We continue our look at what the winners of the Occupational Health Awards 2013 did to make their entries stand out from the crowd by examining the winners of the awards for Innovation in Occupational Health and AOHNP (UK) Occupational Health Nurse of the Year.
Anne Harriss and Sam Westgate, London South Bank University Faculty of Health
Winners of the Award for Innovation in Occupational Health
The challenge
There are few specialties within the family of nursing that offer the breadth and scope of practice of occupational health (OH). OH services operate within diverse settings, including the NHS, manufacturing industries, local authorities, police services, the NHS and City institutions. One size does not fit all in OH practice, which is frequently led by a lone nurse practitioner. Consequently, many OH nurses report that they experience professional isolation, which has become particularly evident through online discussions on OH email forum JISCMail.
What they did
The team developed a two-component resource to underpin practice, education and continuing professional development (CPD), primarily for OH nurses and HR practitioners. Sam Westgate developed the primary component while she was an OH nurse student at London South Bank University (LSBU). Anne Harriss, her course director, further developed the resource by adding the educational component – a range of e-learning resources now used by LSBU OH students and also offered to other practitioners, including the LSBU HR department as part of their ongoing CPD.
With factors such as the potentially isolating nature of OH in mind, Harriss supported Westgate in developing a resource to support practice – a data stick loaded with more than 500 OH and public health resources. These are included as uploaded screenshots illustrating the folders/subfolders and complementary e-learning activities, called “e-tivities”, that Harris had developed or would develop. The resource is now a regularly updated A-to-Z compendium incorporating a variety of materials that provide information ranging from abnormal illness behaviour through to working with nanoparticles and websites supporting OH practice.
Among the resources included are:
- Health and Safety Executive (HSE) publications and government policy documents;
- health- and risk-assessment proformas;
- electronic versions of Approved Code of Practices (ACOPs) and guidance notes published by the HSE;
- advice sheets – for example, “Returning to work after a heart attack” from the British Heart Foundation;
- mental health guidance;
- substance misuse guidance;
- updates on social security benefits – for example, updates from Rethink; and
- standards for data management, including the Employment Practices Code of the Information Commissioner’s Office.
Westgate produced this resource as part of fulfilment of the practice requirement of the OH nursing degree on which she was registered. This, in itself, was an innovative approach to the practice component required of students registered on Nursing and Midwifery Council (NMC)-approved courses. Developing this resource required partnership working between Westgate, Harriss and a range of people including OH nurses, occupational/physical therapists and HR practitioners.
Westgate found developing this resource for OH practitioners to be an excellent learning experience in itself. She also recognised its benefit in supporting her future practice. She agreed that these materials could be stored on a data stick to be issued to future LSBU students.
The e-tivities were presented to the NMC as part of its 2012 quality assurance review. The reviewers – including a nurse, a midwife and an OH nurse – were particularly impressed by the complimentary e-tivity resource, in particular those involving risk-assessment activities. The lead NMC reviewer recognised this to be an innovative resource and confirmed that it could be applied across OH practice boundaries, thus “knocking down walls of tribalism within the specialism”. In common with the practice resource, the e-tivities also cover a broad spectrum, including:
- risk-assessment skills;
- understanding of ergonomics;
- HIV/Aids awareness; and
- knowledge of health and safety and employment legislation, coupled with the role and function of employment dispute resolution body Acas and of employment tribunals.
Some of these e-tivities have now been shared with other university colleagues, including those contributing to programmes offered in the Business School and on an occupational therapy course at LSBU, and on public health and training programmes for healthcare assistants within the LSBU Faculty of Health.
The employment legislation activity has now been shared with the HR director of LSBU and with an HR department external to the university. Sharing this resource was primarily undertaken as a CPD opportunity. A secondary intention is that HR professionals will gain a better understanding of the role and function of OH, promoting enhanced interdisciplinary working.
The resource, which can be stored on a data stick, was piloted with students who studied during the 2012/13 academic year. They evaluated it highly and feedback suggested that they intend to add to it throughout their programme of studies, and then continue to use it throughout their careers. The comments made by NMC reviewers coupled with the feedback from current students suggest that future students will also find it of value and that they are likely to share this material with their colleagues, thus disseminating it to a wider audience.
Susan Gorton, occupational health nurse manager, Great Ormond Street Hospital NHS Foundation Trust
Winner of the AOHNP (UK) Occupational Health Nurse of the Year Award
Susan Gorton trained in OH in 1990 at Luton University, having moved from a holistic community nurse role in a small town in New South Wales, Australia. Her role involved looking after workers in the abattoir and wood saw mills, conducting immunisations and hearing tests for both the local schools and the community, and running health promotion campaigns for a town of 1,200 in an area of 400 square miles.
After reading an article in the Nursing Standard in 1990 on OH, Gorton knew that she had found her niche and has never looked back. In her submission for the award, she said: “Anyone who knows me knows that I am a passionate advocate of OH as a career. OH nurses that I have trained and mentored are now managers of their own services. I believe in sharing my knowledge and experience with anyone who needs it and, like most of us in OH, sometimes to those that don’t want to but who need to.”
In the past three years Gorton has been working towards improving OH knowledge on issues related to mental health at work, including how the effects of mental ill health can be addressed in the workplace. Because she felt she lacked sufficient knowledge of the subject she embarked upon an MSc in Occupational Psychiatry and Psychology at King’s College London. This course has been mentioned in submissions to the Houses of Parliament as being foremost in this field. “I have encouraged other occupational health nurses to undertake this course to improve their practice in this area,” said Gorton.
Summary of achievements
Gorton graduated with merit with an MSc in Occupational Psychiatry and Psychology.
She has trialled a training programme for managers on managing employees with common mental health issues, and developed a collaborative series of workshops with HR and her employer’s employee assistance programme (EAP) provider for managers on promoting positive mental health at work.
Gorton started a mental health support programme for employees of Great Ormond Street Hospital, specifically for healthcare workers and non-patient-facing employees, in order to return to or commence employment with the trust.
She contributed to a web project for the London Deanery on advice to HR and managers, specifically on depression in doctors and the allied professions. She was the practice convenor for the London Consortium of Occupational Health Practitioners (LCOHPs) for three years with responsibility for running workshops, lecturing and facilitating speakers to improve the practice of OH clinicians (doctors and nurses) working in the NHS, on topics including:
- stress policies and OH;
- OH’s role in managing common mental health problems in the workplace; and
- the impact on OH of the demand from the HSE for third-party skin inspection of all healthcare workers.
Gorton is a regular contributor to OH support and advice group JISCMail. She has been invited to guest lecture on the LSBU OH course and on the MSc in Organisational Psychiatry and Psychology at King’s College London.
She is in the process of developing tools to use on the assessment of mental health of employees and the modifications that may help to get them back to work and keep them at work.
Focus on mental health
One person in six in the UK suffers from common mental health disorders (CMDs) – defined as depression, anxiety, phobias and obsessive compulsive disorders – with this number increasing to one in five if alcohol-related issues are included (Deverill and King, 2009).
For the first time in 2011, the CBI’s annual survey on absence reported stress, anxiety and depression to be the number one cause for long-term sickness absence. With total absence estimated at 190 million working days per year for long-term sickness absence, 70 million of these days are believed to be for mental health reasons.
In addition, people with long-standing psychiatric illness are entering the workforce because of improvements in equality legislation. These individuals often require support, understanding and modifications if they are to succeed in their working lives.
Gorton’s research focused on the evaluation of a training programme for managers, which consisted of a three-hour training intervention run by a mental health professional from the Centre for Mental Health following its programme for managers on managing the common mental health of employees. Her dissertation made particular reference to:
- mental ill health, in particular depression and anxiety, as a global issue;
- the extent of this problem in the UK;
- the costs associated with mental ill health in the workplace;
- the prevalence of mental ill health in NHS healthcare workers;
- the influential role of the manager on employee mental health and wellbeing;
- the influence of stigma and discrimination on the management of mental ill health, both in society and in healthcare; and
- training programmes intended to reduce stigma and discrimination, and to improve the confidence of managers in supporting employees with common mental health issues.
“There is significant developing evidence that programmes to improve mental health literacy and ‘mental health first aid’ courses in the workplace are helping to improve understanding, reduce stigma and manage the first appearance of symptoms quickly,” Gorton said. “In terms of promoting health and wellbeing – including mental wellbeing – there is obviously more scope for OH nurses to be involved, not only in such training but also in the one-to-one evaluation and support of employees with mental health issues.
“To provide that support robustly, you also need the tools to improve managers’ confidence and decrease the stigma and discrimination that negatively impacts on ‘help seeking’ and compliance with treatments.”
She continued: “The research demonstrated a positive improvement in knowledge on prevalence of mental ill health and confidence in undertaking certain management. Less certain results came from overall changes in attitude and beliefs. The training met a substantial amount of the self-reported needs of the participants and led to further support from the trust to develop a robust internally driven programme.
“The training had been costly in terms of time and money. There was no doubt that the participants derived benefit from sharing concerns and gaining more insight from the collegiate discussions. This had led to the development of a collaborative series of workshops programme with HR and our EAP provider for managers on promoting positive mental health at work, where I ran two of the four workshops and assisted with a third. The results will be shared with other NHS trusts.”
References
Border P (2012). Mental health and the workplace – POST note. Houses of Parliament, Office of Science and Technology; no. 422.
CBI (2011). “Healthy returns? Absence and workplace health survey 2011”. London: CBI.
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Deverill C, King M (2009). “Chapter 2: Common mental disorders”. In: McManus S, Meltzer H, Brugha TS, Bebbington PE, Jenkins R (eds.). “Adult psychiatric morbidity in England, 2007: Results of a household survey”. Leeds; NHS Information Centre for Health and Social Care.
Jorm AF, Barney LJ, Christensen H, Highet NJ, Kelly CM, Kitchener BA (2006). “Research on mental health literacy: what we know and what we still need to know”. Australian and New Zealand Journal of Psychiatry; vol.40, issue 1, pp.3-5.
