate people-management and leadership skills for core roles in the organisation.

Grespi provides recruitment screening assistance:

  • Training workshops for recruiters/HR on the screening of psychological health variables in –
    • written applications
    • face-to-face interviews.
  • Consultation service on the recruitment and/or promotion of specific individuals or positions at higher mental health risk.

Assignment to new or challenging locations

Being a global business may pose particular challenges to your employees. Some may have to operate in environments and geographical locations that could affect their wellbeing and mental health – whether it is a permanent relocation or a fixed-term assignment overseas.

Grespi offers pre-assignment psychological and physical health screening assessments for employees to endorse their suitability for the proposed role. Screening assessments are delivered by Grespi’s consultants and GP at various locations in London or via Skype. The Grespi consultant will provide a report to you with the written consent of the employee concerned (and his/her family), who will also receive a copy of the report.

Grespi also provides pre-assignment seminars on mental health and wellbeing for employees (and their families), focusing on how to address the challenge of living in foreign environments.

During the assignment overseas, Grespi provides remote specialist mental health assistance via Skype to employees (and their families). Grespi’s capability for providing international support is underscored by its selection as an approved partner of International SOS, a medical organisation providing worldwide medical services to 80 per cent of FTSE 100 companies.

Grespi also offers follow-up in-location screening consultations via Skype, typically on an annual or bi-annual basis, which include a brief mental health report for employers with the written consent of employees.

Mental health MOT for employees

We offer a 90-minute consultation followed by a personalised report on your strengths developmental areas. The report is based on a tailored understanding of who you are, your psychological makeup and your strengths and vulnerabilities. This can help put you on a firmer psychological footing by identifying areas to tend to in your emotional life.

Executive coaching

Some employees need independent support to help them identify and/or tackle weaknesses that are holding them back at work, be they confidence issues, poor interpersonal skills or managing their time, tasks or emotions. Others are doing well but can accelerate their development with the help of a coach. Grespi’s executive coaches have the depth of psychological insight allied to commercial acumen which they acquired over many years of coaching training and business experience, to maximise the professional, interpersonal and leadership potential of their clients.

HR support

Case-based consultation

As HR professional, you are on the frontline of some challenging personal situations, and it is therefore important that you can access help that is specifically designed to support you in your role.

Grespi offers a consultant-facilitated case discussion service for HR professionals which enables them to receive support and share insights with each other. The service is typically provided in a 60 to 90-minute Balint group format, held on site. Balint groups are conducted by consultants specifically trained in this well-established approach, which aims at helping group members to work more effectively in their professional roles.

Telephone consultation service

Grespi offers to HR and relevant managers a telephone or Skype consultation service for complex work-related situations. These typically involve discussions between a Grespi consultant and senior HR personnel and/or departmental directors on the management of individuals, or groups of employees, or dysfunctional organisational issues. These consultations are normally pre-booked. Grespi guarantees that consultations of 60 to 90 minutes will be available within 48 hours.

Organisational support

Organisational and management consultancy

At times dysfunctional dynamics arise from organisational restructuring and change; organisational culture; the interplay of different personalities in particular roles; or the impact on the organisation of external circumstances. In these and similar scenarios Grespi’s organisational consultants have the professional experience, qualification and training to identify the nature of the impasse and recommend how to resolve it. This process typically involves one or more detailed consultations with key people lasting 60 to 90 minutes. It’s followed by a detailed report that includes the description of core dynamics, perpetuating factors, problem(s) formulation, remedial options and process, and framework for review.

Mental Health Plan and Policy – set-up and MOT

Despite the sound business case and growing expectation that companies promote good mental health at work, few have a specific Mental Health Plan and Mental Health Policy.

Without a strong framework of systems and processes in place for dealing effectively with mental health-related situations, your company may be basing its interventions on good intentions, but risks not aware of deficits that may lead to adverse repercussions.

You may have implemented – or be aware of – initiatives or interventions that you can be proud of. Perhaps you have an established set-up of EAP and private healthcare insurance. But just how robust are these arrangements? Have you become aware of any gaps or weaknesses?

As a first step, we suggest that you consider the baseline provision in your organisation and evaluate it against your organisation’s actual needs. Without evaluation, there is a risk of complacency – along the lines of ‘We have a provider and things are therefore OK’, without clarity on what can realistically be expected, confidence that the provision meets your needs, or the capacity for contingency planning for when things go wrong.

Grespi provides training to equip you to evaluate your organisation. We also provide a review of your current policies and procedures from a medico-legal viewpoint.

Training and education

Mental Health Responder Plus (MHR+) training

This training for HR professionals and senior managers covers the promotion of mental health at work and effective management of mental-health-related situations.

Components of the training prepare delegates to:

  • communicate effectively with employees experiencing psychological difficulties and mental health conditions;
  • develop skill in applying a systematic and consistent approach to managing mental health-related situations;
  • observe, collect information and make initial formulations;
  • deal appropriately with psychological aspects of performance management;
  • remain in the driving seat on legal implications;
  • provide guidance on the initial response to mental health emergencies;
  • become a reference point for mental health awareness in the workplace; and
  • provide up-to-date information on how to access mental health help in the private, public and voluntary sectors.

We set out a framework for a proactive approach to mental health in the workplace. This training explains the components of such a framework – what they consist of and how they should work together cohesively. Our training is provided in partnership with employment lawyers, offering a unique clinical-legal approach.

Mental Health Responder (MHR) training

We train selected members of staff, to become MHR, who are able to:

  • identify the signs and symptoms of distress in colleagues;
  • become trusted first points of reference for psychological health in the workforce;
  • provide up-to-date information on how to access psychological help; and
  • support colleagues-in-need to find the appropriate help.

Grespi’s MHR training and expert back-up support are an integrated feature of its full range of medically-led, specialist mental health services. This is in contrast to standalone mental health awareness training programmes, including Mental Health First Aid courses that equip individuals with a basic understanding of mental health conditions but do not provide a support system for participants to use that information safely thereafter.

Bespoke mental health training packages

Grespi provides training to managers or employees on a range of topics. Courses are tailored to meet the specific priority needs of the organisation. Formats can be lecture-based, case study-based and experiential discussions delivered as required to small groups (typically eight to ten members) or large groups.

Identified needs may include:

  • Healthy lifestyle.
  • Managing psychological difficulties outside work – such as bringing up children, supporting unwell family members or ageing parents, coping with bereavement.
  • Managing difficulties at work – such as concerns about quality or quantity of work; calibrating self-criticism and criticism of others; anxieties about relationships with colleagues; ‘impostor syndrome’; motivating/managing difficult groups or individuals; handling difficult conversations; providing meaningful appraisals; managing effectively relationships with clients; making complex career choices; strengthening leadership skills, etc.
  • Skilling-up HR, managers and key employees to provide a higher level of emotional intelligence and knowledge, as well as awareness of wellbeing and mental health-related factors in the workplace and outside work.
  • Overseas pre-assignment training for employees and their families.
  • Facing culturally new or challenging environments.
  • Dealing with traumatic events.