1. WORKING FOR A HEALTHY FUTURE IOM Consulting Limited. London. UKwww.iom-world.org Occupational Health Services – An Introduction Dr James Preston MFOM Accredited Specialist in Occupational Medicine

2. 2 Areas to Cover Occupational Health Introduction Basic functions Referrals and case management Stress definition and consequences Occupational health and stress Breakout groups – discussion and summing up

3. 3 What is occupational health Industrial medicine Work on health Health on work Independent Proactive and reactive elements

4. 4 Work on health Work-related issues Occupational asthma and dermatitis Hand arm vibration syndrome Musculoskeletal symptoms Stress!

5. 5 Work on Health Preventing and reducing (negative) impact of work on health Health promotion Risk assessment contribution Ergonomics/DSE Health surveillance (noise/skin/resp/HAVS) Fitness for work Health and safety policy/steering groups

6. 6 Health on Work Pre-employment assessment Fitness for specific tasks (eg safety critical) Management referral

7. 7 Ethical and Good Practice Independent Confidential Report writing - GMC Consent

8. 8 Management referral - interaction Informal discussion (business partner +/- OH) Take time over referral form completion Report Background Current Position Specific Questions Summary and Recommendations

9. 9 Recommendations Advice not compulsory DDA (Reasonable) adjustments Fitness for work Measures for early return and/or rehabilitation

10. 10 Definition of Stress "The adverse reaction people have to excessive pressures or other types of demand placed on them at work."

11. 11 It is not A medical condition

12. 12 Manifestations Feeling of being overwhelmed Loss of productivity Pre-occupation Loss of confidence Concern Irritability Distress

13. 13 Stress and productivity/performance

14. 14 Distress leading to health issues Hazard in the workplace Anxiety Mild to moderate depression Compound other mental health conditions Blamed rightly or wrongly for physical conditions (onset or worsening) Alcohol intake Drug use Other compulsive behaviours

15. 15 Addressing Stress Match resources to requirements Regard stress as a hazard to health Risk assess Control risk Review Education and training Record what you have done

16. 16 Management Standards areas Demands Control Support Relationships Role Change

17. 17 Where next proactively? Get senior management commitment Get employee commitment Form a steering group Management HR OH Union/employee Health and safety

18. 18 Understand 6 areas and how they relate to your business Demands Control Support Relationships Role Change

19. 19 Gather data Sickness absence data Exit interviews Return to work interviews OH feedback Productivity data Focus groups Surveys Performance appraisals

20. 20 Are there Patterns? Hot spots? Correlations?

21. 21 Cascading Explore problems and develop solutions Steering group Board representation Focus groups Local presentations and breakout groups

22. 22 Examine 6 areas For each area there is a set of states to be achieved to allow for the correct standard to be in place. Demands; employees indicate they are able to cope with the demands of the job Systems in place to respond to individual demands

23. 23 Demands – states to be achieved Adequate and achievable demands within agreed hours of work Peoples skills and abilities matched to job demands Jobs designed to be within capabilites Employee concerns addressed

24. 24 Outcomes Targeted policies (performance management and goal setting; bullying harassment; reporting concerns; drug and alcohol…) Review existing policies Policy awareness Line manager training Job analysis/design Risk assessments Communication and training

25. 25 Finally Action planning Steering group lead Senior management buy-in and support Follow up and embedding Review and continuous improvement

26. 26 Individual case management Occupational health function Avoiding medicalisation Solutions not always medical Usually fit to attend OH/management meeting/hearings/tribunals Balance lies with resolution as the priority Consider mediation Counselling

27. 27 Case studies Break out groups and discussion