The Association of Occupational Health Nurse Practitioners (AOHNP) held its 2014 annual meeting and good practice forum in November in London. The title of the event was: “Mind games – identifying the game plan, not just being part of it”.
At the meeting, the message from the outgoing president, Christina Butterworth, was: “We really do need to have a single voice in OH.”
Butterworth showed how the AOHNP is a key partner in a range of initiatives focused on the future of OH and the education and regulation of nurses.
She acknowledged that the current AOHNP membership of 350 will need to grow if it is to extend its influence within OH and, more broadly, in workplace health. “It’s a good number but it’s 10% of the OH workforce. We need a lot more than that to have influence,” she said.
The conference took place in the aftermath of OH physicians voting “no” to a combined Society of Occupational Medicine and Faculty of Occupational Medicine in September 2014. The result effectively ruled out an OH body that would have included doctors, nurses and allied health professionals.
In the wake of this, the organisation will consult with its members in the new year about whether the association itself can evolve into a potential faculty of OH nursing.
“When the doctors realise how fantastic we are and don’t intend to take over the whole of the world, only a small part of it, then they’ll want to join forces with us,” Butterworth told assembled AOHNP members.
She continued: “We don’t want lots of different groups to be lobbying the Government – it really is about having a single voice for OH nursing.”
Butterworth is one of the nurse representatives on talks to develop a new National School of Occupational Health, along with Anne Harriss, reader in educational development and course director at London South Bank University. They are about to start work on a curriculum for OH nursing, and will be conducting surveys with OH nurses soon.
“What do we need in order to manage workforce wellbeing? Let’s make sure that the few resources we have in OH are used in the best way we can,” she said. Harriss has also responded to NHS Health Education England’s Shape of caring review into the future of nurse education.
The AOHNP is also leading a pilot on nurse revalidation for the Nursing and Midwifery Council (NMC). “We are a special group. We do work autonomously a lot of the time, we have a lot of responsibilities, we don’t have the report structures of the NHS,” said Butterworth. “It is about what we need to be fit for purpose. We need to be able to show people that we really are a good bunch of nurses.”
The AOHNP is also working with the NMC to develop specialist OH training, and address the need for more practice teachers. “The NHS model doesn’t always work for OH nurses,” said Butterworth.
Another project is an AOHNP members’ register to help customers understand the services that OH advisers offer and match these to their requirements. “There are a number of nurses and allied professionals parading OH advice that’s not as high [level] as what we do – we don’t want employers to think that’s the norm,” said Butterworth.
The AOHNP is also considering the Government’s new Fit for Work service and its implications for OH delivery. “We’ve been looking at it and seeing what’s happening,” said Butterworth. “You must remember, the Government is putting in a very strict assurance programme to make sure that [the Fit for Work service] works. We’ve got to stop thinking face to face is always best [for OH]. [Fit for Work] is great to see but we want to see if it is moving in the right direction.”
AOHNP leaders are also involved in a major project to scope out the future of OH, led by the chief medical officer at Devon and Cornwall Police, Dr John Harrison.
Delegates were told by Butterworth: “These are exciting times. Do please get involved; we need your ideas.”
Occupational health role in grievance and disciplinary meetings
Sarah Jane Mogford, OH director at Chantry Health Services, advised delegates about good practice for OH advisers acting as a witness or adviser in disciplinary or grievance meetings with employees.
Mogford said that employees on sick leave often fail to respond to formal correspondence and OH advisers should take into account the fact that this is a “scary process” for individuals. “The outcome of this meeting could be that ultimately you get the sack. Employees are not used to jargony letters and formal procedures,” she said.
She suggested that OH advisers abide by the Acas code on discipline and grievance, raise issues promptly, carry out investigations and establish the facts, inform employees of the basis of the problem and allow them to put their case across.
“Protracting the process is only likely to harm the individual concerned. The longer we drag out the process, the longer the big black cloud of anxiety hangs over their heads,” said Mogford.
“You have to explain it’s a formal process, and it has to happen. You can’t delay communication forever because the person may say they’re not properly informed.”
Where an employee cannot attend for reasons of sickness, the employer should reschedule the meeting at least twice, but then the OH adviser should consider advising the employer to hold the meeting without the employee present.
The employee can provide a written statement to be read out, but Mogford advised that there should be proof of communication, such as sending the statement recorded or hand delivery, or present a reply to show that an email has been read.
At meetings, OH should advise line managers to consider adjustments that may enable the employee to participate. Adjustments include: a third-party venue (although not in the employee’s own home); breaks in proceedings; or tape recordings.
If the proceedings lead to a subsequent unfair dismissal case, Mogford tells the OH adviser: “You must demonstrate you’ve offered every alternative. You’ve got to show your ‘workings out’”.
Changes ahead for the AOHNP
The annual general meeting saw the ratification of new AOHNP President, Diane Romano-Woodward, and the board – Christina Butterworth, Susanna Everton, Kate Kyne, Lyndsey Marchant, Sarah Mogford, Anne Newham, Andy Phillips and Marisa Stevenson.
Romano-Woodward is leading a review of the constitution, the structure of the board and the services offered and will consult with members on what they want. She gave a summary of her vision for the AOHNP, which includes using directors for specific tasks. The website is under tender for an overhaul and the board plans more inclusive involvement of members, using social media and events.
The board is in discussion with insurance providers to ensure members have the best information when choosing their individual cover. A survey on the future of OH nursing has been conducted.
The AOHNP is also progressing towards charity status, which should facilitate a database of OH nurses that can be used in a similar way to the Faculty of Occupational Medicine, which has a qualified physicians register commercially available.