OSH& Welfare in the Health Service within a Governance framework


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OSH& Welfare in the Health Service within a Governance framework

  1. 1. Occupational Health, Safety &Welfare within the Health Service within the context of Staff Governance
  2. 2. 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.
  3. 3. 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,
  4. 4. Holistic Approach to Managing the individual
  5. 5. Risks accept retai n transfe r mitigate preven control avoid t
  6. 6. Employment Risk Matrix Wage increases, Absence, Fraud, Stress,I Mortality Turnover/retention,m Recruitment,pa Safety, Early Retirement,ct Legal Compliance Succession Planning Improvement Potential
  7. 7. 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
  8. 8. Corporate Governance  Financial  Clinical  Staff
  9. 9. 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
  10. 10. 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.
  11. 11. 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
  12. 12. Minimum Standards of an Occupational Health ServicePre-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.
  13. 13. 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.
  14. 14. 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
  15. 15. 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
  16. 16. 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
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. Link between Staff Governance and Patient careMichie S, West M, Measuring Staff Management and HRM in the NHS
  21. 21. 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
  22. 22. Barriers to progress Complex management structure Immunity from regulatory legislation Absence of a “Health and Safety” culture Litigation raised by employees - relatively infrequent
  23. 23. Stimulus for change Loss of Legal Immunity Chief Executives appointed Pressure from insurers Quality standards Parliamentary questions Financial awareness
  24. 24. Financial Awareness Litigation costs Absence from work costs Occupational Injury and Ill Health Hidden costs of accidents
  25. 25. 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
  26. 26. 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
  27. 27. Bridging the Gaps to Workability & Wellbeing
  28. 28. 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