After three years of working tirelessly to promote and support OH nursing, a critical decline in membership numbers means this year could be make or break for the Faculty of Occupational Health Nursing. Chair Christina Butterworth talks to Nic Paton about her hopes – and fears – for 2023.
Back in the summer of 2019 I had the pleasure of presenting a talk at the Faculty of Occupational Health Nursing’s (FOHN) inaugural annual conference in Bristol.
A lot has happened since then, not least a pandemic that, while it may have raised the profile of occupational health, has also stress-tested the ability to survive what was already a diminishing and ageing profession.
At the gathering in Bristol there was considerable optimism. From bumpy beginnings the year before – the faculty had emerged from the failed merger between it and the then Association of Occupational Health Nurse Practitioners, now iOH – there was hope FOHN was beginning to develop traction, beginning to build the recognition it needed to develop into a sustainable organisation.
There were more than 130 signed-up members, with double again who had registered their interest to join via the FOHN website. There were ambitions to run a leadership event in Liverpool later that autumn, to develop a new OH nursing training course, to publish guidance documents to help employers better understand OH, and to work with organisations as disparate as the National School of Occupational Health, SOM (the Society of Occupational Medicine), the Nursing and Midwifery Council (NMC), the Council for Work and Health and the government’s Work and Health Unit, among others.
Indeed, as FOHN chair Christina Butterworth put it at the time: “Our role is about helping people who want to come into the profession to know what they need to know. It is about ensuring that nurses’ viewpoints are heard, that occupational health nursing is being heard.”
Scroll forward three-and-a-half years and, to be fair, many of these aspirations have been achieved. It is clear the faculty carries weight and authority within the profession and with those who work alongside it. In fact, the list of current and ongoing work is impressive.
Faculty of Occupational Health Nursing
“We’ve continued to represent occupational health nurses in all key activities in the field of occupational health,” Butterworth emphasises. “We are active members of the Council for Work and Health and also part of a number of stakeholder groups and fora, including the DWP/DHSC Work and Health Unit, NMC’s work on its new standards for education and practice in terms of OH nursing, the FOM SEQOHS review and the Health and Safety Executive’s OH liaison group.
“We’re also working very closely with the British Occupational Hygiene Society to address some of those key issues around carcinogens in the workplace and other risks, and getting people to recognise the work of occupational hygienists as well.
“We have collaborated with the Faculty of Occupational Medicine on its short inaugural Diploma in Occupational Health Practice (DipOHPrac) designed to provide a foundation in OH nursing, support those already working in occupational health to advance further in their careers and to encourage others to transition into the specialty. We have been working with SOM on various initiatives.
“OH nurses regularly contact us with questions about their career and such like; we try to answer those in a lot of detail. They find that really useful,” she adds.
The difficulty for FOHN is that much of this work, while hugely valuable to the future of the profession, has largely gone on under the radar – at a time when employers, practitioners and would-be members have often been distracted and/or financially stretched.
Decline in membership numbers
In fact, pretty much the only FOHN ‘news’ that OHW+ reported on in 2022 was the faculty’s launch in November of ‘Consent and confidentiality in OH’. This is a document outlining frequently asked questions to help nurses working in OH better understand the principles and practice of obtaining consent and maintaining confidentiality.
It is this lack of visibility, combined with the wider pressures on employers and practitioners, that has arguably contributed to FOHN now facing something of a make-or-break year.
As Butterworth concedes: “We are currently down to 26 members. It is a reflection of the sign of the times, unfortunately. That is our biggest concern. Before we launched the faculty, people said ‘it is really important, we’re going to support it, we’ll become members’ and then it never materialised.”
The much cheaper membership offers of bodies such as iOH have not helped, Butterworth admits, when compared to the current £120 paid for full FOHN membership.
“It has been a difficult thing to reconcile. We need a minimum of about 30 people to keep us viable, just to manage all of our operational requirements,” she points out.
“We [FOHN and iOH] both agree we have different niches that we fulfil, with iOH providing networking support and CPD to the OH professional community and FOHN promoting excellence in the education, research and evidence-based practice of all occupational health nurses within our ever-changing field of practice.
“Through our leadership we continue to bring credibility and recognition of the unique and valuable good the profession does. With both organisations ultimately benefitting the working population” she adds.
Nevertheless, and positively, it is clear FOHN has no intention of going down without a fight. Indeed, in response, the faculty is this year launching a series of initiatives designed to revitalise interest in its work and its value to the profession.
Post-nominals accreditation scheme
Later this month, it will be launching a ‘Friend of the Faculty’ initiative for a £10 subscription rate.
“Anybody will be able to join us as a ‘friend’, whatever their role within or alongside the profession. They will join our membership network and be kept abreast of our work streams and supporting the development of the profession,” Butterworth says.
Perhaps even more significantly, from the spring the faculty intends to unveil a new OH nursing accreditation scheme designed to complement the existing, if narrow, NMC register and allowing OH nurses to use a new set of post-nominals: AFOHN, PFOHN, or SFOHN. These will, Butterworth argues, provide career aspirations and a roadmap from Associate to Practitioner and then Specialist of the Faculty of Occupational Health Nursing.
“Occupational health nurses tend to be either on Part 1 or Part 3 of the NMC register. But what that doesn’t do is recognise all those sub-specialties in Part 1. What this is doing is to look at all those sub-specialties in Part 1 and the career development of SCPHN-OH registered nurses,” Butterworth explains.
Our message is very much simply: support your faculty. We are representing you at a national level in order to make sure that you are – and the profession is – remains viable and successful long into the future” – Christina Butterworth
“It is very much filling that gap but also recognising those who have gone over and above and really are special people. It will help employers to clarify, to some extent, the competence of that individual. Because it will say we’ve assessed that person for their knowledge, skills, training and their other attributes as to how good an occupational health nurse they are. It will help employers and others to understand what they’re getting and what level that person has been trained to and is experienced in.
“The CPD requirements – approximately 450 hours over three years – will complement revalidation but be quite specific. Yet they shouldn’t be too onerous on individuals because they should be collecting this as part of their appraisals every year in their workplace or whatever activities they are doing in their workplace or area of practice. And it is good for those who are lone practitioners as well because they can demonstrate how well they are doing in terms of their own practice and developing as well.
“In terms of governance, there will be a professional accreditation group that will assess portfolios and applications. There will be clear documentation and clear processes and there will be an appeals process. We’ve benchmarked with five other organisations to make sure that we’re taking the best of each of those, to make sure we have got those good governance arrangements in place,” she adds.
Principles of what ‘good’ OH looks like
Alongside all this, FOHN will this year be working to publish high-level principles and frameworks for what makes for ‘good’ OH as well as a new clinical standards framework. “We’re also doing a framework document around quality – what is ‘good’ occupational health nursing and what arrangements should you have in place to demonstrate that you are leading a quality service. So there is a lot of work going on,” Butterworth explains.
Of course, all of this valuable work to put OH nursing on a professionalised footing will only be able to continue if the faculty itself is able to continue. Therefore, to channel Lord Kitchener’s famous First World War recruitment poster – your faculty needs you.
“We recognise the workforce for occupational health – health and wellbeing in the workplace – is changing. As a profession, we have limited resources and we need to be careful we’re not left behind,” Butterworth emphasises.
“The profession needs to be strongly represented to ensure that OH nursing is advanced and recognised at a strategic level and does not get subsumed, as to an extent, it has already been by other allied health professionals. We are trained and therefore best placed to lead the multidisciplinary OH workforce. FOHN are here to support OH nurses define their position.
“Our message therefore is very much simply: support your faculty. We are representing you at a national level in order to make sure that you are – and the profession is – remains viable and successful long into the future,” she adds.