1. Stockport Model

2. Presented by: Donald Menzies 2010 - 2011 Every patient matters Every pound counts Occupational Health Multidisciplinary team

3. Talk The Stockport Way Working with partner regional OH Providers The way ahead

4. PATIENTS To Be Caring, Clean and Safe FINANCE To Deliver Security SERVICE 21 st Century Care STAFF To Develop Our Workforce COMMUNITY Corporate Citizenship Our Top 5 Priorities Every Patient Matters

5. OH Services Provided 2009 Stockport Foundation Trust Stockport PCT Pennine Care Trust Greater Manchester Ambulance Trust Private Care organisations Hospices Voluntary organisations Colleges of HFE Transport companies Private companies

6. OH SHH Clinical Team 2009 1 Consultant Occupational Physician 4 Occupational Physicians 1 Clinical Nurse Manager 4 Occupational Health Nurses Counsellors Management Team Business Manager Secretarial and administration staff Website

7. OH Tender Coverage Merseyside, Greater Manchester, Lancashire & Cumbria

8. Process Initial Discussions (OHS services with geographical coverage) Audit of current facilities Data collection Equipment IT facilities Counselling Physio KPI’s Opening times Costs Use of post, email etc

9. Website development NWAS partition Password protected Manager access Employee access Referral Forms Physio Counselling list OH Services partition Forms Policies Procedures in-house website developer Records - sharing: Scanning

10. Central Unit & Regional Units StockportAintree ChesterPrestonLancasterKendalBarrowCarlisleWigan

11. Our Regional Clinical Team 5 Consultant Occupational Physicians 10 Occupational Physicians 5 Clinical Nurse Managers 25 Occupational Health Nurses 15 Counsellors Dedicated 1 WTE contract administrator Management Team Business Manager Secretarial and administration staff

12. Understanding your Priorities Comprehensive range of clinical services Flexibility to meet changing requirements Skilled professionals Quality service Value-for-money Accessible to employees and managers Prompt feedback

13. Services we can offer Comprehensive Occupational Health Service Pre-employment Health Assessment Advice on Sickness Absence Rehabilitation and Re-deployment Advice Immunisations Counselling Health Promotion Advice on practice legislation i.e. DDA Periodic / Specialised Health Surveillance Access to specialist services

14. Added Value We Offer quality focused Investors in People stamp of approval Commitment to on-going training and development of staff. Committed to clinical excellence, audit, clinical governance and quality assurance procedures.

15. Added Value Offer value for money No hidden costs Not profit motivated Income spent directly on service to you Cost conscious public sector organisation

16. Added Value We Offer NHS focused Proud to be part of NHS Provider of choice to large number of NHS organisations Committed to supporting patient care by supporting NHS organisations Healthy and motivated workforce We adhere to NHS policies and governance requirements

17. Added Value We Offer NHS focused One lead provider – Stockport Foundation Hospital based Managed through local spokes One on-line administration system Local physio and counselling provided Agreed timescales for appointments

18. How to run a Hub & Spoke OH programme (or a fictional railway) You need: A Fat Controller (a Director to get the resources & commitment and support the Engine Driver) An Engine Driver (a “fired-up” person to do the day-to day management work, liaison etc). Red engine, blue engine, green engine etc

19. Conclusion 1 Seemed a ‘brave’ project at inception Supportive cooperative colleagues Has required a lot of negotiating and influencing skills IT has proved the most difficult to integrate SLA’s a problem BUT - we have found very few real service barriers in practice

20. Conclusion 2 Get to know their organisation Projections of workload allows resource planning Service specs – what not how Comprehensive but few performance measures Share information generously Briefings of relevant information

21. Lessons learned IT biggest challenge –Encryption –Records –ESR OH Recruitment of counsellors Regional Physio Online forms works well Regular contract meetings Regular OH meetings Communication

22. Relationship management Honesty Integrity Collaboration Mutuality Passion Humour Working with fellow OH Providers The recipe for a long term relationship BUT both partners have to work at it!

23. Every patient matters Every pound counts EFFICIENCY PROJECTS Better Value Making best use of technology Working with other NHS OH

24. Challenges facing Occupational Health in the UK detachment from mainstream health care little communication with other specialties limited remit uneven provision, only in workplaces diminishing workforce shrinking academic base lack of good quality data image and perception Working for a healthier tomorrow, 2008 Working in silos The challenge for NHS OHS

25. Einstein said… “If you keep on doing the same things and expect things to change, then that’s a definition of insanity.”

26. The world has changed…. Investing in good health at work means organisational change…. presents a huge opportunity for our profession

27. 30 th November 2010 Public Health strategy launched Healthy Lives, Healthy People: Our strategy for public health in England.

28. To change or not to change….that is the question Investing in good health at work

29. ‘At a Tipping Point’ External Drivers Internal Drivers OH reconfiguration response

30. The full cost of poor health for employers 30% S/A costs Absenteeism Overtime Turnover Temporary Staffing Administrative Costs Replacement Training Off-Site Travel for Care Customer Dissatisfaction Variable Service Quality 70% Health-related Productivity Costs (adapted from R. Loeppke, US National Business Group for Health, Philadelphia 2009)

31. 50 % of deaths 1. Tobacco use 2. Physical inactivity 3. Poor diet 3 risk factors 4 chronic diseases Globally, over 50% of deaths are due to these four diseases 4 chronic diseases Three  Four  Fifty Chronic Respiratory Disease Cardiovascular Disease Obesity Type 2 Diabetes Cancer Changing focus - 3 Risk Factors 3 Main Risk Factors can be attributed to the 4 main chronic diseases which lead to 50% of deaths in the UK. These risk factors provide a clear focus for action.

32. Proposal A single collaborative OH service covers the whole of the Manchester health economy Provider of choice for OHS for all NHS in the area. Service capacity and capability to provide a high-quality occupational health service multidisciplinary includes nursing and medical staff with OH technicians, counsellors, cognitive behavioural therapists, physiotherapists and other professionals New standard care pathways Innovative and better working practice

33. Proposal 2 project group to established of key personnel to agree the outline service period of consultation will take place involving all the Trusts who want to be involved, the service users and their representatives. focus on outcomes with flexibility and imagination in the creative joint working with Trusts meet emerging demands including the well-being agenda (Boorman), SEQOHS Standards, NHS employers standards, etc

34. Proposal 3 ANHOPS group to assist with benchmarking/audit Links with Centre for Occup & Environmental Health, University of Manchester - Largest postgraduate centre for OM in UK - Big research portfolio – HSE, EU, Research Council - Published on many topics incl backpain assess t & mental ill health Need experienced facilitator from SHA to work with experience of multi- trust service reconfiguration required to assist drive the project through to conclusion

35. The Door is Open Any questions?