Institute of Health and Work proposed by NHS Plus in Dame Carol Black review

An independent Institute of Health and Work should be set up by the government to promote the relationship between health and work, NHS Plus has told the review into workplace health led by national director for health and work Dame Carol Black.


In its submission to the Black review, written by director of clinical standards Dr Ira Madan, NHS Plus said there was a clear need for a body for workplace health much like the National Institute for Clinical Effectiveness.


“It must be honest, independent, avoid catastrophising and be seen as trustworthy,” said Dr Madan, adding that it should focus exclusively on health and work, avoiding matters of safety.


Dame Carol Black’s review was expected to report during January, but as Occupational Health went to press, it had yet to do so.


The NHS Plus submission also argued that the term “occupational health” was poorly understood.


“We lack the basic data and the necessary research to effectively prevent occupational diseases. The understanding of the epidemiology of ill health attributed to work is poorly understood, as are the steps necessary to ensure that all individuals can retain, regain or access work,” said Dr Madan.


It also proposed a three-level delivery approach to OH, depending on the size of the organisation.


For large employers, it would still be appropriate to recruit or buy in comprehensive services.


For smaller organisations, buying in specific services on an “as required” basis, whether public or private, would probably make more sense.


And for very small employers, the advice and support that they needed could still be provided through normal NHS primary or secondary care services.


There should also be more health promotion within the workplace and more evaluation of the effectiveness of such activities, as well as better education of the general public about the relationship between health and work.


“People rarely visit their GP for a sick note without the preconceived idea that absence from work is necessary,” pointed out Dr Madan.


“Financial arrangements for sick pay and other benefits have a profound influence on whether individuals go off sick, for how long and whether they leave work on ill health retirement. We need more research into how this works in practice and what changes might influence behaviour,” she added.

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