2.2 Medical Fitness, Drugs & Alcohol Policy & Fatigue Management

Are You Fit for Work?

Chapter 2 of the PTS handbook (RT3170) asks a simple question: are you fit for work? It covers three things: medical fitness, alcohol and drugs, and fatigue. Each is backed by a Network Rail standard, and each is also a personal responsibility under the Sentinel Scheme Rules, which require you to be fit for work, not fatigued and not under the influence of drugs or alcohol, and to report anything that may affect your ability to work safely.

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Medical Fitness (NR/L2/OHS/00124)

Network Rail's competence-specific medical fitness standard, NR/L2/OHS/00124, sets the medical requirements for track safety competences. Training providers require candidates to meet it before attending a PTS course.

• Purpose: the medical assessment determines that you are medically fit to work on Network Rail managed infrastructure. It takes place periodically throughout your employment and assesses your general health, vision, hearing and ability to work alone. The intervals and detailed thresholds are set by the standard and applied by the approved occupational health provider.
• Restrictions: for some conditions a medical restriction or risk assessment may be applied. The PTS handbook gives examples such as monitoring blood glucose for people with diabetes, or being accompanied trackside if you have a hearing deficit. Restrictions can be seen when your Sentinel profile is checked, and your Primary Sponsor must give you advice and instruction on them.
• Glasses and contact lenses: if you need them, this is shown on your Sentinel record and you must wear them. If you wear contact lenses, always have a spare pair of glasses with you.
• Colour vision: a colour vision defect is shown by a blue circle on your Sentinel record. It does not stop you holding PTS, but it prevents you holding some competencies.
• Your duty: it is your responsibility to keep your Primary Sponsor informed about any medication you are taking or medical condition that may affect your safety on the track. If you are asked to do something you are medically restricted from doing, explain why you cannot.

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Drugs and Alcohol (NR/L2/OHS/00120)

Network Rail takes a zero-tolerance approach to any employee or contractor attending work in an "unfit state" due to drugs, alcohol and/or other substances. The PTS handbook states that this is considered a reason for gross misconduct.

The governing standard is NR/L2/OHS/00120, Drugs, Alcohol and Substance Misuse in the Workplace. Issue 8 was published on 1 March 2025 and fully implemented by 7 June 2025. It merged the former NR/L1/OHS/051 into a single standard, added ketamine and tramadol to the testing panel and removed propoxyphene.

Alcohol Limits

Supplier drugs and alcohol policies that apply NR/L2/OHS/00120 define an unfit state through alcohol as a test result above these levels:

Any detected trace of the drugs on the testing panel (such as cannabis, cocaine, amphetamines, opiates, benzodiazepines, methadone, MDMA, tramadol and ketamine) is also a positive result. Alcohol from the night before can still be in your body when you start an early shift, so plan your drinking around your shifts.

When You Can Be Tested

• Pre-sponsorship, when your new Primary Sponsor requires it (not needed if your record shows a screening in the last three months).
• Before an initial PTS course: training providers require a negative Network Rail drugs and alcohol test carried out no more than three months before the course and uploaded to your Sentinel profile.
• Random (unannounced) testing. Network Rail carried out 5,694 random tests in 2024–25, of which 20 were positive.
• For-cause testing, when there are signs that someone may be impaired, and post-incident testing.

Medication

Some prescribed and over-the-counter medicines can cause drowsiness or slow your reactions. If you work in a safety-critical post, the PTS handbook says you must declare any medication that may affect your safety through the medication declaration process. Check with your doctor or pharmacist whether a medicine could affect you, tell your sponsor, and follow any restriction you are given.

Consequences

A positive result leads to a Sentinel suspension. Network Rail reports that in 2024–25 there were 220 Sentinel suspensions for breaches of NR/L2/OHS/00120, each resulting in a five-year ban from safety-critical duties.

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Fatigue (NR/L2/OHS/003)

The PTS handbook defines fatigue as a decline in mental and/or physical performance that results from prolonged exertion, lack of sleep or disruption of the internal body clock. It increases the risk of accidents, especially when combined with everyday railway hazards such as failing to notice underfoot conditions, losing situational awareness or losing attention while using tools.

Managing fatigue is a shared responsibility:

• your Primary Sponsor reduces the risk through good planning, effective shift and roster management and suitable welfare facilities, and must operate a fatigue risk management system;
• you must look after your own rest through a healthy lifestyle and adequate rest between shifts, and highlight anything that could affect your rest. Most adults need 7 to 9 hours' sleep to perform at their best.

Working-Time Limits

Network Rail's fatigue risk management standard is NR/L2/OHS/003. Supplier working-hours policies that apply it on Network Rail infrastructure use these limits; going beyond them is an exceedance that must be risk assessed and authorised in advance:

The Sentinel Scheme Rules add a personal rule: you must not report for duty if you have worked within the preceding 12 hours unless your Primary Sponsor has approved a risk assessment and put controls in place. Sub-Sponsors must tell your Primary Sponsor about the hours you work for them so that your total hours can be managed.

Travel Time Matters

Travel counts towards door-to-door time. A long drive to a night shift, followed by the shift and the drive home, can push you well past safe limits even when the on-site hours look reasonable. If your travel is excessive, raise it with your sponsor, who can arrange accommodation or transport, or adjust the roster.