Hiring Occupational Health Services – Managers Guide

Hiring Occupational Health Services

A Manager’s Guide

Employers have legal duties to protect the health and safety of their employees and to act fairly when dealing with individuals.

To help understand the issues, health professionals are asked to give advice, especially for high risk work or for complex substances or processes. Although the employer is responsible for making employment decisions – occupational health professionals give competent advice to guide an employer through the maze of implications and legal requirements for managing health and protecting workers.

What is Occupational Health?

Occupational health (OH) is defined by the Chartered Institute of Personnel and Development as

“a specialist branch of medicine focusing on health in the workplace that is concerned with the physical and mental wellbeing of employees”.

OH specialists will typically

  • advise on work-related illnesses and accidents
  • carry out medicals for new starters and existing employees and
  • monitor the health of employees.

The opinion of OH specialists can be crucial in determining how to manage a capability issue and supply key evidence in legal cases. But, unlike health and safety at work, occupational health is more than legal compliance. Lately the emphasis has shifted to preventing ill health, improving wellbeing and managing absence.

Proactive (preventative) Health Advice

Some proactive measures include advising on

  • ergonomic issues and workplace design;
  • promoting good health education programmes;
  • promoting healthy eating;
  • monitoring symptoms of work-related stress and providing advice and counselling.

Who Advises Best?

Some organisations employ a full-time nurse or doctor who has training in occupational health with support from other professionals. How many and the type of professional depends on the size of the problem and type of health risks. For example, an employer that operates in a hazardous sector is likely to need more occupational health support than one with just office facilities.

This article takes you through the steps of hiring an Occupational Health service whether for a ‘one of’ health assessment or to have a long-term relationship.

Competency

It is essential that people who advise on workplace health issues such as health surveillance (a legal requirement for some businesses) are competent to do so. The level of competence depends on the tasks they perform.

Make sure that you and your business are clear about what you expect from your occupational health service and what you have to do to make it all work.

Level of Training

When hiring occupational health services consider whether you need Doctors, Nurses or Technicians; and whether you want employees or contractors to manage and run health matters in your organisation.

It is recommended that any OH service has fully qualified and accredited OH services as listed on the SEQOHS website as a first choice; these services are audited for quality, health, safety and effectiveness. If you use other services and individuals it is the employer’s legal duty to check their competence.

The Faculty of Occupational Medicine has produced guidelines for employers – FOM advice on choosing an OH provider/Doctor

Free National Helplines and Websites

If you require further advice regarding Occupational Health or workplace health issues or don’t know where to start. Consider checking out the excellent knowledge bases of the websites mentioned:

What level of Occupational Health support can you afford?

A Flow chart to take you through the process
Flow Chart to Decide

Ask the three questions in the flow chart above.

Occupations with Health Risks

Some health checks need special qualifications or experience such as:

    • divers
    • bus taxi and lorry drivers
    • train drivers and guards
    • offshore workers
    • maritime
    • nuclear industry
    • pilots
    • fitness to practice (teachers and health professionals)
    • high-risk health activities such as lead, asbestos, compressed air, ionising radiation
    • those working with vibrating tools

If in doubt about what level of expertise is required to advise your company when hiring occupational health services – go to the Health and Safety Executive website where you can search by sector or by a health issue.

Health Professional’s Qualifications

Check the competence and registration when hiring occupational health services. Members of the public and employers visit their professional websites for qualifications:

10 Steps for Hiring Occupational Health services

  1. Ask other similar or local organisations who have OH for recommendations of a good service or consider sharing services.
  2. Ask for references from any potential OH service or individual and ask for website access and leaflets. Look at their marketing literature which explains what the OH service does – if you understand their messages the chances are they are mindful of their customers.
  3. Ask for three quotes by setting out your company requirements for an occupational health assessment by telephone or email with your three chosen candidates or services.
  4. Set out any special arrangements that are important to your company, for example, if you have shift personnel, night staff, or home workers you want to be included in any health promotion campaigns.
  5. Ask the OH service about specific issues such as availability for night workers, what happens if the service cancels a clinic on site, is there a dedicated contact for the contract, review dates, suggestions of ways to improve the health of your workforce. Do not be afraid to ask for cost reduction strategies such as price matching or reductions for a longer term contract etc (5 years instead of 3 years).
  6. Agree to the logistics of the health clinics, testing and appointment system to see your workers e.g. time, place, disability access if applicable, any special considerations. Also agree payment arrangements contact details, what happens if, expectations. Also, any special requirements of the occupational health service for example if meeting on sites they would be asking for a confidential room, or in the case of work stress some employees prefer to meet away from work.
  7. Set up a service level agreement if possible setting out all your requirements.
  8. Agree on long-term arrangements and regular meetings/telephone calls to review services.
  9. Complaints procedures – who should you contact if things go wrong
  10. Nominate someone in your company, who understands the contract, health risk assessment and has authority. Without this, your occupational health service and health of employees may suffer.

MUST DO STEPS before you start a new Occupational Health Service

  1. Ask the occupational health service to provide training programmes for managers – the service cannot and will not be successful unless there is real cooperation and understanding of the occupational health role.
  2. Arrange for training for all your supervisory staff to explain the function of the service and take them through the process of filling in a referral form. Ask the new OH service to provide a sample to see or go to blank report that you can use. Be clear on the types of questions that you want occupational health to answer.
  3. Communicate with your employees about the new service and the benefits it will bring to them. Many employees view an appointment with occupational health as a disciplinary measure if there is no understanding of the role that it has.

How Much will I be charged for OH Work?

The current daily rate (Nov 2018) for a professional contracted OH worker would be about:

  • £200 a day for a technician
  • £350 day for a nurse (without the occupational health qualification/previous experience)
  • £500 a day on average for a qualified/experienced occupational health nurse advisor
  • Up to £3000 a day for a senior fully qualified OH physician or Doctor
  • Specialist, niche and expert providers could charge more in any sector
  • Most occupational health providers have a different price range depending on whether the employee is seen on the client site, from a mobile unit or in their corporate offices.
  • Consider also travel time, travel expenses, follow up, parking etc that may be added to the cost of the service
  • You can ask to price match
  • For an in-house service be prepared to pay a salary in the range of £35 – 40K per annum (plus employment costs and ongoing training) depending on location and experience for a nurse practitioner.
  • Generally, OH Doctors are used on a part-time basis to support the OH specialist nurses unless the organisation is large or has specific health issues to deal with.

Geographical Influence

Where in the UK are you working? Prices vary enormously across the country with London being the most expensive area. Also in some areas of the country, there are limited options for specialist work eg hand-arm vibration screening, so charges can be higher.

Size of Company

How big is the OH business because bigger companies have higher overhead costs which will be passed on to you. Individual OH advisers or sole traders can afford to charge less as there are no premises or minimal administrative costs to pass on to the purchaser.

#Top Tip – Single or small OH companies are able to undercut their bigger rivals due to less overhead costs.

Priced by Time or Item

Consider whether to ask for the cost of a health check, for example, an LGV driver medical for £150 (must be signed by a Doctor hence the high charge) or a daily rate. Often the daily or half day rate will be more economical

Retainers

Consider using an annual retainer. Retainers can be set up when occupational health advice is on a case-by-case basis or emergency OH advice may be needed. Clients benefit from preferential treatment and an agreed timescale for you to respond.

Service Level Agreements

The usual way of dealing with the expectations of the client and their workers is to discuss and agree on how your service will work in the preliminary discussions before awarding the contract. Once agreed the service to be provided should be clearly set out in a service level agreement (SLA) or contract which should also contain agreed targets that your service promises to achieve e.g. ‘I will send a report back to management within five working days after a display screen equipment assessment’, or, HR will be responsible for setting up all appointments.

Resources

[1] Adapted from my Book How to Start a Healthy Business: An Insider’s Guide to Occupational Health Success.

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