Access for all

In 2000, the Health and Safety Executive (HSE) estimated that only 3% of UK employees have access to occupational health services, and most of these were in larger organisations. In other words, OH professionals whose salaries are paid by larger employers are failing to reach 97% of the workforce. So how can OH reach the parts it has so far failed to reach?

One solution could be Workplace Health Connect (WHC). It was launched in February this year to offer small and medium-sized enterprises (SMEs) free advice through a national advice line and five pathfinder pilots in the North East, North West, West Midlands, South Wales and Greater London.

So far, the programme has been funded through the HSE’s budget for special programmes, but the announcement in June that a sixth pathfinder project, planned for the South East, was to be dropped due to lack of funds, showed the scale of the challenge. As WHC will not necessarily be funded by the government, it will have come up with some innovative funding options to survive.

The director of WHC, Elizabeth Gyngell, is undaunted. “I’m passionate about doing this because people have said it’s the right thing, and we really do have to make amends for that terrible statistic of 3%,” she says.

WHC forms a key part of the government’s Securing Health Together 10-year targets, launched in 2000, to improve workplace health, and fits in with the welfare reforms, which aim to get a million people on incapacity benefit to return to work.

It is the twin of Pathways to Work, which focuses on the employee and helps incapacitated individuals return to work. WHC, on the other hand, targets the employer.

The project draws on lessons from a range of previous initiatives and input from stakeholders.

“What these people told us, including nurses, was that this needed to be something divorced from the enforcing authorities – SMEs perceive a prosecution risk,” says Gyngell.

However, data so far suggests that smaller employers were less nervous than anticipated, and the HSE is about to launch a higher profile marketing campaign of the advice line through direct marketing to firms, adverts in local newspapers and radio, websites and links.

Employers ring the helpline with a question, then, if appropriate, an adviser visits the workplace and helps draw up a report and action plan.Local approved specialists can then help the organisations tackle longer term problems.

Service providers are local partnerships contracted to the HSE, with quality standards set out in a handbook and monitored through visits and ‘mystery shopping’. Among the professionals involved are OH practitioners, physiotherapists, ergonomists, engineers, and hygienists.

“What we’ve been learning is that sickness absence does matter to small firms because of the effect on its business – staff are less likely to be off when they are not ill,” says Gyngell.

However, while unwarranted absence may be less of a problem in smaller organisations, genuine work-related ill health is a different matter.

“A lot of SMEs don’t have a clue about how to get people back to work,” says Gyngell. “There is a huge lack of awareness about health problems.”

More employees have contacted the service than their bosses, making 57% of calls compared to 37% from employers. So far, 400 companies have requested a visit compared with the target for the next two years of 4,750. Other targets include 60,000 calls to the helpline, and a positive effect on 95,000 workers. The service is currently being independently evaluated.

It will be a challenge to get measures of the impact on absence because many SMEs do not keep absence records, but the HSE is encouraging them to do so.

Not surprisingly, Gyngell is right behind the government’s workplace health strategy, in particular, the coming together of the Department for Work and Pensions with the Department of Health and the HSE.

“The fact they have appointed Carol Black – who is an important individual – as director of health and work is an important indicator that they mean business, but we must recognise the enormous difficulty of getting this sort of partnership working,” she says.

Gyngell is retiring in September after 30 years at the HSE, and sees the development of WHC as the culmination of much of her work. If it succeeds, it will be a tribute to her vision. However, her work is not quite over yet. “I’m very anxious that this baby is weened,” she says.

Health and Safety Commission advice line: 0845 609 6006

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