First-class delivery

For The Post Office’s Employee Health Services team the challenge is to
provide a high standard of healthcare to 200,000 people at different locations
across the UK.  By Kate Rouy

I absolutely love my job. Every day something new lands on my desk. It is a
tremendous challenge."

So says Denize Bainbridge, principal nurse coordinator for employee health
services at The Post Office. And the challenge indeed is formidable. The Post
Office is one of the UK’s largest businesses, covering every geographical
region, and employing in the region of 200,000 people and generating annual
revenues in excess of £7bn.

Such a huge organisation needs an effective occupational health team behind
it to keep it up and running. And that team, Employee Health Services (EHS),
needs to rise to the commercial as well as the medical challenges of looking
after the health and wellbeing of such a large and geographically disparate
workforce.

Business challenge

"As far as we are concerned, our challenge is in terms of providing an
effective and efficient service, as well as providing the best value for money,
and added value to The Post Office business," says Bainbridge. "We
have to continually question ourselves about the value we are adding.

"The culture that has been created has impacted on our occupational
health staff, and there is pressure on us to look at what we are doing, why we
are doing it and to question our role."

According to Bainbridge, EHS is in a constant state of change and
development, "because of the nature of the beast; because The Post Office
is this huge public service and is continuing to evolve."

As a result, she says, EHS fits into the organisation as a business unit,
along the same lines as other sectors of the business. It is a national
service, modelled on the Post Office’s regional territories: the North, the
East and the West.

Management of the EHS teams in these areas was taken over from doctors last
year by professional Post Office managers, although the service remains
doctor-led, says Bainbridge. In terms of nursing staff, each area has around 20
nurses, although that varies from region to region.

Bainbridge herself is based in Farnborough, in Hampshire, the base of the
EHS business services team, which includes information support, finance and
customer service facilities, although with the whole of the UK to cover,
inevitably a large amount of her time is spent on the road.

Recent appointments to the team include the recruitment of an occupational
therapist and a physiotherapist, and Bainbridge says the aim is to bring about
a tighter collaborative service from all sectors of employee health services,
including welfare and safety.

"We are not a treatment service," she emphasises.

"We are a clinical practice for a public service, and we are very
streamlined into the needs of the business," she adds. Musculoskeletal
injuries are the main hazards faced by The Post Office’s occupational health
advisers, but issues such as stress are also increasingly coming to the fore.

Bainbridge acknowledges that such a focus can have its downside. "Our
OHAs can begin to feel a little bit deskilled," she says. The need to keep
the commercial aspects of the business in mind can also prove difficult for
some, she adds.

"Our nurses have to balance their clinical skills within a commercial
context, and for some that can be a bit of a problem."

Forming partnerships

But, she says, controlling sickness absence has to be a priority, since it
costs The Post Office so much every year. And this is where teamwork and cross
cooperation comes into play.

"We work dynamically with human resources and try to align our
practices," Bainbridge says. The OHAs also work closely with the welfare
team, who offer an advice programme for employees on issues such as divorce,
life problems, housing, debt counselling, substance abuse, and low levels of
stress.

In terms of the team as a whole, "in the three territories we do all
sing from the same hymn sheet, even though in terms of the business, they want
different things at different times from us," says Bainbridge.

And in order to increase awareness of the service among employees, a number
of methods have been devised by the team.

One of the most important of these for getting closer to managers, says
Bainbridge, is monthly case conferences, used to study aspects of both short-
and long-term sickness absence.

"The nursing side of the team is focused on helping the business manage
its sickness absence," she says.

A more visible means of raising awareness of occupational health provision
has been the "medi-trailer", a converted large goods vehicle, touring
the regions offering health screenings to employees – a successful tool, says
Bainbridge.

Future aspirations, she adds, also include a health database for employees
and a movement towards standardised electronic medical records.

In the three years since Bainbridge joined the team, she has also developed
a system of clinical supervision within the organisation.

"Together with a group of OHAs we have researched a model of clinical
supervision and have grown that collaboratively within the service," she
says.

There is a strong business case for such a model, says Bainbridge, to emphasise
the importance of maintaining professional credibility, and to make it clear
that EHS is there to add value "by selling our expertise, within a
framework of clinical excellence. We are now using clinical supervision in the
territories to help develop standards and nursing protocols.We have always been
very dynamic as a service in terms of looking at research for best
practice."

Health initiatives

In the meantime, however, the team has been working on other initiatives.

These include the use of data mining technology to launch a campaign that
could help save thousands of lives. As one of the UK’s largest employers of
men, the EHS sent leaflets on testicular cancer to its workers with the aim of
helping them identify the tell-tale signs and seek early treatment.

This project followed on from its Q Health campaign, run in partnership with
Bupa, which asked all Post Office employees to fill in a voluntary health
questionnaire, covering family medical history, diet, alcohol consumption,
smoking and mental health. While regional variations showed up various health
patterns, the one constant across employees was the number of men not
appreciating the risks from testicular cancer. In conjunction with the
Institute of Cancer Research, EHS is backing the national campaign, fronted by
Robbie Williams, to raise awareness of male cancers.

"We got involved in a huge awareness campaign, devising an information
pack which we sent out to every individual," says Bainbridge. "We
think it was very successful. We always have things like this going on in the
background."

Another initiative is The Post Office’s telephone helpline, EHS Connect, a
one-stop shop for employees seeking health advice. Bainbridge is seeking to
develop this further into an effective and easy to access healthcare
communication system, enabling nurses to deliver a more diverse OH provision.

Career building

The health team certainly doesn’t stand still. They meet once a year at an
annual conference, and Bainbridge’s ambition is to continue to make EHS more
proactive and less reactive, hence, she says the appointment of an occupational
therapist and physiotherapist.

She is also seeking to create more of a career path for nurses within The
Post Office and, "to reward those with ability. As far as I am concerned,
it is all about reward and recognition, if we are to retain our staff."

Although a great supporter of higher education within OH, she says that
those more mature OH advisers are sometimes more reluctant to push themselves
further up the career ladder, despite their wealth of clinical experience.

In order to develop a more managerial role for OHAs, she has developed a
programme of lead practitioners within the teams.

"This has been a big step," she says. "It is a leadership
role, not a management role, but it enables management responsibilities. I
think it is working very well.

It has created a much more structured system of management and communication
and has created more solidarity among the workforce.

"We are big on sharing best practice," she says. "For the
future my vision is to develop the lead practitioner role into a proper
supervisory role. We want to make a more cost-effective use of our staff and
use them to their fullest potential. Our aim is to provide a highly professional
service with the best people and the best resources."

Describing herself as "ambitious, hardworking and very energetic",
Bainbridge clearly expects great things from her team.

"I feel very strongly about people making themselves marketable, "
she says. "I want people to be confident, and I always tell people you
must maintain your networks and use them to your advantage. My message to any
individual working in occupational health would be to maintain your own
competency."

In the meantime, the OH team at The Post Office have to keep asking
themselves the same question, she says. "Are we fit to deliver?"

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