What is occupational health?

Traditionally, occupational health was a distinct branch of medicine. It was concerned with how an employee’s health can affect their ability to do the job and how work and the working environment can affect an employee’s health. Today, occupational health is more wide-ranging. It is still concerned with employees’ health but can also include health promotion, risk assessment and well-being. It sometimes addresses lifestyle issues such as smoking, fitness, stress management, nutrition and obesity.
In the UK, employers must choose how they will fulfil their duty of care towards employees. They have a legal obligation to provide adequate management systems and services to deal effectively with occupational health risks. Employers need to decide the level of occupational health provision they need to achieve this. They also need to be clear on the role that they want occupational health advisors to have in helping them manage sickness absence. Many employers include a clause within their sick pay policy to the effect that an employee may be required to visit the OH service as a condition for continuation of sick pay. Many also promote employee wellbeing.

One of the main differences between a good and a not-so-good occupational health service is the level of knowledge the occupational health advisors have of the employer’s workplace. This ranges from the office environment to the manual labour in the works depots and everything in between.

The business case

There is a strong business case for providing occupational health services. A 2004 study concluded that investment in workplace health promotion can bring about cost savings of £10 for every £1 spent.
For employees and employers, there is increasing evidence that working is generally good for health.

Meeting employers’ legal obligations

The 1974 Health and Safety at Work Act (strengthened by many subsequent regulations) places a ‘duty of care’ on every employer to be concerned for the health and safety of its employees.

The specific obligations regarding occupational health are contained in the Management of Health and Safety at Work Regulations (1999). The regulations cover all workers (including mobile and home workers) and include specific requirements to:

• Assess risks. The regulations give guidance on what constitutes a ‘suitable and sufficient assessment’ of the risks to which employees are exposed at work.
• Record the findings of the risk assessment in a retrievable form available to employers, safety and other employee representatives and visiting inspectors.
• Implement preventative and protective measures. The regulations set out principles underlying the employers’ actions and require employers to make ‘such arrangements as are appropriate’, having regard to the nature of the risks and the size of the undertaking.
• Provide ‘such health surveillance as is appropriate’.

There are particular requirements within the regulations for new and expectant mothers and for young workers (aged under 18).

The regulations do not define the precise form of occupational health services. The model used should be designed to ensure that all the requirements are covered within the particular context.

Ignoring the requirements could have serious consequences:

In September 2006, an employment tribunal found that one city council in Scotland (Dundee) breached the Management of Health and Safety at Work Regulations 1999 by having an inadequate management system to deal with occupational health risks and that an ‘Improvement Notice’ issued by the HSE was justified. The Council didn’t have in-house occupational health specialists or a contract with an external occupational health provider. The tribunal ruled that this breached regulation 5 of the management regulations, which states that employers should make arrangements to manage effectively health and safety, even though the regulation makes no specific reference to occupational health. Subsequently, the Council has developed a proactive ‘well-being’ strategy.
Failure to comply with an Improvement Notice issued by the HSE can result in prosecution, and in the Crown Court, this can result in an unlimited fine.

See: http://www.hse.gov.uk/enforce/enforcementguide/court/sentencing/penalties.htm

Invest to Save

Evidence suggests that money spent wisely on an occupational health service can be a sound investment:

Cost of occupational health services

Research found that the average cost of providing an occupational health service in the public sector is £30 per full-time employee per year.

Figure 1 Public sector organisations spent £30 per full-time employee per year on occupational health

Source: IRS (2007) ‘Role of occupational health services in managing absence’, IRS Employment Review Issue 878, 30 July 2007.

To avoid the risk of legal action

While the primary purpose of occupational health in the public sector is to promote well-being and good health among employees, it can also help employers avoid the growing risk of prosecution and significant potential penalties. Wherever a risk to the safety of an employee or group of employees has been identified, the organisation has a duty of care to its employees and must take steps to overcome or mitigate that risk.

Source: Wales Audit Office 2010