Can the AOHNP, the only body that solely represents occupational health nurses, unite workforce health managers around a common purpose and single voice in 2015? Nic Paton reports.
This year will be the 23rd anniversary of the formation of the Association of Occupational Health Nurse Practitioners (AOHNP). There is nothing particularly memorable about that as an anniversary, no zeros or fives to celebrate. But, arguably, the next 12 to 18 months could be the most memorable time so far for an organisation that is rapidly becoming much more prominent within the OH landscape.
In the wake of the failure in summer 2014 of the Society of Occupational Medicine (SOM) and the Faculty of Occupational Medicine (FOM) to secure a mandate from members to combine to form a single organisation, the spotlight is turning to the feasibility of the AOHNP to become an alternative platform for OH nurses; their “own” platform, rather than one “owned” by doctors.
As AOHNP vice-president and London regional director Susanna Everton puts it: “There were a lot of OH nurses who were, I think, disappointed that the doctors did not get the mandate they wanted. But now there is a view that, while they sort themselves out, there is no reason why we should not forge something ourselves.
“We don’t need to attach ourselves to the coattails of the doctors all the time, and a body that can speak with one voice for OH nurses will be really useful,” she adds.
Goals of the AOHNP
The AOHNP has a very simple goal: “To increase representation and raise the profile of occupational health nurses” (see box below). However, much like the profession as a whole in relation to the wider nurse community, it is (or has been up to now) a relatively small organisation, with 370 members, which represents around 10% of the OH nursing population.
History of the AOHNP
The AOHNP was founded in 1992 with a goal to increase representation and raise the profile of occupational health nurses. Its first patron was journalist and bowel cancer champion Lynn Faulds Wood, who was appointed in July 2000.
Its membership comprises OH nurse practitioners working across all sectors of UK industry and at all levels of employment, from service directors to students.
Its current structure is of a loose membership network, with a constitution and managed by an elected board, all of whom offer their services on a voluntary basis. The board is supported by a number of working parties formed from interested members. The association’s stated aims are:
- To actively represent and promote the practice of occupational health nursing.
- To support and influence the learning and development of OH nursing through participation in curriculum development and OH standards.
- To support and promote the continuing professional development of OH nurses.
- To work in association with other relevant agencies to benchmark and research OH nursing practice.
- To provide a network of professional expertise and support.
Its membership benefits include: a regional contact point; networking opportunities; access to specialist legal, HR, marketing and research advice; a member website and social media sites; a quarterly membership e-newsletter; and access to the Ruth Alston Memorial Lecture.
It also offers access to: Unite and the Medical Defence Union; a monthly e-bulletin from regional directors; scholarships; two events per year; and regional workshops and study days.
Nevertheless, with the Royal College of Nursing’s OH nursing group being subsumed a few years back into its much more broadly based Public Health Forum and now the SOM/FOM merger being knocked into the long grass, there is a growing consensus that the association could be the best national vehicle available to OH nurses to share knowledge, evidence and standards and, just as importantly, articulate their concerns and priorities to a wider audience.
Certainly, it is a vision that new president Diane Romano-Woodward shares: “We, as nurses, have to go ahead and become the strong force that we actually are, with less emphasis now on joining up with doctors. Whatever the result of the single organisation vote, there was always going to be a role for OH nurses, so, in reality, it’s business as usual. But it is exciting times.”
“The AOHNP has not, in the past, ‘sold’ itself as well as it could; there are practitioners out there who do not know the benefits we can offer to them. We also need to get the message across that membership of AOHNP may benefit you, but also it can sometimes be about benefiting and promoting the whole profession.”
Romano-Woodward adds: “We do a lot already and our opinion is valued, for example by bodies like SOM and the Health and Safety Executive. But we definitely want to attract new members; my goal, as I’ve said in the past, is to double our membership over the next two years. It’s a bold objective but I am confident it will happen.”
And there is already a lot happening. First, in October 2014, the association carried out a survey to gauge reaction to the SOM/FOM vote and see what appetite there might be for nurses to “go it alone” and create their own single representative body (see box opposite). The overarching message from this was a resounding “yes” in principle, with many also seeing the AOHNP as being best placed to take the lead on this.
A second important development was the decision in November by the Nursing and Midwifery Council (NMC) to task the association with piloting and assessing models for the revalidation of OH nurse practitioners.
This, argues Romano-Woodward, is a major feather in the cap for the association and, just as importantly, valuable recognition by the NMC of the specific challenges that revalidation is likely to pose for OH nurses.
“For the NMC to allow the revalidation project to go ahead is a real acknowledgement of our importance; it is a big step. The NMC may not understand OH very well but what is positive is that it is open to us providing different ways to revalidate, for example for people who are self-employed or in single practice,” she says.
“The relationship that OH has with its clients is very different to other forms of nursing, in that there may be occasions where we are telling the client things they don’t want to hear.”
A further major piece of work now being taken forward by the association – and one that may in time significantly change the OH landscape – is to look into the feasibility of developing a faculty for occupational health nursing.
As Christina Butterworth, immediate past-president of the AOHNP who is leading this work, explains:
“Had the SOM/FOM vote gone forward, one of the next stages would have been to look at developing a faculty for occupational health nurses. The vote, of course, did not go forward, but I still think a faculty is definitely an idea for the future, bringing together all of the various OH nurse groups and multidisciplinary networks and organisations.
I think the AOHNP is in a good position to develop this and we have already held a short meeting with a group of OHNs, not all of whom are association members. We just threw around some ideas, looked at things we could do and what sorts of opportunities there might be, and the idea of forming a faculty was one of the key things put in place.”
“The plans are still at an early stage, and there are many issues to work through and different models to consider. The timescale is also fluid, especially given the level of consultation and engagement with members. But having something in place within the next 18 months to two years would probably not be unrealistic, Butterworth estimates.
“There is broad agreement to start working on this. It would be funded by membership subscriptions and would provide a lead on training and development, conferences and other work. There would also likely be some work around assurance and audit,” she says.
A third key strand of activity is that the association is looking closely at the feasibility of transforming itself from what has traditionally been a relatively informal membership network into something more formal, with charitable status.
As Everton explains: “We looked into becoming a charity around three or four years ago, as we thought it might be an easier way to fund and provide more services for members. But it was not taken forward as an option at the time and since then we’ve remained just a loose network.
“But, over the past four months we have been looking closely again at this idea of acquiring charitable status in much the same way as the SOM has. We do offer things such as funding for some scholarships and some financial support already, but if we became a charity we could organise it much better and make things much more formalised. It would put us in a much better position to take up some of the ideas that we are considering at the moment.
“We could feasibly, too, develop a trading arm and it could also have the advantage that, if we can offer more benefits, we will be more attractive as an organisation to new members who want to join,” she continues.
A new draft constitution and business plan has already been written and the association has started work on appointing a board of trustees. It would also need to move its registration, currently based in Scotland, to England.
“The whole plan is running in tandem with the moves to develop a faculty. The actual process doesn’t take that long; what takes the time is putting everything together before you put in the application. It is simply about giving us more flexibility and freedom,” says Everton.
The final piece of work will be an overhaul of the association’s website over the next six to eight months, says AOHNP director Andy Phillips, of the Health and Work Consultancy Ltd.
“It has long been recognised that the website needs to become more responsive and the association needs to step up its game in this area,” he says.
“So we’re tendering to appoint a web designer. The idea is to have a website that is enabled for people coming to it from tablets or smartphones but which can also offer members a lot more than it does at the moment.
“We’re planning for it to have an education page and webinars, and for us to be able to take payments from members through the site,” he adds.
What all this activity adds up to – at least potentially – is a sea change for OH nursing. There is, argues association director Sarah Jane Mogford, of consultancy Chantry Health, a real excitement and buzz around the opportunities here for OH nursing, and for the association.
“Had the SOM/FOM single organisation gone ahead, the association would have had to change anyway. But even if it had, there were some things about it we were worried about, like talk about SOM running our registration,” she says.
“But the minute it was not carried, that upped the stakes. Although it would have been good to have had that single organisation, I think we do now need our own role. We are not doctors, and we think about things very differently to doctors; it’s important we don’t lose that. Maybe, yes, we can be in charge of our profession.”
AOHNP and revalidation
The decision by the NMC to partner with the AOHNP on revalidation for OH nurse practitioners is potentially a significant one.
The move, announced in November, will see the association joining a wide range of other healthcare organisations piloting systems and processes for revalidation in their specific areas.
The pilots, said the NMC, “will help identify any ways in which the NMC should refine the model, guidance and forms before its introduction at the end of 2015”.
Under revalidation, nurses and midwives will be required to confirm to the NMC that they are up to date and fit to practise every three years. To do this, they will need confirmation from a third party that they continue to practise in accordance with the NMC’s code and have reflected on feedback from service users, the NMC has said.
The AOHNP has been tasked with piloting revalidation for independent OH nurse practitioners. The idea is that nurses and midwives taking part in the pilots will go through a process of online testing between April and June 2015.
NMC chief executive Jackie Smith said: “Revalidation is an important system of regular checks which will make sure that nurses and midwives are up to date and fit to practise throughout their careers.
“The organisations and individuals we will work with in the coming months will help us to make sure that revalidation works for all nurses and midwives, no matter what their practice setting, level of seniority or employment situation,” she added.
Single organisation survey
AOHNP at sea
The AOHNP will hold a mini-cruise for members this October to Bruges, famous for its beers, waffles and chocolate.
The cruise (10-12 October on the P&O Ventura), will sail from Southampton and will be in addition to the association’s London AGM and the Ruth Alston Memorial Lecture.
The weekend will be a networking event, and will be open to non-members as well as members. There will also be continuing professional developement educational elements plus a factory visit in Bruges with supporting lectures.
The cost will be between £199 and £319 per person, depending on the cabin, with a deposit required of £39-£50, the AOHNP has said.
For more details, contact AOHNP director Anne Newham on 07565 962254 or email firstname.lastname@example.org
The AOHNP’s survey in the wake of the SOM and FOM vote secured a total of 504 responses from nurses, technicians, doctors and others. This found that more than three-quarters (391) of respondents had been aware of the SOM and FOM initiative.
When asked who they believed best represented the current views of OHNs or technicians, 315 said the AOHNP, against 16 for SOM. Intriguingly, 96 said regional health groups did this best while, worryingly, 88 said “nobody”.
The survey also concluded that there was potentially a strong appetite for a single body to represent nurses and/or other allied health professionals such as technicians, with nearly two-thirds (292) of respondents supporting this as an idea.
“There is a strong feeling the association is currently best placed to represent OH nurses and technicians. But, it is also very clear that, if we do go down the route of developing a single representative body for nurses and technicians, there will need to be a lot of work done to explain it to practitioners and raise awareness about it beforehand,” says Phillips.
There was strong support for nurses to continue to have a professional register (427 respondents) but significant ambivalence as to whether or not the NMC remained the best body to oversee this. Nearly half (221) backed the notion of a register separate or split from the main NMC-run register. Moreover, more than one-third (164) felt that this might also be a role the association could take on in time.