Points of view: Sayeed Khan – chief medical adviser for the Engineering Employers Forum

If anyone’s views on how occupational health (OH) services should be provided in future are worth listening to, then Dr Sayeed Khan’s are. His influence is evident in the government’s Health, Work and Wellbeing strategy document, launched in October 2005, and he has put his neck on the block again by vocally supporting the government’s plans to get people off incapacity benefit and back to work.

Khan is the only chief medical adviser (CMA) for an employers’ body, manufacturers’ organisation the Engineering Employers Federation (EEF), and he is networked into every organisation with a remit for OH in the UK.

Formerly head of OH for Defence (Europe) and Energy Businesses at Rolls Royce, he took up his CMA role at the EEF in 2002, and last year he was appointed one of the Health and Safety Commission’s independent commissioners. A former GP, he is a fellow of both the Royal College of General Practitioners, and the Faculty of Medicine of the Royal College of Physicians.

He has ties with the Royal College of Nursing, including the Society of Occupational Health Nursing, and is a member of the Institute of Occupational Safety and Health. In his spare time he is special professor of OH at Nottingham University.

So how does Khan see OH service provision and the roles of OH physicians, OH nurses and health and safety professionals developing in the future?

Understandably, he is impatient with the delay in appointing the national director of OH, promised to be in place by the end of 2005 in the Health, Work and Wellbeing document.

“It’s so frustrating – it gives the cynic a field day because you [the government] can’t even sort out who’s going to run it.”

Khan would make a worthy candidate himself, but he says he is not interested in the role. He is clear about how the ambitious aims of the strategy can be achieved when OH doctors and nurses are in short supply. It will need some OH practitioners to raise their game.

He believes that a big rise in OH provision can only be achieved by extending the responsibility of health and safety professionals.

“This isn’t a dumbing down of OH nursing or physicians – this is about the appropriate use of specialist skills. You don’t need nurses or doctors doing audiometry, spirometry or taking blood. They [employers] must have an overall supervisory person to manage it.”

He thinks the advance of IOSH, which achieved chartered status last year, means health and safety professionals will be up to the challenge. “They’ve gone up a level,” he says. “There are 28,000 safety members – that is the pool to look at in terms of an advanced professional place in workplace health.”

Khan would like to see all the professionals with a stake in workplace health undergoing a paradigm shift that would persuade employers of the business benefits of investing in OH.

He is involved in developing a course to train chartered members of IOSH to do the tasks of OH technicians, and to support rehabilitation of incapacitated staff. Khan also sits on the board for the Med 3 sick-note pilot scheme, and recognises that plans to get people back into work will flounder unless GPs shift the emphasis from diagnosis of illness towards assessing the functional capacity of incapacitated employees, and making recommendations about part-time working or a change of role at work.

The Royal College of General Practitioners, he says, is in the process of redrafting the GP training syllabus, allowing external stakeholders to comment on it for the first time.

Running through all the work Khan has done at the EEF is the principle of providing practical, evidence-based tools and disseminating them as widely as possible. He would like to see the HSE make all of its materials available free online.

If communication, partnership and evidence-based practical interventions can spread OH services beyond the 25% of companies currently covered, then Khan will play a key role in achieving this.

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