Next generation OH

Deborah McGrath
OH business partner,

“I was working in A&E, and decided to spend six months in OH to see what it was all about. After a short time I was hooked. It’s a fascinating area and it is so disappointing that OH as a discipline is not covered on the medical or nursing curriculum.

“Let’s face it – all healthcare professionals come into contact with the working population on a daily basis, and putting it on the curriculum would educate all healthcare staff that work is good for you and may reduce the barriers employees have about working when they have an illness. This is particularly important as people will often listen to that healthcare worker who says you must not work, but actually not working could cause them more physical or emotional harm.

“Keeping up to date is vital. I tend to read a wide spectrum of medical journals and research and refrain from limiting my reading to the OH journals. It’s important to me to understand and know about medical advances in management of medical conditions as ultimately I am advising on fitness to work and I need to ensure I have an understanding of a broad spectrum of medical conditions in order to do that.

“However, I am really lucky to work in a forward-looking department. I work in a team that is never satisfied with the status quo and is always looking for that next development. Our current focus is about changing the way the business looks at mental health. I could talk about the head shed, but frankly there just isn’t time.

“As a manager I sometimes miss the daily clinical consultations (although I have kept my hand in) but I found dispelling the myths about Med 3 forms and expectations at a strategic level an enjoyable challenge.

“OH is about giving whatever business you are in an opinion of an individual’s fitness to work and to support an employee to an early return to work. I’m sure most practitioners have heard those magic words: ‘My GP says…”. Well, for me it about changing perceptions and in the business I work in, that culture is changing.

“Obviously, it also goes beyond this. Among other things we’ve got an ageing workforce and if they are not healthy in the future, they won’t be working for us. We have a big role to play in the strategic approach to ageing.

“I would like to understand why people with disabilities find it so difficult to secure employment. I was listening to Radio 4 a few weeks ago about mental health and the visually impaired. Both programmes reported on research that had been undertaken which highlighted that employers were less likely to employ an individual with mental health problems and that 70% of those registered as blind or partially sighted were unemployed.

“I’d like to work with the disability minister and employers to improve employment for individuals with underlying health conditions as I believe they have a lot to offer in the working environment.

“I believe it will help with changing perceptions and dispelling beliefs that work should be avoided if you are ill or recovering from illness. Work is a fundamental part of our lives and there are very few medical conditions that prevent people from working. In my business it won’t change our practice as our role is to give an opinion on fitness to work, but I am sure it will have a positive impact on those industries that have no access to an OH service.

“I think that OH is at a crossroads. Carol Black’ review and the government response give us an opportunity. If we grasp it we will move to be more influential and have a bigger impact in industry and in the boardroom. If we don’t, we will remain in a small room away from the action.

“Part of this change is about recognising we are a valuable and scarce resource and we should go about making ourselves heard. We also need to recognise there are not that many of us and we should adopt a leadership role using the skills of others to reach wider into the UK workforce.

“Jan Maw was an inspiration to me when I undertook my degree in OH. She is extremely knowledgeable – but also inspiring.

“As for how I spend my free time, I am involved with the local cricket club… but I have no idea of the rules of cricket or even the scoring system. But I am a very good social member, and I am currently arranging a Pimms evening which I am sure will be a great success.”


Fay Collier
OH delivery manager,

“I have a business degree, and was a store manager for Argos, but became disillusioned. Nursing had always appealed to me, so I decided to give it a go. I studied at Nottingham University from 2003 till 2006, seeing it as a good opportunity to use my business degree. When I qualified, jobs were not available in general nursing – but I got a job as an OH nurse in two weeks.

“I’m currently doing my post-graduate diploma at Wolverhampton University, so keeping up to date with what is going on is part of my studying. I also read Occupational Health magazine.

“I really like to be able to relate to people and speak to them one-to-one. I also like the fact that we are able to help people in the workplace. Everyone respects you and listens to you as a medical professional. In general, I feel disjointed from HR and possibly closer to line management – but only those managers who understand what OH is and what it is about.

“To keep up to date, I use Jiscmail, which has lots of very useful information on it, and also attend wellbeing conferences. That is very useful when it comes to putting a face to a name. OH is such a small, select group, and it’s important to get to know people.

“It is probably too early in my career to say exactly what my ideal job would be, but I would like to have a role which uses my management skills and my clinical skills as well.

“I think the ideas in the Black report are really good, and would definitely help in the workplace. I would like to see a better understanding and a closer relationship between OH and GPs. And it does make sense to use ‘fit notes’, which say something about a person’s capabilities.

“There is definitely a feeling that the work is changing. But there is still a focus on the old stereotype in people’s minds.

“My role-model is Anne Harris, as well as Bashyr Aziz and Greta Thornbory. And there are lots of really good OH nurses. But we could still do with someone telling the Royal College of Nursing (RCN) and the General Medical Council (GMC) who we are and what we can deliver.

“Relaxing is certainly vital when you work in OH. I like cycling, going to the gym – and bingo sessions!”


Grant Ciccione
Senior OH adviser,
AIG Medical & Rehabilitation

“I was attracted to OH because I wanted to do something different. Nursing has changed beyond all recognition. While the basic tenets are the same, nurses appear not to have the time to actually care for the patient – there is the need to meet government targets, and ensure that the production-line of getting patients in, treated and out is maintained.

“But in OH, I have time to talk and listen to the people I look after, and advise and guide, ensuring that all aspects of their health and welfare is taken into consideration, while meeting the needs of the business.

“Keeping up to date is easier currently because I am undertaking my OH degree at London South Bank University. Apart from that, I try to attend as many courses and conferences as possible, and of course there is Occupational Health magazine. Jiscmail is also useful. It is a real community out there – and someone is always prepared to answer a question or give advice no matter how trivial the question may seem.

“What I really enjoy is that OH is all about the individual as a whole. It does not stop with the workplace. The advice and support given can have a real impact on all aspects of an individual’s life. And I already feel I have the ideal job. I work for the financial services industry and all the recent challenges that it has faced made us all stretch our skills and knowledge. It has been a fantastic learning experience.

“The recommendations given by Dame Carol Black are progressive, and if properly implemented they will have a positive impact on working Britain.

“My only concern is that there will not be enough money in the pot to ensure that they are taken forward. The ‘fit to work’ certificates are a good idea providing that the GPs who will be writing them will have adequate acknowledge and training to ensure that employees are sufficiently supported in the workplace.

“Evidence-based working is important. In my role as a senior OHA, we have a huge database of evidence-based articles to use. My team is always encouraged to use them when writing reports. All reports are peer-reviewed to ensure that they meet our evidence-based and clinical governance guidelines. This is what employers want and we have found that by using this approach we have reduced absence levels by 30% in some cases. One key challenge is raising the profile of occupational health. Unfortunately, OH nurses are not always good at making themselves known and putting their cases forward. To make real changes, they need to be more proactive and let the world know they are an important part of the workforce and are there to ensure the best for employees.

“When it comes to my own relaxation, I read, and I love walking. I also enjoy visiting historic palaces and houses – and a nice glass of red wine doesn’t go amiss, either!”


Glenn Raybone
Specialist practitioner,
Royal Wolverhampton NHS Trust

“I went into OH as I’d been working on a hospital ward for eight years, and didn’t really wish to go into management. The ward I was working on was closed as bit by bit the whole hospital was shut down. The treatment of the staff and the lack of support was awful, and I couldn’t believe how staff could be cast aside and moved about like pawns in a game of chess. This inspired me to find out more about OH and then to move into OH so that I could at least try to offer support to staff, unlike my own experience.

“For me, the best thing about this job is actually making a difference to staff and their work experience. And I like the hours. I love my weekends off to spend time watching Wolves [Wolverhampton Wanderers] play football, and being with my wife.

“The downside is the lack of job security and unrealistic expectations. Will Dame Carol Black’s report make a difference? Like most things it’s good on paper, but will the key parties sign up to it and, most importantly, will GPs support it? As for leadership, we’re certainly not getting this from the RCN or the NMC – they are doing an awful job!”


Sian Edwards
Occupational health adviser,

“I came into OH by accident. I was working in acute medicine and considering what speciality I would like to move into when I hurt my back. I was off work for eight months in total, and was looking at unsuitable options for redeployment.

“I happened to look on the Fish4jobs recruitment website and saw an advert for a ‘screening nurse’. I remember being in that interview and being unable to get the image of people cutting off fingers out of my head – I was thinking on the spot and it was a ham factory, so I figured that accidents would be a risk to health! Somehow though, they saw the potential in me and I got the job. I loved it so much that I have stuck with OH ever since.

“I keep up to date by reading journals, using Jiscmail, and attending study days and other events. And for me, one of the best things about working in OH is being listened to and respected for my experience, knowledge and advice. Being able to take credit for good outcomes is also important – I am able to ‘prescribe’ plans without reference to doctors for example.

“One challenge is getting over this need to hold onto a bit of ground which is for OH nurses only – we know we have good knowledge, training and experience and have a valuable role to play in improving health at work and so on. However, in my opinion, the best way to get results is to work as a team, and that might involve different skills mixes in the OH team (sorry, we don’t all have to have jumped through NMC hoops to be SCPHN (OH) registered) including technicians, nurses, advisers, specialist practitioners, doctors and OH physicians, physios, counsellors, occupational therapists and ergonomists. That might also mean working in wider teams to promote health at work, including health and safety specialists, HR, managers, and engineers. Comments like: ‘you health and safety guys are just after our jobs in OH’ (made during the Q&A session at the Ruth Alston Memorial Lecture in February) are elitist and, in my opinion, irrelevant.

“Another problem I find in manufacturing is a reluctance to be flexible about getting people back to work – the attitude from managers is often ‘if they are not 100% fit for their own job, we can’t have them back’ but that is often because if they do have people back, this has an effect on budgets and efficiency.

“My ideal job would be somewhere that had solid management buy-in to safety and health, and close to home so that I could walk to work. Although I am often working alone on site, I would actually quite like to be part of a small team – I’d like the chance to sit with a colleague and have coffee and talk about the ups and downs of work.

“My inspirations are Angela Palmer (my first manager/mentor in OH); Sharon Greenwell (an operations manager in one of my jobs who was always enthusiastic, supportive and passionate); and Cynthia Atwell (who was still at Warwick when I started my course there in 2007).”


Hannah Edwards
OH adviser,
Horizon Factory

“I stumbled into OH – I took an agency role at a car manufacturer and loved it. The role I had was treatment based, but I could see what the OH advisers were doing, and wanted to do that. I then found a provider that was willing to take someone on with minimal experience and progressed from there.

“For me, working autonomously is one positive factor, and having a close network of support is another. During my time at university I have developed this with the other practitioners and often use their support for this.

“I love the fact that I deal directly with people and I can make a difference. Perhaps that’s a little idealistic – but those people who come back and tell me I have make up for the ones that don’t turn up for appointments.

“At present, our company is working towards the OHSAS 18001 health and safety standard, and OH is a large part of this. My other biggest challenge is to get management and employees to see OH as a benefit and not a ‘Big Brother’ tool for watching over employees.

“I think evidence-based working is important. Having just completed an evidence-based practice module at university, I know that this is important to practice. I think prior to this I worked on best practice and taught skills from my OH colleagues over the years. Now I do search for evidence into how I practice.

“What would really improve my working life is a greater understanding from the management team of all of my factories as to the role of OH. Management do not always realise the value of OH and occasionally I feel as though the OH department is only here to place a tick in the relevant box.

“I work full-time, have been doing my SCPHN degree part-time, and I have a two-year-old girl, two step-children, a partner, and everything that comes with that. When I do get spare time I can often be found in the kitchen or the garden!

“As for role models, I have been most inspired by my first manager at the OH provider that I worked for. I saw that she carved a career for herself as well as having a family to care for. She seemed to be very knowledgeable and was always there to support us OH advisers.”


Maria Hale
OH nurse,
Ministry of Defence Police and Guarding Agency

“Working in my area of OH is challenging, multi-faceted and totally spontaneous. I absolutely love it and thrive on making a difference, particularly in changing perceptions of OH and establishing positive links after gaining trust. The best thing about working in OH is the variety. I flourish when every day differs and I have the opportunity to alter acuity when meeting individuals face to face.

“One of my best attributes is the ability to network. I have joined a Police OH Nursing Society and have close links with Tri-Service healthcare establishments. I find meetings create longer-lasting links than telephone or e-mail contact.

“The role of the OH nurse is continuing to evolve from attending to casualties to promoting health, safety and wellbeing at work. I am enjoying being part of the evolution, linking into the public health chain and influencing policy within the agency by ascertaining the needs of the workforce together with the wider community, conveying these to management – and gaining specialist advice to establish best practice.

“I network with other groups and welcome clinical governance together with advice from other healthcare professionals, enabling me to stay abreast of clinical developments. Healthy debate based upon evidence is a positive way of gaining others’ perspectives which can only benefit optimum efficiency. I have been inspired and influenced by my mentor, Julie Hanley who works at HMS Drake in Devonport, Plymouth. Her enthusiasm for OH and love of academia drew me to her and she has pulled me up by my bootstraps while mentoring me. I don’t think she realised the challenge she undertook when she agreed to mentor me, but despite her full-time work and own study commitments, I have had an unrivalled level of input and support.”

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