Dr Maze


regular comment for managers on workplace health issues

Managing Return to Work – Northern Ireland 2005

Joan Lewis,  MCIPD,MA (Law & Employment Relations)

Legal considerations

  • Employment Rights Act 1996
  • Capability a potentially fair reason for dismissal
  • Fair procedures needed
  • Impact of new dispute resolution procedures

Practical issues relating to dispute resolution

  • Employee objects to having health issues treated as a problem
  • Standard and modified procedures
  • Any proposed sanction is appealable
  • Employee has the right to raise a grievance

Disability issues

  • Risk of overlap between disability discrimination and dealing with ill-health
  • Justification and the amended Disability Discrimination Act 1995
  • Reasonable adjustments
  • Paul v National Probation Service

A safe place for the returner

  • HASWA effect
  • Dorset Hospital case
  • Risk assessment for existing job
  • Employee employed to do a job!
  • Glitz v Watford Electric Co

The Lynock approach

  • Nature of  illness
  • Likelihood of recurrence/other illness
  • Length of/spaces between absences
  • Need for job to be done
  • Others carrying the load
  • Even-handed policy
  • Clarification of issues to employee

Lynock applied

  • Review & compare absence records
  • Check HR contacts
  • ? medical report re special needs?
  • Meeting or home visit
  • Consider domestic factors
  • ? ergonomic assessment?
  • Employee participation in risk assessment
  • The nature of the illness
  • Freer Bouskell and claustrophobia
  • Recurrence & reliance on key person
  • Taylorplan v McInally
  • Length of absences & pattern/consistency
  • Does employee return or leave
  • Variation of terms
  • Impact on others & involve team in return-to-work assessment
  • Deal with regular workers resentment
  • The ultimate choice
  • East Daubney v Lindsay – consult
  • Bliss v S E Thames RHA
  • No co-operation = end of the line

 The OH burden

The overall test is still the conduct of the reasonable and prudent employer, taking positive thought for the safety of his workers in the light of what he knows or ought to know; where there is developing knowledge, he must keep reasonably abreast of it and not be too slow to apply it; if he has fallen below the standard – he is negligent.

Stokes v GKN (Bolts and Nuts) Ltd [1968]1WLR 1776

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Legal Implications for Occupational Health Professionals

Notes from one of the other lectures at the NI OH update meeting.

 Legal Implications for Occupational Health Professionals

 Siobhan Donnelly, Lawyer/Safety Consultant

 How much law to impart?

  • What should I do I am being bullied?
  • I was suspended pending investigation, where to now?
  • My arms are still sore should I still be fitting blinds?
  • I know paint fumes are escaping from booths will I get asthma?
  • Do you think I should sue?

 Your dilemma

  • Commence Bullying investigation?
  • GP if medical issues, do not enter legal boxing ring.
  • Consultant re Repetitive strain, do not fear referral
  • Fear of developing condition can be psychological damage, initiate inspection
  • See a solicitor or you could be sued!


  • OH objectives: Policy
  • Risk assessment/risk control: Planning
  • OH management programme
  • Structure training awareness competence consultation emergency
  • Checking and corrective action
  • Management review

 Customer’s perspective

  • Fitness
  • Hazards
  • Promotion
  • Exposure
  • Communication
  • Research
  • Law
  • Management

 Beart v HM Prison – applies to you

  • Wrongful demotion, depressed never returned to work
  • Illness a disability
  • Private investigator, report wrongfully refused
  • Court held evidence re relocation or redeployment would have succeeded
  • Prison: already thought so badly of Beart felt justified in not accepting medical advice!
  • OH report: unlikely to recover until employment issues resolved, suggested redeployment.
  • OH report: unlikely to recover until employment issues resolved, suggested redeployment.
  • OH blamed by Prison as no prognosis given therefore could not reasonably redeploy ongoing illness
  • Held: No attempt at reasonableness under DDA

 Stress and Bullying

  • Barber v Somerset County Council
  • Managing Stress: Why you?
  • Hartman v South Essex mental Health CC Trust
  • Who manages your stress?
  • You know I am being bullied don”t you?

 Evaluation of OH

  • More aware physical hazards
  • Advice helped with day to day workloads
  • No difference in number of symptoms reported
  • Significant number of GP visits reduced


Health and Safety awareness needed:

  • For Patient benefit
  • For Self protection

Think legal agenda

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The Knowledge and Skills Framework (KSF) and Agenda for Change (AfC)

Ursula Doherty, AfC Unit, DHSSPS

Agenda for Change and the KSF

The HR Challenge for 2005 is in implementing Agenda for Change – the new integrated pay and learning system for all staff.  My wish is that this should be successful, to the benefit of staff and patients alike. Andrew Foster, Director of Human Resources, DOH in People Management

 The Vision – Six of the highest ranking employee needs*:

  •  Understanding what is expected in the job:

Clear information about how each post fits into the wider NHS/HPSS structure and about the knowledge and skills required from new recruits and experienced staff members in each role – with specific examples of how these should be applied.

  • Opportunities to “do what I do best”

The opportunity to demonstrate and discuss personal strengths and aspirations and to explore how these talents can be unlocked and developed within current or future roles

  • Encouragement of development:

A universal recognition that all staff are entitled to development opportunities either within their current posts or help for them to achieve career development – and that managers and organisations have a duty to support this principle

  • Regular reviews of progress

Structured feedback using an objective framework for all staff to enable any difficulties to be identified and resolved  before they become major problems.  The opportunity for staff to highlight their own development needs

  • Co-workers committed to quality

The knowledge that everyone will be expected to fulfil the requirements of their post, including the core dimensions and that action will be taken to ensure that this happens 

  • Opportunities to learn & grow

A culture which allows people to develop flexibly as individuals, recognising that there are many alternative career pathways and timescales, and that skills and knowledge can be acquired in many ways and are often transferable

How can the KSF help?

  • A KSF Outline for every post
  • A Development Review at least once a year
  • A Personal Development Plan
  • Support in fulfilling the PDP
  • Access to KSF Outlines at recruitment and in career planning
  • Focussed Development for Everyone

Purpose – The KSF is designed to

  • support the development of individuals in their current post
  • support career progression
  • facilitate the development of better services

What it is:

  • Defines and describes the Knowledge and Skills that HPSS staff need to apply to their work in order to deliver quality services
  • Provides a framework on which to base the review and development of all staff
  • Applicable and transferable across NHS/HPSS

What it is not:

  • It does not seek to describe what people are like or their particular attributes
  • It does not describe the exact knowledge and skills that people need to develop
  • It does not determine job weight or pay band


  • KSF Post Outlines – set out the dimensions and levels that apply to a post
  • Dimensions ­- broad functions that are required to provide a quality service
  • Level Descriptors ­- each dimension has 4 levels, a level descriptor is simply the title of each level
  • Indicators – describe how knowledge and skills need to be applied at that level
  • Examples of Application – show how the KSF might be applied in different posts
  • Gateways – defined points where decisions are made about pay progression as well as development

Structure of the KSF – 30 Dimensions

6 of which are core and apply to every post

  • Communication
  • Personal and People Development
  • Health, Safety and Security
  • Service Improvement
  • Quality
  • Equality and Diversity

24 of which are specific, a selection of which will apply to each post

  • Health and Well-being (10 dimensions)
  • Estates and Facilities (3 dimensions)
  • Information and Knowledge (3 dimensions)
  • General (8 dimensions)

Example of Specific Dimensions

  • HWB 7 – Interventions and Treatments
  • EF2 – Environments and Buildings
  • IK2 – Information collection and analysis
  • G5 – Services and Project Management


  • The KSF must be fully implemented for all staff by December 2006 with all gateways fully operational
  • Outlines and Development Review therefore needs to be in place by December 2005
  • All HPSS organisations have KSF Leads and an implementation plan
  • KSF Outlines are being developed and shared via the National Library
  • The e-ksf tool has been designed specifically for the NHS/HPSS
  • KSF web pages

The KSF provides a structure for development

  • but users need skills to have PDP discussions and identify learning needs and plans
  • the organisation needs policies about how to implement and embed the KSF
  • and the organisational culture needs to embrace change and value learning and development

So what will this mean for the NHS/HPSS?

  • Better recruitment
  • Better retention
  • Better morale
  • Better productivity
  • Better quality

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Northern Ireland OH Update

Today, I had the opportunity to attend the Northern Ireland Occupational Health Update 2005 organized by IRS/LexisNexis.I’ll post my notes on this over the next week or so, but for now, here are the lecture titles to whet your appetitite.

Siobhan Donnelly: Keynote Lecture – Stress and bullying in Northern Ireland

Walter Brennan: Dealing with violence at work

Trevor Maze: Fit for work

Joan Lewis: Managing return to work

Greta Thornbury: Sickness absence and rehabilitation

Ursula Doherty: Knowledge Skills Framework and Agenda for Change



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First Posting

Well, after many false starts, I finally got this blog up and running. It will take another week or two before it is exactly as I want it. Please be patient.

So who am I?  My name is Trevor Maze and I”ve been an occupational physician for some 11 years. And what exactly is that? Occupational physicians (OPs) are medical doctors who specialize in work-related health issues. Where an employee’s health affects his/her work or vice versa, we provide management with advice on managing the employee within the workplace, including job modifications, special precautions, rehabilitation after absence and, if necessary, early retirement on ill health grounds. If you continue to read this blog, you will begin to see how this works.

Occupational medicine in the British Isles is a post-graduate specialty and most OPs have previously specialized in another branch of medicine such as general family practice, dermatology or respiratory medicine. In my case, it was anaesthetics (anesthesiology to those of you from the USA).

My aim is to help you understand the basics of occupational health and how to use it in your business. I’ll do this by discussing research, actual examples (disguised to protect the innocent), and questions submitted by readers such as yourself. I’ll also reference reliable sources of help and advice, so that you can check things out for yourself. I’ll also reference reliable sources of help and advice, so that you can check things out for yourself.

Please feel free to email your questions to me.

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