How to develop a career path in occupational health

Promotion is not the only option for creating opportunities in the workplace. Tricia O’Neill, former group head of health for Centrica, summarises other potential pathways for career progression.

Career pathways are often considered linear – you do a job for a year then progress upwards or perhaps laterally to broaden your skill set and knowledge base. But sometimes life gets in the way and you just need to take your time; however, there is still opportunity to grow. Progressing your career does need some planning and opportunity, but the impact of the economy is seriously compromising many occupational health professionals’ career paths.

The most recent review of the UK occupational health market (MCi, 2012) indicates a 3% decline in 2011 in the provision of OH in the UK. In the same report, it was estimated that, by 2011, 53% of all UK OH needs had been outsourced, which means that many practitioners are now working independently or as part of a sizeable remote-based organisation.

Functional specialists such as OH advisers are now typically aligned to geography or a business unit (matrix structure) rather than part of an in-house function, which has disadvantages ranging from narrower development, delayed or limited promotion prospects and diluted communication (Chen and Nath, 2005). Being integrated into a matrix organisation can have advantages as this helps build personal and functional credibility in a shorter time than a more traditional organisational structure. Personal credibility is said to be more important than the technical know-how (Higgs, 2006) but occupational health professionals will need both to survive in this environment.

However, one of the drawbacks of the matrix organisational structure and virtual team management is that managers do not see the potential of their team. Likewise, the aspiring team member cannot view how other roles might work – providing no opportunity to benchmark their own capabilities or consider what development is required. This may account for the findings of a survey that found that a quarter of remote workers do not receive the same training as office-based workers and half miss out on coaching and mentoring opportunities (Nelson, 2003).


There are many factors that will influence the expected 30% growth of the occupational health market (MCi, 2012) over the next five years to 2017 (see table 1 below), including the need for organisations to manage absence and presenteesim better and, therefore, a need for credible and competent occupational health professionals.


Table 1: “PEST” analysis of factors that influence the growing need for occupational health expertise in the workplace
Political/regulatory pressures Increased interest in the public health agenda that has a focus on mitigating absence includes “Responsibility Deal” (Department of Health, 2011), Boorman Report 2009. Safe Effective Quality Occupational Health Service focus on quality and competence of OH professionals and services.
Economic impact Recession affecting wellbeing of UK population; average UK plc absence is 7.7 days per person at a cost of £673 per person (Chartered Institute of Personnel and Development).
Societal expectations Equality Act 2010. Removal of the default retirement age and increased potential for OH opinion on individual’s capability.
Technology changes Step change from face-to-face to remote-based OH activity, enhanced software capability and geographic spread of workforce and OH professionals.

In 2010, the Council for Work and Health estimated that there were 5,000 OH nurses working in the UK, with only 3,300 registered with the Nursing and Midwifery Council (NMC) as a specialist community public health nurse (SCPHN) working within an OH environment. But we know this is a diminishing pool, a scarce resource as most funding for the SCPHN degree is secured within the NHS sector.

Many organisations do not have in-house teams so private funding is not available and fewer individuals can afford to self-fund. The Council for Work and Health has recently made recommendations to the NMC to review the curriculum for a standard OH qualification and the arrangements for funding to encourage more nurses to attain formal qualification.

A formal qualification in occupational health provides a sound base but much of the opportunity and career growth is generated from experiential learning, such as work activities, experience in different types of businesses, and leveraging networks and acquiring people responsibilities.

Today’s economic climate is impairing movement in the occupational health market and job security is becoming increasingly cherished by occupational health professionals. Organisations prefer to source interim resource rather than permanent employees and maintain rather than invest in strategic programmes.

All these factors contribute to the lacklustre picture for OH career paths and development. There is an apt German proverb that says: “You can’t direct the wind, but you can adjust the sails.” Bearing that in mind, if the opportunities are limited, how can you create a new pathway?

Occupational health professionals in the NHS already have established development and career pathways. Others may be fortunate to work for commercial organisations that offer a development framework, but there will be many practitioners who need to construct a career pathway using various sources. This does not necessarily mean expense. Personal and career development is usually incremental and is constantly evolving. Reviewing your own career plans each year helps you reflect and assess your direction.

Often, the occupational health professional gets caught in a cycle of up-skilling in the technical aspects of OH, which becomes very limiting after about three years when your expertise needs to widen to enable development and, more importantly, your career growth (see table 2 below). In addition, OH professionals also need to recognise the shift of focus, to one where the business is a customer, which demands a different skill set to that based on a one-to-one employee relationship. (McBain, 2010).


Table 2: How potential development needs could change
Emerging (1-3 yrs) Growing (3-5 yrs) Consolidating (5+ yrs)
Professional qualifications Core degree, BSc occupational health. Consider an MSc or diversify into NEBOSH, health promotion, business studies. Consider an MBA or similar – make this business focused.
Competency Typically developing and maturing technical competency in aspects of practice – eg health surveillance, case management. Governance and assurance of clinical practice and functional remit. Strategic and operational deployment.
Management and leadership qualities Develop yourself and peer groups. Develop others and teams. Develop department and function.
Stakeholder management Local management. Middle management, eg heads of functions/departments. Senior management, board or executive team.
Networking Peers, professional body, eg RCN, AOHNP. Sector/industry, allied professional groups. Central and regional government, NGOs, allied professional groups.

A broad working portfolio is an attractive feature on a CV so it can benefit practitioners to move into a new area, such as from the NHS into the commercial/private sector, or to develop auditing skills, specifically with regard to OHSAS 18001 Health and Safety Executive (HSE) management systems, where there is currently very little expertise in the OH network.

Drawing on this skill mix of clinician and systems assessor would be advantageous. The HSE landscape offers another path for the OH professional and additional qualifications such as National Examination Board in Occupational Safety and Health (NEBOSH) or other relevant Institution of Occupational Safety and Health certificates will widen the market for your skills.

Even without the availability of funding or a job role change, there are many opportunities for the OH professional to continue to develop using internal channels to leverage development (see table 3).

There are also books such as “A Manager’s Guide to Self-development (Pedler et al, 2007) that can provide the self-directed learning to develop both management and leadership skills, irrespective of the type of work environment, by using activities to understand development gaps but using the work environment as the tool. Peer journals and guidance published by professional bodies such as the Royal College of Nursing (RCN) and the Association of Occupational Health Nurse Practitioners (UK) (AOHNP) are all sources of current knowledge and expertise.

Career development

Too often, the experience and growth of occupational health professionals is not articulated well in CVs or at interview. CVs can be no more than a chronological list of all the jobs that the practitioner has had, and there is little thought on how to match the experience and learning to the next role. To help build this picture use “context, action, results”, or “CAR” (see table 4), as a way of structuring learning, keeping a personal development journal and/or practising your interview technique. This helps demonstrate capability and experience in these situations.

Evidence of skill and knowledge gaps includes problem solving, being a team player, communication skills, stakeholder engagement, development of new skills including contract negotiations, supplier relationships and technical expertise. All it usually says on an occupational health CV is “attended an audiometry course”.

Each time you have a new opportunity or have been on a course, study day or just read an article where you have applied the learning, write it down in the CAR format and make sure you add a date and place of work – this soon builds up a ready portfolio of examples that you can draw on for interviews and CVs to address the job specification. Additionally, business recruiters will be delighted as they will know that they are appointing an OH professional who is business focused rather than one with just technical expertise.

On the same theme of recruitment, covering letters are an insight to the future whereas CVs are a glimpse of the past and you need to ensure you articulate both. The covering letter should highlight how you will use your experience for the role advertised, what you will bring to the role that will add value and help organisations to deliver their goals.

Attracting and retaining occupational health professionals

Learning and development is a basic requirement for building a team and requires a clear career and development pathway to exist for the advancement of both the individual and the employer.

“Employer of choice” awards confirm the attention and focus organisations have on increasing their people. The discerning occupational health professional will use these “badges” and a company’s reputation for growing the team as a way to gauge which employer has the most to offer their career. It is not just about the name of the brand but looking for the whole package, including development and career potential. Today, candidates appear to be looking for an “engaging deal” rather than a “long-term deal”.

Purcell et al (2003) highlight the role of the manager as pivotal in developing teams. Managers require good coaching capabilities, the ability to identify opportunities for growth and to provide honest feedback about performance to team members; these skills are often honed over years.

What is crucial is that there is more face-to-face time between employee and manager to create the coaching opportunity but more importantly the connection and trust. This can be done through the use of Skype if working remotely, meeting half way, or having more interactive remote sessions such as webinars or live meetings.

Engagement, trust and commitment to an organisation

A development strategy and career pathway is part of the value proposition to help retain internal talent and contributes to the “affective” commitment to the employer (Meyer and Herscovitch, 2001). This means that they have a desire to remain with the organisation and a willingness to provide discretionary effort.

These engaged employees are twice as likely to stay with the current employer (Higgs, 2006), therefore mitigating employee turnover, disruption to delivery and destabilising team dynamics.

Furthermore, measures such as operating margins, shareholder return, customer commitment and employee attrition have all been found to correlate with employee affective commitment.

Research cited in “Engaging for success” (Macleod and Clarke, 2009) showed that an investment of 10% in good work practices that relate to engagement (such as development) could improve profits by £1,500 per employee.

Engaged individuals who make decisions regarding their own development plans are more likely to stay with the organisation, which strengthens the psychological contract, engenders a sense of loyalty and affective commitment to the company (Meyer and Herscovitch, 2001).

Career development should be as important to the OH professional as it should be to managers and organisations of OH teams if we want a pipeline of OH talent that moves OH forward in the UK.

For more information Tricia O’Neill can be contacted via tel: 07725 484279.


Chen L, Nath R (2005). “Nomadic culture: cultural support for working anytime, anywhere”. Ubiquitous Computing, pp.56-64.


Chartered Institute of Personnel and Development absence management annual report (2011).

Harriss A (2010). “Training and qualifications for occupational health nurses”. London: The Council for Work and Health.

Higgs M (2006). “The emerging significance of total reward management as a strategy for building employee engagement”. HRN 2006 04 Henley Research Note: Henley Management College.

Macleod D, Clarke N (2009). “Engaging for success: enhancing performance through employee engagement”. London: Office of Public Sector Information.

Meyer JP, Herscovitch L (2001). “Commitment in the workplace. Toward a general model”. Human Resources Management, vol.11, pp.299-326.

Pedler M, Burgoyne J, Boydell T (2007). A Manager’s Guide to Self-development. 5th edition. Maidenhead: McGraw Hill.

Purcell J, Kinnie N, Hutchinson S (2003). “Open minded: inside the black box”. People Management, vol.9 (10), pp.30-33.

MCi (2012). “The UK occupational health development market report”.

Woodall J, Winstanley D (1998). Management Development: Strategy and Practice. Oxford: Blackwell.
Role models

Watch and learn. For example, take note of good presenters or managers, what did you like about their style and how could you build that into your work, or imitate it?
Special projects


These provide the “stretch” you need to grow – using problem-solving skills, taking responsibility, risk-taking and decision-making all support your career growth by building your confidence.










Source: Adapted from Management Development: Strategy and Practice; Woodall and Winstanley (1998).

Table 3: Leveraging development opportunities
Channels Learning/development opportunities
Learning from another person
Coaching Seek regular feedback from your customers, team or manager. Reflect on gaps, build on strengths. Consider the challenges and how to address them.
Mentoring and sponsorship This can provide support and advice as you grow in a role or provide you with an opportunity that enables you to demonstrate your capabilities.
Learning from tasks
Job rotation Can you change responsibilities for six months to provide insight and exposure to new responsibilities and skills? Perhaps cover for absence, maternity or annual leave.
Shadowing/informal visits Be inquisitive, curious even – a safe way to sense check roles or new activities without commitment but helps you sift out where you might progress. Why not contact an organisation or industry sector you are interested in for an informal discussion or visit?
Secondment/deputising An excellent opportunity to “test the water” – covering new tasks, skills and responsibilities. Even if no internal opportunities this experience is an important feature on a CV – it shows your potential.
Learning from organisations
Working parties All sorts of opportunities may exist from within your own organisation, local communities, local government, other agencies/charities such as Business in the Community – they are particularly important as you progress into functional leadership as it helps shape your strategic understanding and stakeholder engagement.
Networking Interaction and building connections. LinkedIn groups, JISC, RCN, AOHNP local groups. Conferences/events, workshops.


Table 4: Building “CAR”
Context Write/talk about the work environment the example pertains to and identify the gap.For example: I was working in company ABC and a new process was introduced that increased the noise to an action level that required 20 employees to undergo health surveillance. I had little knowledge of hearing surveillance or managing this type of programme.
Action What did you do?For example: I discussed with my manager and a colleague in another industry the options for building the knowledge and experience to coordinate a site programme. The decision was to outsource this requirement based on cost and logistics. However, I recognised my knowledge gap and agreed with my colleague to attend some tutorials over several months and had agreement to attend an audiometry course.
Results What was the result?For example: I developed an education package for the employees affected and worked with the team managers to deliver the programme without affecting production. I built new relationships with the company’s procurement and accounts team and learnt about contract negotiations and requirements. Working with the outsource provider increased my knowledge of programme elements and evaluation of results. The programme was delivered over a one-month period before production began.
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