Dr Maze

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regular comment for managers on workplace health issues

Swine flu in UK and guidance for employers

Now that cases have been reported in the UK, people in Northern Ireland are starting to report symptoms. Thus far, none of them have been found to have swine flu, but you should remain vigilant. 

The Faculty of Occupational Medicine have published guidance for employers that you can download  (right-click on the link, then save as).

Filed under: Uncategorized

Swine flu outbreaks in Mexico and North America

Please view the entry on the jabs2go website:  http://www.jabs2go.com/?p=5

Companies should look carefully at whether there is a clear business case for travel to affected areas. If travel is unavoidable, do provide your employees with appropriate advice and travel kits. Dr Maze can advise you on this.

Filed under: Uncategorized

Returning To Work Can Help People With Anxiety and Depression

Work often gets blamed for causing stress and depression. Recently published research shows that getting back to work can actually help employees get back to normal. However, employers do need to be sensitive and they should consider such things as changing the employee’s hours and job tasks when they initially return to work. An early return to work is more likely when line managers keep in touch at least once a fortnight.

 

A study published in the specialist journal Occupational Medicine looked at over 500 people from a variety of industries who were off work with depression. A return to work significantly promoted recovery. The approach and flexibility of their employers was a vital factor in the successful return to work.

Dame Carol Black’s Review ”Working for a healthier tomorrow” had previously acknowledged that work is good for the long-term health of most people and for the well-being of their family. Her review found that ill health costs the country £100 billion a year and £40 billion of this was related to mental health.

Dr Gordon Parker, President of the Society of Occupational Medicine said “Better access to occupational health services and psychological support are essential if employees with depression and anxiety are to get back to work quickly.  Employers are often frightened of contacting an employee whose sick note says ”depression” for fear of being accused of harassment, but sympathetic contact with the employee and early help through occupational health can identify the most appropriate support. Occupational health services are ideally placed to advise managers and employees on the best return to work plan and should be involved early in the management of the employee’s absence.”

Each year, roughly 1 in every 4 employees in the UK will have a mental health problem, and depression is one of the most common. Whilst being distressing for the person involved, it also makes them less productive at work and is responsible for high rates of sick-leave, accidents and staff turnover. Work plays a large role in shaping people”s identity and employees who are absent for prolonged periods due to anxiety or depression,  can lose their sense of self-worth. Going back to work is often one of the most important factors in accelerating a return to full health. It helps the employee to regain a sense of self-esteem and puts routine and stability back into their lives.

A good occupational health service can help senior management develop programmes to educate line managers and the workforce about depression so that the problem can be recognised, appropriate early intervention given and employees enabled to remain at, or return to, work. Occupational Health staff have experience of sensitive issues such as workplace confidentiality, job security and the timing of the return to part-time or full-time working. They will know about the particular stresses and strains of the work environment and are  well placed to work closely with family doctors and medical specialists.

Depression and anxiety are now the most common reasons that people take long term sickness absence. This is likely to be an increasing problem as the present economic difficulties increase and we move into a depression. By investing in occupational health services, senior management teams can play a key role in helping employees return to work. This improves the overall performance of the organisation and of individual employees and reduces the costs of sickness absence.

Filed under: Uncategorized

Presenteeism and Poor Productivity

One of the unintended side-effects of a strong attendance policy is that employees may come to work when they really shouldn’t. Productivity falls, safety breaches and near misses rise, the employee may not concentrate on his work and may even resent the fact that he is in work.

Robert E. Sterling M.D. has several brief, but good articles which I’m referencing below. I wouldn’t endorse all he says, but these articles are worth referring to.

A Conundrum  http://tinyurl.com/6yr6bf

<blockquote>Your most important resource is your employee. Your greatest single expense is your employee. Your greatest potential for revenue enhancement is through your employees. Your greatest risk for sudden loss of revenue is through your employees. WHY THESE POLARITIES? Many of these polarities are due to health, mood, psychological, attitudinal, and alertness issues that affect productivity that you …</blockquote>

Do You Know The Value Of Your Healthcare Dollars?  http://tinyurl.com/5zp6hr

<blockquote>Business is complicated enough with employers trying to wring out as much productivity from their employees prior to upsizing. It is therefore crucial, in seeking productivity gains to target healthcare expenditures. But where exactly is the nexus between health and productivity to be found? The location is easy to find if you know where to look. A worker is said to be productive if he is at w…</blockquote>

The currency is irrelevant, the isssues are the same, wherever you are.

Health Promotion & Productivity  http://tinyurl.com/6ewm7h

<blockquote>It is a rare instance when what will benefit employees (EE) also will benefit employers (ER). This happy union occurs, as recent research has found, when preventive health programs preempt the onset of disease or control disease symptoms, to the benefit of EE and ER alike. A growing body of evidence has linked worker productivity with worker health. Of particular importance is the recognition that …</blockquote>

Filed under: Uncategorized

Health Risks and Corporate Travel

Increasing numbers of British and Irish employers now send their employees abroad to work, either for brief periods or for several years as expatriate workers. The individual traveller clearly bears responsibility for his/her own health and safety while away from home. What many employing organizations fail to understand is that they too have significant responsibilities in this regard. Domestic safety legislation may apply to the company”s business activities abroad, requiring it to protect its staff on company business abroad.

In the UK, the Corporate Manslaughter Act 2007 has now come into effect, codifying a responsibility on individual senior managers to protect the life of all those who may be affected by the organization”s business activities. This would include customers and passers by as well as employees. The implication is that where an employee dies as a result of business activities, individual managers and directors may face court proceedings and large fines or imprisonment if convicted.

Tying these two together, if an employee suffers a fatality that is attributable to working abroad, there is a potential liability on the employer, particularly if that risk is foreseeable and avoidable. For example, an individual goes on secondment to a location where malaria is endemic (lets say, an engineer involved in a building project). At some point, either during his stay or following his return home, he develops a fever that is either not diagnosed or is not appropriately treated. He subsequently dies from cerebral malaria. Or, he gets bitten or scratched by a rabid animal, but doesn”t get medical treatment until after he starts to develop symptoms of rabies. By this time, it is too late to vaccinate, there is no treatment and he dies (rabies is considered 100% fatal once symptoms appear). Or, perhaps he just falls asleep at the wheel and dies in a road traffic accident the day after he arrives, because he has been working long hours before travel with little sleep to meet a tight deadline and now also has to contend with jetlag.

In all these cases, the employer may well be at risk of litigation. We are not talking here about the corporate body, but about specific named individuals legally considered as bearing the responsibility for the corporate activities that led to the death. Employers need to urgently reassess their travel policies and ensure that they have a travel health policy in place. They need to exercise due diligence on all their foreign corporate activities, particularly in countries where the local legislation or attitudes to worker health and safety are less stringent than they are at home. This may not require very much change if you do business in France or Germany. But if you don”t have company policies on foreign travel and working, you may need to develop them and ensure that they are publicized and actioned within the business.

For more travel advice, please go to http://jabs2go.com

If you need to consult on occupational health risks, including travel, please contact me through http://environmed.co.uk

Filed under: Uncategorized

Workplace Interventions for Common Mental Health Problems

Mental health and musculoskeletal disorders are “the big two” causes of sickness absence in the UK working population (about 40% each in the absence statistics). Each year, about a quarter of the UK population experience some form of mental health problem such as depression, panic attacks or stress. The economy loses about £11.6bn annually, due to time off work with these conditions.

The British Occupational Health Research Foundation (www.bohrf.org.uk ) funds high quality research that has direct application to the workplace. They have been looking at the effectiveness of “Workplace Interventions for Common Mental Health Problems.” Earlier this week, they launched their Evidence Review at the Royal College of Physicians in London. A secondary launch is planned for next Friday at the Royal College of Surgeons in Edinburgh. The study was sponsored by First Assist (www.firstassist.co.uk ) and carried out by the Sainsbury Centre for Mental Health.

Many employees with mental health problems end up losing their jobs. The report found that counselling could help staff to stay in work. Cognitive behavioural therapy (CBT) was particularly effective. This method deals with the way you think about your problems as well as focusing on your behaviour.

So what can you do? Employers have a key role in preventing job loss and in reducing employee sickness rates. Creating a mentally healthy workplace is as important an investment as any form of staff training or development. If you’re worried about cost, it will pay for itself. Employers need to develop policies to help workers with mental health problems. Supervisors should contact employees off work with mental health problems at least once every two weeks. Early interventions should be used as much as possible – an eight week course of CBT can make the difference in helping your staff remain at work.

Workers’ representatives also support this approach. Hugh Robertson, head of health and safety at the Trades Union Congress (http://www.tuc.org.uk ), welcomed the report saying, “Most employers are doing very little in this area. They don’t know what to do if someone is off work, whether to contact them or not, so often they don’t.”

Filed under: Uncategorized

Up and running again!

I’ve not posted here for a while, due to a combination of time constraints and some “accidents” with the software (messing about when I didn’t know what I was doing). Everything seems to be running again now, so I’ll try to post at least once a week from here on.

For now, here’s a common problem most managers face at some time or other: “I have an employee who says he can’t attend work because he hurt his leg and his doctor told him to stay off it. What do I do now?”

Sample Responses:

1. Before it happens, have you put in place a policy that requires the employee to keep in touch with the company during his absence?

2. Do his terms of employment require him to attend your occupational health provider for a review of his capability for work at reasonable hours appointed by you?

3. Are you prepared to offer him alternative duties that are within his capabilities for the duration of his incapacity?

4. If you don’t retain or have access to an occupational health advisor, you may have to write and ask the GP exactly what he means by saying that the employee should refrain from work.

  • If he means “all work” can he offer you some justification for such a drastic restriction?
  • Outline the nature of the contractual duties and ask whether any of these are within the employee’s capability.
  • Suggest that as the problem is related to standing/walking, you can offer work that does not require this. Outline the other job tasks that you might be able to offer the employee – sitting job, reduced daily hours, etc. Ask whether there is any medical objection to him doing these specific tasks.
  • Ask for a realistic time scale for the restrictions and when you can reasonably expect him to be able to resume his full duties.

Note – you must be prepared to abide by your promised restrictions and not renege on the deal once the employee is back at work. Otherwise, you will lose all credibility with the local GPs and with your employees.

5. You may wish to arrange a one-off assessment by a local occupational physician (OP), and you are entitled to accept that opinion as superceding the GP’s opinion where the two are at variance. The GP may have no knowledge whatsoever of the workplace and will have had input from only one source (the employee). The OP will have been briefed by you and will have a wide familiarity with similar workplaces, so may be able to make a more balanced assessment.

Of course, the problem with the leg may not be the real problem. There may be other issues going on in the background and we will cover such situations on another occasion. The important thing to observe here is that sick pay should only be granted for medical incapacity. Social or domestic reasons for absence may be equally valid, but should be covered by compassionate leave or other special leave, whether paid or unpaid.

Filed under: Uncategorized

Complete Tolerance – Why Zero Tolerance is failing

 This is the last summary from the papers delivered at the Northern Ireland OH Update in 2005.

Walter Brennan, Independent Training Consultant & Expert Witness on Conflict Issues, Oliver Brennan Training Ltd, www.oliverbrennan.co.uk

Facts and Figures

The much vaunted Zero Tolerance campaign aimed at addressing violence in the NHS has made little difference to “shop floor” staff who feel no better protected now than they did before the Zero Tolerance Campaign was launched in 1999.

This is what they said:

  • They put posters up saying that we will do this and that and then when we are hit or attacked they do nothing! – Paul – a Porter
  • I was threatened with having my house torched and was told by my manager, I needed to be more caring! – Catherine – receptionist
  • The Police came and had a friendly chat with a woman who spat in my face and threw chairs around the waiting area – Carol – Junior Doctor

 A total of 221 NHS employees interviewed

  • 80 Nursing staff, 14 Junior Doctors, 12 Medical Students, 47 Porters, 68 Admin. Staff (Secretaries, Ward Clerks)
  • Staff worked in: GP Surgeries (28%), NHS Trusts (49%), Private Sector (23%)
  • Geographical areas: North Wales (4%), South Wales (11%), Scotland (13%), North of England (19%), South of England (53%)

 How much of a problem would you say violence is within your area of work?   Score 1=low, 5=Medium, 10= High

  • Nursing staff average score 8
  • Porters average score = 9
  • Admin. Staff average score = 5
  • Overall =scored an average of 7
  • North Wales scored average 6
  • South Wales scored average 7
  • North of England scored average7
  • Scotland scored average 9
  • South of England scored average of 8

If you have been attacked or hit how much positive support did you get from:

Colleagues (84%), Managers (1%), The Trust (3)%, The Police (8%), The Judiciary (none)

 If you were attacked tomorrow what positive support would you expect

Colleagues – 93%, Managers (2%), The Trust (None), The Police (2%), The Judiciary (none)

* Three respondents said they got no support from anybody!

 The problem with some managers

  • Send staff on training courses, but don’t go on the course themselves and then contradict what the staff have been told on training course
  • Haven’t got a clue about violence. They seem to be oblivious to the problem
  • Haven’t done a risk assessment into the hazard of violence
  • Take the aggressor’s side against their own staff!

 Problem with Some Trusts/Employers

  • Blame staff for being a victim
  • Don’t examine training courses for content and duration
  • Rarely prosecute on behalf of their staff
  • Much more concerned about patients or relatives complaining than about looking after their own staff
  • Fail to have in place formal support mechanisms for victims of violence

 Problem with the Police

  • Don’t appear to want to attend to incidents
  • Appear to feel Security staff should be dealing with violence
  • Often advise staff that prosecution will not work because they were not in control of their bodily functions!
  • Appear to advise staff that Crown Prosecution Service will throw the case out so arrest and prosecution is pointless

 Problem with the Judiciary

  • Appear to be badly informed
  • Appear to continue to view violence against NHS staff as an occupational hazard
  • Appear to be reluctant to punish offenders
  • Appear not to understand that verbal abuse is also an act of violence as defined by the Zero Tolerance Campaign in 1999

 The problem with training

  • Training rarely linked to risk assessment and training needs
  • No standard training course
  • No standard requirement for trainers
  • No clear guidance on the use of physical interventions
  • Not enough done to make policy awareness a training issue
  • None or little inclusion in helping staff to cope with being a victim

 The way forward

  • Re-launch the Zero Tolerance Campaing and give it a new name e.g. – SAFE ENOUGH TO CARE
  • Provide training courses for Magistrates, Judges, Crown Prosecution Service
  • Provide training courses for Police
  • Provide a 1 day training course especially for managers  and include:
  • How to do a risk assessment for violence
  • How to put in place formal support mechanisms for staff affected by violence
  • Emphasise a duty of care to staff by providing case law of Civil cases or Employment Tribunals where managers have failed to execute their duty of care to staff

 Training Courses

Minimum of one day

Ensure trainers are trained to train. They should have a professional qualification

They should have a good working knowledge of:

  • – Violence
  • – Trigger factors
  • – Legal/ethical issues
  • – Self awareness
  • – Defusion skills
  • – Verbal abuse
  • – Break a way skills
  • – Restraint skills (where identified)
  • – Critical Incident Debriefing

Courses need to have a competence assessment for participants 

Filed under: Uncategorized

Fit for work – What does it mean?

Here is the outline of my lecture last week. Hopefully it will help you to make best use of your business OH resource.

What  we need to consider:

  • Purpose of medical standards/guidance
  • Job description
  • Employee’s medical condition
  • Scope for job modification
  • Legal compliance
  • Business Protection /Reputation Protection /Loss Control

If we get it wrong:

  • Sickness Absence
  • Accidents
  • Legal & Insurance Claims
  • Poor Decision Making
  • Poor Customer Service
  • Difficult Working Relationships
  • Low Morale & High Staff Turnover
  • Low Productivity & Poor Quality
  • Lack of Innovation & Creativity

Costs of ill health to the employer:

  • Sick pay, pension fund contributions if IHR
  • Recruiting, training, assessing replacement
  • Management and investigation of absence
  • Insurance, litigation and compensation
  • Loss of experienced and skilled staff
  • Low morale

Costs of ill health to the employee:

  • Physical and mental pain and distress
  • Financial loss short/long term
  • Possible career loss
  • Loss of social standing and interaction
  • Loss of daily/weekly structure

“Fit” – to do what?

  • Attend/Handle Pressure?
  • See/Listen/Talk?
  • Sit/Stand/Walk?
  • Think/plan/Make decisions?

 The referring manager should:

  • provide a Job Description that lists the activities and tasks of the role
  • clearly and realistically distinguish between essential vs non-essential elements
  • indicate the scope for job modification
  • indicate the scope for alternative roles/redeployment

 Do the Job Tasks involve:

  • Standing / Walking/ Lifting / Carrying
  • Confined Spaces /Climbing Ladders / Working at Heights
  • Chemicals / Biological Agents
  • Skin or Respiratory  Irritants / Sensitisers
  • Dangerous Machinery / Vibrating Tools
  • Dust or Fumes
  • DSE  / Computer Work / Prolonged Sitting
  • Travel  – UK or Abroad / Vocational Driving
  • Work Pressure / Demanding Job

Legal compliance:

  • The legal position of medical standards
  • Disability Discrimination Act 1995
  • Human Rights Act
  • Health & Safety at Work Act 1974
  • Management Regs 1999
  • Working Time Regs
  • Sex Discrimination Act 1975
  • Employment Rights Act 1996
  • Freedom of Information Act
  • Maternity & parental leave Regulations
  • Pension schemes
  • Common law (Personal Injury Claims)
  • Relevant Case Law

Disability Discrimination:

  • Who decides? – Employment Tribunal; OH can only offer a tentative opinion
  • Definition of disability
  • Direct and indirect discrimination
  • Conflict with other legislation – H&S and criminal law have precedence
  • Reasonable adjustments
  • Disability related discrimination
  • When does the DDA not apply?

Individual variation:

  • Individual assessment
  • Risk assessment
  • Tolerance of symptoms
  • Reasonable adjustments

An Acceptable Risk?

You have to weigh up:

  • Cost of sickness absence
  • Cost of training vs loss of performance
  • Cost of medical support or assessment
  • Cost of IHR or injury awards
  • Opportunities for redeployment
  • Pressure to avoid IHR or reduce sickness absence

What can OH assessment offer? At:

  • Recruitment
  • Absence
  • Rehabilitation after absence
  • Health surveillance
  • Health promotion
  • Retirement

Recruitment

  • Know workplace
  • Assess job requirements
  • Liase with management
  • Establish standards
  • Review health declarations
  • Examine as required
  • Advise on disability
  • Advise on job adjustments

Sickness Absence

  •  Early meaningful advice helps; so refer early, rather than late
  •  Early intervention
  •  Influence early return (employee, health providers, manager)
  •  Remove the barriers to resuming work
  •  Managed rehabilitation
  •  Focus on ability not disability
  •  Functional ability assessments
  •  Adjustment assessments (DDA)
  •  Identify IHR cases early
  •  Case Conferences (Attendance Reviews)
  •  Review patterns
  •  Consider policies
  •  Agree parameters
  •  Assess referrals
  •  Liaise with GP/specialist
  •  Submit reports
  •  Monitor & review
  •  Case conferences
  •  Job modification
  •  Graduated return to work

Rehabilitation after absence

  • Assess
  • Investigate
  • Functional evaluation
  • Intervention
  • Co-operation

Health Surveillance

  • Identify risks
  • Education
  • Screening
  • Modification of exposure
  • Monitor & review
  • Risks:
    • Noise
    • Lead
    • Ionising radiations
    • Asbestos
    • Driving
    • Diving
    • Manual handling
    • Heights
    • Shifts
    • Allergens

 Health Promotion may influence attendance at work

  • Identify target population
  • Identify issues
  • Coronary risks / Mental health / Musculoskeletal / Diet
  • Screening
  • Workplace / Consultations / Courses / Ad hoc
  • Education
  • Leaflets / Reports / Special campaigns
  • Referrals

Retirement

  • Know pension regulations
  • Company policies
  • Criteria
  • Assess
  • Diagnosis
  • Reports from GP/specialist
  • Review treatment
  • Prognosis
  • Advice to management
  • Job adjustments
  • Monitor & review
  • Recommendation

Types of Referrals & Reports

  • Referral to Occupational Health
  • Referral to Occupational Physician
  • Referral to Specialist
  • Reports from GPs
  • Reports from Specialist

When To Refer

  • Sickness and Absence
  • Recurrent short spells of absence causing commercial concern
  • Prolonged sickness and absence
  • Combination of both
  • Fitness for Work
  • Report After Accident at Work
  • Before Job Transfer / Modification / Promotion
  • Suspicion that health may be impacting on work performance.
  • Suspected Alcohol or Drug Misuse

 Referring manager should provide:

  • Date when sickness absence commenced
  • Attendance record
  • Diagnosis on medical certificate (if known)
  • Other relevant information, particularly if the employee is unlikely to mention it
  • Specific requests

 What managers should ask

  • Is the employee fit to undertake their current role?
  • If the individual were not fit to fulfil their role, would adjusted duties or temporary redeployment apply?
  • Is the performance significantly affected by ill health and how long is this likely to continue?
  • Is the ill health work-related?
  • Likely date of return to work?
  • Is the employee likely to render reliable service in the future?
  • Is it likely that an employment tribunal would consider that this case falls within the scope of the Disability Discrimination Act and if so what adjustments should be considered?
  • If the individual is not fit to return, is ill health retirement appropriate?

What NOT to ask

  • What is the precise medical diagnosis? You need to know what he can/can’t do.
  • Can we fire this skiver?
  • If the individual is not fit to return, is ill health retirement appropriate?
  • What treatment is this person on?
  • GP says he’s not fit, but we need him to do xyz, can you make him fit?

Reports requested by OH from treating doctors

  • Request a medical report on the present condition and further information on:
  • Guidance on a diagnosis
  • Progress of the current condition
  • Any current residual disability
  • Ongoing medical review &/or treatment
  • Sight of appropriate specialist reports relating to the current condition
  • Any further advice that we can give the company, such as a rehabilitation programme
  • Likely return to work date

 Management Reports

These are advice to the manager on medical capability and should not contain personal medical information.  They should give advice/opinion on whether:

  • the employee is fit to work in their contractual/current role,  in a restricted role (list adjustments required) or is unfit for all work at present (if possible, estimate date for return to work)
  • the employee is permanently incapacitated [recommend ill health retirement]
  • a rehabilitation programme is recommended (give details)
  • the employee needs treatment/review by a physiotherapist/counsellor/specialist
  • the company should consider funding this referral or whether the employee should seek referral via his GP
  • a medical report was requested from the employee”s GP/Specialist
  • the ill health is likely to be work related
  • there is/is not an underlying ill health problem that may affect future performance
  • the employee has have a disability that is likely to be considered to fall within the scope of the Disability Discrimination Act
  • a risk assessment should be undertaken (give details)
  • a further review is necessary (when?)

Fit For Work? – Over To You!

Filed under: Uncategorized

Role of the Occupational Health Department in Absence Management and Rehabilitation

Another of the NI Update lectures

 Dr Leslie Hawkins

 Absence management

Facts & figures: CIPD survey July 2005

  • Analysis based on 1110 organisations & over 2.9m people
  • Average cost is £588 per employee per year
  • Most important cause is minor illness; 61% – 5 days
  • Manual workers – back pain
  • Non-manual workers – stress

Absence management policies

  • 87% organisations have absence management policies
  • Return to work interviews are regarded as the most effective method of managing short term absence
  • Involving OH is seen as most effective tool for managing long term absence

What is rehabilitation?

  • An approach whereby those who have a health condition, injury or disability are helped to access, maintain or return to employment – DW&P 2003
  • Is a process that, for the client, should develop better life quality, vigour, knowledge, capacity for coping with disease and recognition of opportunities and limitations – K E Anderson in Practical Ethics in OH 2004
  • Occupational rehabilitation is the process of assisting employees back into the workplace following injury or illness whether  it is work related or not – Hughes 2004

Why Rehabilitation?

  • Financial
    • Reduces costs
    • Reduces claims
  • Moral
    • Return someone to where they want to be, usually to where they were before the accident or illness
  • Legal
    • Management of Health & Safety at work 1999 Reg 6 Health Surveillance
  • HSC’s strategy 2010 & beyond – to work with stakeholders to strengthen the role of H & S to getting people back to work through much greater emphasis on rehabilitation

Government statistics

  • 1995 – 27,000 people forced to give up work
  • Each week – 3000 people move from SSP to Incapacity Benefit (IB)
  • 90% on IB believe they will return to work
  • 5:1 odds against returning to work

Research & Pilot studies

  • Job retention & vocational rehabilitation: the development of a conceptual framework. (James & Cunningham 03: HSE 106)
  • The Job Retention and Rehabilitation Pilot DW&P 02-04
  • Developing a framework for vocational rehabilitation. A discussion paper DW&P May 04

Case study

  • British Telecom v Pelling (May 2004)
  • YET
  • PersonnelToday 07.09.04
  • BT boasts 8000 home-workers, 70% of their 90K workforce working flexibly

Principles of Rehabilitation

  • Policy
  • Commitment of stakeholders
  • Eligibility criteria & support
  • Budget & resources
  • Commitment to confidentiality
  • Accountability
  • Dispute strategy
  • Early contact
  • Referral to OH
  • Developing an agreed rehabilitation plan
  • Support with therapeutic interventions
  • Flexible return to work – recuperative duties
  • Work adaptations or adjustments

Those involved

  • Employee
  • Line Manager
  • OH
  • Therapeutic services e.g. physiotherapists, ergonomists, counsellors

OH role

  • Referral process
  • Referral circumstances
  • Serious &/or long term medical conditions
  • Stress related problems
  • MSDs
  • Work related illness or injury
  • Frequent periods of absence
  •  
  • Assessment of the individual
  • Identifying health problem
  • Obtaining further medical information
  • Length of absence or likely return to work
  • Residual disability
  • ? DDA applies
  • ? Restricted duties long or short term
  • Ongoing treatment e.g. physiotherapy, medication
  • Review of refer?
  • Assessment of the workplace
  • Risk assessment or “job analysis”
  • Focus on capabilities and not disabilities
  • Travel to and from work
  • Access & egress in emergencies

Advising on “recuperative duties”

  • Points to consider
  • Reasons for length of absence
  • Acute or chronic condition
  • GP/specialist opinion
  • Job analysis
  • “Psychological” fitness
  • Employee attitude
  • Travel arrangements or home working
  • Company policy or insurers conditions for payments

Tolley”s recommendations for reduced hours

  • >16 hours per week and >4 hours per day
  • Agreed gradual increase over 6-8 weeks
  • Rehab treatment outside these working hours
  • OH review progress

Prevention is always better than cure, however there will always be the need for rehabilitating the sick and injured employee

References & bibliography

  • Chartered Institute of Personnel and Development (2004) Employee absence 2004: a survey of management policy and practice http://www.cipd.co.uk
  • Chartered Institute of Personnel and Development (2004) Absence Management fact sheet http://www.cipd.co.uk
  • Walters M (2005) One stop guide: Absence Management http://www.personneltoday.com
  • HSE (2004) Managing absence and return to work: an employers and managers guide HSG249
  • Waddell G, Burton A K (2004) Concepts of Rehabilitation for the management of common health problems, London: TSO
  • Hughes V et al (2004) Tolleys Guide to Employee Rehabilitation, Lexis Nexis UK
  • Better Routes to Redress http://www.brtf.gov.uk
  • P James et al (2003) Job retention and vocational rehabilitation: The Development and evaluation of a conceptual framework, HSE Contract Research Report 106
  • Department for Work and Pensions (2004) Building Capacity for Work: a UK Framework for Vocational Rehabilitation http://www.dwp.gov.uk
  • Access to work, information for employers Ref No:DS4JP July 2004

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