This document discusses occupational health, safety, and welfare within the health service context of staff governance. It provides perspectives from a CEO on the importance of workforce health and engagement. It outlines key issues like corporate social responsibility, organizational change initiatives, and equalities. It presents a holistic risk management approach and employment risk matrix. The objectives of occupational health are defined as promoting staff well-being, ensuring fitness for work, and protecting patients and employees. Minimum standards for an occupational health service are listed.

1. Occupational Health, Safety &
Welfare within the Health Service
within the context of Staff
Governance

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. 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. Holistic Approach to Managing the individual

5. Risks
accept
retai
n
transfe
r
mitigate
preven control
avoid
t

6. Employment Risk Matrix
Wage increases, Absence,
Fraud, Stress,
I Mortality Turnover/retention,
m Recruitment,
p
a Safety, Early Retirement,
c
t Legal Compliance Succession
Planning
Improvement Potential

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. Corporate Governance
 Financial
 Clinical
 Staff

9. Preventive health and well-being management
services 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. OH,S&W anchored in principles of
Staff Governance
Under 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Link between Staff Governance and Patient care
Michie S, West M, Measuring Staff Management and HRM in the NHS

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. Barriers to progress
 Complex management structure
 Immunity from regulatory legislation
 Absence of a “Health and Safety” culture
 Litigation raised by employees -
relatively infrequent

23. Stimulus for change
 Loss of Legal Immunity
 Chief Executives appointed
 Pressure from insurers
 Quality standards
 Parliamentary questions
 Financial awareness

24. Financial Awareness
 Litigation costs
 Absence from work costs
 Occupational Injury and Ill Health
 Hidden costs of accidents

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. 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. Bridging the Gaps to
Workability &
Wellbeing

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
ent
Education Primary Care Secondary Care Rehabilitation Rehabilitatio
Promotion Screening n
Risk Surveillance Screening
Assessment Surveillance
Risk Gap
Control 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