Analysis: OH service standards

Last month’s formal launch of new standards for occupational health (OH) providers was, according to Professor David Coggan, president of the Faculty of Occupational Medicine, “an important development for occupational health”.

As the first stage of a process that should by next year lead to a working accreditation system for OH providers, Coggan’s comments were, if anything, an understatement.
The standards (see box below), for the first time, give both NHS and commercial OH providers a yardstick against which to judge themselves, and are a way of showing – to themselves, potential clients, suppliers, commissioners, employers and staff – that how they operate, and what they provide, is of a high and credible standard.

The standards are also a key element of national director for health and work Dame Carol Black’s reform of workplace health, as advocated in her landmark Working for a Healthier Tomorrow review.

OH standards

The standards cover business probity, information governance, people, facilities and equipment, relationships with purchasers, and relationships with workers, and have been in the making since August 2008. And they have had input from OH, nursing, occupational medicine, commercial providers, employers, the government and workers’ representatives.

Draft standards were published for consultation in June 2009, then piloted and re-published in November 2009, and the final version was unveiled in January 2010.

Aims and objectives

The idea behind publishing the standards a year ahead of an accreditation system, which is due to be piloted later this year and then rolled out in 2011, is simply to give providers, employers and OH professionals time to become familiar with them, argues Dr Paul Nicholson, project lead at the Faculty of Occupational Medicine and chairman of the British Medical Association’s Occupational Medicine Committee.

“This is a way of demonstrating that you have an independent verification, a kitemark, and that you have been independently audited and shown that you have met the required standards,” he explains.

“Currently if an organisation buys occupational health services it has no way of knowing if what it is buying is good or bad – for example, such as what are the most appropriate qualifications that an individual in that organisation should have, and so on,” he adds.

The standards, it should be stressed, only apply to core clinical OH services – in other words, those services provided by doctors, nurses and OH technicians. They do not apply to non-clinical services, such as occupational hygiene and ergonomics, for example. They also relate solely to professional activities, and so do not extend to an employer’s legal responsibilities.

Accreditation process

Once up and running, the accreditation process will incorporate, first, a pre-qualification questionnaire. This will allow the provider to attest to their eligibility criteria for accreditation, and will need to be signed or co-signed by at least one registered health professional from the OH service.

This will be followed by the provider having to supply a list of customers and key contacts, from which a sample will be approached to complete and return a customer satisfaction survey answering pre-determined questions. After this, an online assessment will be carried out to determine the provider’s readiness for the next stage, an on-site assessment and external audit. Finally, there will be a self-assessment process, where providers seeking accreditation or re-accreditation will have to undertake self-assessment where or when external audit is not provided.

Requirements

This may all sound daunting but, argues Nicholson, providers and practitioners should not feel threatened by the standards or the forthcoming accreditation process.
“As with any process of audit or accreditation, it may well be that you are already doing the right thing,” he says. “The key now is going to be able to show that you can prove it – do you have the right documentary evidence?

“But meeting the standards is not going to be insurmountable. We have tried not to make it too burdensome, we have tried to make it proportionate,” he emphasises. “Occupational health practitioners now need to be making themselves familiar with the standards and minimum requirements, in particular around examples of evidence.

“When the accreditation system is launched later this year, they will need to be able to prove they have robust systems in place and they are tracking, maintaining and operating those systems effectively too,” he adds.