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Project number: 2020-STN-001

Improving medical fitness standards for rail


The project reviewed rail’s medical fitness requirements. It produced a new industry standard, RIS-3789-TOM. It gives industry up-to-date, clear, and consistent guidance.
'We now have a safer and more robust method of measuring colour vision deficiency.'
Andy Cook
ASLEF Representative, Govia Thameslink Railway

The challenge

Feedback from the industry and a review of previous medical standards identified that revisions were required. It was recognised that they needed to be redeveloped from the ground up to better meet industry needs. Changes reflect advances in medical knowledge, examination methods, and legal updates.

Transport operators must ensure that staff in safety-critical roles meet medical, psychological, and health requirements. These standards confirm that workers are fit for duty. The medical requirements must be reasonable and legally sound. Overly strict standards that lack justification could harm the rail industry’s reputation.

What we did

This project created a single Rail Industry Standard, RIS-3789-TOM, to replace the previous two standards. A guidance note on medical fitness was also replaced. The key documents were:

  • RIS-3451-TOM issue 1 – Medical fitness standards for train drivers.
  • RIS-3452-TOM issue 1 – Medical fitness standards for workers involved in train movement, such as dispatchers, shunters, and those traveling as competent persons with drivers.
  • GOGN3655 issue 2 – Guidance on medical fitness for safety-critical workers.

The project involved consultations with health professionals through OHHAG. Research projects T1279 and T1324 also contributed findings.

Benefits delivered

The new standard offers a clearer, more consistent way to assess and manage medical fitness. It has best practices that may reduce delays caused by medical issues. It helps transport operators show due diligence in preventing impairment at work and ensuring workers’ fitness.

For example, if an operator applies a higher medical standard than required, they risk violating the Equality Act 2010, leading to unlimited financial penalties. The new standard helps avoid these costs. Estimated benefits are £17.8 million over five years.

One key improvement is a safer, more accurate measurement of colour vision deficiency. This change improves safety and career prospects for train drivers who were previously affected by outdated tests. The industry has come together to create a fairer, safer system for all.