Changing face of OH

If we are going to have a much older workforce, the occupational health (OH) industry is not going to be able to cope with it. There will not be enough people with the expertise in this area. Companies have not yet caught up to the adjustment that will be involved,” warns the Employers’ Forum on Age (EFA) director, Sam Mercer.

What’s more, she says, employers are only just beginning to cotton on to the fact there is an ageing workforce and that it is going to have a “massive impact” on OH.

“HR is aware about health and safety, but there is very little awareness about it in relation to the future age legislation,” Mercer adds. “There is an assumption that existing health and safety legislation is going to override the age legislation. People have just not thought about this and are not anticipating the impact of an ageing population on the occupational health industry,” she stresses.

Latest figures from the EFA predict that by 2006 – when age discrimination legislation comes into force – there will be more 55-64 year-olds than 16-24 year-olds in the population than ever before. By that date, 45-59 year-olds will also form the largest single group in the labour force.

The reality of an ageing workforce has been creeping up on HR professionals for some time. The energy industry, however, has had to face it head-on. British Energy, for example, which supplies around 20 per cent of the UK’s energy, estimates that 65 per cent of its 5,300 employees are aged over 40. Of these, 2 per cent are between 50 and retirement age.

“As an employer, we put a value on experience. But there can be a conflict between having people who are highly-valued and people who might be less than fully physically fit,” explains Geoff Pears, HR manager at Hinkley Point power station and the company’s former head of diversity.

Generally though, HR’s focus when it comes to older workers has primarily been on areas such as pension provision, retirement ages, discrimination and managing office culture. Now, however, HR professionals are increasingly beginning to realise that managing the health of older workers is likely to be one of the biggest future challenges.

A key element of British Energy’s employment policy, for instance, is that every employee, irrespective of their age, has an annual task or job-related health assessment, says Pears.

While attitudes are beginning to change higher up the chain, there is still much to do to change preconceptions and prejudices among line managers, Mercer argues.

OH will have a pivotal role in the future because of its responsibility for carrying out pre-employment assessments, believes Dr David Matthews, Bupa Health At Work occupational health physician.

“It is the role of OH to ensure that people have a totally objective assessment from the onset,” he explains. OH will, in effect, become an advocate for older workers – arguing that, contrary to any prejudices from managers, a worker is capable of doing a particular job or carrying out a particular function.

Similarly, if a worker is unable to carry out a role, but could still be productive in a different or adapted role, it will be down to OH to make the case to HR and line managers. “OH will need to be communicating to employers that these people do have a place in companies and should not just be retired off,” Matthews argues.

Yet, while it is generally accepted that older workers take less sickness absence, there’s no getting away from the fact that, as you get older, common health issues can arise. “Older workers do have certain physical facets that will deteriorate, but not that much,” stresses Matthews.

As a result, it is quite feasible that the role of the OH practitioner will have to change as the workforce ages. Much like HR, OH professionals have for some time been trying to carve out a more strategic niche for themselves.

The idea of a nurse-based ‘sticking plaster, tea and sympathy’ service has given way to one where OH is dealing with key strategic issues, such as absence management, rehabilitation and risk assessment.
Yet as the workforce ages, employers may well want access to a more medicalised service, particularly once GPs take more of a back seat in dealing with workplace sickness certification.

“More employers are already asking us to provide a service in the workplace that is a treatment service. I think OH is going to become much more involved in the rehabilitation of older workers and in ensuring access to treatment, even if OH cannot treat itself,” says Matthews.

OH may also find itself managing the treatment of more chronic medical conditions, such as chest problems, high blood pressure and malignant diseases, which can be common among older people. “These are not things that OH has had to deal with very much in the past,” he explains.

What this means in terms of the relationship between HR and OH is less clear-cut. The dynamic between the two functions can be tense at the best of times, but if health issues shoot up the agenda as the workforce ages, how OH and HR co-operate will be critical.

Yet, according to Jeremy Smith, vice president of the Association of Occupational Health Nurse Practitioners (UK), the ageing workforce may in fact have much less of an impact than feared.
“I don’t think it is going to make a great deal of difference to what we do,” he argues. “Our role is making sure people are fit for work and already it is more about capabilities, regardless of age.”

Promoting better and more healthy lifestyles and carrying out well-being and health checks already come under the OH remit, Smith suggests. “If someone is fit for a role, we look at the whole person rather than their age. If the Government removes the break from retirement age, we will see a greater number of senior people coming into the workplace. But it will be the fit people who will be carrying on over 65. The unfit ones will not continue anyway,” he argues.

“Occupational health is flexible enough to meet the demands of an ageing workforce, if those demands need to be met,” Smith adds, although he concedes there might be more health screening and health promotion as a result.

Despite Smith’s optimism, the big question is whether the OH profession will be up to the challenge. Despite health shooting up the business agenda, if anything, access to OH provision has been declining in recent years as employers tighten their belts.

Two years ago, a study for the Health and Safety Executive found that just one in seven workers in the UK – about 30 per cent – now have access to comprehensive OH support. This compared with 50 per cent in 1990.

How employers will have to handle health

More medicalised occupational health service

– Greater emphasis on pre-employment assessment, screening and workplace rehabilitation

– Need to manage workers with chronic medical conditions back into the workplace

– Need for a greater understanding of common elderly-associated conditions, such as diabetes, coronary heart disease, high blood pressure and chest diseases

– Recognition that workers will need to be assessed on capability rather than age

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