Occupational Health Service
Holmhurst Medical Centre assists employers and industry by providing a competitively priced consultant led Occupational Health Service. Based in East Surrey, services are provided to industry in South London, Surrey, Sussex and Kent.
Occupational health services, such as those listed below, can help protect business profitability and productivity against expensive problems such as the costs of sickness absence, production loss, poor performance, litigation, insurance, management distraction, overtime, staff turnover, investigation time and loss of key staff.
33 million working days are lost due to occupational ill health each year costing employers at least £11 billion. Increasingly it is being recognised that good health is good business. Occupational Health remains an unexploited source of value and competitive advantage for many firms.
Research shows occupational health services can be very cost effective, reducing the probability, frequency, and hence costs of adverse events at work such as accidents, or ill-health arising though work and causing physical or mental illness.
Service to Add Value
Occupational Medicine includes all areas of medicine. It provides an interface between work and health. Much occupational health work is proactive and assists in:
- Prevention of work related ill health
- Tuning work to maximize output for an individual in the context of his or her medical problems
- Drawing an individual back into the workplace earlier than might otherwise have been expected
- Supporting both the individual and management in health and safety responsibilities
- Improving the overall risk profile of an organization as a result of the above with possible insurance benefits
- Identifying clusters of work related problems
- Identifying areas of work that may contribute to work related ill health
- Improving morale where necessary
- Providing a confidential forum to discuss medical concerns
- Providing a robust second opinion where this is necessary regarding fitness to work
- Advising on the requirements for first aid provision if needed
Available services are listed below:
Pre-employment health screening examines new employees to ensure that they are fit for the job for which they are being recruited and to minimize any risk that the job will adversely affect their health.
Employee recruitment is hugely important to the ongoing success and development of any business. Pre-employment health screening demonstrates an early commitment to the health of employees.
The new recruit benefits by taking part in a confidential medical overview of any health problems in the context of the work undertaken so that potential problems can be identified in advance and possible work adjustments made before problems arise.
The business benefits as a result of:
- Baseline health measurement which is important if an employee subsequently claims that work has caused a health problem
- Compliance with legislation (Equality Act 2010) so that disabilities are identified and reasonable adjustments for the purposes of the Act are instigated in good time
- Reduced risk of sickness absence if appropriate adjustments are put in place for longer term medical problems (although it must be understood that the best predictor of future sickness absence is past sickness absence)
- Reduced risk and cost of litigation by having risk assessments in place and having taken steps to prevent work related ill health
- Reduced staff turnover by enabling those employees with medical problems to work in a safe and adapted environment and thus improve morale - the company cares
- Reduced long term costs e.g. all the hidden costs when things go wrong such as loss of productivity, loss of morale, re-recruiting and replacing staff with consequent skill loss, training new staff etc. etc.
Many pre-employment screens can be undertaken by paper screen but where the case is complex, a medical interview may be recommended. This can occur at Holmhurst Medical Centre, or at the place of work. Having the assessment in the workplace has the added advantage that hazards at work may be more easily identified.
Sickness absence management including rehabilitation, redeployment and ill-health retirement
Health assessments when staff become unwell can assist employers in fulfilling their obligations to their staff. Problems may arise during capability management, or performance management when staff have a medical problem contributing to the situation. Employers can benefit from expert advice in areas such as:
- Fitness for work
- Possible prognosis of a condition including assessment of likely future sickness absence which assists with planning
- Workplace 'reasonable adjustments' that may fulfill the purposes of the Disability Discrimination Act
- Possible rehabilitation packages balancing the needs of the individual and those of the business
- Consideration of redeployment within the business
- Consideration of ill-health retirement where a scheme exists
- Searching for clusters of similar cases which may indicate a need for alteration in work practices and review of risk assessments
- Provision of a robust second opinion can also be useful where there is repeated sickness absence and medical reports already received appear confusing or prejudiced
Return to work assessments
(probably only valuable for long-term sick or where there is a clear cut underlying problem e.g. psychological problems or substance misuse).
Return to work assessments are normally undertaken by management following a spell of sickness absence. Occupational Health may not be able to help in a situation where short-term sickness absence is the main problem. Where it is apparent to a manager that the underlying problem relates to possible problems with an individual's well-being e.g. depression, substance or alcohol misuse, or social difficulties such as caring for an aged relative or child, then in those circumstances, Occupational Health may be a valuable resource in assisting a company with:
- welfare policy planning
- providing clear advice to management regarding welfare depending on company requirements and current health and safety legislation.
Where you decide you would like a medical opinion, you can expect the advice given to cover the areas set out in Sickness absence management above, in addition to specific advice relating to any policies you hold in relation to alcohol and substance misuse, or general welfare.
Assistance with Risk assessments
Hazards present in the workplace may be loosely grouped into:
- Physical hazards e.g. heat, cold, noise, vibration, ionising or non-ionising radiation etc.
- Ergonomic hazards e.g. manual handling, use of equipment, display screens, working space etc.
- Psychological hazards e.g. shift work, target driven work, bullying and harassment, interpersonal problems etc.
- Chemical hazards as part of COSHH
- Biological hazards as part of COSHH
Risk assessment is normally the responsibility of the employer; however, Holmhurst Medical Centre Occupational Health Service can provide help and support in considering the medical implications of any hazard exposure of whatever nature for an individual employer.
Holmhurst Medical Centre Occupational Health Service utilizes a fully trained and experienced ergonomist who is able to provide expert advice in Manual Handling, and the Display Screen Regulations in addition to several other areas of day-to-day work.
Night worker medical assessments
Staff who work nights are entitled to a medical assessment to ensure there is no likelihood of night work interfering with any underlying medical condition. This is mostly a paper-based exercise and inexpensive. Occasionally in complex cases a face to face medical is required.
The Working Time Regulations 1999 provide workers with certain entitlements including the right for night workers to be offered free and confidential health assessments before starting work, on a regular basis, or as appropriate to the individual.
The regulations define night time as the period between 11pm and 6am, and a night worker as someone who normally works at least three hours a night on a regular basis. Occasional work at night does not constitute a night worker.
Certain conditions may be exacerbated by night work including gastrointestinal complaints, diabetes, asthma, epilepsy, certain cardiovascular diseases, those on complex medication regimes and psychological problems including sleeping problems. Pregnancy required its own risk assessment and is a special consideration for night work. Please seehttps://www.gov.uk/working-when-pregnant-your-rights
Further information is available at: http://www.direct.gov.uk
Investigation and management of work-related ill health where appropriate
Businesses need help and support when considering possible work related ill health. Not only is there a requirement to provide a safe place of work by appropriate risk assessment, controlling the risks, and ensuring staff are trained in the risks and their controls, but any illness that may have arisen in the course of work needs to be properly investigated to ensure that work has not caused the illness.
Such cases may demonstrate a failure in safety mechanisms, or even a new problem not previously foreseen. As an occupational physician, I can help in this situation and in advising on other obligations including reporting of work related ill health under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR).
Careful management of this sensitive problem can reduce the likelihood of litigation and thus save enormous amounts of valuable time, while helping keep staff morale high.
The Management of Health and Safety at Work Regulations and the Control of Substances Hazardous to Health Regulations (COSHH) require an employer to provide health surveillance for their staff. This depends upon the outcome of the risk assessment, which may demonstrate the likelihood that an exposure known to cause harm to humans is present in the workplace and that the exposure is at a level likely to affect health. This health surveillance is mandatory.
There are other specific situations where this is necessary including working with:
- Ionising Radiation
In these circumstances, health surveillance is statutory and must be undertaken by an Appointed Doctor.
The need for Health Surveillance can be discussed on an individual basis. The following link provides further advice from the Health and Safety Executive: www.hse.gov.uk/pubns/indg304.pdf
Health, safety and welfare
The Health and Safety Executive have produced a useful document summarizing the requirements for a workplace in terms of Health, Safety and Welfare at www.hse.gov.uk/pubns/indg244.pdf
In addition to these considerations, an employer may wish to consider purchasing other welfare provisions for their workplace including:
- Influenza vaccination
- A welfare policy in the management of Drugs and Alcohol in the workplace
- Preparation for Pandemic influenza
Central to good welfare is a robust Sickness Absence Policy and Holmhurst Medical Centre can assist in setting up workable policies in these areas.
These programs can range from improving general fitness of individuals including examining lifestyle factors such as exercise, diet, obesity management, smoking cessation programs and safe alcohol intake with tailored advice on specific medical problems, through to full executive medicals including investigation of changeable risk factors such as cholesterol, blood pressure, kidney disease and screening for diabetes.
Studies have shown that providing workers with influenza vaccination is effective and likely to save costs.
First aid provision
Employers have obligations under The Health and Safety (First-Aid) Regulations 1981 to provide First Aid at work. What is actually delivered depends on the size of the organization, the nature of the work and the hazards in the workplace. As usual, this follows from an adequate risk assessment of the need for First Aid.
There are rules regarding training of first aiders who must be registered, in addition to provision of appointed persons who may be able to provide basic care in a lower risk situation.
Holmhurst Medical Centre can help in advising on the minimum levels of first aid that may be needed in a given situation.
Ian King is a Consultant in Occupational Medicine with experience in healthcare, having previously directed the occupational health department at St George's Hospital, London. He is the clinical lead in Occupational Health at Croydon University Hospital where he works as a consultant in occupational medicine.
He also has considerable experience in occupational medicine in higher education, local government, finance, pharmaceuticals, and metal working.
Holmhurst Medical Centre provides state of the art facilities in addition to ample parking.
Fees are charged out on either a cost per item basis or on the basis of a negotiated contract of service provided by Holmhurst Medical Centre.
Discussion of needs and individual quotations may be provided without obligation.