Discussions about the occupational health technician’s (OHT) role, knowledge, skills and experience have been the subject of much talk in OH journals, conferences and social networking sites over recent months, and the growth of OHTs as members of the OH team appears to be gathering momentum.
With the number of specialist community public health nurses (SCPHNs) practicing in the UK said to be in the region of 7,000 (Kirk 2009), there is a growing need for a cohort of competent OHTs to support the range of OH service delivery and to release nurses from some of the more routine tasks of their day-to-day work. After all, did we really spend three years training as a nurse, followed by the slog of a post-registration course to qualify as a specialist nurse, to spend our time inviting our clients to pee in a bottle, or cover one eye and read from top to bottom?
OH and OHTs
Following the publication of Dame Carol Black’s Working for a Healthier Tomorrow and the government’s response, it is abundantly clear that as specialist practitioners, we are more than ever to be called upon by our masters to support them in the management of the health and wellbeing of their employees. The recent publication of the Department for Work and Pensions guidance on the fit note includes several recommendations to employers to seek the advice of OH services, and so it seems that we will have a very clear role to support the employee and employer in the rehabilitation and early return to work of the ‘ill’ employee.
The recent publication of the Occupational Health Service Standards for Accreditation by the Faculty of Occupational Medicine recognises in Standard C1 that an “OH service must ensure that its staff are competent to undertake the duties for which they have been employed, and that they must ensure appropriate supervision”.
This premise is further supported by the Nursing and Midwifery Council’s Code of Conduct, which reminds nurses: 1) to establish that anyone to whom they delegate care is able to carry out their instructions, and 2) that they remain accountable for the appropriateness of the delegation and for the provision of an appropriate level of supervision to carry out the delegated task.
And so the scene is set to embrace the role of OHTs.
In acknowledging the potentially important role they could have in OH practice and in support of this, the Royal College of Nursing’s (RCN) Public Health Forum recently sponsored a workshop, which saw representatives from OH nursing and medicine, OHTs, OH educators, NHS Plus and representatives from the Association of Occupational Health Technicians, together with other members of the Community Public Health team, coming together to discuss the creation of ‘Standards and Competencies for OH Technicians’.
The main focus of the meeting was to agree that there was a need for standards of practice for OHTs, to identify the main areas of practice and how these link with the role of the NHS healthcare support worker (HCSW), and to consider whether existing HCSW educational material could be used to form the base for OHTs’ training. The meeting also explored specific additional skills which should be acquired by the OHT working in the OH setting.
An outcome of the discussions was to develop a number of domains on several key areas, including the definition of an OHT, clarification of the scope and main aspects of their role, their education and training, with consideration of the specific training needs, and discussion about whether there should be a defined academic level for OHTs.
The selection, recruitment and competencies of any member of the OH team are vital if they are to stay the course. This is equally so for OHTs, and the process of their selection and recruitment should be designed to ensure, as far as practicable, that ‘good beginnings’ for the OHT new to healthcare can be achieved in the often challenging environment of OH.
For many, the role and responsibilities of OHTs have been of concern, and this was the focus of one of the domain groups with much discussion about the key tasks of an OHT and the relevant assessment and audit criteria.
Unlike registered practitioners currently, OHTs are not accountable to any registration body, including the Health Professional Council or other body. However, several have joined the RCN as healthcare assistants, which provides them with the full membership benefits, including indemnity insurance. The registration of OHTs is an important factor to be considered, and discussion over the potential use of the title ‘assistant practitioner’ (a title with defined parameters which has been developed in a number of areas of healthcare practice) is one which perhaps merits wider debate.
As a result of the workshop discussion, the stakeholders agreed to reflect on publications and processes which were readily available, and have agreed to consider the NHS Education for Scotland Guide to Healthcare Support Workers’ Education and Role Development to develop and model this for a future RCN publication.
It is hoped that the ‘Standards and Competencies for OH Technicians’ will be published in the Autumn of 2010.
Graham Johnson, RN, SCPHN (OH), OH development manager, Bupa Health and Wellbeing UK.
Kirk H, September 2009, OH education: Healthy progress? Occupational Health, Volume 63, no 9