Royal College of Nursing and Society of Occupational Medicine conference: news in brief

Case managers play key role in pilot success

Non-clinical case managers were a key element behind the success of an innovative Scottish NHS occupational health project.

The OHS Xtra project was piloted in NHS Fife and Lanarkshire and provided physiotherapy, occupational therapy and counselling to NHS staff through a case management approach. Dr Ewan MacDonald, consultant occupational health physician at Glasgow University and director of Salus Occupational Health & Safety, said managers could either refer people to the project or staff could self-refer, with an emphasis not only on those already off work, but those still in work but struggling.

The 18-month project, which may now be extended, had 217 referrals with satisfaction and approval ratings around the 90% mark. “OH is changing rapidly and so is the type of people that we need,” said MacDonald.

Who is in charge of occupational health?

Who is in charge of OH, asked Dr David Wright, chief occupational physician at Atos Healthcare and past president of the Society of Occupational Medicine.

He said that it was not just a question of doctors and nurses, but staff, employers, shareholders, pension funds, unions, internal and external OH providers as well as practitioners.

Similarly, when staff from small businesses wanted OH advice, more often than not, they simply visited their GP. “We need to be very clear that the right advice needs to come from the right place and the right people,” Wright stressed.

OH technicians must be given a broader role

The role of OH technicians needs to be expanded, with technicians taking on more of the routine OH tasks, said Graham Johnson, operations manager for Bupa Wellness.

“The future of OH is very buoyant, but we need to look at how we provide those services,” he said. “Change is on the horizon, the government’s Health, Work and Wellbeing strategy is pushing us forward and we need to take that on board,” he added.

Failure to do so would be akin to the profession shooting itself in the foot, he argued.

Conference Q&A highlights

Fit notes

The Q&A session also tackled the plans by the Department for Work and Pensions to redesign the Med 3 sick note to become a “fit note”.

This was a move welcomed by the panel. “I think the change in emphasis is good,” said Harrison. “It makes a more positive message and alters the way you approach the issue of return to work.”

“The emphasis is entirely right,” agreed the FoM’s Brown. “We should be looking at what people can do rather than what they cannot do.”


The contentious issues of the future shape of pre- and post-registration training and the Nursing and Midwifery Council’s registration structure also came into the spotlight.

Julie Matthews, professional adviser for specialist community public health nursing, said that, as the NMC’s consultation on pre- and post-registration training launched in November was still under way, it was too early to pre-judge what the future might look like.

“The consultation is still in full flow. Until we have seen the outcome of that we cannot really say. We need to get the views of the nursing profession on these issues,” she said.

And she stressed that the controversial third part of the register, which has put OH nurses in with school nurses and health visitors, was, for now, here to stay.

“We have 29,000 nurses on that part of the register. At this moment in time, it is alive and fully functioning,” she said.

OH for Holby City?

The panel was asked whether they felt one way to make occupational health more attractive to younger doctors and nurses was to get it featured in a storyline on one of the popular TV medical-based soaps, such as Casualty or Holby City.

This would certainly raise the profession’s profile, agreed the Royal College of Nursing’s Bannister, but she warned nurses to be careful what they wished for.

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