Worries for Occupational Health Professionals in 2013
Whether working for yourself or as part of a bigger company Occupational Health professionals should keep an eye on the horizon and be aware of how business is evolving and changing. The world of work and priorities are changing but still there is the pressure of the bottom line influencing company decisions. Many indirect services such as HR and marketing functions once employed by the bigger employers have been dropped in an effort to cut down overhead costs and produce bigger profits. Internal Occupational Health services are under a constant threat of being abandoned as management and priorities change in these austere times, yet there are other threats that need to be considered if you are an occupational health professional – whether doctor, nurse or technician.
Here is my list of worries for Occupational Health Professionals and services in the coming year:
1. Government Initiatives
New initiative to refer individuals to an independent OH provider in 2014
The government in its response to Dame Carol Blacks report click here for details has said that it will provide a free referral service to business for anyone who has been off sick for more than 4 weeks.
The report says:
The establishment of a health and work assessment and advisory service to make occupational health advice more readily available to employers and employees, so they can better manage sickness absence. The new service will be delivered in 2014 and include (amongst other things) case management for those employees with complex needs who require ongoing support to enable their return to work.
The report points out that as only one in 10 small employers provided employees with access to occupational health services compared with eight in 10 large employers this is good news for small employers, however how will this new service impact on the large companies who already have absence managed by Occupational Health professionals already? If I were a large employer I would prefer to use a free service rather than pay for my own with associated costs such as training, education etc. Already employers are keen to seek this expert advice. This may make the decision to ‘lose’ in house or contracted Occupational Health service sooner rather than later as companies who already have OH advice will be expected to use their own service rather than use the new absence service.
How this new service will take shape is difficult to predict but once stated it will happen presumably. I would think that the larger Occupational Health consultancy services are already considering how to build their cases for being awarded the contract, destined to be worth in the region of £50 million per year. But what of the those already providing this service are there continguency plans for a loss of this business in 2014. If there isn’t then there needs to be some serious digging of head out of the sand to face the issues that may be looming.
Restructuring of NHS
The restructuring of the NHS has been the largest upset to the NHS for years with many not understanding the new powers of purchasing by GP’s. If you don’t understand how it all works now click here to use an interactive map on the new structure. These changes need to be understood. Some years ago I was pitching for a contract at a large company in Wales and the subject of prescription charges came up – I commented that the current prescription rate had recently risen to which the audience pointed out that in Wales prescription charges had been abolished. Needless to say this was one of the reasons I believe we lost the contract.
Occupational Health professionals need to keep up with changes in the country and locally to be seen as adding value.
2. Accreditation with Safe Effective Quality Occupational Health Services (SEQOHS)
In order to be considered for large government contracts and for the bigger OH companies including those in the National Health Service; the gold standard nowadays is to be accredited by SEQOHS which is an organisation set up in late 2010 to oversee high quality Occupational Health practice. Being a SEQOHS assessor myself I welcome the new standards and suggest that this mark of quality is adopted if you want to move into the larger OH markets.
Accreditation with SEQOHS is definitely on the cards this year if not already achieved. Looking at the list of accredited occupational health companies I note that there are 97 to date (July 2013). Costs for the accreditation are published on the website here. However, very few single handed practitioners on the list. And this may be due to the cost and effort needed to actually become accredited. Will this change in the coming year – we need to watch the SEQOHS website for proof of this. But this must be a one of the worries for Occupational Health professionals who may be struggling to survive.
3. Legal action
The number of people actually receiving awards for work-related injuries or diseases is down from 219,183 in 2000/01 to 87,655 in 2011/12.
The report in the online Guardian reports that government figures, published in the health and safety journal Hazards, show that even the families of those dying from occupational diseases have little chance of securing a pay-out. For most occupational cancers, the odds of getting any compensation pay-out are less than one in 50.
So, far from spiralling upwards, these statistics show a broad decline across a range of claims.
Recession and cut backs
RT reports that Britain has been much slower to recover from the global financial crisis than most large economies, such as the US, Canada, and Germany who have all managed to go back to their pre-recession economic levels. According to the National Institute of Economic and Social Research, the UK’s longest peacetime economic slump since 1920 has been plagued by high inflation, weak eurozone demand, and austerity measures.
Britain’s economy re-entered recession in 2012, the first double-dip recession since 1975.
National currency also suffered a knockout during the recession. Over the past 30 years the British pound’s value has fallen by almost two thirds, according to a survey by Lloyds TSB Private Banking.
UK unemployment rose to 2.56 million in April, the Office for National Statistics revealed, while 70,000 people lost their jobs and ‘went on the dole’ between December and February 2013.
With this outlook many businesses are looking to cut overhead and indirect costs which means that Occupational Health services are in the firing line. Although this may be scary for internal OH business as the services are put out to tender, larger contract Occupational Health services can offer cost effective alternatives, that deal with statutory health and medical surveillance programmes and health risk assessment processes.
Globalisation and the changing world of work
In the past, globalisation has often been seen as a more or less economic process. Nowadays, it is increasingly perceived as a more comprehensive phenomenon that is shaped by a multitude of factors and events that are quickly changing our society. It has created more opportunities for economic development, but it has also intensified competition and increased economic pressure, resulting in companies restructuring and downsizing and business activities being outsourced and offshored. The consequences for workers include job insecurity and work intensification.
Restructuring — company reorganisation, closures, mergers and acquisitions, downsizing, outsourcing, relocation, etc. — is necessary if companies are to remain competitive. . In operation since 2002, the European Restructuring Monitor (ERM) recorded over 14,000 cases of large scale individual company or organisation restructuring from 2002 to mid-2012 (Eurofound 2012).
Already before the crisis restructuring had become a permanent structural component of the economy. In this difficult context of the economic crisis, anticipating, managing, limiting and cushioning job losses, however they are caused (from mass redundancies following the closure of large companies to sporadic lay-offs in SMEs and the termination of contracts of casual workers), is increasingly challenging.
Transfer of undertakings (TUPE)
The Transfer of Undertakings (Protection of Employment) Regulations 2006 apply to what are known as ‘relevant transfers’ which may occur in a wide range of situations many of which are mentioned in the changing world of work (see above). The two broad categories where TUPE can occur are business transfers and service provisions changes; in this peripheral staff such as occupational health professionals have found themselves confronted by this jolly sounding process – but which turns out to be anything but.
The TUPE regulations apply if there is a transfer of an economic entity that retains its identity (such as an occupational health service). To decide if there is a stable economic entity that is capable of being transferred, the factors to consider include:
- Is the type of business being conducted by the transferee (incoming business’s) the same as the transferor’s (outgoing business)?
- Has there been a transfer of buildings and moveable property (although this is not essential)?
- What is the value of the assets at the time of the transfer?
- Have the majority of employees been taken over by the new employer?
- Have the customers been transferred?
- Is there a high degree of similarity between the activities carried on before and after the transfer?
Service provision changes
A ‘service provision change’ occurs when a client who engages a contractor to do work on its behalf is either:
- reassigning such a contract (whether by contracting out, outsourcing or re-tendering), or
- bringing the work ‘in-house’ (where a contract ends with the service being performed in-house by the client themselves).
It will not be a service provision change if:
- the contract is wholly or mainly for the supply of goods for the client’s use, or
- the activities are carried out in connection with a single specific event or a task of short-term duration.
Being taken over by another Occupational Health service can be traumatic; one day you are working happily away in your job and the next it is sprung on you that you are being ‘moved’ to another company. Individual’s should consult with trade union representatives prior to any agreement and try to negotiate with the incoming provider for perhaps better conditions than that which is offered. For help and advice on TUPE click here
5. Demographic changes
The European Agency for Safety and Work at Health reports in 2013 tells us that the European Union (EU)’s population is becoming older: the number of people aged 60 and over in the EU is now increasing by more than 2 million every year. The working population is also ageing, as the proportion of older workers in employment increases in comparison with the numbers of younger workers. In the 27 Member States of the EU, the 55- to 64-year-old working-age population is expected to increase by about 16 % between 2010 and 2030.
Policies that address the ageing of the population and its workforce focus on enabling older workers to remain active and productive for longer.
Given current policy directions, which are focused on preventing premature retirement and prolonging workforce participation, identifying the factors affecting retirement decisions becomes crucial. Research on the employability of older workers has identified that the low participation of older people in the labour market is the result of a combination of wage conditions, rigidity in workplace organisation, inadequate skills and competencies and poor health status, rather than the wish to retire early.
Several studies acknowledge that more research is needed into how workplaces should be designed and work organised to meet the needs of older workers. Further research is also needed on the effects of specific workplace exposures on the trajectory of normal ageing. Workplace interventions targeted at older workers, including improving work organisation, training and workplace accommodations, deserve the highest level of attention.
Until then Occupational Health professionals may be used to screen older workers on fitness for work which, in the light of the Equality Act, becomes more difficult to accurately predict.
6. Technological changes
Keeping up to date
Technology has been cited my many health observers as being the single most important change in the way that health is being dealt with. Everyday new headlines come out with ways of dealing with health. Also patients now have the opportunity to look on the internet or download apps which provide monitoring and advice for all sorts of health issues. Or they come with information gleaned from dodgy websites promoting strange cures and medical aids. How is the OH person supposed to counter this advice without first looking for the source of the article. Information overload on what is good and what is bad is difficult to keep up with. Although access to health information is now mostly universal it is proving a challenge to occupational health professionals who have to counter the opinion with reasoned arguments that will point out flaws in the choices without alienating the client.
One such argument is the most recent report on salt in the diet reported in June 13, this is now under debate – for years it has been limited and now the US are thinking of changing this restriction citing that too little salt can cause just as many problems although some argue that the research is flawed.
Talking about this with a colleague we both agreed that we had better stick to the old rules until we are sure that the new research is supported by the health professionals world wide.
Technology and Communications
Also, is it time to learn a bit more about technology? Those wanting to keep up with contemporary health discussions must learn to read, take in and reflect on this and have this in their action plan for keeping up or be labelled a dinosaur. I recently sent an email to a friend via Facebook who told me she could not understand how this worked and was afraid it would be detrimental to her and possibly unethical to reply via Facebook although I was asking her about how she was? I admit to being rather taken aback by this approach to social media which is here to stay and needs to be harnessed if occupational health professionals are to be seen as relevant in business today.
My advice for single and inhouse occupational health professionals in 2013 is to start looking at keeping up to date, scanning the horizon for changes in your contract or companies and learn to use technology, all the time making yourself indispensable and adding value to those who pay your wages. But most importantly if you are just providing absence management services to companies either start working on winning the contract for the new service or consider adding other services to your portfolio.
Aug 6th 2013
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