Professor Sayeed Khan FFOM, FRCGP, FRCP, FRSA, CMIOSH, DM Chief Medical Adviser, EEF Board Member, H

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Professor Sayeed KhanFFOM, FRCGP, FRCP, FRSA,
CMIOSH, DM Chief Medical Adviser, EEFBoard
Member, HSE
How should OH care be delivered in the 21st
Century?
Effective provision for the control of
occupational hazards.
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What Im going to talk about

• Effective provision, the
• Who
• How
• What
• Where
• Why
• When (now)
• Acknowledge, amongst others...
• Dr. John Osman ( team at HSE)
• Dr. Andrew Curran (HSL)
• Dr. Debbie Cohen (Univ of Cardiff)

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HSE infoline
I want to take part in some therapeutic butchery
skinning rabbits to put the mind at ease. Will
I be covered by public liability insurance? As a
workers mortgage repayments increase, this
raises stress. Why doesnt HSE give him a grant
to tide him over?
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Effective provision For what? New and emerging
problems / opportunities

• Demographic change
• Nanotechnology
• Recycling
• Human performance enhancement
• Pervasive computing
• The Hydrogen Economy
• Cyber security
• Carbon dioxide sequestration
• Obesity

• Genetic testing
• New and emerging diseases
• Biotechnology
• Terahertz technology
• Robots and artificial intelligence
• Flexible working and employment patterns
• Keyboard design/non-keyboard input devices

(HSE Website Horizon scanning)
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Effective provision Why? New HSE strategy

• Strategy content
• Investigating and securing justice
• The need for strong leadership
• Building competence
• Involving the workforce
• Creating healthier, safer workplaces
• Customising support for SMEs
• Avoiding catastrophe
• Taking a wider perspective
• Driving change for the better

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Effective provision Why? New HSE strategy
Building competence To encourage an increase in
competence, which will enable greater ownership
and profiling of risk, thereby promoting sensible
and proportionate risk management Customising
support for SMEs To adapt and customise
approaches to help the increasing numbers of SMEs
in different sectors comply with their health and
safety obligations
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Effective provision Why? New HSE strategy
Creating healthier, safer workplaces To
specifically target key health issues and to
identify and work with those bodies best placed
to bring about a reduction in the number of cases
of work related ill health To set priorities
and, within those priorities, to identify which
activities, their length and scale, deliver a
significant reduction in the rate and number of
deaths and accidents
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Effective provision Why? Economic climate

• Drivers for private sector employers-
• Profitability
• Productivity
• Costs
• Competitiveness
• Successful and sustainable
• Brand image
• Anything that affects above, matters
• For public sector, quality of service, not profit

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Effective provision Where? Increase in SMEs
Source BERR, UK, 4.5 M enterprises
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Effective provision Who (leads)? Joined up
government / stakeholders
Tackling worklessness
Preventing work-related Ill-health and injuries
Workplace health promotion
HSE
DWP
DH
Early interventions
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• Effective provision Who (does it?)
• Professionals in UK doing (some) OH

• Occupational Physicians
• _at_ 780 As, Ms FFOM 370 DOccMed
• (about same as Finland OHS Act)
• Nurses working in Occupational Health
• _at_ 6,000-8,000
• Ergonomists / Human Factors
• _at_ 1,500
• Hygienists
• _at_ 1,000

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• Effective provision Who (does it?)
• Professionals in UK doing (some) OH

• EHOs
• _at_ 10,000
• Safety Health Professionals IOSH (UK)
• _at_ 33,000 MIOSH (gt10,000 Chartered)
• GPs
• _at_ 50,000
• CIPD
• _at_ 130,000
• Line managers
• _at_ ???

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(No Transcript)
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Effective provision How? New legislation /
regulations?

• How about an occupational health services Act?
• Key requirements already set out in legislation
• general eg HSAW, MHSWR
• specific eg COSHH, CLAW
• provides a framework for Large / SMEs / Sectors
• But need
• Standards for occupational health services
• Voluntary accreditation FOM-led workshop

(poor quality of occupational health services)
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Effective provision Who? Upskilling / new ways
of working
OH Technicians HS practitioners GPs / other
healthcare professionals Improving sources of
information
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Effective provision Who? Upskilling / new ways
of working
Role of OH Technicians

• Audiometry
• Lung function tests
• Blood pressure, etc
• Vision screening
• DSE assessments
• Level two HAVS
• OH records, data mgt., etc)
• Equipment
• maintenance
• calibration

(Acknowledge Dr Andrew Curran)
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Effective provision Who? Upskilling / new ways
of working
Role of OH Technicians
The technician is a supporting role, supervised
and managed by an appropriate OH professional.
NOT there to make clinical judgments.
(Acknowledge Dr Andrew Curran)
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Effective provision Who? Upskilling / new ways
of working
Role of OH Technicians - concerns

• Accountability?
• Conflict with other OH professionals?
• Who will be responsible for policing OHT
  activities?
• Quality and competence

(Acknowledge Dr Andrew Curran)
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Design HS practitioner survey - emerging
future workplace health priorities

• Expert Interviews (n30)
• OH physicians nurses, HS practitioners
• Professional bodies
• Regulators, union representatives
• Education/training providers
• Delphi survey, 2 rounds (n25, n18)
• Pilot questionnaire (n10 HS practitioners)
• Questionnaire (n7,500 - IOSH)
• 21 response rate

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Delphi study
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HS practitioner survey - emerging future
workplace health priorities
Knowledge Areas

• Attitudes, persuasion behaviour change
• Risk perception communication
• Change management
• New legislation guidance
• Organisational culture
• Ethics, codes of practice, competence
• Bio-psycho-social model of health

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HS practitioner survey - emerging future
workplace health priorities
Skills Areas

• Influencing skills
• Making the business case for workplace health
• Monitoring surveillance
• Understanding business processes models
• Project management
• Presentation skills
• Assertiveness
• Evaluating interventions
• Mediation conflict management
• Time management
• Managing referrals to external OH providers

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Effective provision Who? Upskilling / new ways
of working
Role of HS practitioner in workplace health -
concerns

• Accountability?
• Conflict with other OH professionals?
• Who will be responsible for policing HS
  practitioner activities?
• Quality and competence

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Workplace Health Course I-WHO, Univ of Nottm.

• Course level MSc/Diploma/Certificate
• Design - modular, part-time, distance learning
  (e-learning workshops)
• Recognition/endorsementetc
• IOSH
• BOHS
• CIEH
• NEBOSH

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Effective provision Who? Upskilling / new ways
of working
Occupational Health Technician
HS practitioner
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HSE infoline

• Is there a maximum noise limit for children?
• My telly's bust. I got it from Argos. It's not
  on!
• A suicidal squirrel jumping onto a substation
  caused a county-wide black-out. Is this a
  dangerous occurrence under RIDDOR?

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Effective provision How? Upskilling / new ways
of working
General Practitioners

• Its not my job
• Its not what I trained for
• I dont have time

(Acknowledge Dr Debbie Cohen)
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Educational initiatives for GPs / other
physicians

• National Education Pilots in Work and Health
• GP certificate level training
• On line learning
• GP Essentials

PDPs

• SpRs in Wales
• Healthy Working Wales Project
• (Whats happening in Scotland)
• (IOSH OH toolkit)
• (HSE website downloads / NHSplus website / NICE)

(Acknowledge Dr Debbie Cohen)
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Healthy Working Wales Project

• Development of a central website for work and
  health in Wales
• Education
• Resources
• Email service for work and health issues

(Acknowledge Dr Debbie Cohen)
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(Acknowledge Dr Debbie Cohen)
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(Acknowledge Dr Debbie Cohen)
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Effective provision How? Upskilling of line
managers
MSA05 www.eef.org.uk
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Effective provision How - Re-invention?
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Effective provision How - Re-invention?
Unique selling point of OH physicians?
Leadership skills Decision-making skills Status
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Effective provision Where we work?
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Effective provision Where we work?

• Staffordshire
• Shropshire
• West Midlands
• Herefordshire
• Worcestershire
• Warwickshire

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Finally... control your own destiny or someone
else will (Jack Welch, Ex-CEO, GE) Workplace
health clinical skills Occupational Health
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Thank you for listening