This is the best way forward for all the employees

Committed to Health PDO Chief Medical Officer Dr. Sulaiman Al Rawahi, MD, MSc(OH), MSc(DM),FFOM(I) PDO Chief Medical Officer

We can provide better employee Welfare Remain a challenge in PDO concession area, mostly in contracting workforce population which has increased significantly to over 55,000. Of many of employees with known chronic medical conditions, no appropriate follow up. Health risk factors, Life style issues, employees denial of medical problems and ignorance of medical advice. Issues with return to work following significant illnesses. Inappropriate medical facilities in some locations or rigs e.g. MER issues including competence of Contractors’ doctors and nurses, shortage of drugs and MER equipments. Recent observed incidents of suicides. Investigations often not conclusive with difficulties in conducting autopsy in many cases.

Non Accidental Death - Challenges

The main factors to NADs Challenge Causes 1 Pre-existing conditions HTN, Diabetes, High cholesterol level 2 Individual behaviors and life style issues Lack of exercise, Heavy smoking, Over eating, obesity, etc. 3 Attitude, culture and beliefs issues Bad beliefs, Fears, Ignorance of medical advice and denial. 4 Non-compliance with FTW Standards and medical surveillance Issue of appropriate exams. 5 Issues with return to work medicals Ignorance v/s fear of losing job 6 Occasional no follow up of cases with chronic medical problems. Inappropriate follow up and care of chronic medical conditions

Rate of NADs expressed against Man-hours Total manhours (mln.) rate/mln hours 1998 15 59.31 0.253 1999 13 52.81 0.256 2000 10 51.62 0.194 2001 8 48.47 0.165 2002 53.39 0.150 2003 11 60.87 0.181 2004 67.21 0.119 2005 64.26 0.171 2006 18 78.84 0.228 2007 99.62 0.151 2008 21 127.06 2009 17 147.07 0.116 2010 16 147.93 0.108 2011 141.24 0.092 2012 7 149.15 0.047 2013 9 158.49 0.057

Background Following external and internal medical services review, and the investigation of several NADs and other medical emergency responses, the decision was made to centralized contractor provision of medical services in each hub to better serve the workforce and deliver a coordinated Medical emergency response. This means that all contractors’ clinics, run single hand by nurses in locations where PAC is available will be required to close down their facilities and relocate their healthcare services to the nearest PAC. This decision will neither affect mobile rig clinics, whose services are handled by competent paramedics, nor temporary clinics in remote areas, which will exist only under strict criteria and which will be supported by PDO/PAC doctors (and later by centralized clinic) by some form of telemedicine.

Centralization of Medical Services The phasing out of small clinics manned by single nurse and provide centralized facilities manned by doctors who will be able to follow up chronic medical conditions which increased risk of heart attack and other causes of sudden death. No more sub standards medical services.  

Background

Contractor medical centralization It is envisaged that in this harmonization of health provision we will have better management of chronic medical conditions such as diabetes, hypertension and other heart ailments by a qualified physician. Furthermore, fitness to work medical check of employees, which hitherto, were defaulted, will now be easily monitored and reinforced, as are the skills and competency of the doctors performing the checkup due to their exposure and clear knowledge of the PDO working environment. A string of meetings and communications on the issue were held with all the concerned parties - CHs, CEOs, Area Coordinators etc., involving the Managing Directors, Mr. Raoul Restucci, as well as members of the PDO medical team in the interior. The restructuring (i.e. centralisation) of the contractors’ Primary Healthcare Services (PHC) has been driven by the unacceptable living conditions of the workforce resulting in a number of social behaviours, poor health and even NAD’s as established and reported by the Occupational and Public Health teams, in several inspections.

Benefits of medical centralization Better organizational design with a unified PDO health vision for both PDO and contractors. This will in turn align health services with business goals directly and easily under a single umbrella of care. Both service and quality are managed in parallel with defined responsibilities of different parties (PDO staff for quality and supervision, contracted staff for service). This will in turn facilitate improvement of quality of service among contracting community as there will be direct supervision and monitoring. Better management and control of chronic medical conditions, such diabetes, hypertension and heart ailments, which have connected to past cases of NADs. Enhance the effectiveness of MER system through integrated service and unified team. This provides coordination and team management during MER with full fledged team available at one site for management of incidents. Better management and control of OH services which include elements such as improved and controlled fitness to work (FTW) and health surveillance system where all employees are managed at single point of service and access available for all workers, OH reporting and investigation, etc.

Benefits of medical centralization Better communication and facilitation of consultations through the virtual organization approach that will reduce the need for travelling to a doctor-manned clinic, improve safety and enhance patient satisfaction. This will also facilitate harmonization of health services within contractor employees as a basic requirement. Improved integrated health service where full collaborative/supportive team (including doctors with more extended capability) will be available in most of the clinics. This in turn will reduce stress and other organizational /working factors for medical staff operating clinics single handed. Removing the burden of direct provision of medical services to allows the contractors to focus on their core business and safety issues and hence improve performance. PDO Medical Services could become a role model in the business with such an integrative, well-organized health services with broader coverage of all employees and contractors. This will add to positive reputation of the company.