An employer s Guide to engaging an occupational health physician

Transcription

1 An emplyer s Guide t engaging an ccupatinal health physician When and why d emplyers need the services f ccupatinal physicians? Being in business invlves risk. Business pprtunities are inherently uncertain and need t be assessed and managed. But ther risks are als part f running any business. An imprtant area f risk is arund emplyee health. Such risks can ptentially have a majr impact, whether frm ill health (either related r unrelated t wrk) r frm litigatin, bth civil (alleged negligence, wrk-related damage r failure t cmply with disability discriminatin requirements) and criminal (health & safety ffences). Where a defined benefits pensin scheme fr emplyees is in place (r ther emplyee benefits fr lng term ill health are available) funding needs t be apprpriately managed. Occupatinal physicians are able t help an emplyer significantly reduce the risks and thus assist with ptimising prductivity whilst reducing csts related t health. Hw can they d this? Minimising the impacts f health risks t the business: Identifying the legacy f impairment/disease in new emplyees and establishing at emplyment the baseline f health. Ensuring emplyers are aware f adjustments required t cmply with the Disability Discriminatin Act. Identifying wrk-related disease at the earliest pint, t facilitate early interventin and treatment, enable cst cntainment and avid legal challenge. Advising n preventing/minimising wrk-related illness. Cmplying with health surveillance, and, where required, advising n statutry reprting f wrk-related disease. 1

2 Assessing fitness fr wrk during and after illness/disease nset recmmending adjustments and restrictins (mstly temprary) t reduce absence csts. Training managers t manage attendance, prevent /mitigate physical r mental illness, including stress. What is different abut ccupatinal physicians? When there is a need fr medical supprt in the wrkplace, it is nt sufficient t call in any dctr. Medicine is a very brad discipline; while all practising dctrs have t be n the General Medical Cuncil (GMC) register, being n the register by itself gives n guide t their specialist skills and cmpetencies. Many dctrs wh ffer their services as experts r advisers will nt have had any specialist training in ccupatinal medicine. Mre ften than nt, they will have nly very limited knwledge f the wrkplace and f health issues, assciated with the wrkplace. Dctrs purprting t practise ccupatinal medicine shuld have had further training in ccupatinal medicine. Even then, there are levels f training and, if yu are cnsidering engaging the services f an ccupatinal physician, yu need t be aware f the differences in degrees f expertise. Sme dctrs, fr example general practitiners, will have had sme very basic training. They may have dne the Diplma in Occupatinal Medicine (DOccMed); this shuld enable them t give basic day t day advice and they shuld have sme understanding f the main issues that affect wrk and health. But ccupatinal medicine is nt their main speciality and they wuld have t cnsult specialists n mre cmplex issues, as they have the cmpetence apprpriate t a generalist. Specialists in ccupatinal medicine will have had in depth training and experience in ccupatinal medicine and will be judged t be fully knwledgeable in ccupatinal medicine thery, practice and delivery. They will be Members r Fellws f the Faculty f Occupatinal Medicine and will have the letters MFOM r FFOM after their name. There are sme practitiners wh hld the qualificatin f AFOM (Assciate f the Faculty f Occupatinal Medicine); this qualificatin is being phased ut. Thse wh have the qualificatin have cre knwledge in ccupatinal health but are nt specialists. If a medical practitiner des nt have any f these qualificatins (DOccMed, AFOM, MFOM r FFOM), it is likely that they nly have the minimal training in ccupatinal medicine, which mst, but nt all, dctrs get at medical schl (a few hurs wrth). They d nt have the qualificatins, experience r validatin that wuld enable an emplyer r a wrker t be cnfident f their cmpetency in this field. It shuld be nted that sme f these dctrs may wrk in a cmpany r unit where ccupatinal medicine specialists have versight and clinical respnsibility fr the dctr s wrk. Custmers shuld satisfy themselves that there are arrangements fr the gvernance f the dctr s wrk. 2

3 Even within ccupatinal medicine, there are thse wh specialise in particular areas r types f wrk, fr example, aviatin medicine. Nte: The term specialist has a specific legal meaning in medicine. A dctr can nly call themselves a specialist if they are n the GMC Specialist Register; the register will state the field in which they can call themselves a specialist. N dctr shuld call themselves a cnsultant unless they are n the specialist register in the apprpriate field f medicine. Hw t chse a prvider? Chsing an ccupatinal physician shuld invlve tw main steps: First, be clear abut what tasks need addressing, wh else will be invlved in the wrk and what yu expect the ccupatinal physician t d. The task culd be abut the medical assessment f peple starting wrk r returning t wrk, r pssibly leaving wrk. Yu need t be clear abut nt just the medical assessment but als the legal situatin. Suitably qualified and experienced ccupatinal physicians can bring a wealth f practical knwledge f the brader cntext in which such medical assessments take place, as well as the experience t assess fitness fr wrk. The task culd hwever be abut health and ill health issues in the wrkplace. What are yur ther health and safety advisers already cntributing? What added value d yu expect frm the ccupatinal physician? Occupatinal physicians will be familiar with risk assessment fr health risks in the wrkplace and with the intrductin f necessary cntrls. They will be especially experienced in such things as health and medical surveillance f wrkers, and maintaining health and surveillance recrds. Secnd, having established what cntributin yu want frm the ccupatinal physician, chse an ccupatinal physician t wrk with yu. Yu can d this by seeking tenders, r by direct recruitment. Yu may want t take advice frm ther emplyers in yur field f business. Hwever yu g abut recruiting an ccupatinal physician, be clear n the specific skills and cmpetencies yu want and ensure that thse yu cnsider have thse skills and cmpetencies. Yu may want t engage a firm ffering ccupatinal health supprt. This can bring a range f skills and individual cmpetencies t bear. But des yur need merit this cmprehensive apprach? Alternatively, especially fr narrwly defined tasks, yu may want t engage an individual r small cnsultancy. 3

4 Hw t mnitr delivery and get value fr mney? Occupatinal Health Service Standards have recently been publised Occupatinal Health Service Standards fr Accreditatin (ISBN ), (available at: r in hard cpy frm the Faculty f Occupatinal Medicine). It is recmmended that emplyers shuld use these standards t ensure they are getting the services that will deliver value fr their enterprises. The key standards fr this purpse (nte these are minimum standards and individual businesses might wish t aspire t higher standards) are that the service: has cmpetent persns, as defined by the Management f Health and Safety at Wrk Regulatins 1999, and as required by the custmer s peratins; and the service can demnstrate that their emplyees are up t date (bth in terms f knwledge and prfessinally). has public and emplyers liability and prfessinal insurance/indemnity fr the wrk. maintains ccupatinal health clinical recrds that cmply with the requirements f the Data Prtectin Act and the Health & Safety at Wrk Act (and its regulatins), and prtects the intellectual prperty f clients. has agreed prcesses fr referral and reprting utcmes t the emplyer, the emplyees (and their representatives and GPs) and HSE (when statutry reprting is required), and has a cmmunicated cmplaints prcedure. has access t a specialist ccupatinal physician (see abve fr definitin). has apprpriate facilities (when required fr the wrk, e.g. emplyer has suitable premises) and equipment that is used and maintained t manufacturers specificatins. prvides clear infrmatin n fees. has a prcess fr disclsing all matters that culd reasnably be expected t impair bjectivity r independence in prviding services t the custmer and nly prpses services the custmer needs. ensures they undertake turs f the wrkplace (thrugh peridic visits) t understand the culture, values, and needs based n reliable and recent infrmatin. has a service level agreement t ensure delivery and undertake peridic custmer satisfactin feedback. What prfesssinal limitatins are required f ccupatinal physicians? T remain eligible t practise as a dctr, ccupatinal physicians must: cmply with the requirements f the General Medical Cuncil (GMC) as laid ut in Gd Medical Practice. In essence, this means that they must ensure cnsent by an emplyee t any prcedure they undertake cnsultatin, treatment and/r disclsure. ensure that they maintain the cnfidentiality f any medical infrmatin they hld. This means that while the ccupatinal physician can advise emplyers n, fr example, an individual s fitness t wrk r n pssible ill-health effects, they are nt 4

5 allwed t prvide emplyers with full medical details n the individual, withut their cnsent. undertake cntinuing prfessinal develpment (CPD), audit their clincial practice and subject themselves t annual appraisal (nw a legal requirement t retain a licence t practise as a dctr). Failure t cmply can (in serius circumstances) lead t withdrawal f their rights t practise as a dctr and/r civil litigatin. Occupatinal health physicians are advised by their prfessinal bdy the Faculty f Occupatinal Medicine n hw t cmply specifically with these requirements when wrking fr emplyers. Adherence allws fuller cnfidential emplyee disclsure f health prblems t facilitate rbust advice t emplyers. Faculty f Occupatinal Medicine 6 St Andrews Place Regent s Park Lndn NW1 4LB Updated April