Minutes: 23rd of May 2019 – Occupational Health

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There were 19 members and guests present at the meeting. Robert Bradford introduced Roseanne Nixon the Business Development Manager for the occupational health provider SALUS who are owned by NHS Lanarkshire.

Roseanne began her presentation by advising the meeting that she has started working in occupational health in 1996 when companies were relatively new to the provision of occupational health services. And has worked for a number of companies before joining SALUS. SALUS is a part of NHS North Lanarkshire who provide an Occupational Health service as well as a Safety and Return to Work Department. Any profit made is returned to the NHS. Occupational health is defined by the World Health Organisation as “the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people and people to their jobs”. When a company employs an occupational health provider there is a higher probability that you will comply with the law, improve the health and wellbeing of the workforce, reduce absence costs and risks to the business. Prevention of an illness due to the provision of occupational health results in a reduction in lost wages of about 57%. Employer’s costs can be reduced by approximately 19% due to savings in productivity, sick pay and insurance costs. Government savings as a result of reduced benefits and NHS costs can be around 24%.

Health surveillance is a statutory risk based programme of ongoing health checks where workers are exposed to substances or activities that may cause them harm. It aims to identify work related ill health symptoms early to allow employers to know if their existing controls measures are adequately managed. To allow this to be carried out efficiently the employer should identify health hazards, staff exposed, have controls in place and understand the efficiency of the controls. When the exposure to noise, vibration and hazardous substances cannot be reduced below the stipulated levels then occupational health surveillance is required. The health provider should be given information on exposures, controls etc. Health surveillance results should be monitored to determine whether there are specific issues (anonymized data analysis), the same information can be used to brief the workforce. Good reporting by the provider is essential. When an occupational disease is suspected it must be confirmed by a suitably qualified occupational health physician.

The requirements for surveillance are
Noise – baseline audiometry pre-employment, annual for the first two years (new employees) thereafter at three yearly intervals.
Vibration – baseline (Tier 1) pre-employment, Annual Tier 2 paper screen and at year three a Tier 3 assessment
Respiratory irritant / sensitizer – baseline pre-employment, 6 weeks post exposure, 12 weeks post exposure and 6 months post exposure.
Skin sensitizer /irritant – baseline pre-employment and thereafter an annual assessment.

When an Occupational Health Provider is contacted ask about their experience in your industry, obtain references, ensure competencies e.g. physicians should be members of the Faculty of Occupational Medicine (FOM)), ensure staff are trained (including update training). Note that there is a FOM approved vibration course. Ask whether they are SEQOHS accredited as this demonstrated that they can have systems in place that are audited. (A List of accredited providers is on their website)Ask about membership of the B&CE scheme for occupational health as this may be very useful in the future if it can be made to work. SEQOHS and B&CE membership are now being specified in tender documents.When writing / agreeing a contract with the provider make sure everything is covered and that all statutory requirements are being met – some providers only want to deliver a service managing absence which covers personal or mental health.

Make sure that the premises to be used by the provider are suitable or check whether the provider has a service from a van with an acoustic booth. Ensure that the provider has relevant risk assessments and COSHH assessments before they make the visit.

After conducting the health surveillance you should receive a health record which will not contain clinical information but will advise you on the fitness of the individual to carry out work e.g. fit, fit with restrictions or unfit. These records should be kept with other records held about the individual including exposures. When a company changes ownership the records should be transferred as well. At periodic intervals you should receive a report giving details on what has been done in the previous period. This information will show trends in work related ill health which can identify problem areas you were unaware of. The information should also be used to brief the workforce. If an employee is classed as unfit to carry on with a task, ensure the employee is informed, review the risk assessment, review other employees carrying out the same task and assign the affected person to other tasks. It may also be necessary to report the problem to the HSE under RIDDOR.

When you change OH provider you should inform, the employees of the change to the OH provider and the incumbent provider is responsible for transferring the records to the new provider.

Free access to complimentary services is available from
Healthy Working Lives (HWL’s) are funded by the Scottish Government and provide free OH, H&S & wellbeing advice, support and some services . HWL’s are a SEQOSH registered NHS provider of telephone, email & web chat services. Funding is available in some health boards to deliver free workplace visits to <250 sized organisations. Contact www.healthyworkinglives.com or telephone Tel: 0800 019 22 11
Working Health Services Scotland (WHSS) is a case management Scottish Government funded programme delivered throughout Scotland it is a free and confidential specialist health care supportive programme (mainly telephone) for employees of SME’s (<250) to support employees to remain in work. Employees can access the programme by self-referral or GP referral via National Advice line: 0800 019 22 11 or
www.healthyworkinglives.scot/workplace-guidance/illness-absence/Pages/employees-with-health-conditions.aspx
Access to Work – Mental Health is a Department of Work and Pensions service. It aims to assist people living with mental health difficulties have more good days than bad ones, it offers up to 9 months support either telephone or face to face throughout UK. Access is via www.able-futures.co.uk or telephone 0800 321 3137.

Suggested steps to take when commissioning an OH service
www.som.org.uk/sites/som.org.uk/files/Suggested-steps-commissioning-OH-service.pdf
Top tips for purchasing OH services
www.hse.gov.uk/chemicals/workshop/occupational-dermatitis
Example health surveillance pack
www.healthyworkinglives.scot/resources/publications/Documents/health-surveillance-employers-pack.pdf
Tips for purchasing Occupational Health Services (HSE NI)
www.hseni.gov.uk/sites/hseni.gov.uk/files/tips-for-purchasing-occupational-health-services-2019.pdf
Occupational Health: the value proposition Society of Occupational Medicine (SOM)
www.som.org.uk/sites/som.org.uk/files/Occupational_health_the_value_proposition.pdf

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