Can you Afford an OH Treatment Service?
A treatment service is like a doctor’s surgery where workers can go to get medical advice, treatments or ask advice about health problems.
When I started out in occupational health (OH) too many years ago, it was in a treatment service at the Ford Motor Company. Fords paid for a 24-hour cover, equipped an emergency ambulance and used a full nursing team to cover everything from accidents, heart attacks, to vaccinations, arc eye, and inserting sutures. It was a full-blown treatment service and much appreciated by the employees. However, it was expensive and over time; it reduced to the basics, and the service went. Too expensive. The company kept a skeleton staff to do the legal requirements of health surveillance, health screening and preplacement medicals but it was difficult explaining the difference to the workers though, who continued to come in for Paracetamol and plasters.
Nowadays, employers wanting to attract and keep staff and are considering whether treatment services should return. Are they appropriate? This article discusses the pros and cons of a treatment service at work.
Often employees go to the doctors for blood pressure checks or to have vaccinations for holidays. If you have a treatment service on site, then often the nurses and doctors will supervise this for you. This isn’t so much an advantage for people that are local but a godsend for those who commute or live away from home, for example, in the construction industry where people live on site and have no access to a regular doctor.
A good example was at the 2012 Olympics in London. There was a massive focus on a worker’s health and safety and a treatment service was part of this.
A treatment service in the UK is private healthcare, paid for by the employer. There is always the National Health Service to fall back on, and our pharmacies who give out advice for free and vaccinations at a reasonable price. But by providing a treatment service, the company shows they value staff and it is a huge perk.
A treatment service is also useful to introduce new workers to the company. Invite them in for a full health check and this is how we value your health and safety here. The health check need have nothing to do with work, such as eyesight or blood pressure, or even to talk about their domestic situations. If they’re feeling stressed, they know where to go to get help.
How much time/staff do you need to run a treatment service? What will come through the door – how many? There may periods of doing nothing and times when the queue snakes around like a fun fair ride.
It was like that in my second OH job; everyone returning to work was asked to come see me before going on the factory floor! I dreaded Monday mornings, they were a nightmare.
There are many interruptions for the OH staff who run a treatment service. You can get over this by offering appointments or session times, but often if it is a treatment service, then you will get called out for any emergency on site and take over from the first aiders. This is great for the workers but the First Aiders lose their skills and they constantly interrupt the OH practitioner. And what happens at night because many treatment services offer an office hours only service?
There is an issue with confidentiality. Staff will come to occupational health and may have health issues caused by work. They may fear that they’re being exposed to some dangerous substance and mention it or they have issues with their team, domestic issues or their Manager may be difficult. Once the worker comes into occupational health, they fall under the umbrella of medical confidentiality, which can get difficult for both the employee and the occupational health person who may be obliged to report this. It has caused me problems in the past.
When I first started out, I had regulars; people who would visit for a chat. Perhaps to give an update on their medical situation where they were in their treatments. What their GP had said to them. Or, the hypochondriac who is forever asking you ‘what do you think this is?’
Managers get annoyed with time wasters and the OH cannot turn them away.
Employed OH professionals are covered under the company insurance and this can raise your premiums. Medical claims are expensive.
Equipment is expensive. And it’s not just on the initial outlay. It all needs calibrating and some need costly peripherals. For example, some dipsticks used with machines are £40 per bottle and go out of date. You require a clinical disposal service to collect biological waste too. And to train the OH staff.
Winter flu vaccinations are difficult. I always work on the premise that 30% of employees will take up the offer but numbers vary, depending on circumstances. And, if you order too many you can’t send back those you haven’t used. Or, if you don’t have enough, it’s too late to order more. We order flu vaccinations in May for use in September. Vaccinations need proper fridges and many services choose oxygen to be available for anaphylaxis. It all adds to the cost of the service.
There may also be a conflict with the local GPs, although usually they’re happy to let the Company do some of their work. There may be times when they are kept in the dark by the employee and that annoys many. Also the employee may go backwards and forwards between the two services; testing and playing each off against the other which does not make for good relations.
Managers have to acknowledge occupational health is a professional service and have some input into risk assessment and health and safety. If all they do is a treatment service, then they will be treated as nurses and not recognised for the talent they have or what you pay them for. Remember, you’re paying for extra qualifications in the OH nurses and doctors and that is expensive and wasted on just providing a bandage and headache service.
Consider too, staff holidays, you will need extra staff to cover your service all year round.
I believe treatment services are unnecessary. We need to empower people to look after themselves and go to the correct places in the NHS and give them time to do it if required. There may be occasions when workers request help such as monitoring blood pressure. Do it, but make sure it’s only for a few weeks. There are blood pressure machines that people can learn to use and in most GP surgery’s there are blood pressure booths. I advise you to regulate any treatment focussed interventions by setting up clinics or giving appointments.
A comprehensive treatment service is expensive. But if your company can afford it, then go for it. But if you do, it will need rules and resources controlled.
If you decide to go with a treatment service, it is a fantastic perk for your employees and workers.
Have you got a treatment service at your company? Tell us your stories…