How occupational health may need to respond to a fast-changing working world

From an ageing workforce through to remote working, rising self-employment and technological advances, employment is changing rapidly in the UK, and with it the challenges and opportunities facing occupational health. A recent conference by BHSF looked at how OH practitioners may need to change and respond in the future, as BHSF’s chief medical officer Dr Philip McCrea reports.

The focus – and investment – we’ve seen being put by employers on workplace wellbeing in recent months and years has cast the spotlight firmly on employee health like never before.

Employee health is becoming a priority for most organisations, regardless of size or industry, as they strive to create supportive and healthy environments that people want to work in. This creates a huge opportunity for occupational health (OH) providers to play a significant role in helping to shape the workplace of the future , one that puts employee health front and centre.

It was against this backdrop that BHSF held its BHSF Occupational Health Conference in Birmingham in October, bringing together experts from across the industry to discuss the latest ideas, approaches and challenges facing OH.

The aim behind the day-long event was to provide an informed perspective on some of the important health issues facing the workplace over the coming years, and how best these can be tackled by the OH industry.

The modern workforce, we all recognise, has changed enormously over the past decade, as have working practices. It is therefore vital for workplace wellbeing that OH keeps up with these trends and prepares for the future challenges presented by, for example, increased remote working, an ageing workforce and the rapid pace of technological advancements.

Innovation is key and throughout the day many new ideas were presented. Here is an overview of the main themes from the conference.

Sickness absence is a management issue

The traditional view of sickness absence is that it’s a medical issue for managers to deal with in a reactive way. Malene Nielsen, managing director of Honeydew Health, put forward an alternative view.

She discussed the idea of taking a much more proactive approach, namely giving managers effective tools that help them take control when it comes to managing sickness absence.

With the right framework and training, which involves creating a clear and consistent company-wide policy, she argued that managers can have the confidence to deal effectively with the issue.

Broaching the subject of sickness absence can be awkward and scary, with managers often not knowing what to say or how best to approach the conversation. Turning a blind eye may seem to be the easier option, but ignoring the issue can mean that problems escalate, and employees don’t get the right help and support they need to recover.

Once an employee goes off work with illness for more than a few days, they become increasingly likely not to return. One in five employees will not return to work after just four weeks of absence.

Having a framework in place that allows a consistent approach from every manager, each one knowing exactly where to turn to for help from the very first day of absence can seriously improve an employee’s chance of recovery. Rather than waiting for a situation to worsen, potentially serious issues can be addressed in the first few days and help or support can be arranged swiftly.

Addressing the shortfall in OH professionals

There has been a steady decline in the number of medical professionals specialising in occupational health over the last few years. This has been because of a number of factors, including the low profile of the industry and the failure of providers to hire specially trained OH professionals, rather than medics with no qualifications in workplace medicine.

Stuart Nottingham, managing director of Sun Rehabilitation, pointed out that this, coupled with increased demand, is creating something of a crisis that needs urgent attention.

He suggested that encouraging charted physiotherapists to become more involved in OH could be one solution to the shortfall in resources. He also advocated using new technology, such as video assessment to ease the burden on OH professionals and make more effective use of their time.

As the workforce ages, there are just under 1.2 million people aged 65 and over in employment, a record number. This demographic shift means employers need to take a different approach to keeping their workforce healthy. Introducing inclusive exercise opportunities for employees, such as yoga classes, and designing workplaces to encourage a healthy lifestyle can also help prevent problems before they even start.

Thinking differently about early intervention for mental health

A reoccurring theme throughout the day was the need to tackle the mental health crisis in the workplace more effectively.

Mental ill health in the UK is the single largest cause of disability and its impact on productivity is costing the UK economy £94bn a year, according to the Organisation for Economic Co-operation and Development (OECD).

Clare Price, head of psychological services at CBT Clinics, talked about how early intervention in mental health is vital if we are to turn these figures around.

She called for employers, again, to take a proactive approach and introduce initiatives to support mental wellbeing to prevent employees even going off work sick. Three-quarters (75%) of all mental ill health starts before the age of 18, so many workers will enter the job market with an existing condition.

Therefore, creating cultures that are open, honest and inclusive and designing jobs that have meaning and value, will help employees feel healthier and more positive in the workplace.

OH begins with recruitment

Employers in all areas and industries are becoming more aware of the value that greater diversity and inclusion can bring to their workforce, and occupational health is no exception.

Creating equal opportunities to anyone with the right skills can help extend the candidate talent pool and inject new ideas and ways of thinking into a business. Employers are used to working with OH providers to make reasonable adjustments for employees after an illness.

Claire Jones, sales director at Clear Talents, discussed the need for employers to do this at the recruitment stage too. By encouraging candidates to ask for adjustments to be made, employers can be sure they are broadening their reach and their appeal.

Personalise your approach

Getting an employee successfully back to work following an illness relies on the treatment they receive being administered swiftly and managed effectively. Ensuring that treatment is right first time is key.

Jayne Molyneux, head of managed healthcare services at Patient Advocate, discussed the importance of putting people on the right path for treatment as soon as possible. Having one point of contact for the employee who has oversight of their case and their progress was vital to ensure continuity, she argued.

This approach also means the employee knows exactly where to go for help and has the confidence that their recovery is valued and will be seen through to the end. There are huge benefits for the employer too, as it is honouring its duty of care, has simplified lines of communication and has a clear vision of the employee’s progress.

Taking employee support to the next level

The final talk of the day was from myself and Sue Burke, BHSF clinical standards manager.

We argued that the time is right for the next evolution in employee assistance programmes (EAPs). The stark reality is that many EAPs have been introduced as a tick-box exercise to give employers peace of mind when it comes to tackling mental health.

But, in reality, the limited service many EAPs provide is not making the difference they need. Just having a helpline that employees can contact, and which most staff are perhaps not even aware of or the opportunity to have a few counselling sessions, is not going to stop growing levels of mental ill health.

By 2023 it is predicted that 70% of all absences will be related to mental health. Employers’ existing measures are woefully inadequate to deal with this.

EAPs are only used on average by 4% to 6% of employees, yet it is estimated 22% of employees will experience some form of mental ill health each year.

This shows there are large numbers of people who are not getting the help and support they need. Employers need to consider how they can do better on this, the conference heard.

At the moment, most EAPs will just treat the symptoms without looking at what is causing the problem. Triggers for mental ill health could be financial problems, juggling work and caring responsibilities or an issue with colleagues in the workplace.

Without therefore looking at the full picture and helping an employee deal with all of their problems, no long-lasting cure can be found. We made the argument that it is time for a different approach, time to evolve EAPs to make them more personalised, connected and, ultimately, effective.

In our view, joining up support services through one dedicated point of contact can also ensure employees get the help they need much quicker and feel like they are being treated as a person.

The future is bright

Overall, for me, the day showed that, while there are significant challenges, these remain exciting times for occupational health.

There is a real opportunity for the profession to make a positive difference to the lives of many employees. The day highlighted what a valuable role occupational health expertise has to play in creating the sort of healthy and safe working environments that employees want to work in, now and in the future.

References
UK labour market statistics: December 2017, https://www.ons.gov.uk/releases/uklabourmarketstatisticsdec2017

12 statistics to get you thinking about mental health in young people, https://www.mqmentalhealth.org/posts/12-statistics

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