Guest blog by Dr Sarah Jackson
I joined EDF eight years ago as a Consultant Physician in Occupational Medicine, swapping the green uniform of the British Army for the strong orange and corporate branding of EDF Energy. I was excited to be working for an in-house occupational health (OH) service. I loved the sense of belonging to one organisation and the shared business purpose. When I researched EDF I felt that the company’s values really chimed with the kind of service I wanted to deliver. Plus, my experience in safety critical work commonplace in the Army meant that my skills would be well used in the nuclear and renewables sector.
Another draw for me was that I wanted to know if I could make my voice heard, in a busy cutting-edge executive boardroom where health and wellbeing had to be balanced alongside commercial priorities. This was quite different from the way that we might present our views in the military, where I might author written formal policy recommendations to be then presented to senior military leaders through a more remote chain of command. My Army experience also helped me to understand that I enjoyed seeing the impact of the service delivery in real time and when I couldn't it felt frustrating. Like the NHS, the military is a huge organisation with complex funding arrangements, high levels of political interest and it can therefore be very slow to make change and to realise its impact.
I haven’t been disappointed; OH is fully embedded in EDF such that we have a seat at the table at most of the key meetings regarding safety, health and wellbeing, and human resources. I am invited to attend the executive team health and safety meetings and find the boardroom to be very open to listening to ideas on how we can improve worker health and safety. COVID, whilst a challenging time, was such an opportunity to steer the business. Along with the Chief Medical Officer of the time, we were able to procure laboratories for testing, develop an incredibly efficient track and trace as well as undertake daily site risk assessments where controls varied with the risk rather than just implementing the lower-level blanket government advice. During this time, I think the company really understood the value of in-house OH and we were busier than we have ever been.
More recently we have been helping the company with the complex discussions surrounding risk management for safety critical workers using medicinal cannabis, managing neurodiversity and medications and helping to educate on both.
There are, of course, downsides. Ultimately service delivery is down to me and my team and if employees are not seen in a timely fashion or if advice is not seen to be robust or helpful, the business is quick to challenge and hold me to account. As we are in-house we can get pulled into company activities, not all of which may be the best use of our time or where there may not a clear clinical evidence base. Where the business wants to discuss patients under our care we have to be very careful with confidentiality and it can be difficult at times remembering what you know from your medical contact with an individual and what the business has actually shared. Finally, there is always politics in the business world and it can be hard to not get pulled into the business politics when we have to work and operate in the same environments.
I have also developed a huge respect for those companies providing outsourced services. They can be seen as outsiders to the organisation and can be treated with a degree of antagonism which must be difficult to manage at times. Occupational health (OH) providers can only sell what businesses will buy and if the company team procuring the service do not understand the preventative value of OH, then it must be frustrating to have to constantly deal with the aftermath. It must also be challenging if the employer only wants OH to have one contact with the individual and few resources are available as a means to help rehabilitate the employee. In an in-house service we are able to see a case through to a resolution and more to guide the business in how much OH input is appropriate. As a result it is easier to learn as to what works within that organisation and what can be accommodated. Sometimes the business cannot accommodate adjustments and may assist with redeployment or an employee may leave the company. Whichever path, our role is to help support both the employee and employer in their journey through this period whilst advising on likely prognosis, risk and basic employment law. Of course, the most effective role we can undertake is driving efforts to prevent ill health in the first place and our continued focus on health and wellbeing is a key tenet for us as an in-house service. Keeping these things in mind really helps to ensure that we remain up to date, focused and knowledgeable to get the best outcome for the employer and employee.
A couple of weeks ago, I had the privilege to attend one of my patient’s funerals. She was only young. Despite this, she kept working up until a month before her death, through a challenging treatment regime. She said to me that work helped to keep a sense of normality, something that we as OH clinicians know. She loved her job and her colleagues. I sat and cried with her husband and her colleagues as a montage of photos was played to “Electric Dreams”. Many of these images included her time at work.
The sense of purpose, belonging, wanting to look after all of our employees to keep them healthy through their working life and beyond. These things mean the world to me. I think it is fair to say I am proud to be orange through and through!
Dr Sarah Jackson is Chief Medical Officer at EDF Energy.