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Conference day 2



1 What is the role and the functions of primary-care centre regarding the
health of workers and under which conditions this role can be expanded?

Work healthy – should have relationship with PC

Relationship doctor – patient communication, GP knows the patient.

Self employed, informal sector, all people should have access to OH

Company doctors, treating families. GP responsible for all aspects of health
care, including OH.

PHC can do a lot, from prevention to disability assessment.

Who are the patients and what do they need

OH is specialty, special knowledge.

Not shifting OH to GP. GP can help. OH history. OH specialist assume GP does
not know about work. GP may know more than expected. When complete
annual exam: full OH history, then relevant. Use tools, integrate in electronic
record. Open MRS system – also access in developing countries.

Need for electronic system with all data, GP, OP and hospital

Register work with demographic data.

Training paramedics.

Summary: GP listen and know worker, collaboration, incentives, infrastructure,
funding, access to OH for everybody. Tool for GP to assist with info, what can
GP do for worker – integrate. Utilize guidelines, VE OH can be integrated, all HS
in one centre, including assessments. Limitation when injuries, hospital care.
OH Care is multidisciplinair.

Policy to educate GPs in OH.
2 How to strengthen the collaboration between occupational health and
primary care providers, services, centres and what capacities, skills, and
support is needed for this?

Task GP: recognize OH problems and refer to OH specialist or actually treat OH
diseases?

Establish effective referral system between PC en OH

Education, knowledge

Legislation

Human resources

Projects that show benefit of collaboration

Training together (GP/OP)

Administrative issue: report to same source (GP/OP)

Make OH an important part of training GP (>150 hrs), possibilities: classes,
online, practice, CME.

Easy access for GP to OH-information by computer, integration occupational
disease in health information system, use same classification

Collaboration: multi-morbidity, mental disorders

Relationship with patient differs for GH /OH problems.

Identify stakeholders, let them see benefits of collaboration.

Summary: identify and involve stakeholders, enhance collaboration through
training, GPs and OPs should know each other and patients should know their
doctors, Doctors should work for the same population, lack of focus on
reintegration, administrative and financial barriers should be removed, need of
research on collaboration, joined committees for OC and PC.
3 What support is needed to empower workers, work communities,
enterprises to take care of their health and what is the role of primary care
centres and occupational health services in providing such support?

Use media, modern techniques, to raise awareness, health promotion
campaign in the workplace. Keep in mind: sometimes no time for media (long
working days). Face-to-face communication also important, for example during
lunchtime in factory.

Workers can keep own record

Identify what kind of workers in community - involve workers/ community,
involve NGO’s, unions

Worker needs to know: what does it mean to me, etc. pres Richard. Patient
needs knowledge about what he should and can do, and capabilities to act on
it. Help with legal issues, how to deal with legal issues.

Barrier: not allowed to visit doctor during working time. Regulation for easy
access for workers to visit GP/OP

Education, orientation program, refresh courses

Promote participation

Worker satisfaction, involve workers. Ask workers what they need

Attention for women

CPD for workers, for example with bonus after reaching certain level

GPs and OPs should give a good example

WHO: program healthy work places, take care of their own health problems,
empower communities.

OH center for all workers with independent doctors/ public.

Where do you go with complaints? Who can protect the child who works with
poisonous substances
Summary: motivate workers to change behavior, use different techniques,
involve workers, involve stakeholders like unions, Ngo’s etc, consider individual
context. Legal issues. Ensure access to occupational health care.

4 What actions should be undertaken to move to people-centred care
regarding workers' health at the local, national and international level,
including research to fill knowledge gaps?

Legislation: good OH care for workers

Community based participatory research and action research, development of
tools

Medical schools: OH research involvement

Involve insurance companies

International independent survey on needs for empowerment, including
informal workers

Reach out to nurses, community health workers, allied health professionals

Education students, education prgram

Make it easy to do the right thing (food, exercise etc)

Needs assessment for local situation, culture sensitive

Start knowledge at school, medical students

Infrastructure

Evaluation

Partnership with people, gender specific

Change in management, educate bosses

Guidelines, instructions, protect quality

Global initiative increasing number of training centers, also in countries where
they do not have them now. Training should be accessible all over the world.
Training setting also needs services, residents need to see proper setup for
OHS. Sometimes training abroad necessary. Worldwide legislation. We should
train OH nurses.

Need of occupational health care needs to be accepted.

Appropriate obligatory postgraduate training in OHS of GPs

Hazard identification, risk assessment

Occupational health/ medical services Directive (EU)

Independent financing

Liberalization of services not possible without quality control

Attention for women workers

Coordinate across ministries, countries, continents

Technical support for physicians

Sum: research, legislation, training also providers, infrastructure, support

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Rt 2 roundtable day 2 notes

  • 1. Conference day 2 1 What is the role and the functions of primary-care centre regarding the health of workers and under which conditions this role can be expanded? Work healthy – should have relationship with PC Relationship doctor – patient communication, GP knows the patient. Self employed, informal sector, all people should have access to OH Company doctors, treating families. GP responsible for all aspects of health care, including OH. PHC can do a lot, from prevention to disability assessment. Who are the patients and what do they need OH is specialty, special knowledge. Not shifting OH to GP. GP can help. OH history. OH specialist assume GP does not know about work. GP may know more than expected. When complete annual exam: full OH history, then relevant. Use tools, integrate in electronic record. Open MRS system – also access in developing countries. Need for electronic system with all data, GP, OP and hospital Register work with demographic data. Training paramedics. Summary: GP listen and know worker, collaboration, incentives, infrastructure, funding, access to OH for everybody. Tool for GP to assist with info, what can GP do for worker – integrate. Utilize guidelines, VE OH can be integrated, all HS in one centre, including assessments. Limitation when injuries, hospital care. OH Care is multidisciplinair. Policy to educate GPs in OH.
  • 2. 2 How to strengthen the collaboration between occupational health and primary care providers, services, centres and what capacities, skills, and support is needed for this? Task GP: recognize OH problems and refer to OH specialist or actually treat OH diseases? Establish effective referral system between PC en OH Education, knowledge Legislation Human resources Projects that show benefit of collaboration Training together (GP/OP) Administrative issue: report to same source (GP/OP) Make OH an important part of training GP (>150 hrs), possibilities: classes, online, practice, CME. Easy access for GP to OH-information by computer, integration occupational disease in health information system, use same classification Collaboration: multi-morbidity, mental disorders Relationship with patient differs for GH /OH problems. Identify stakeholders, let them see benefits of collaboration. Summary: identify and involve stakeholders, enhance collaboration through training, GPs and OPs should know each other and patients should know their doctors, Doctors should work for the same population, lack of focus on reintegration, administrative and financial barriers should be removed, need of research on collaboration, joined committees for OC and PC.
  • 3. 3 What support is needed to empower workers, work communities, enterprises to take care of their health and what is the role of primary care centres and occupational health services in providing such support? Use media, modern techniques, to raise awareness, health promotion campaign in the workplace. Keep in mind: sometimes no time for media (long working days). Face-to-face communication also important, for example during lunchtime in factory. Workers can keep own record Identify what kind of workers in community - involve workers/ community, involve NGO’s, unions Worker needs to know: what does it mean to me, etc. pres Richard. Patient needs knowledge about what he should and can do, and capabilities to act on it. Help with legal issues, how to deal with legal issues. Barrier: not allowed to visit doctor during working time. Regulation for easy access for workers to visit GP/OP Education, orientation program, refresh courses Promote participation Worker satisfaction, involve workers. Ask workers what they need Attention for women CPD for workers, for example with bonus after reaching certain level GPs and OPs should give a good example WHO: program healthy work places, take care of their own health problems, empower communities. OH center for all workers with independent doctors/ public. Where do you go with complaints? Who can protect the child who works with poisonous substances
  • 4. Summary: motivate workers to change behavior, use different techniques, involve workers, involve stakeholders like unions, Ngo’s etc, consider individual context. Legal issues. Ensure access to occupational health care. 4 What actions should be undertaken to move to people-centred care regarding workers' health at the local, national and international level, including research to fill knowledge gaps? Legislation: good OH care for workers Community based participatory research and action research, development of tools Medical schools: OH research involvement Involve insurance companies International independent survey on needs for empowerment, including informal workers Reach out to nurses, community health workers, allied health professionals Education students, education prgram Make it easy to do the right thing (food, exercise etc) Needs assessment for local situation, culture sensitive Start knowledge at school, medical students Infrastructure Evaluation Partnership with people, gender specific Change in management, educate bosses Guidelines, instructions, protect quality Global initiative increasing number of training centers, also in countries where they do not have them now. Training should be accessible all over the world. Training setting also needs services, residents need to see proper setup for
  • 5. OHS. Sometimes training abroad necessary. Worldwide legislation. We should train OH nurses. Need of occupational health care needs to be accepted. Appropriate obligatory postgraduate training in OHS of GPs Hazard identification, risk assessment Occupational health/ medical services Directive (EU) Independent financing Liberalization of services not possible without quality control Attention for women workers Coordinate across ministries, countries, continents Technical support for physicians Sum: research, legislation, training also providers, infrastructure, support