Ahead of the government in July launching its long-awaited consultation into workplace and occupational health, the Society of Occupational Medicine argued in a report that the specialty also needs a new multi-disciplinary research hub, a national Centre for Work and Health. Nic Paton looks at what it has proposed.
As Occupational Health & Wellbeing highlighted back in June (vol 71 no 6), it is now more than a decade since Dame Carol Black published her landmark report Working for a Healthier Tomorrow and there has been much debate as to how far (or not) workplace and occupational health has come in that time.
Innovations such as the Fit for Work service did of course (if briefly) see the light of day as a result of her recommendations. But one of Dame Carol’s areas of focus in 2008 that rather fell by the wayside was the need to build, and crystallise, the evidence base for employers around what works in terms of workplace health interventions. As she recommended at the time, government needed to work with employers and representative bodies “to develop a robust model for measuring and reporting on the benefits of employer investment in health and wellbeing”.
There needed to be “systematic gathering and analysis of data at national, regional and local level to inform the development of policy and the commissioning of services”. Alongside this, Dame Carol called for the development of “a business-led health and wellbeing consultancy service, offering tailored advice and support, and access to occupational health at a market rate”.
Reshaping workplace health
This idea for, in essence, a national Centre for Work and Health that can provide leadership for, and co-ordination of, UK occupational health research and best practice is at the core of a new report from the Society of Occupational Medicine published in June, just days before the launch of the government’s consultation, which was also expected to happen during July.
The report, The Value of Occupational Health Research, set out nine primary and two supplementary recommendations all with the aim of putting OH research at the heart of shaping – or even reshaping – how workplace health and wellbeing is managed within the UK and, from there, making UK plc more productive and competitive.
The report is the final part of what can be thought of as a trilogy of reports from the society running from its 2017 report Occupational health: the value proposition and its 2018 follow-up Occupational Health: the global evidence and value.
And, as report co-author Professor Ewan MacDonald, chair of the UK Academic Forum for Health and Work and head of the Healthy Working Lives Group at the University of Glasgow, emphasises, it is making a clarion call that needs to be addressed with some urgency. “There is a crisis in terms of the reduction of people doing research into health and work. There needs to be very much more more investment,” he says.
The report was formally launched at an event at the House of Lords attended by former home, education and work and pensions secretary Lord Blunkett as well as academics, senior practitioners and representatives from the government’s Health and Work Unit.
So, what might this new centre look and feel like, should it come to pass? The report argued the centre should be a “multi-disciplinary institute that will provide leadership, co-ordination of UK OH research together with training for early career researchers, OH clinicians, employers and employees.”
It would then have a further objective of being able to “network and collaborate with academic institutes, research funders, businesses and public and third sector organisations to ‘market’ OH research and generate impact, to drive the research agenda and facilitate translation of research into practice.”
Part of this, naturally, would also mean gathering insights and learning from other similar bodies around the world, with the report citing The Finnish Institute of Occupational Health and The Institute for Work & Health in Canada as potential examples.
Modern day occupational health research, the report suggested, had the “scope to be even broader in its role, not just targeting ‘occupational diseases’ but also accessing a wide range of the population to ‘prevent’ and ‘manage’ broader population health issues.”
The report echoed Professor MacDonald’s comments in arguing that “urgent attention needs to be given to retaining and developing the OH academic base; to attract, train and support new OH researchers with appropriate resourcing for this”.
‘Lack of good-quality evidence’
There needed to be “improved dissemination and better ‘marketing’ of key and relevant OH research findings” to clinicians, employers, employees and government.
“The feasibility and implementation of many of the recommendations above will only be possible with funding investment in OH research. Government, employers and industry, as co-beneficiaries of workplace health, should lead this investment,” it said.
More widely, the report emphasised that the UK’s current gaps in OH provision needed to be addressed. “Alternative models of OH provision for the UK working age population should be investigated and potential new models assessed with rigorous evaluation and research,” it argued, although whether this is overtaken by the outcome of the government’s consultation is, of course, now moot.
It also highlighted the specialty’s ongoing capacity challenges. “The numbers of clinical and other staff providing OH need to increase, through more training posts and recruitment. OH remains a poorly publicised and understood specialty. Much work is still needed to increase its profile and to ‘market’ careers in OH,” it argued.
Finally, the report in its conclusions made the compelling point that: “While there is a persisting lack of high-quality health economic assessment of the value of OH interventions, based on our evaluation of the research and qualitative study,there is a strong case supporting the OH, societal and public health value of OH research.
“We conclude that OH research should be at the core of shaping a healthy workforce and productive economy and should be developed accordingly.”
Naturally, the mechanics of how such a centre might be structured, staffed and, crucially, funded if it does become a reality remain, for now, up in the air. The thinking and some of the discussion at the launch event was that the government’s “What Works” network of centres (notably the What Works Centre for Wellbeing) could be one model or template to consider.
Only time, of course, will tell whether this idea for a new research centre for OH will ever come to fruition. But the society is very much hoping that, with the government’s consultation now “live”, this is precisely the sort of proposal that may be able to gain some traction within Whitehall.
The Value of Occupational Health Research: history, evolution and way forward, Society of Occupational Medicine, June 2019, available online at https://www.som.org.uk/sites/som.org.uk/files/SOM_Value_OH_Research_June2019.pdf
Occupational Health: the value proposition, Society of Occupational Medicine, 2017, available online at www.som.org.uk/sites/som.org.uk/files/Occupational_health_the_value_proposition.pdf
Occupational Health: the global evidence and value, Society of Occupational Medicine, 2018, available online at www.som.org.uk/sites/som.org.uk/files/Occupational_Health_the_Global_Value_and_Evidence_April_2018.pdf
What Works Network, Cabinet Office, www.gov.uk/guidance/what-works-network
What Works Centre for Wellbeing, https://whatworkswellbeing.org/#
Working for a Healthier Tomorrow: Dame Carol Black’s review of the health of Britain’s working age population, Department of Health and Department for Work and Pensions, March 2008, available online at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/209782/hwwb-working-for-a-healthier-tomorrow.pdf