The Role of the Health and Safety Practitioner in Workplace Health and Wellbeing

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The Role of the Health and Safety Practitioner in
Workplace Health and Wellbeing

• Professor Neil Budworth
• Corporate Health and Safety Manager E.ON UK

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Stand up Bingo (Or the Derren Brown Test)
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Predictions

• Between a 1/3 and 1/2 will sit down on the back
  pain question
• Of the remainder about 1/2 will sit down on the
  stress question
• Of the remainder 90 will say that hey work for
  organisations with more than 100 people and I
  will have less than 10 people standing
• Everyone will think that OH is under resourced

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Predictions - Round 2

• 60 -70 will have access to OH services
  (majority large organisations)
• Of the remainder about 80 will think that
  Safety Professionals have a greater role to
  play in supporting health
• All bar 1 or 2 people will think greater access
  to Physio would help
• Everyone will think that OH is under resourced

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• The current problem
• Whats happening to address it
• What does this mean to us ?
• The role we can play and what is happening now

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864 Million
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The Cost to the UK of Health Related Worklessness
100 Billion
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Every week - Forever
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Cost To the UK

• 2 Million people suffer from work related ill
  health
• 2.65 Million people claim incapacity benefit
• 40 Million working days lost each year

600,000 People start to claim incapacity benefit
every year half of these come from employment
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Why this Growth ?
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The Current Problem Occupational Health Resources

• There are -
• 1,500 Occupational Physicians
• 2,195 Members of the Society of Occupational
  Health Nurses

BUT 35,000 members of IOSH 100,000 NEBOSH
Certificate holders
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The Current Problem The Role of the GP

• Average appointment time 7 minutes
• Available options Sick note or no sick note
• Knowledge of the working environment / activity
• Ability to access suitable therapies

Recorded Reasons for Absence - None - TaTT
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• Musculo Skeletal Disorders
• Back pain affects all industries, not just a few
  high-risk sectors.
• In 2003/04 an estimated 4.9 million working days
  (full day equivalent) were lost due to back
  pain caused or made worse by work.
• There are in the region of 330 000 claiming
  Incapacity Benefit due to MSDs

• Mental Health
• Approximately one third of working days lost due
  to work related ill-health or injury are due
  to stress, depression or anxiety.
• 40 of the overall Incapacity Benefit caseload
  is due to mental health an increase of 12
  since 1997

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• These problems are not medically severe
• Most of us experience at least one of them at
  times
• Usually there is no serious disease or lasting
  harm
• Most episodes settle quickly, even if
  symptoms may recur
• Most people with these problems could remain
  at work or soon return

Why then do so many people become long-term
disabled?
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• There is no good medical explanation
• Often something has gone badly wrong with the
  way theyre handled
• The longer people are off work, the less
  likely they are to get back, ever

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Fact or Fiction

• A simple bruise could cripple you for life

FACT

• Non specific back pain is in effect bruising
  around your spine. If you rest too long and
  avoid activity in case it causes more damage your
  back will get weaker and become more likely to
  get hurt which causes you to rest more etc etc.

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No Early Intervention - EG Back Pain no
expert advice in the workplace no access to OH
professionals no quick therapy options no
rapid referral options no access to
rehabilitation Varied understanding of health
and work
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Chances of Return to Work Following Long Term
Absence
At 3 Months 75- 90 At 6 Months 50 -60 At 9
Months 25 30 Over 1 year lt 10
After 2 years the individual is more likely to
retire or die than return to work
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What is Being Done About the Problem ?

• Dame Carol Blacks Review
• The Government Response

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The Black report

• Supporting the health of working age people
  requires the co-ordination and integration of a
  range of professional disciplines
• A new Fitness for Work pilot scheme drawing on
  the biopsychosocial model, to provide OH support
  under the NHS banner, should be considered
• Services which range from physiotherapy to
  counselling on matters such as debt and personal
  relationships should be included
• The business case for wellness programmes in the
  UK needs developing
• Demographic, societal and economic factors
  increasingly underpin wellness programmes in many
  leading UK employers

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The Government Response

• Creating new perspectives on health and work
• Electronic fit note
• A National Education Programme for GPs
• Health, Work and Wellbeing Co-ordinators
• National Centre for Working-Age Health and
  Well-being
• Improving work and workplaces
• The Business HealthCheck tool
• National Strategy for Mental Health and
  Employment
• Further NHS Plus development
• Occupational health helpline for smaller
  businesses
• A challenge fund
• A review of the health and well-being of the NHS
  workforce
• Supporting people to work
• Piloting early intervention services
• Access to Work

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We Need to Change the Way We Think !
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What Are Your Views of Occupational Health ?
WRONG !
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More Likely - This
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What Are Your Views of Health and Safety?
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• From
• Manufacturing
• Machinery
• Inspections
• PPE
• Clipboards
• Policemen
• Men

• To
• Graduates
• All workplaces
• Facilitators
• Key performance indicators
• Management systems
• Cars
• Non traditional risks stress
• Research / Evidence led
• Health and Safety Directors

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The role we can play and what is happening now
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An Aunt Sally - Consider Back Pain ?
Frequency of Contact

• Safety Professionals
• Daily / Weekly

• Occupational Health Nurses
• Monthly / Yearly

• Occupational Physicians
• When required

Long Term Chronic Complex Case
Easy Simple fix
Complexity of problem
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Where do we fit in ? What is our Role ?
Frequency of Contact

• Safety Professionals
• Daily / Weekly

• Occupational Health Nurses
• Monthly / Yearly

• Occupational Physicians
• When required

Complex Chronic Cases, Very specialist medical
support required
More complex Cases, specialist Support / Case
Management
Early Identification Simple fix Rapid referral
Long Term Chronic Complex Case
Complexity of problem
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Our Role Depends on Two Things
Where we are in the process
What support there is in place
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Our Role - Prevention
CARE4S

• Communication
• Assessment
• Engagement
• Education
• Evaluation
• Early action
• Referral
• Support

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Our Role During Absence
AIR

• Advocate
• Communication channel
• Chase modifications
• Make case for recommendations
• Keep cases on the agenda
• Investigate
• Review

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Our Role - Rehabiliatation
LARKS

• Liaison
• Adaptations
• Risk assessment
• Keeping the issue on the agenda
• Support for management team

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How is IOSH Supporting this Role ?

• The IOSH DWP Pilot Course
• The OH Toolkit

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Occupational Health Toolkit

• Bringing best practice together in one place
• Responding to government agenda
• Helping us to play our part

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Summary

• There is an epidemic of work related ill health
• Dominated by Musculoskeletal disorders and mild
  to moderate mental health issues
• Massive cost both to individuals and to the UK
• Early informed intervention is critical to
  stopping this epidemic
• Safety and Health practitioners are ideally
  placed to make a difference
• Pilot work is underway with IOSH and DWP to see
  what we can do
• We have to embrace change and do things
  differently

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Thank you Questions ?
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Frequently Asked Questions

• Why should we do this ? - Weve got enough on
  our plate !
• We are not medical professionals what can we add
  ?
• What do our OH colleagues think of this ?

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Why should we do this ? - Weve got enough on
our plate !

• 300,000 people a year are consigned to the scrap
  heap and we can change that.
• Fits in with what we already do
• In business there is a great cost benefit for
  doing this.
• Develops engagement with the senior management

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We are not medical professionals what can we add
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• We can spot things much earlier
• Most of the blocks (gt70) are not medical
  management inaction, communication,
  misunderstanding etc
• Without a voice at the table individuals are
  quickly forgotten

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What do our OH colleagues think of this ?

• Brilliant together we can make a difference
• Safety tends to get more air time so you
  can get the managements attention
• If it works well do it
• We already do this and it works

• You simply shouldnt mess around with
  medical stuff
• You could do more harm than good
• You are trying to take our jobs
• You are trying to marginalise us
• You are already too powerful