OSH& Welfare in the Health Service within a Governance framework
Occupational Health, Safety &Welfare within the Health Service within the context of Staff Governance
A CEO’s view If you don’t have healthy workforce, you don’t have a service, If you don’t enjoy what you do, you will not do it well, There is no limit to what can be achieved if the individual is engaged with the corporate culture and mission.
The Wider Picture- Headline issues Corporate & social responsibility, Supporting quality care -governance, revalidation, Organisational change, “Quality & Fairness” Improving working lives- “APPM”. Recruitment & Retention- the war for talent, The Equalities agenda, The rehabilitation agenda,
Corporate Health Risk Management Pyramid Cost per case Total Cost increases High impact claims - ET, PI, Increases DDA, H&S fines, IHR, reputation Long Term Sickness Absence Short term sickness absence Sub-optimal performance at work Well at work
Preventive health and well-being managementservices are proven to impact the following business drivers Employee engagement Employee retention Productivity Decrease ‘Employer of Choice’ positioning Absence Stress Increase Cost of ill-health Staff turnover
OH,S&W anchored in principles of Staff GovernanceUnder staff governance employees entitled to be; Well informed, Appropriately trained, Involved in decisions which affect them, Treated fairly and consistently, Provided with an improved safe working environment.
Objectives of occupational health within the health service “promote & maintain physical, mental & social well- being” (WHO definition), ensure applicants are fit for & placed in appropriate work assist management in protecting employees from hazards arising in their work or workplace protect patients, visitors and others who may represent a hazard contribute to organisational effectiveness by enhancing performance and morale by risk reduction
Minimum Standards of an Occupational Health ServicePre-placement checks of all prospective employees,Health surveillance of in service employees,Health promotion & education, Comprehensive risk based immunisation program, A confidential counselling service, Programs for elimination of accidents causing PI,occupational illness,Education, promotion of adherence to legislation Case management of health-related absence.
Contact with the OHS altered work performance/conduct/safety concerns work affecting health, health on work ability to deliver regular & effective service Rehabilitation/resettlement/redeployment potential retiral or termination of employment on medical grounds.
Health assessments Pre-placement statutory assessments (IR, driving, asbestos, noise, biological agents regs) health screening, surveillance immunization reviews post sickness absence (food handlers) health education & counselling rehabilitation ill health retiral
Occupational Health Work affecting Health affecting health ability to work physical physical – ergonomic – heart disease – chemical – back pain – radiation – asthma social social – shifts – child / elderly care psychological psychological – violence – bereavement – organisational – mental ill health
OHS&W Supports Safe Working in a Contractual Relationship Work on Health Health on work Health & Safety agenda HR agenda hazards Increase productivity risk assessment human capital fitness in safety critical attendance management roles rehabilitation human factors employee support health surveillance healthy worker effect Di f f er ent manager s m ay want di f f er ent t hi ngs
OHS&W Supports Safe Working in a Contractual Relationship The relationship is essentially between the ‘client’ and the ‘organisation’ Which manager? Not clinical care in OM? Health and safety issues Contractual and employment issues Disability issues and fitness to work Managers need results to stay in business Employees also have a duty of care OHP duty of care to both Complex ethics and law means scope for conflict
What are the Priorities for OHP’s from Employers? Advice on Law and Ethics Assessment of Occupational Hazards Assessment of Disability and Fitness to Work Communication Assessment of Environmental Exposures to Health Research Methods Com pet enci es of Occupat i onal Health Promotion Physi ci ans – t he Cust om er Per spect i ve Management Ret oo KN, M JM acDonal d EB, Har r i ngt on HSE Cont r act Resear ch cr 247 2004
Characteristics High Performance Cultures Good Management Time based Good work Resourcing the medium term Optimal risk taking Bias for action Alignment Learning focus Distributed leadership Measurement, reporting Integration of effort Clear Goals
Link between Staff Governance and Patient careMichie S, West M, Measuring Staff Management and HRM in the NHS
Analysing key issues Health protection Motivating healthy at work lifestyles Protecting Rehabilitation patients after ill health Fitness for Sickness absence recruitment control Fast access to Extending treatment Redeployment services to the advice wider community
Barriers to progress Complex management structure Immunity from regulatory legislation Absence of a “Health and Safety” culture Litigation raised by employees - relatively infrequent
Stimulus for change Loss of Legal Immunity Chief Executives appointed Pressure from insurers Quality standards Parliamentary questions Financial awareness
Financial Awareness Litigation costs Absence from work costs Occupational Injury and Ill Health Hidden costs of accidents
Towards a Safer Healthier Workplace Strategy Document Best Practice documents Minimum Dataset Standards, Audit and Benchmarking Research Programme Extension of OHSS to General Medical and Dental Practitioners and their staff
An effective occupational health and safety management programme Setting policies Organising for health and safety Planning and implementing Measuring performance Reviewing performance Auditing and feedback loop
Health Risk Management Benef i t s i ncl ude: Ret ai n t r ai ned Process st af f I m ove pr Oc cupat i onal Heal t h Ser vi c e - end t o end pr oces s managem f orn ance per i m a j ob entEducation Primary Care Secondary Care Rehabilitation RehabilitatioPromotion Screening nRisk Surveillance ScreeningAssessment SurveillanceRisk GapControl Gap Cost di s per sed and not c al c ul at ed or r ecogni s ed: E. T. – DDA, unf ai r di sm ssal i Per sonal i nj ur y HSE not i ce or f i ne Absence Sub Opt i m al DSFA / i nsur er or m Per f / ance on f und pensi HSA/ Saf et y Disability I l l Heal t h Ret i r ement Depar t m ent i n Or gani sat i on Heal t h Ser vi ce Execut i ve Death K Hol l and- K Holland Elliott 2004 El l i ot t