Nothing makes me angrier than hearing from Managers who are being held to ransom by occupational health (OH) providers who insist on providing expensive medical services when there is no real need. Once I heard that an OH provider suggested all site staff have a hearing test, or other workers would feel they were “discriminated” against. Which wasn’t true – why would you give a hearing test to an administrator who never even went on the shop floor? It was a total waste of money.
Many companies are looking at costs today and the problem with trying to reduce your occupational health bill is that there’s so much “misinformation” out there, it’s hard to know what’s true and what’s just hot air. But medical services are expensive and “hot air” of this sort costs.
This article explains the top 5 secrets every business owner needs to know to reduce their occupational health bill, and, incidentally, usually improves the health of the workforce.
Secret 1: Eliminate Health Hazards
Businesses engage an occupational health service when workers use substances or work in processes that could affect their health and make them ill. The OH service advises an owner, with their expert knowledge of the body, on how to cut down the risks and will do medical checks to make sure there is no harm. But, if you take away, or eliminate, the dangerous substance or process, there is no need for health checks or advice.
You save money by not having to have an occupational health service, management time (from all the medicals, arrangements and discussions that are not needed) and, most importantly, you completely eradicate the health risk.
Look at your workplace and see if there any health risks from the work. Is it dusty, noisy, stressful etc? Listen to your workers – what do they find difficult or uncomfortable? Check with the HSE website or other similar industries.
Are there jobs that need professional medical input, examples include:
- Hearing tests
- Breathing tests
- Skin checks
- Biological tests (for example, blood or urine samples)
- Urine tests
- Fitness for work checks (for example, safety critical workers, divers, drivers, food handlers, teachers, medical workers)
- Vibration white finger
Ways of eliminating the health risk from a managers perspective:
- Outsource the work to specialist contractors, for example, asbestos removal contractors
- Omitting that particular process/work from the work in your business
- Mechanise the process or get robots to do the hazardous part
- Use engineering controls to provide a barrier – if you can keep the hazards away from workers, there is no risk
- Use different methods of work, for example:
Use liquids instead of a powders
Order smaller packs (to cut down the risk of muscle and back strain)
Damp down dusty areas
It is essential that you check any control methods are working throughout the life of the project. Things can go wrong. For chemical substances you can request an annual check of process limits from an industrial hygienist.
It’s critical to remember that Secret 1 is the most effective method of cutting down your occupational health bill. If you eliminate the risk – end of story. No health risk and no occupational health service costs
Secret #2: Control health risks
If you can’t eliminate or substitute the process, you will need to control the health risk to a safe limit, so that there are minimal health issues. How you do this will depend on the hazard/risk.
Ways to consider controlling the risks:
- Enclose the process so there is no escape of the hazardous substance or issue
- Use local exhaust ventilation (dust extraction) to remove the dust or fume before it gets to the worker
- Reduce the time that workers are in close proximity to the hazard
- Information, instruction, training and supervision empowers workers to look after their own health and gives the reasons for doing so.
- Provide personal protective equipment (PPE)such as gloves, masks, work creams, overalls etc
If you fully control the health risk there is no need to engage an OH service for checking your control measures, which is, in effect, what they are doing.
It is essential you check that the control methods are working and you can prove this to your workers and regulatory inspectors.
Secret 2, whilst being useful can incur long term repeating costs (PPE and buying and maintenance of local exhaust ventilation). Plus you haven’t taken away the need for an occupational health service to check workers health. Many of the health surveillance programmes are not sensitive to early changes in workers health and it is difficult to identify individual health problems early on. Health issues can take years to develop so even if the health check is OK one year, there may still be the beginnings of health problems lying in wait (asbestos and radiation effects can take decades to appear).
Statutory medicals such as working with compressed air and lead must have a suitably qualified doctor appointed. Click here for the list of when statutory medicals are required.
Secret #3: Absence Management
Absence from work can be prevented, especially if it’s linked to stress or musculo-skeletal issues, which are the two main reasons for work related absence from work. You also get workers who take the odd day off here and there, well, just because they can. Whether it’s a genuine health issue or fake absence, both instances cause disruption and poor customer service, as well as putting pressure on your other workers who have to step in to cover for the absent person.
Occupational health services are brought in to manage absence because of high absence levels and because many managers are afraid to tackle the issues of personal ill health.
Agree and draft a good absence management policy and set up training for all supervisors dealing with absence. Absence has to be dealt with effectively and consistently across the company – from the first call in from the worker, to say they are sick, to the return to work interview and rehabilitation programme.
Add in the policy about accommodating illness before the worker goes off sick; and if there is a culture of poor attendance – start by telling the workforce that things are going to have to change. Point out how much money is lost and the stress of trying to cope with unplanned absences. Then lay down some ground rules about how absence is going to be dealt with from now on.
There is also the new Fitness for Work service which employers, employees and GP’s can access for free occupational health advice. For more information on this service click here.
The new Fitness for Work service is voluntary – you cannot force a worker to attend the service. Remember too that people who are genuinely sick must stay at home when required and not struggle in to work where they become a liability if they make mistakes or infect others.
Secret #4 Fitness for Work
Employers have duties under law to ensure they look after their workers’ health and safety and those affected by the work they do, that is, the public. You have to consider if workers are fit and able to work. Some come to work when they should be at home resting or carry on working when they are unfit. Occupational health services undertake preplacement medicals and return to work medicals after illness, as part of the employers risk assessment process. But companies can do the preliminary work themselves or at least identify those who actually need a full medical assessment with occupational health.
Not all workers need a full medical before starting work and you don’t need to know every single detail of a worker’s past history in order to screen workers. One way to save time and money, is to send out a pre-screening questionnaire that is linked to the job requirements. This will not ask intrusive medical questions, but a general set of questions, which indicates if a full questionnaire and occupational health assessment is required. By having a pre-screening assessment you will cut down the number of fitness for work assessments, cutting costs and speeding up the process.
The fitness for work test must be specific for each job role and linked to health and safety requirements, as well as assessing capability.
Medical information is classified as sensitive under the Data Protection Act and workers are unlikely to declare health issues to non-medical personnel – nor do they need to under law (unless there is a serious health and safety risk)
Secret #5 Train Up Responsible Persons
Occupational health services undertake many non-medical and administrative tasks during a contract with a business. Here are some examples:
- Setting up appointments
- Typing reports
- Writing to GP’s/Specialists
- Distributing and reviewing questionnaires
- Display screen equipment set up
- Drug and alcohol testing
- Eyesight testing
- Tier 1 and 2 hand arm vibration screening
- Skin inspections
- Wellbeing programmes
- Night worker assessments
- Training on using personal protective equipment
- First aid updates and supplies
- Investigations of health problems
- Asking about work related symptoms, for example, problems with breathing
You don’t need to pay professional occupational health services to do all these tasks – many can be done in house by competent individuals. By using your own staff you can reduce costs, control what happens in your own company, and enrich current worker’s jobs, if they chose to become a responsible person.
I have trained up many First Aiders to undertake skin inspections or monitor a health issue in the workplace. It works really well.
By being aware of what is and isn’t medical – the savvy employer can train up their own staff to do the preliminary work and undertake many of the above tasks. The important thing with using your own staff is that they understand the workplace and are on hand to deal with issues as they arise.
If there are problems identified by the responsible person there must be a means of dealing with issues; which usually involves having an occupational health service available for consultations and advice.
Occupational health services must be competent. The government backs a scheme of accreditation for occupational health services called the Safe Effective Quality Occupational Health Services (SEQOHS).
For a list of all accredited occupational health services click here
By reducing health hazards, cutting down on administration time and training up your own staff as responsible people, all businesses can greatly reduce their occupational health bill, but, more importantly, begin to understand their own health issues and find effective ways of protecting their own workers.
 Use an industrial hygienist for scientific measurement of health hazards.
 Health and Safety at Work Act 1974 – Guidance from the Health and Safety Executive
Do I need a Fork Lift Truck Medical Programme at Work for Managers
How to Look after the ‘Elf in Health and Safety – a book by Jane
Post also published on my LinkedIn pages – October 16th 2015