How new Faculty of Occupational Health Nursing could change the workplace health landscape

October saw the launch of the new Faculty of Occupational Health Nursing. What exactly is it, how will it work and what will it cost to join? Equally importantly, how will – can it, even – change the workplace health landscape? Nic Paton looks for answers.

Back in the autumn of 2016, a respondent to a nationwide survey of occupational health nurses undertaken by the then-nascent Faculty of Occupational Health Nursing’s Development Group articulated the intense frustration felt by many OH nurses at their perceived lack of a voice, representation and even recognition within the profession.

“The Nursing and Midwifery Council (NMC) does not support OH practitioners, the Royal College of Nursing (RCN) is a toothless lion and there is nothing for me to tap into to support my practice,” the OH nurse said.

That survey of 1,429 nurses, carried out with the publishing group The At Work Partnership, concluded that barely a fifth – 17% – of nurses felt “represented” by an occupational health body. Fewer than half (44%) felt “professionally supported” at work, despite most (93%) being members of the RCN. Nearly nine out of 10 (87%) felt a faculty for OH nurses would be beneficial, and nearly three out of four (74%) said they would be happy to join such an organisation.

What this highlighted, as this publication reported at the time, was that – on paper at least – there was “genuine enthusiasm” for the notion of new faculty specifically for OH nurses.

Who represents FOHN?

Eventually, of course, the new Faculty of Occupational Health Nursing will be all about its membership. But the process of setting up and establishing the faculty has been led by the FOHN Development Group, which has been made up of qualified occupational health nurses. The group has comprised:

Christina Butterworth (chair). Christina Butterworth, also chief operating officer of the faculty, is now semi-retired, but a director of Optimal Health Consulting. Her notable roles have included health and safety specialist at Crossrail and head of health at BG Group. She represents OH nursing on the Council for Work and Health and National School of Occupational Health. She was awarded an Honorary Fellowship from the Faculty of Occupational Medicine in 2015 for leadership in OH nursing.

Fiona King (deputy chair and treasurer). Fiona is senior OH manager at HS2, where she is pioneering health strategies in the construction sector to improve health outcomes for the individuals working there.

Susanna Everton (governance). Susanna Everton is a freelance OH nurse and safety consultant with a special interest and expertise in OH and safety management systems and health surveillance, particularly hearing and noise. She is a member of the BSI Committee HS/001 OH and Safety Management and is a CMIOSH.

Joanna Elliot (business development). Joanna Elliot is chief nursing adviser, lead practitioner and OH manager, working within health and social care, justice and the communications industry in England, Scotland and Northern Ireland

Allison Caine (communication and marketing). Allison Caine is founder of Occupational Health Business Management Ltd, working in industries as diverse as manufacturing, education, care providers, food manufacturers, engineering and construction.

Elisabeth Eades (education). A Bart’s Nurse, Liz Eades was an A&E sister before moving into occupational health to work as the “store sister” at Debenhams in Oxford Street. Until recently, she was a member of the HR senior management team at Surrey Police.

Lyndsey Marchant (membership services). Lyndsey Marchant completed her initial nurse education in the Royal Navy, worked in the prison service and set up her own company Phoenix Occupational Health Ltd in 2011, working across education, manufacturing and engineering. She was also an auditor for the Fit for Work service during its pilot scheme and has been a director for the Association of Occupational Health Nurse Practitioners.

Scroll forward two years, and last month (October) saw the formal launch of the Faculty of Occupational Health Nursing (FOHN). What this means, of course, is we now come to the moment of truth as to whether that enthusiasm from 2016 is still there, and if it will translate into OH nurses backing, supporting and, crucially, being prepared to join this new body.

Chief operating officer Christina Butterworth tells Occupational Health & Wellbeing: “Obviously, building the membership base is going to take time, whether we end up with 100 or 1,000. I’d hope that at the very least we’d be able to achieve perhaps 500 members as a starting point.”

What, then, is this new faculty all about? What is it going to do or focus on? What will be the benefit for OH nurses in joining? And what is it all going to cost?

Butterworth outlines that the faculty will have three core workstreams: creating and disseminating standards on best practice; developing education standards and OH nurse career frameworks; and acting as an advocate for the OH nursing profession.

As she explains: “On professional standards, we will continue to engage with the NMC to ensure they meet the requirement for registration and revalidation but also ensure that they meet the quality expectations for OH nursing.

“Then, on education, we will focus on career development for OHNs and set an educational curriculum for specialist training, working with the National School of Occupational Health to make sure there is also a quality educational process.

“We want to be ensuring OH nurses are better supported in their career development, both those who are new to the specialty and those who are already working in practice. It is about not seeing OH as just a job, but a worthwhile career,” she adds.

Guide on OH nurses for employers

Indeed, one of the faculty’s first publications is due to be a guide for employers about what an OH nurse should look like and what qualifications should be expected, building on Public Health England’s 2016 document Educating Occupational Health Nurses: an approach to align education with a service vision for occupational health nurses.

“Finally, on representation, we intend very much to act as a voice for OH nurses. We want to ensure OHNs are represented at both national and regional levels, within practice-specific networks and forums,” says Butterworth.

“We want to ensure OHNs or nurses working in occupational health are proud of their achievements and to showcase good practice. We want to ensure that all stakeholders are coming to us for comment and insight, and we are already working with bodies such as the Health and Safety Executive and we will be continuing to work with the Council for Work and Health,” she adds.

One key element of this networking and representation activity is the intention to hold an annual “hearts and minds” networking and professional practice conference for members. While it is still early days, the aim at the moment is this will probably take place around June next year.

“Another important element is ensuring our members and others interested in occupational health are kept well-informed, whether through our website or e-newsletter. We will start sending out social media alerts from the middle of October,” explains Butterworth.

FOHN will be setting up two committees: professional development and quality and practice, and the intention is that there will be a number of CPD workshops held on key projects. We will also use the power of social media to engage with our members and others with both a Facebook and LinkedIn group.

“It [the faculty] is also about connecting people with their peers; helping OHNs to realise that, even if they are working single-handed or in isolation, they are not alone in their practice. It is very much about trying to create a one-stop-shop for OH nurses, within which the website is likely to be very important,” Butterworth adds.

Relationship to NMC

Is there likely to be a risk – or an opportunity, depending on your point of view – that FOHN will start to step on the toes of the NMC in terms of regulation and standards? After all, Part 3 of the register may be part of the review that is underway at the NMC and, as we reported in October’s edition of Occupational Health & Wellbeing, there are growing question-marks over the future of NMC-approved Specialist Community Public Health Nurse (SCPHN) occupational health courses.

Butterworth emphasises that the faculty is very much not about invading the NMC’s turf. “The NMC has no objections in us setting out voluntary standards. They may not necessarily be NMC-approved, but the NMC is not averse in principle to us setting standards, especially if it all helps to raise and maintain standards of professional practice and public safety,” she points out. But she adds: “The NMC’s standards by their nature have to be quite generalist, because they have to serve all nurses. So we can work to create a much more specific range of standards for OH nurses.

“It is very much about recognising all people who do good work within occupational health, and not just those who are on Part 3 of the register. There are many, many nurses out there who are not on Part 3 but do very good work. Their knowledge and experience just does not happen to be recognised fully by the NMC as they did not complete an approved course.

“We’ll be looking at areas such as’ quality of training, how to put theory into practice and how OH nurses impact practice through their behaviour. We will also be also be looking hard at determining how we assess all that in order to give due recognition,” explains Butterworth.

In terms of funding, the intention is that the faculty will become self-sustaining through income from membership, CPD and other services. Up to now, its development costs have been covered through a partnership with Kays Medical, with whom the faculty will continue to work on a number of projects.

Predominantly virtual organisation

To keep costs down, the faculty will primarily be a virtual organisation (hence the focus on webinars, the e-newsletter, the website and the LinkedIn group). But it will also have a physical address at the Faculty of Occupational Medicine’s new offices in Greenwich, south east London, including access to the Education Centre for Occupational Health, which is also located there.

In terms of the specifics of membership, the original plan had been for FOHN to merge with the Association of Occupational Health Nurse Practitioners and offer joint membership. But this fell through in the summer (see below ) and so membership of the faculty will be £120 for a year for individuals and £80 for affiliates.

“There will be a range of member benefits that people can sign up for – discounts on things such as indemnity insurance and so on. But the main benefit is simply going to be the access you get to professional standards, to educational development and peer and social networks,” explains Butterworth.

“You cannot wrap indemnity insurance into the membership for ‘free’ because then you run the risk of it being viewed like PPI and will potentially get us into all sorts of issues. There will in time I think be a specialty register, which will be an additional cost for members to sign up to. So it may be that, by the second year, there will be that additional benefit,” she adds.

What, then, about the view from outside, from within the profession itself? While, naturally, there is still a long way to go, the faculty does appear to have the goodwill of many working within occupational health behind it.

As one OH nurse, who wished to remain anonymous, tells Occupational Health & Wellbeing: “I don’t think you’ll find anyone in OH who doesn’t feel the advent of the FOHN is a good thing.”

Another, Jo Clayton – a member of the UK Occupational Health Practitioners Facebook Group – says: “I’m hoping it’s going to support and direct with clear guidelines and standards etc. I really hope this is the case. I often feel misled…. lost…. confused and I’m hoping to stop feeling like this.”

However, cost will be an important issue, she concedes, given the multiple and competing membership demands (such as the RCN and NMC) there are already on OH practitioner budgets. Having said that, the attraction of FOHN as a fresh alternative could be compelling, as Clayton highlights. “I am fed up with forking out for NMC and RCN and being rewarded for my hard-earned cash with nothing but a handbag diary!”

“It is going to be really interesting to hear what people say about the faculty,” agrees FOHN development group member Liz Eades. “I think the faculty is about giving a voice to OH nurses, which is something we have not had before. If I think back over the years, I have had the occasional conversation with Dame Carol Black, who has often said that we – OH nurses – need to come forward more.

“OH nurses are not good at that, nor are we good at shouting about what we do and can do; we are not good at promoting ourselves and helping others to understand what it is we can offer. Because we tend to be so busy running around doing our jobs, we do not have the time or space to promote ourselves and push ourselves forward.

“So I see the faculty as giving OH nurses a certain extra gravitas. It is not a union, it is a professional body, and I think we as a profession need a professional body, a professional voice. It is going to be the professional body that underpins nursing practice, as well as a networking body and advocate. It will also be about sponsoring research and academic work as well as offering members some benefits, such as subsidised indemnity insurance,” she adds.

The failed merger

In June, it emerged that the faculty and the Association of Occupational Health Nurse Practitioners (AOHNP) had called off the merger (including joint membership) that had been set to go ahead when the faculty formally launched last month.

In a statement at the time, FOHN said: “With less than five months before the launch of the FOHN on 1 October 2018 and with no formal agreement made or transition committee in place, the FOHN Development Group has decided to focus on the launch and establishment of the new standard setting organisation and progressing its strategic objectives.

“Both organisations will continue to work as separate entities until any future merger arrangements have been agreed. Irrespective of this decision, there is clearly a need for the FOHN and AOHNP to work together to avoid unnecessary duplication of services, save costs and provide a unified voice to the external world,” it added.

FOHN emphasised that it would have its own fee structure from October but would also “honour our promise of a discounted membership for present AOHNP members for the first year.”

The failure of this merger has raised eyebrows on both sides. One AOHNP member, who wished to remain anonymous, contacted Occupational Health & Wellbeing to express concern that there had been no clear explanation as to why the merger had failed to go forward, especially since it had received strong backing from AOHNP members the previous summer.

“Regardless of any issues FOHN might be thinking of tackling for OH nursing, it may also have to do some bridge-building if it wants the unqualified support of the AOHNP,” the member said.

“Personally, I’ve let my AOHNP membership lapse and am throwing my hat in with the FOHN, which I feel is better for the good of OH nursing in general going forward,” they added.

Nevertheless, FOHN development group member Liz Eades suggests that, even though things have not worked out between the two organisations this time round, it may be a case of “never say never”.

“It was very unfortunate. I really cannot understand quite why it failed because I think it is potentially going to weaken both bodies rather than making them stronger. But I do think it may come back on to the agenda at some point,” she says.

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