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The assessment and work implications of Psychological conditions are of key importance in Occupational Health. This is due to the impact such conditions have on fitness for work and their prevalence among the national workforce. It is also true that work itself can impact on psychological conditions in both a positive or negative way. Nowhere is this more important than in the myriad safety critical settings in which we advise, including fitness for Occupational driving and Train driving. Creating evidence-based standards and guidance in relation to work and psychological ill health is considered integral in ensuring safety and equality. In Transport for London Occupational Health the approach to creating standards and guidance relies on close and early collaboration with stakeholders and subject matter experts. Risk assessment and medical literature review are also an important part of the process. This guidance outlines the assessment criteria and the framework for individual risk assessment. Through this approach we hope to achieve high quality occupational health advice that is evidence based and risk appropriate. The advice is also targeted to the individual and their specific work role.