This week I had a question on my website about the pros and cons of having an occupational health service. I wasn’t sure if a person searching on my site would be able to pick up the information quickly so I’ve chosen this as my latest blog post.
So here is my take on the pros and cons of having an OH service.
Pro’s Of Having an Occupational Health Service
Of course, I would advocate an occupational health service. Otherwise, I would be doing myself out of a job, but let me look rationally at this question from an organisation’s point of view. Here are the main issues a Manager should consider.
The overriding reason for companies to engage an occupational health service is to protect workers, and for legal reasons. There is health and safety legislation which specifies the need for health checking, such as, the Control of Substances Hazardous to Health Regulations and the Control of Noise at Work Regulations where health surveillance is clearly set out. However, no law stipulates an OH service per se. So when would think about engaging one?
a. High-Risk Work
Work with high-risk compounds or processes such as asbestos, lead and compressed air can severely affect workers; so the law says workers must have statutory medical checks. These checks can be through an OH service or by other means such as a local doctor or an HSE appointed Doctor
b. Health Surveillance
If you use a substance or process where health checks might be needed (dependent on risk assessment), such as, excessive noise, or chemicals, you may need an occupational health service. If you’re not sure if this applies to you, visit the HSE website pages on health surveillance
Currently, the law says that anyone with a long-term health issue may fall under the Equality Act; in which case the employer has to make certain concessions. Although a health professional cannot make the concessions, they would be able to recommend if a worker is likely to be covered by the Act. For more advice about disability at work, read the Government guidance
Fitness for work is important too, not only for the worker but also for an organisation. For example, construction workers have to climb scaffolding or work with earth moving equipment. These workers usually need a higher level of medical fitness than say somebody who works in an office. Occupational health services offer these checks, tailored to suit your workplace.
Some categories of workers too, such as train drivers and guards, must, by law, have medical clearance before starting work.
3. Product related
An occupational health service can give instant access to medical professionals; you do not have to wait for NHS GP or Specialists. One area where this is particularly important is when the product you make or supervise, is affected by the health of your employees. Here are two examples:
a. Food handlers
Those who process food can have problems that may affect the quality or the integrity of the food. Food poisoning is a serious issue, especially for those who have been abroad and those who have an underlying illness such as diarrhoea and vomiting. Bugs can get into the food and passed on to customers. For food producers or processors, an outbreak of food contamination can result in serious penalties.
b. Health Care Workers
You wouldn’t want to go into hospital and catch something nasty, would you? Diseases such as Hepatitis B or HIV? In these examples the vaccination status of each worker is important. OH services can check this (and other diseases) and arrange vaccinations if needed; or recommend limited work for the health care worker, so as to protect vulnerable patients.
People taking off time sick fraudulently is costly and disruptive for any organisation. Medical professionals challenge those who are regularly off sick and decide whether there is a valid reason or whether they are just playing the system. They report their findings back to the Manager in the form of recommendations. Once you have advice, you can either make provisions for their illness or take disciplinary action.
You can start your own well-being programs tailored to your workforce; such as, if you have call centre staff they are usually young and, in my experience, tend to smoke and drink more than other work groups. By raising awareness of binge drinking and smoke related lung diseases such as COPD you may be able to influence their health behaviours, thus protecting their long-term health.
You may also incidentally improve their attendance.
6. Best practice
If you wanted to improve the PR of your company and attract more employees, having an occupational health service is a great work perk. Your organisation could ease the burden on the local NHS service too.
Con’s of Having an Occupational Health Service
a. Medical staff
Medical staff, because of their extended training and ability are an expensive commodity. Doctors are more expensive than nurses, and nurses more expensive than technicians.
In-house medical staff need specialist insurance and regular continuing professional development and ongoing training which is costly. Also, occupational health is a specialist qualification for both doctors and nurses, and there is a shortage in both areas, meaning that the cost is usually higher than other professional medical groups.
b. Time off work
You must allow time off work for employees to attend an occupational health appointment and reviews; maybe even referrals to specialists.
Equipment here covers any cost of medical equipment such as lung function testing or perhaps an audio booth on site. Not only do you have to pay for the equipment if it’s an in-house service but regular maintenance checks and peripherals as well. If you engage an external OH or visiting service, the cost is included in the contract, but in this case, there is the inconvenience of having to set up equipment each time it’s used, with problems of transport and clinic rooms to use.
In order to have an efficient and effective occupational health service you want to train managers, HR, Trade Unions and employees on what they can and can’t do through your OH service. Without the training, an OH service is often perceived as dysfunctional.
You will also need to write policies and procedure’s for your company, covering the main points of referral, health surveillance and management actions.
When an employees talk to occupational health the information they share comes under the umbrella of medical in confidence. Managers are then in the dark about the real reason for a person’s absence. However, if you didn’t have an occupational health service, the employee would’ve probably shared everything with you and you would have a full picture of what’s going on. Some Managers find the confidentiality aspects of an OH service to be obstructive to their management of a worker.
Waiting for things to happen in occupational health can sometimes take a while. This is especially true when waiting for letters from GPs or specialist or perhaps trying to arrange appointments with reluctant employees.
You also have to add in how often OH services visit your site, time for reports to arrive, what to do when you receive a report and if you can carry out the changes. Without an occupational health service, a manager would do what s/he perceived as necessary. The manager is in control and can act when they want. Much simpler.
One way to control time-wasting is to set up a service level agreement with timeframes specified; such as ‘we will give an appointment to an employee within five working days of receiving the request’.
Click here for a simple example of a service level agreement
But bear in mind that some things will be outside of the OH service’s control, for example, the results from a drug and alcohol testing laboratory or specialist reports from an individual’s NHS doctor.
You need to decide the type of service for your organisation; whether it’s all singing all dancing, like a GP practice where your workers make appointments for themselves, or just the bare minimum service, to comply with the law.There are sometimes boundary issues between on-site departments such as HR and safety. Everyone needs to understand their roles so there is no confusion.
To minimise any problems, responsibilities must be set out in both policy documents and during training programmes.
Without boundaries for your service, workers and manager can become confused about the role of OH within the company.
7. Loss of Control
Once occupational health is involved with an employee, the Manager is relying on the recommendations to be workable and pragmatic. If they aren’t then Managers and OH professionals should confer. Without this last step, you will have raised expectations of the employee and wasted the referral process. Managers can often be seen as obstructive too.
This is a controversial issue, but, if an OH service monitors health over time, it stands to reason that any deterioration is on record and, the loss of health has happened in your company. This opens up the possibility of liability in law (although health issues can take years to develop), and evidence of lack of health controls. Worker’s can use the evidence for compensation claims.
If you have an occupational health service and then ignore their recommendations or refuse to refer a worker to the service, you will be in a difficult situation if the case goes to court or arbitration. Once you have an OH service and policy and procedure it will be important to carefully consider their recommendations before rejecting them. You can, however, argue that the recommendations did not meet your organisational needs.
So, have you made a decision? Which points are important to your organisation?
The pro’s and con’s mentioned here, do not apply to all organisations, some industries are more high risk than others. Also, there may be other factors to consider, such as size, place, spread and manager competence; plus the risk to the workers and the control measures already in place.
I hope this article helps you make the important decision, not just for you as the Manager but also for your workers and their long-term health.
Want to know more?
Read my book The Manager’s Ultimate Guide to Health and Wellbeing where I cover many work health issues in greater detail with legal references and how an OH service can help.
Or watch the video here: