Improving workability

The importance of Acting Together

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Again, the Health and Wellbeing conference in March this year was an excellent opportunity for me to network and re-enthused me in my mission to remove the health-related barriers to employment. Over the last few weeks, I have been contacted by newly acquainted professional colleagues ranging from sleep specialists and independent Occupational Therapists to Remploy specialists to collaborate and improve the offering for workers with long term conditions and disabilities.

Although I am now very optimistic about the future of Occupational Health, does the HSE’s strategic aim of Tackling ill health address the issues underlying disease and absence? Highlighting and addressing the costs of work-related ill health may go some way to understanding the immediate impact for an employer, but does it help them to prevent absence?

The Law of Unintended Consequences

In 2009, the Boorman review emphasised the importance of creating healthy workplaces and the importance of working with staff.  I would urge those responsible for identifying and implementing new initiatives and measures to consult carefully with employees, especially those with long-term conditions.   Teachers are a particularly good example of how, regardless of good intentions, these initiatives have to be applied by human beings, not machines.  In this case, it is essential that schools can provide consistency of teachers and sustainable improvement in academics and citizenship.  It is likely that students on pupil premium, who form OFSTED’s current priority group, will be a principal beneficiary of these improvements.

Teachers are a particularly good example of how, regardless of good intentions, these initiatives have to be applied by human beings, not machines.  In this case, it is essential that schools can provide consistency of teachers and sustainable improvement in academics and citizenship.  It is likely that students on pupil premium, who form OFSTED’s current priority group, will be a principal beneficiary of these improvements.

Support services provided by the charitable sector:

The Education Support Partnership (ESP) and Retail Trust (RT) continue to impress me with the support available to staff working in their industry sectors.  Despite this, I fear that schools will increasingly struggle to deliver against the government’s changing priorities and objectives when having to cope with growing sickness absence.  Teachers and support staff try to access support, but community mental health services appear to find this difficult to provide unless the individual is in crisis.  IAPT services have long waiting lists for counselling and apart from the charitable sector, employees at risk of being unable to cope with work and going off sick fail to access preventative support. This lack of access is despite staff willingly collaborating to try to find the best solution for their patients.

NHS IAPT services have long waiting lists for counselling and apart from the charitable sector, employees at risk of being unable to cope with work and going off sick fail to access preventative support. This lack of access is despite staff willingly collaborating to try to find the best solution for their patients.

The government’s fit for work programme is helpful where an employee has been off work for 4 weeks or more, but independent Occupational Health practitioners can offer specialist advice support and solutions to both the individual and their managers to prevent absence from occurring in the first place.

Is your business reaping the benefits of autism?

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A new survey reports the incidence of autism as closer to 1 in 45 people.  This is almost one in every classroom, and certainly one in every small to medium sized business, and two in every medium sized business.

This is good news, because neuro-diversity brings a breadth of skills, and diversity insight and ideas to the table and depth of commitment otherwise missing in a neurotypical workplace.

But is your business benefitting from these, or does your work environment, culture and structure restrict your neuro-diverse employees from achieving their potential?

Here are some ideas and suggestions on how you can make your workplace more autism-friendly and gain the benefit of employees with autism reaching their potential.

 

Improving workability – hot tips

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Most of the clients I see are struggling with workability in some way.  They regularly need days off work, due to a fluctuating condition or a build up of fatigue, or are struggling to keep up with work and being monitored under a performance or capability procedure. Some arrive at my door anticipating a disciplinary procedure or job loss. 

It is my opinion that my patients are all experts in themselves – after all, we are all unique and respond to our health and environment differently.

Below is a checklist of things you can do to ensure you are getting the best support possible:

top tips

  1. Be aware of your health, finances, relationships at home and at work;
  2. Talk to professionals before things get on top of you; they prefer to help you to prevent problems rather than have to start fixing them;
    • Citizens Advice Bureau
    • Colleagues / Line manager / HR
    • GP / Practice Nurse
    • Specialist Nurse if you are under the care of a hospital consultant
  3. Assess your own workability score, to identify the main issues affecting your ability to work;
  4. Improve your knowledge and understanding of your condition through reputable sites:
  5. Find support from other people suffering from your condition:
  6. Make the most of your Occupational Health assessment – we are here to help you.

Lifestyle and stress at work

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Which came first? Chicken or egg: Stress or lifestyle?

More reports point to stress at work adversely affecting lifestyle and health.

Does your Occupational Health service address lifestyle during contact opportunities with your employees?

Below are sample specifications for OH services, but we recommend that you carry out facilitated stakeholder meetings to identify your organisation’s individual needs.

 

 

Employment as a health outcome?

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Kate Lee argued this week that employment was not an achievable health outcome.  What needs to happen for this to work is for care to continue on return to work, and ideally proactively when an employee’s performance starts to show signs that point to deteriorating health.

As an OH professional, I would like to feel that this is achievable, and is what I believe workability solutions is all about.

I’d love to work together with a partner to carry out a pilot study to see if proactive support makes a difference to workability.

 

Lessons Learned Sharing (LLS) programmes

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We should all learn from Scandinavia.  Eirik Bjerkebaek, corporate head of health and working environment at Statoil, the Norwegian energy group says “People have the resources to take care of their health and they expect business to be part of that as well.”

To read more, see the FT.

Clinical Professional Development for Nurses working in Occupational Health

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This year I joined the NHS National Performance Advisory Group as an Associate; and on Thursday I delivered my first training module to RGNs, Assistant Practitioners and Technicians working in Occupational Health.

Clinical Professional Development for Occupational Health Nurses modules offer AOHNP members a 10% discount.

The first two modules I have delivered were Employment Health Assessment and Assessment and Case management in COSHH health surveillance.

Learning outcomes for this course are as follows:

  • Legal & ethical framework
  • Medical fitness standards
  • Safety critical work
  • Vaccination, immunisation and exposure prone procedures
  • Reasonable adjustments and the reasonably practicable test
  • Assessment and evaluation of functional capacity
  • Case Management Advising employers

Listed below are some interesting questions from delegates on arrival.  One of the key factors to note is the number of staff who are not RGN qualified, but who are carrying out employment health screening within the NHS.

Specific questions (and answers) about OH practice

  1. Occupational Health over-ruling a sick note – when can this be enforced?
    • New guidance on the fit note published by the Government in March 2013 and could allow an employer to give precedence to the views of an occupational health practitioner over those of a GP.
    • In the guidance for employers and line managers, under the headline “Is the fit note binding on me?”, the Government has made it clear that the answer is “no”.
  2. As New OH staff, what are my expectations?
    • Work within your level of competence.  Best practice is to follow the NMC code of conduct, even if you have not yet completed your RN training.  “6.1 make sure that any information or advice given is evidence-based, including information relating to using any healthcare products or services, and 6.2 maintain the knowledge and skills you need for safe and effective practice.”
  3. What are outcomes of fitness for work?
    • Fit for the role as described, no adjustments or adaptations required
    • Fit with adjustments or adaptations (description required)
    • Fit with individual risk assessments to identify safe working practices (stress, manual handling, DSE, etc.)
    • Unfit (usually only confirmed by an Occupational Physician)

Comments about experiences in OH

  1. Views on untrained staff advising Fit for work – on Health Conditions
  2. In’s and out’s of referrals – incorporated in training
  3. We’re always at the end of list for meetings – coming soon blog on raising the profile of Occupational Health
  4. Progress within OH? – coming soon blog on professional development
  5. How to convince staff that OH is not a punishment

Specific skills

  1. What is needed before we give clearance? – incorporated in training
  2. Immunisations and vaccinations – incorporated in training
  3. Better knowledge of legislation / Acts – incorporated in training
  4. Best Universities to do OH degree?
    • 26 SCPHN courses are identified on the NMC website.  Some courses require additional placement and training for Occupational Health, such as workplace health surveillance and therefore you are strongly advised to contact individual institutions before registering on a course; to confirm that their course offers specialist modules meeting the specific requirements of OH in practice.
    • Exciting developments are happening in the field of Occupational Health.  A new Faculty of Occupational Health Nursing has been formed and the School of Occupational Health promises to bring specialist multidisciplinary training to the profession soon.
    • Further information from fellow OH professionals can be found by joining the AOHNP, or following the

For more information about training and development days for OH nurses and technicians, check out the NPAG:

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