Guest blog by Janet O’Neill, OHNA, RGN (MSc, PG Dip OH, RGN)
In June, The Great Big Workplace Adjustments Survey was published by the Disability Forum, with nearly 1,500 disabled employees and 400 managers responding. It considered the process, experience, and impact of adjustments on disabled people and those with long-term conditions. Although significant focus was placed on the Health adjustment passport, occupational health (OH) was discussed in detail and was a running theme.
A quick overview: of the 68% who had access to OH, 22% of disabled employees and 25% of employers found OH effective. 32% of disabled employees found OH useful - but only 9% of 577 reported a positive experience when using their own words.
At a follow up SOM Commercial OH Providers Working Group meeting many of us jumped to the defence of OH – that OH was misunderstood, with unrealistic expectations. Someone said: “We could produce the best, evidence-based report but if it conflicted with what the employee or manager wants, then the reflection will be poor.” OH do see these issues time and time again.
The report recognises that employers could do more to enable better outcomes from OH. Pages 67-68 state that employers should ensure a tender or procurement process that details diversity and inclusion, equips managers to understand and utilise OH effectively, with OH involvement when developing disability and attendance policies and procedures. Feedback and robust complaints procedures are also necessary. This makes sense as OH is tied by the tender as to what we can provide.
But, OH should use this report to reflect on how it provides an effective service for their organisation. OH needs to ensure it integrates with all relevant functions so it meets the needs of the employer and employee. It should promote training for managers on effective referral to and use of OH. OH must maximise its value so it is not an intimidation tactic, increasing mistrust. OH should advise communication between the employer (especially the manager) and the employee before a referral to OH and only refer when this will add value. OH provides the manager with information to support the individual, within policies and procedures, and how this information will be used.
OH as a clinical specialty thrives on reflection to continually improve and learn. Let’s:
- Use SEQOHS as a kitemarking tool for quality OH. Several of the concerns raised within this report, relating to OH, are covered in its updated standards.
- Train and educate stakeholders on the effective use of OH – ensuring OH referral process and report provision are as simple as possible, with manager involvement, but also flexible to take account of different needs.
- Consider alternate ways of service delivery depending on the situation e.g. using case management, vocational rehabilitation, and case conferences. Use a multidisciplinary team if possible, adding value with different expertise. Providing information and advice to the employee using motivational interviewing skills can add value.
- Utilise triage to ensure referrals are correct and use OH effectively.
- Upskill clinicians (page 56 notes that clinicians seemed to have little knowledge of issues such as deaf awareness, Long COVID).
- Provide an effective report to management that adds value. This last point needs expanding. SOM has produced an excellent guide to an OH assessment and report. OH providers may have their own report template, but consistency in assessment and report provides a level of reassurance. OH is judged on its assessment and report and therefore must be individualised and professional but also practical for the role and organisation. The report should be justified and evidence-based but also outline advice that tells managers what they can consider. It can facilitate communication between managers and employees. Avoid poorly written reports with spelling and grammar errors! Copy and paste sections that create a generic feel and do not provide clarity to the advice are seen negatively by both employers and employees. Every report should be individualised to the person, role, and employer. Any assessment must set expectations and be individualised within the boundaries of good history-taking.
OH delivers a service to the employer and the employee but is also a representative of the employer to the employee. Customer service and active listening are crucial so managers get clarity on the advice provided if needed.
Both employer use of OH and OH delivery have room for improvement. It is clear from this report (pages 61, 62, 65) that when OH is used effectively and provides a good service, it makes a significant difference in people's working life.
Janet O’Neill
OHNA, RGN (MSc, PG Dip OH, RGN)
Head of PAM Academy (PAM Group)