Independent allies

occupational health departments shrugged off their old image of tea, sympathy
and sticking plasters a long time ago. Nowadays, they can have a significant
role to play working with HR across the business. Nic Paton reports

Occupational health (OH) and HR departments should have a symbiotic
relationship. Theoretically independent of each other, they are often
physically located in the same place, with OH commonly reporting to HR. But
while working to the same end – the well-being of their workers – they can often
find themselves at loggerheads. HR needs to know what is going on when it comes
to employees, but the OH nurse is bound by strict rules of patient

Most occupational health departments shrugged off their old image of tea,
sympathy and sticking plasters a long time ago. Nowadays, they play a key role
in risk assessment, health promotion, workplace health and safety, absence
management, employee rehabilitation, medical referrals, the organising of
counselling and, increasingly, stress management.

The lines between HR and OH (and training & development) are becoming
increasingly blurred. At London Underground, for instance, the combined
50-strong team, which covers medical advice, trauma counselling and a drug and alcohol
service, is beginning to play a significant role at an organisational level –
for example, it ensures that health messages are included at induction

"The perception has definitely moved away from a treatment service to a
case management service," says Dr Jenny Leeser, clinical director for
occupational health at Bupa Wellness. "But it depends on what the
agreement is with the organisation and how much OH is involved in drawing up
policies. If you are just doing half a day and you have 10 patients to see,
there is a limit to what you can do."

Even locating OH within HR can sometimes cause problems, because a worker
may feel reluctant to confide in OH if they have to walk through the massed
ranks of the HR department to get there, Leeser suggests.

Now that the Health & Safety Executive has put stress high up on the
business health and safety agenda, HR professionals can no longer afford
confrontation with their OH colleagues.

The OH department will normally have a pretty good view of the culture of an
organisation; it will know the absence levels of each department, will be able
to spot any ‘clusters’ and will know how to go about educating staff on stress.

Take Aegon UK, the British subsidiary of the Netherlands-based insurance
firm, and the name behind Scottish Equitable. Last November, its OH department,
under occupational health and safety adviser Angela Dunlop, was the only OH
team to be shortlisted for the Managing Health at Work category in the 2002
Personnel Today awards last November.

Located within and reporting to the HR department, but contracted in rather
than employed directly by Aegon, Dunlop and her team have brought in
initiatives such as a monthly health promotion topic and staff needs survey.
Therapists offer osteopathy, reflexology and aromatherapy, and an alcohol and
substance misuse policy has been put in place.

Rehabilitation and absence are key issues, and since 1998, 76 employers have
used the firm’s rehabilitation programme. Now, there is a long-term absence
rate of just 0.67 per cent, and the team is in the process of developing a
company-wide stress leaflet for staff.

"OH staff need to explain why they want to do something," says
Dunlop. "I need to be able to justify it. But it’s also up to HR to
challenge me, to ask the right questions.

"It’s not just a case of me giving information to HR, they also give me
a lot of information. I learn a lot from my HR colleagues."

Independence is what gives OH nurses their authority, she argues. "If
HR tries to start to exert pressure, it’s not going to work. I offer
independent advice and, if necessary, I have to be able to justify it in

The relationship between the two functions can be difficult, concedes
Dunlop’s boss, group HR manager Gareth Humphreys.

"Very often, HR people will want to know a bit more and OH people will
be reluctant to provide anything – most often quite rightly," he explains.

"OH plays a wide role because it can be a tool to manage long-term
absence and the return to work, and because it can be an outlet for people who
feel they have health issues. But you have to respect the patient
confidentiality that often comes with that," he adds.

The relationship must be built on communication and trust, and will often
only work over time and through continual effort, he warns.

Dunlop adds: "If there is a separate function championing OH and HR,
the business can be very difficult to control. But it is not an easy one. It
can be a difficult relationship to manage sometimes."

– There is no central register of OH nurses, but most company GPs will
know of local OH providers. Alternatively, the Association of Occupational
Health Nurse Practitioners (0116 281 3720) keeps a voluntary register, as does
the Royal College of Nursing (020 7409 333

OH factfile

There are around 6,000 OH nurses currently working within the
UK, compared with around 118,000 HR practitioners who are members of the
Chartered Institute of Personnel Development.

Before someone can call themselves an occupational health
nurse, they have to qualify as a specialist practitioner. When hiring an OH
professional, therefore, HR practitioners need to look at what level of person
they want and what the organisation wants from them.

Specialist practitioners will normally lead a team of nurses
and some organisations may prefer to rely more heavily on their HR department
complemented by lower-level (and cheaper) OH practitioners.

Many organisations have in-house OH departments, but equally
others contract in services, either on an annual fee or on a per-item basis.

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