2nd Workshop in Manchester a Success Feedback from one delegate follows:
"I would just like to thank the AOHNP & in particular Mary McFadzean for the thought provoking, interactive, workshop held in Manchester Last Friday.
Having dragged myself down from sleepy Cumbria, & woke myself up to the realities & probability, of significant change in the Future of Occupational Health as we know it, I would like to share some recently gained knowledge!
It seems Cumbria may not be quite as sleepy as I’d previously thought!
We appear to have some very forward thinking chiefs & medics who are developing health service systems to meet the governments new health iniatives, in response to the ‘Black Report’.
As well as relocating all of the local, sporadic health services under one roof, they have formed an Independent private business in Occupational Health - ‘Cuedoc Holdings Occupational Health’, which is owned by the 76 Local GP shareholders.! A business manager is in place , with a Part time OHN ( 3 days/ week), 2 OHP Consultants, with currently 4 bank OHN’s, 2 of which are about to be funded through an Advanced Diploma In Occupational Health. The Company went operational in April 2009, & it seems to be going from strength to strength , with 20 local SME’s currently buying in to the service. The OH service provides not only sickness absence screening & Rehabilitation, but all forms of health surveillance.
I will be attending a local event next week organised by the job centre plus, focusing on the positive links between health & work with Keynote Speaker – Dame Carol Black. It is placing Mental health in the Workplace high on the agenda, and asks local busineses, ‘Can you be a Fit 4 Work Employer?’
I will be meeting with ‘Cuedoc Holdings Occupational Health’ after the event, & I will be happy to feedback any other significant detail I can."
The Future of OH Nursing Our first workshop was held on Friday, 3 April at the BG Group offices in London by arrangement with our Director, Christina Butterworth. The next workshop will be held in the north of the country, venue and time to be advised shortly.
As can be seen from the feedback from this workshop, there is a very important role for OHN’s to play within the proposals contained in the Black Report. The findings of the report were widely published and it was very disturbing to learn recently that there are still many OH nurses in the marketplace who appear to have no knowledge or understanding of how these proposals will affect their role.
The AOHNP (UK) will continue to represent our member’s interests in these areas. We currently have an active voice within the Council of OH, respond to consultative documents and will support OHN’s who take up positions within the new Fit for Work Services by providing a medium to network as well as keeping them updated with information as it becomes available.
However in order to represent our members we need to hear your views - to enable us to fully participate in the changes that will be occurring in occupational health. You can get involved by: participating in the workshops as they come to your area; joining the discussion forum on our website – www.aohnp.co.uk; volunteering to attend meetings in your area; writing individual comments to the Association Administrator who will forward them on to the board and encouraging your colleagues to join the Association.
The more OHN’s the Association represents the greater will be our credibility when we are attending National and Government level meetings. Jeremy Smith, President May 2009
Feedback on Black Report Workshop - 3 April 2009 Dame Carol Black’s review of work age health is one of the most important documents of its day for Occupational health Nurses....but we haven’t featured much in the actual document or subsequently in how we should become involved.
The AOHNP have used Mary McFadzean from MMC Absence and Health Management Ltd to bring members together and share views as to what we consider to be the main issues arising from the proposals.
Workshops were advertised on the website and in OH Today to give nurses an opportunity to attend a workshop and share views on the Black Report. The workshop gave an overview of the Government response to the Report but concentrated on the proposed return to work services, outlining what the current system looks like now (GP sign off sick and long NHS waiting lists) to GP Fit notes (what people can do in work as opposed to what they cannot) and referral by them to the fast track “Fit for Work Services”.
Workshop participants were asked to consider the role of Occupational Health both as part of a Fit for Work Service and as an employer based OH service working in an area of the country where a Fit for Work pilot was in operation. The potential problems and opportunities that became apparent during this exercise were quite revealing.
Below is an outline of what participants considered would have impact and what deserved detailed consideration in the set up of the pilots:
OH as part of a Fit for Work Service:
· The OH nurse would need to be involved very early on in the assessment to ensure that functional not medical capacity were considered early on in the process. With only a GP referral system in place it could be that initial “medical management “of employees becomes the norm.
· Occupational health nurses, having been trained in organisational culture and business acumen would know how to liaise successfully with the employer (manager and HR) to get an early resolve to the situation and hence reduce the barriers for returning the person to work.
· Waiting times for treatment on the NHS are currently a problem.The management of the pilots would have to be very carefully overseen to ensure that waiting times are not extended beyond 10-14 days for those with psychological and musculo-skeletal problems, warranting treatment.
Employer based OH service working with Fit for Work Service in area:
· Potential for more confusion over “Fit Notes. ”Occupational Health would become heavily involved in advising HR and Managers what adjustments could be reasonably managed as a result of the new Fit note scheme.
· Potential conflict of interests with employer based OH services. GP’s will still only have 7 minutes with a patient. This means that they are unlikely to find out during that time whether the person has access to OH at work. Referral to a Fit for Work Service could cause a conflict of interests with an employer based service if management have referred the employee to their own service for case/health management advice. Some services will also have better access to rehabilitation support for the individual so this area needs to be carefully managed.
· FFWS would need to have a good understanding of OH services so that those referred get thebest possible care in timely manner. OH already work hard on building bridges between health and non-health professionals..physiotherapists/psychotherapists/HR etc in their own every day practice. The FFWS would need to understand the business objectives of returning people to work, as-well as the health. Advising on sickness absence policies is the remit of many occupational health nurses.......other health professionals within the FFWS will need to consider this area of expertise when considering the barriers and opportunities for returning people to work.
In terms of general opportunities for Occupational health nurses, participants could see many, not only where new roles had been supported by the Government (Regional Health and Well-being Co-ordinator role, advice line and consultation service for SME’s)) but also where the need is greatest—for those in receipt of Employment and Support Allowance(which replaced incapacity benefit in October 2008).
Going forward there should be roles for Occupational health nurses in Job Centres and GP surgeries so that a functional capacity assessment can be carried out by those with the expertise at the beginning of an individual’s health management journey. The Government’s non-movement on funding more OH programmes and public sector services is disappointing and could cost them far less than supporting the growing numbers on benefits.
In terms of funding per se, we are aware that there is £13 million to fund the Fit for Work Service pilots which includes the evaluation of these services and nothing else. This is not much considering the ambitious plans put before us by Dame Carol Black at the start of this review. It is important with funding at a premium that the voice of Occupational health nursing expertise is taken seriously and plans that involve changes to workplace health have nurses at the heart of their activity. Mary McFadzean May 2009
WORKSHOPS TO CONSIDER WHAT THE “BLACK” FUTURE HOLDS FOR US
The Government response on Dame Carol Black’s review of workplace health is due out shortly. This is probably the most important report of its kind and gives occupational health nurses a key opportunity to be part of a new era in the delivery of workplace care. Whatever our thoughts are about the proposed changes….one thing is clear…if we don’t grasp the nettle now, stand up and be counted, others will. Naturally if the report is issued whilst the workshops are running, then we will update our information and let those who have already attended know the changes.
The central tenet of Black’s report is the need for early intervention with the use of multi-disciplinary teams, guided by competent case managers. Such an approach has been successful in other parts of Europe and a modern day intervention along these lines could work here. The Fit for Work services (as they are to be called) are likely to be piloted across the UK before being delivered into mainstream practice. Whether we are to be directly affected by these pilots or not, we need to consider our position as Occupational health nurses both now in every day practice and as part of the wider plan for shaping the future of workforce care.
The AOHNP is an ideal vehicle for helping us put forward ideas and concerns about what the future might hold. We are therefore proposing to run a series of regional workshops between January and April 2009 which will cover the main themes of the Black Report and what the proposed changes could mean to Occupational Health Nurses.
Mary McFadzean from MMC Absence and Health Management Ltd is a new member to the AOHNP and has offered to run the workshops for us. Mary is experienced in developing case management models for companies and has spoken many times at conference on the subject. She plans to make the workshops as interactive as possible covering the following areas:
Opportunities and barriers to collaborating with GP’s on sickness absence cases; The use of multi-disciplinary services and rehabilitation programmes in current practice; Interim/Fit for Work services in practice, who will use them, when, how and why; Fit for Work Services collaboration with existing OH services, or fragmented/stand-alone?
Collective views from the workshops will be published for all to share.
It is proposed that the workshops will be run in the following regional areas, depending on up-take for the event:
North West, North East, Yorkshire, Midlands, London, South
If you are interested in attending a workshop, please e-mail Linda Riseborough (admin@aohnp.co.uk) with your name, contact details and preferred area of attendance by 9 January 2009. We will then advise you as to where the workshops will take place, cost and other details. We will try to keep costs as low as possible by obtaining sponsors for the events.
We hope that as many of you as possible join us to debate this important topic. Look forward to hearing from you. December 2008
Suzanne Elliott recently attended the Westminster Briefing - Healthy Working Population on 18 September 2008. Members can download an interesting .pdf of the powerpoint presentation given at this briefing.
Sarah O'Hara also attended a DH meeting with several other stakeholders to discuss the Review. Further information will be added on this subject shortly. October 2008
Dame Carol Black has now published her review "Working for a Healthier Tomorrow http://www.workingforhealth.gov.uk/documents/working-for-a-healthier-tomorrow-tagged.pdf). In this she asked the Occupational Health Profession to take the lead in developing consistency of the standard of provision of services to industry. Whilst the AOHNP are sending their own response to this document we are also taking part in meetings being organised by COHPA (Commercial Occupational Health Providers Association) - key bodies invited are FOM, SOM, RCN, AOHNP, NHS Plus, European Academy of Occupational Health Psychology) and the RCN/SOHN.
If you have any comments you wish us to consider then please advise the Association Administrator. April 2008
We are now trying to move the "One Voice" (of Occupational Health practitioners) forward and would like as many views as possible. If you would like to join in, please read the letters below and make your comments either via the discussion forum or by email directly to admin@aohnp.co.uk. The letters are published in date order.
Email to OH Groups - 20 November 2007 Kim was at a meeting with Dame Carol Black a couple of weeks ago and the Review of the Health of Britain’s Working Age Population was discussed again. Dame Carol is currently seeking evidence to inform the review on a number of subjects and is particularly keen for response to the following :
How can we keep working age people healthy and how can the workplace be used to promote health? How can people best be helped to remain in or quickly return to work when they develop health conditions including chronic disease or disabilities? How does the age of the person affect the support that is needed? How can we encourage action to improve employee health? What underlies the apparent growth in mental health problems in the working age population and how can this be addressed? What constitutes effective occupational health provision and how can it be made available to all? What would be the impact on poverty and social inclusion of a healthier working age population? What are the costs of working age ill-health to business and what are the benefits to companies of investing in the health of their staff?
Whilst we have asked our members for their comments we felt that it would be a good idea for individuals or groups who have responded to the One Voice to send their comments directly in this instance.
Thanks for your help. If you would like to send us a synopsis of any comments you make we would be more than happy to include these on the One Voice section of our website.
Letter to OH Groups - 20 August 2007 Further to my letter of 18 July 2007, AOHNP were recently asked by POOSH to suggest which areas we felt should be initially addressed by the organisation in order to progress working in a cooperative manner. We have responded as follows:
The AOHNP suggest that we (POOSH) explore "communications" and "evidence of good practice". The focus to be on how to improve communications:-
1. between "a treating practitioner" and the occupational health provider (in-house or external).
2. between "a treating practitioner" and the employer (where no occupational health provider).
NB Relates to the employee who is off sick or to the employee who is at work but not fully fit to undertaken his / her full normal work activities.
We look forward to hearing your views on this subject as well as any other ideas that you may have. If you could respond by 15 September this would be very useful. Kim Boggins - 20 August 2007
Letter to OH Groups - 18 July 2007 Many thanks for responding to our recent email on One Voice. Over one third of the people emailed responded – however we do think that some contact details are out of date! You may also have noticed that the letter was published in OH Journal. We will continue to keep Noel O’Reilly informed of our progress so that he can help us to ensure that we get as many practitioners as we can involved. We will also keep putting the information on to our own website –www.aohnp.co.uk and have opened a “Discussion Forum” on this very topic which can be accessed by anyone.
We believe that the specialist skills of an OH Nurse Practitioner are (in no particular order):
Communication i.e. pulling together relevant OH practitioners
Functional integrated health assessment
Absence management
Inherent health knowledge we have already acquired via our nurse training.
It is these skills that we must ensure are not bypassed in the changing world of Occupational Health. We need to get people to appreciate what we are doing, how it is happening and how it can be accessed.
AOHNP (UK) are part of the POOSH (Professional Organisations in Occupational Safety and Health) Group and at a meeting on 3 July the guest was Dame Carol Black. We had the opportunity to find out what “she has discovered” about the realities of the provision of Occupational Health across the country. The key points from her presentation and POOSH discussions with her are as follows:
Key Points from Dame Carol Black’s Presentation and our Discussions. Good work is good medicine. Workplace is a good environment to hear messages about prevention and health. Early action is essential and need to improve rehabilitation to get people back to work. Query whether we should have fit certificates as opposed to current sick certificates. No official way that GPs link with Occupational Health or employers. Found no constructive ongoing links between GPs and Occupational Health or employers. GP and Occupational Health need to “think out of the box” to have regular links and not just current ad hoc communications. Puzzled while email is not used very much in communications. Rehabilitation both via treatments and employer involvement is often too slow. Need for UK to give a higher priority to health and the workplace. Need to stop people dropping out of workforce due to health issues. It is possible not to be fully fit and work. Need to have constructive case management, de-medicalise absence from work and have effective rehabilitation. Be proactive. New ways of communicating between employers and health professional required. Differences between Occupational Health and Public Health now blurring.
NB Dame Carol Black wants to hear “one voice”. She recognises that there cannot be complete agreement on everything. She is keen to hear via “one voice” the generic issues we agree on plus the span of other issues and the various elements to consider and variants in opinions.
The other POOSH organisations wish to be kept informed of our progress on One Voice. Please visit their website (www.poosh.org) to see who else is involved in this group.
“We are part of very exciting times with government really wanting all employers and employees to have access to effective Occupational Health advice. The government is seeking advice from professionals and interested parties on the best way forward. As the saying goes “change is a given” and time for staying in the past and providing the same type of service in the same way is gone. We are not trying to suggest that the underlying principles of Occupational Health have changed, but that we need to be open to working in true partnership “with others” and not be too precious about hanging onto our job titles and only working within our organisation or clients’ organisations. Time now to seriously consider how we could work more effectively with related professionals and to be open minded about how we can cross that bridge to work in greater harmony and partnership with GPs and within public health.” Alison Persson, Vice President, AOHNP (UK)
As our next step forward we would like you all to consider what you believe are the key issues for One Voice so that we can discuss them amongst ourselves, with other organisations such as POOSH, OH Educators, DOH, FOM/SOM, SOHN, RCN OH Managers Forum etc. and then feed them to Dame Carol Black. We need to show we have one voice and are thinking consistently.
In this regard we are also going to try and compile a database of OH nurses. We realise that there are a lot of people who currently work within OH who will have something to contribute and would like to hear from as many people as possible. At the very least we would like to hear from people who are on the specialist practitioner list. We attach a proforma and would be grateful if you could ask as many people to register as you can. If they wish to send the information by email then please ask them to quote the relevant question number and their response. We would like to get the list started by 31 August although the list will, of course, be updated as necessary. You can either send the completed proforma(s) directly to admin@aohnp.co.uk, to our office – AOHNP (UK), P O Box 11785, Peterhead AB42 5YG or ask individuals to contact us directly with the information.
We look forward to receiving your responses to this letter by 31 August so that we can keep up the momentum of this initiative. Kim Boggins, President - 18 July 2007
------------ Letter to OH Groups - 3 June 2007 On 3 June 2007 Kim Boggins, President, sent the following letter to all the different OH groups listed in the back of Occupational Health Journal, amongst others. If you would like to take an active part in the discussion please let us know by 15 June. (To date we have had a good response).
“One Voice” The appointment of Professor Dame Carol Black to implement the Strategy for Health, Work and Wellbeing spans many government departments (DWP, HSE, Dept of Health) and organisations and it is vitally important that Professor Dame Carol Black fully appreciates the role of the occupational health practitioner. There are estimated to be only 4,500 qualified OH nurses and doctors working in this speciality and capitalising on existing good OH practice is important for the health, work and wellbeing strategy to be effective.
There are many occupational health nurse groups throughout the UK and it is essential that we do not get overlooked due to our lack of “one voice”.
The Association of Occupational Health Nurse Practitioners (UK) has no political agenda. It is an association formed to help and support its members and to promote occupational health. We are very fortunate to have access to a part-time administrator who acts as a conduit for passing information amongst the membership. We have a regular newsletter, website with discussion forum and Association email address and already sit on various national groups representing OH nurses. We would like to offer these resources as a benefit to Occupational Health Nursing in an effort to produce “one voice”. This could be used to discuss how we can try and influence the Government and other organisations in relation to the Strategy for Health, Work and Wellbeing as well as, for example, advising one another of planned study days/conferences so that we avoid overlap and reduction in delegate numbers to these events.
As you will see this letter has been sent via email to the distribution list noted below. If you would like to become more involved in “one voice” then please let Linda Riseborough, our administrator, know by 15 June 2007 so that we can move things forward to the next stage. If there are “other groups” we have not included in the distribution list, who you think should be involved, please do let us know.
