How to improve occupational health in your organisation
SHP meets Charles Alberts, Head of Health Management at Aon, to discuss why occupational health matters and how professionals can improve it in their company.
In your opinion, are British firms giving enough resources and importance to occupational health (OH)?
Charles Alberts (CA): “It’s surprising that not all employers procure occupational health (OH) services. According to Aon’s 2018 Benefits and Trends survey, 96% of employers agree that they have a responsibility to influence employee health, yet only 65% access Occupational Health services. Survey results are dependent on the audience – according to figures from the Society of Occupational Medicine a mere 30% of the UK population have access to OH advice and assessment.
“At its core, OH advises an employer on the impact work has on employee health, and the impact employee health has on their ability to work. It helps employers to monitor and manage risks to health through health surveillance, and provides rehabilitation and return to work strategies, including adjustments for people with health problems or disabilities. Ultimately, OH helps to protect people’s health at work through creating healthier workplaces, minimising sickness absence and improving performance.
“Employers have a legal responsibility under the Health & Safety at Work Act 1974 to protect the ‘health, safety and welfare’ of all their employees. Occupational Health services help employers to meet their obligations, and minimises the risk of litigation. It’s perhaps for this reason that OH tends to be more prevalent in larger organisations and those with very specific health and safety obligations.
“But we believe that there is an opportunity for employers to gain more value from OH – shifting the focus from a reactive risk-based relationship to a more proactive approach that aims to prevent ill health in the first place. The value of OH is far wider than is often realised.”
What sort of benefits could occupational health programmes bring them?
CA: “Research indicates that employers procure OH services for three main reasons:
- Financial (i.e. to reduce costs);
- Legal (health and safety law compliance); and
- Moral (the responsible thing to do).
“OH helps employers to prevent employees being absent due to health reasons through enabling early intervention and support for employees to recover from illness while at work. OH also helps employers to protect people from harm in the workplace, avoiding litigation and improving their corporate image. Using OH proactively can help to enhance employee wellbeing, preventing health issues from occurring in the first place.
“It’s a win-win; employees benefit from improved health, greater protection against work-related illness, and being at work means they can maintain their earnings and quality of life.”
Are there still a lot of misconceptions about occupational health, and if so what are they?
CA: “There are numerous misconceptions about OH from both the employer and employee, and those involved in procuring OH services on behalf of organisations.
“Employees may be concerned that a referral for an OH assessment means that their employer is trying to get rid of them, and that the provider is trying to catch them out. To address this it’s vitally important that the employer openly discusses the reason for the referral with the employee. Many OH providers also offer printed or video guides for employees to explain what will happen during the assessment, which can also help to alleviate any concerns.
“Employers may fear that the OH provider isn’t truly objective, and will ‘side with the employee’, perhaps making recommendations that are impractical for the business to accommodate, and/or only reflecting the employee’s views. It’s for this reason employers should carefully draft their referral, making sure they are clear about what they are looking for the OH provider to advise on, and provide relevant supporting information such as absence records and the employee’s job description.
“Another misconception is that OH is a clinical service to diagnose conditions and provide treatment. Whilst the employee will usually be assessed by a nurse or physician, and they are able to signpost or refer to treatment, OH is primarily an advisory role and does not replace the GP or specialist. OH can help to interpret medical information from treating clinicians for the employer, but do not provide any medical treatment.
“There is still a view amongst some employers and procurers of services that OH assessments have to be conducted in-person by a physician. The best practice contemporary approach is for the OH provider to review each referral and to decide whether the assessment is best conducted by a nurse or physician, and whether remotely or in person.
“The majority of assessments now tend to be conducted by a nurse over the phone or via video, which is both more cost-effective for the employer, and more convenient for the employee. It tends to be only the trickier or more complex cases (such as when multiple conditions are involved) that need to be assessed by a physician and naturally where functional capability needs to be assessed this is best done in person.
“I would caution against a fixation on price in OH. Whilst costs differ between OH providers, so does service levels, systems, processes, clinical quality, capability, and outcomes to name a few. It is therefore important for those procuring OH services to conduct a thorough review to understand the differences between providers and reach decisions on the total value delivered. No two providers are exactly the same, and purchasing OH on price alone could be a costly mistake.”
Do companies need to think beyond the traditional definitions of occupational health and take a more ‘holistic’ approach and include elements in other areas of their organisation as well?
CA: “When we consider that OH providers are specialists in health and work, it’s only logical to engage them more proactively to help prevent illness and absence. Many OH provides now provide services such as health promotion events, flu vaccinations, workstation assessments and pre-placement medical assessments – these and similar preventative services remain under-utilised by employers.
“For organisations where a number of different providers have a stake in the health and wellbeing of employees (such as Private Medical Insurance), there is benefit in employers bringing their providers together on a regular basis to discuss how they can work more closely together, improve pathways for patients, share trends that they each see in their data, and discuss ways to tackle health risks.”
What are your top tips for improving occupational health in an organisation?
CA: “Our top tips for improving OH in an organisation:
- Invest time and energy to find the provider that is the best fit.
- Consider the overall value the provider delivers; avoid focusing purely on price.
- Build a close relationship with your OH provider, take time to understand the breadth of their service offering, and reach out to them to discuss how they may be able to support you with particular employee health issues
- Provide training to line managers to understand what OH is and how to get the most out of it.
- Engage with employees being referred to OH, giving you an opportunity to dispel any myths, and turn it into an opportunity demonstrate a caring and supportive approach.
- Use OH proactively – refer employees for an assessment whilst they are still at work, with the aim to keep them at work.
- Remember that in OH it is often true that you get out what you put in. Carefully craft the referral, make sure all relevant supporting information is included, and be clear on what you would like the provider to answer.
- Involve OH in your health and wellbeing strategy, and use their data to inform your wellbeing interventions.
- Invite your OH provider to join meetings with your other health-related providers (such as EAPs), and use this opportunity to identify how they can work more closely together.
- Use OH as a preventative measure to protect employees against hazards the workplace poses to their health. Don’t dismiss contemporary hazards such as work-related stress, which has risen in prominence and is not exclusive to professional services organisations.”
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