Thirty years ago a group of disgruntled OH nurses got together to consider how the profession could be better supported and represented. The result was The Association of Occupational Health Nurse Practitioners which, now known as the more multidisciplinary iOH, is still going strong today. Nic Paton reports on its three decades of OH advocacy.
This month (October) iOH, the Association of Occupational Health and Wellbeing Professionals, is 30 years old.
The organisation, which began life on 1 October 1992 as The Association of Occupational Health Nurse Practitioners (AOHNP) has in that time gone through many twists and turns, not least the painful period back in 2018 when the proposed merger between it and the Faculty of Occupational Health Nursing (FOHN) collapsed.
However, as current president Neil Loach tells OHW+, the association is currently in a good place. “We currently have some 748 members, which is amazing. OH Today has gone from being a newsletter to a respected, peer-reviewed open-access journal read by more 5,000 people every quarter,” he points out.
Loach’s presidency has coincided with the sharpest rise and biggest numbers in membership in the 30-year history of the association, in large part down to the radical switch in 2020 – just days in fact before the first pandemic lockdown – to a cut-price membership rate of just £10, compared with £66 previously.
We’ll return to the impact and effect of that change momentarily but, as founding president Carol Cholerton recalls, the creation of AOHNP came out of the familiar and longstanding sense of many in the profession that, too often, OH is misunderstood, if understood at all, by its colleagues in the NHS.
“It all started off in the late 1980s,” she tells OHW+. “There was growing disappointment with the way the Royal College of Nursing was supporting – or not supporting – occupational health nursing. There was a Society of Occupational Health Nursing and then it had an OH managers’ forum. But it was felt that the support out on the ground wasn’t there.
“If a nurse rang up the RCH for advice, for instance, they were firstly asked which regional health authority they worked for, and then which hospital they worked in. If the practitioner then said, say, ‘well I work in NatWest bank’, they had no understanding of how they could support them really.
“Disappointment grew and about 100 of us met at Loughborough University – we were known as ‘The Loughborough 100’ – to debate this, whether we should have our own organisation so that we could improve the peer support, for a start, and also lobby better for educational issues,” Cholerton continues.
“The meeting took place and it was decided to form another organisation, and that is how it came about,” she adds.
A working group ran workshops around country to identify what the issues were and what nurses wanted with a list of aims and objectives then drawn up. Drawing on examples of similar organisations in the US, the association formed a management committee, board and regional representation. “We wanted to encourage OH nurses to become more business-like in their approach to the businesses in which they were working,” says Cholerton.
As for AOHNP, Cholerton concedes with a laugh: “It was a bit of a mouthful as a name but it was democratically arrived at.”
Challenge of failed merger
Perhaps the most challenging period in the association’s history came with the split in 2018 between it and the newly launched FOHN. As OHW+ reported at the time, despite the idea of the merger being broadly supported by AOHNP members, it broke down because of an inability, on both sides, to reach agreement on how such a combined body might work in practice.
It was a period of discomfort for a lot of people, and it took a couple of years at least to build things back again; it wasn’t easy” – Lynn Pratt, OH Today, on the failed merger with FOHN
The consequences, and fallout, weren’t great for AOHNP, Loach concedes. “We got down at one point to about 70 members. So it was really a very small membership. It was at that point that Lucy (Kenyon, ninth president), myself and Lynn (Pratt, editor of OH Today), took the decision it was either make or break. We considered whether we would fold but we decided instead to concentrate on a very different direction.”
That led, in time, to the £10 membership model, sponsorship by Vitalograph, and the focus on creating a much broader, more inclusive membership base, making the organisation much more of a broach church than simply a body for occupational health professionals.
“In a way I think that [the failed merger] did the organisation a favour,” says Loach. “We did lose a lot of support when the merger didn’t go ahead. But the decision was taken to go with the strength of our conviction that it wasn’t right for the members. Ultimately, I think that was the right decision.
“We decided that the focus really needed to be on publication and encouraging people to write; it was also about education and sharing knowledge and skills. We decided it was really about support and CPD. And then going back to the original founding principles – representing and promoting the practice of occupational health nursing, influencing learning and development, support and CPD, and then benchmarking,” he adds.
“It was a period of discomfort for a lot of people, and it took a couple of years at least to build things back again; it wasn’t easy. We had to look at alternatives of how we were going to engage people, really investing in our website and OH Today and things like that,” agrees Lynn Pratt.
“We got there in the end, but it wasn’t a comfortable period. We do still work together, we all want the same thing after all. I think it would be nice to see more of a knitting together in the future because there is just not the space for so many organisations within OH.
“We have diversified to looking at other professionals in the workplace, which has really worked well for us,” she adds.
Wider membership than just OH
The fact the membership now encompasses wellbeing practitioners, occupational therapists, OH physicians and rehabilitation specialists makes it much more reflective of the multidisciplinary reality of occupational health on the ground these days, Loach highlights.
The 30-year-achievement is having settled into our own skin. We have found our own space” – Janet O’Neill, National School of Occupational Health
The intention now is to develop various forums for different workplace health professionals to engage and collaborate within, and to work on how to develop and sustain pathways into the profession.
“One of the things I am particularly keen on doing is working more in conjunction with the NHS Network Board, National School of Occupational Health and the Council of Deans for Health,” says Loach.
There will be a focus on trying to connect pre-registration students with people who can offer placements. “We need to gather than momentum and start to shout. Occupational health nursing, let’s face it, at the minute is likely to become a dying profession, with lots of people either retiring or retiring early. The only way we’re going to be able to save the profession is to grow our own. We need to train and grow our own people,” Loach adds.
“I think iOH is very much there for the clinician on the street but also has some fantastically interesting stuff for managers, HR, and others within workplace health. Because it is able to have such a wider perspective,” agrees Janet O’Neill, clinical director and deputy head of the National School of Occupational Health and an iOH board member.
“We have tried very hard over the past couple of years to include other professions; physios and OTs, technicians and so on. We are definitely moving towards that multidisciplinary model being inclusive for everybody and moving away from the nurse-based model.
“Occupational health is multidisciplinary now and that is the way it should be. We don’t have enough nurses to be able to cover every aspect. To be able to utilise the skills from other clinicians is really, really important. It has a bit of a family feel too, which is really nice. We are quite focused on people new into OH, especially as we also have free membership for trainees.
“I think the 30-year-achievement is having settled into our own skin. We have found our own space,’ O’Neill adds.