The Future of Occupational Health/Medicine

I read the article by Mandy Murphy, Occupational Health: A speciality worth fighting for? (Sept 2019). Mandy tells us that numbers entering occupational health (OH) and medicine (OM) are falling and many are over age 53.

She suggest OH/OM is a speciality and whether we are trying to do too much. Have we thrown the baby out with the bathwater and confused everyone? I agree with her view. We must tell our current employers what we can and should do – how we add value.


Mandy tells us occupational health needs about 47,000 professionals to support the health needs of the working population of the future. But that trainees in occupational medicine have fallen by 62% since 2005. I researched this further and see figures from the Royal College of Nursing (RCN)  – show UK nurses and midwives joining the register for the first time is down 2,034. Registrations to work in the UK have also fallen 2,385.

a crystal ball to see the future of ohRevalidation

Mandy writes how revalidation is the reason many nurses have given up being a nurse. I resonate with this. That is me. It was why I decided not to re-validate. I do little clinical work and I could get the same jobs with continuing professional development (CPD) and revalidation through my safety professional body, IOSH. If I wanted to keep dual registration, I would have to pay double fees and do the same CPD although in a different format. One hoop too high for me to jump.

And do not get me started on having someone senior to sign off my revalidation – we all know it is a load of baloney. Even more so with me working in the private sector and at the height of my professional tree. Who is going to choose someone likely to not sign them competent? Also I kept a PREPP diary for years which was a total waste of time. The only time I ever looked at it was every 2 years when I put my certificates of learning in order and wrote a short reflective piece.  But I needn’t have bothered. What a fiasco. Will revalidation go the same way?


Mandy gives great suggestions on how to improve the numbers and interventions of OH professionals including using technology, teams, apprenticeships, alternative learning methods and disruption to the old methods. It might work. But with Brexit and University fees so high – the future does not bright.

My Solution

If we want to be truly disruptive, we need to throw occupational health and medicine up in the air and think again. Let’s take it away from doctors and nurses. Let’s give it back to the managers and business owners, they are already there. They take the blame and have the responsibility in law.

They may point to the Health and Safety professionals who they already employ. But few deal with health. We  need to take that moniker out of the their titles unless they have earned it via the new national programme we will construct.

I should like to see a mandatory framework in place for each company to have access to a trained person in workplace health. Just as we mandate First Aid. The numbers of people made ill by their work make it an absolute necessity. We cannot limp along the way we are, with only the super-rich companies able to afford the diminishing commodity of OH professionals. This new provision won’t necessarily come from a doctor or a nurse. They will run the courses, advising, visiting and mentoring. Overseeing the whole programme.


As Mandy hints; the situation is dire. But it is not the OH and OM professionals we should worry about. We must be selfless and think of workers who continue to suffer work related ill health. If we are all concerned about the health of workers and we know there is not enough love to go round, we need drastic action and now. We need to lobby and make the case. I agree with Mandy. OH must evolve or die. My suggestion of a mandated programme would be truly disruptive and radical. The wise must empower the masses at company level and all companies, the SME’s, the hairdressers, construction. Not just the few who decide they can afford it. This is the viable future of occupational health and medicine.

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