A force to be reckoned with

The roles played by OH practitioners are as many and varied as the
occupations they work in, and much can be learned from sharing experiences.
Here we are given a glimpse of what life is like for an OH adviser in the South
Yorkshire Police, by Sharon Samworth

Having been approached by the OH Managers Forum to speak at its conference
in June 2002, I felt somewhat overawed as to what I could say that would be of
interest to my peers. I decided to present a personal account of my experience
of working within South Yorkshire Police with particular regard to the OH role
in absence management.

Working in the police presents unique challenges for occupational health
advisers. All OH practitioners have different challenges within their varied
workplaces depending on the type of organisation, its culture, its aims and the
reason for its business. Whatever their own challenges, experiences and
problems, OH practitioners can gain invaluable information and skills from
sharing their experiences.

OH adviser’s role

The occupational health adviser has what is probably the most
multi-dimensional role of any branch of the nursing profession. Should the
number of hats OH advisers have to wear be considered a burden or do they
provide them with an exciting variety of opportunity and depth and complexity
of role that they can take advantage of?

Some of my experiences may differ from those of OH practitioners working
within, say, the private sector, but you may recognise some of the varied roles
described below.

– Protector: OH advisers are the client’s advocate. They act as adviser to
the organisation to ensure compliance with legislation. They advise managers,
often protecting them from themselves.

– Educator: OH advisers deliver health promotion at many levels (from
working with the individual to creating a positive healthy workplace culture).
They educate employers about the role of the OH professional, especially with
regard to what they can and cannot do.

– Arbitrator: OH advisers act as arbitrators in complex and sensitive issues
where employees and the organisation run into conflict with each other. They
have the skills to facilitate and arbitrate but this can be a very precarious
role (and not always welcomed). The OH unit is often responsible for ensuring
absence and other workplace issues are managed for the good of the client and
the organisation.

At present there is no alternative route to resolve such issues where the
health of the individual is a factor and a concern.

– Challenger: the OH adviser challenges the culture, behaviour and attitude
of the organisation when this impacts upon the health of that organisation and
the individual.

– Evaluator: The OH adviser acts as an evaluator in assessing health needs,
functional capability and risk management across the organisation.

– Counsellor: As a counsellor the OH adviser explores clients’ health
beliefs – identifying secondary factors that may be affecting their recovery
and return to work. They offer advice and support.

– Professional: by complying with their own code of conduct, OH advisers
maintain high standards of OH practice and are assertive with regard to their
ethics of practice (when these are at risk of being compromised by managers).
They are responsible for being honest and non-collusive with either clients or
management.

– Peacemaker: OH advisers may be blamed for sickness absence and other
problems within the organisation – as one colleague put it: "We wouldn’t
have a problem with sickness if it was not for OH". Therefore, OH advisers
need to be patient, to remain objective, to fight cynicism and to forge through
new ways of thinking about and approaching the problems they are faced with.

Overall, OH advisers are reluctant peacekeepers.

Sickness absence management

Sickness absence reveals much about an organisation. It is the mirror that
can reveal what kind of employer the organisation is.

The type of policies, procedures and resources that support absence
management indicate an organisation’s motivation and true intention regarding
staff welfare issues.

South Yorkshire Police is currently developing a human resource strategy and
a ‘work-life balance’ policy and has rewritten its absence management policy.
The priority on such welfare-based policies indicates a real intention to
improve workplace health, and shares the philosophy of ‘good health is good
business’.

How an organisation uses OH reveals how effective and honest it is:

– Is the OH unit allowed to practice to its full remit of expertise?

– Is the OH unit resourced effectively and given its own budget?

– What status do the OH advisers have within the organisation?

Status is very important in the police service – the pips, stripes and
crowns on the shoulders are of primary importance. Within South Yorkshire
Police the OH team is invited to all key meetings and is actively encouraged to
attend other working groups. Managers of the OH unit are paid at senior
management level and hold the unit’s budget. My line manager is the Assistant
Chief Constable, which allows me direct access to a senior figure without the
frustration of moving issues through layers of hierarchy.

The causes of sickness absence also reflect the type of work, management
styles, resourcing problems and the health and safety culture within the
organisation. The top two reasons for sickness absence in South Yorkshire
Police are stress and musculoskeletal injuries, which comes as no surprise and
is consistent with all working environments. However, within South Yorkshire
Police these problems are often intertwined with management issues: a bad back
may not just be a bad back, it can have a bad manager attached to it.

Work culture

The culture that exists within South Yorkshire Police is ingrained and
complex. It impinges upon all OH interventions and the experience of all its
employees. It requires more detailed attention than this article can give but,
in brief, it is entwined in the following.

People who work for South Yorkshire Police are divided into two types of
employee: police and civilian support staff. Although great efforts are now
being made to ‘equalise’ the experiences and status of the two groups,
traditionally the ‘inequalities’ that existed created real challenges for the
OH advisers in their role in absence management.

Although now amalgamated, the human resources department was originally
divided into two teams: one responsible for police staff and the other for
support staff. This set-up made the co-ordination of proactive interventions
difficult. Either the working parties were too large or there was a reluctance
to take overall responsibility for the issues to hand. This left the OH unit
trying to be proactive, but only really succeeding with reactive measures – OH
was pulling people out of the river instead of the organisation working on a
strategy to stop them being thrown in in the first place.

The police and support staff each have their own set of very different
regulations, relevant to their employment within the service. This means the
processes for managing absence and related issues (such as medical retirement
and incapability issues) have to be dealt with differently to comply with the
regulations.

The Health and Safety at Work Act came into force in 1998 for police
officers, but the Disability Discrimination Act still does not apply to them
(although this is planned to come into force in 2004). The difference in
employment regulations creates its own challenges for the OH unit as clients’
motivation for work can be affected by them. For example, South Yorkshire
Police operates a six months full pay plus six months half pay absence policy.
Traditionally, all support staff will go onto half pay as per the policy
(unless the illness is terminal), yet police officers rarely do, regardless of
the nature of the absence.

South Yorkshire Police does allow the OH unit to follow the ethos and
principles of the DDA for police officers, although there is actually no legal
requirement for this at present. However, it is regarded as good practice.

Unfortunately, some of the differences in the way the regulations are
applied create a feeling that police officers are more valued than support staff.
OH staff cannot change the culture and this perception on their own, but must
learn to use the situation to the best advantage. So, when requesting
resources, any business case must emphasise the value and benefit to the police
officer as this argument will be most persuasive.

Good working relationships are essential between the OH team and the
employer. OH is not an island and the OH adviser must develop mutually
respectful working partnerships within the organisation. The OH adviser must
target key people, such as human resources, managers and health and safety
personnel, to ensure OH practice and needs are understood.

Investment in building relationships will be repaid in times of need: when
the OH manager needs to ask for more resources, if the key people are familiar
with the OH unit, they will understand why more resources are needed.

Trust

Building trust at all levels within the organisation supports OH staff in
their role in managing sickness absence. Employees will work with OH staff in a
trusting and co-operative way if they ‘know’ them and have seen them around the
work environment developing these relationships. This helps when the OH adviser
then has to deal with the more sensitive and complex sickness absence and
organisational issues.

Marketing is a skill the OH adviser should learn from day one of their
practice. They must be able to promote themselves and persuade others of their
worth. They must find ways (devious if need be as long as they are legal) to
achieve their aims and objectives. South Yorkshire Police has a very effective
‘grapevine’ which, if used well, will carry information from one forum up to
its intended target (usually those who have decision-making powers).

Getting an appointment with a member of the senior command team (the people
with power and money) can be very difficult due to their heavy work schedules.
An ‘informal’ way of seeing them is to wander past their offices with a blood
pressure monitor and invite them to have their blood pressure measured. Once you
have them captured with the cuff on their arm you can get across any points you
want to make. The next time you ask for more resources they at least may know
more about you. They might still say no, but they will say no with a smile on
their face.

It is a constant battle to persuade police officers to look after themselves
as their job is often everything. The task, the operational procedures and
doing a good job are the priorities. Health and safety are regarded as an
encumbrance.

This is not just a macho attitude but stems from a real love of the work.
The challenge for occupational health is to educate police officers on health
and safety and also ensure that the advice is ‘practical’ and ‘credible’.
Recuperative duties must be individually assessed according to specific work
activities. The aim is to enable the officer to work as fully as is safe.
Anything less will result in non-compliance with the advice due to frustration
and a consequent risk of further injury.

Managers are key players in absence management. They can themselves cause
many problems due to poor training and skills resulting in ‘difficult’
management styles. Absence management is so much easier with ‘good’ managers.

Mental health

A further change in police culture can be seen in the attitude towards
mental health. Psychological support is now asked for more readily across the
force and sick notes are now stating ‘stress-related ill health’ instead of
diagnoses such as diarrhoea and vomiting.

A macho attitude does still exist however in some managers and employees.
The attitude that prevails within a specific work environment has to be a
consideration for the OH adviser when returning an individual back into the
workplace. With the support of a good manager, a member of staff will return to
work sooner, with a speedier and better recovery. And the OH adviser will be
able to return that person confident that the ‘duty of care’ has been complied
with.

In the case of a poor manager with an unsupportive attitude, this may mean
that the OH practitioner cannot advise a return to work until the individual is
strong enough to cope with that type of environment.

In a task-orientated service, the biggest challenge for the OH adviser is in
educating all members of staff about what occupational health actually is.
That, as a ‘people service’, its staff are the organisation’s most valuable
resource. Good people management is not soft and fluffy, it is good business
and is dynamic. Occupational health can deliver real solutions in the
management of sickness and absence problems and in creating a healthier
organisation overall.

The future

The South Yorkshire Police occupational health service is a victim of its
own success in that demand for the service outweighs its resources. We are
currently awaiting decisions from the senior management team following a
supportive best value review, to determine whether appropriate resources for OH
are going to be forthcoming.

South Yorkshire Police is a changing organisation. Government directives are
also forcing change and demanding the service manages its staff better with
regard to health and safety and welfare issues. OH is a key player in this but
it must be resourced appropriately to be able to respond to these growing
challenges. The current challenge for the OHA is to remain optimistic and
patient.

Sharon Samworth is an OH adviser for South Yorkshire Police

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