How
the Northern Ireland Civil Service Occupational Health Service became the first
OH department in Northern Ireland to pick up a prestigious award, by Patricia
McQuillan
In
December 2002, the Northern Ireland Civil Service (NICS) Occupational Health
Service (OHS) became the first group within the Northern Ireland Department of
Health, Social Services and Public Safety (DHSSPS) to achieve a Steps to
Excellence quality award.
The
OHS is a branch within the public health, medical and allied group of DHSSPS
and provides a comprehensive OH service to all NICS departments and associated
agencies – approximately 30,000 employees.
Just
over half of the employees are men, with women predominating in the junior
administration grades, with one-third of staff aged over 45.
Almost
30 per cent of employees work in clerical posts, with 20 per cent in
supervisory and management and 19 per cent in professional and technical
grades. Prison officers account for 10 per cent of employees, industrials
number around 3,000, typists and miscellaneous posts form a small percentage
and just over 250 staff are employed in senior administration posts.
Medical
advisory services are provided to a range of non-departmental and statutory
public bodies. These include: civil service, teachers, and health service
pension schemes and medical advice on driver licensing for the Driver and
Vehicle Licensing Agency Northern Ireland.
The
NICS OHS is a multidisciplinary organisation comprising medical, nursing and
administrative staff.
Dr
Ken Addley, director, heads up the team, with four part-time and three full-time
medical officers, one senior OH nurse specialist, five OH nurse specialists and
a medical suite nurse.
The
NICS chief welfare officer post sits within OHS, as does the workplace health
improvement programme co-ordinator post. In addition, there is a team of 12
administrators.
Staff
are experienced and highly-trained in either occupational medicine, nursing,
health and safety, health promotion, financial management or administration.
Work
of the OHS
The
main work of OHS includes giving OH advice and support to NICS
departments/agencies.
This
includes recruitment and placement assessments; sickness absence and return to
work guidance; recommending rehabilitation and Disability Discrimination Act
(DDA) adjustments after illness/injury; carrying out ill health retirement
assessments and conducting a range of health surveillance and special job
fitness assessments. OHS is also involved in providing OH and health policy
guidance.
The
unit also takes the lead in the NICS workplace health improvement programme and
runs a lifestyle and physical activity assessment (LPAA) programme on a
full-time basis.
The
LPAA programme is the key health promotion initiative delivered by OHS for
civil service departments and agencies and is based on the Fitech System, a
computerised, scientifically-validated system. To date, more than 6,000
assessments have been carried out.
A
follow-up research programme, measuring the impact the programme has on
affecting and maintaining lifestyle changes six months on, has been carried
out, and the findings published in a reputable medical journal.
The
programme also won joint third prize in the 1999 UK Fitech/Occupational Health
Safety and Environment Awards.
OHS
continues to carry out research in OH and workplace health promotion. In
addition, OHS is a validated unit for training occupational medical and nursing
professionals.
Quality
award
Northern
Ireland Quality Awards Steps to Excellence scheme is a recognition programme
for Northern Ireland public sector organisations, to be assessed against the
European Foundation Quality Management (EFQM) Business Excellence Model. The
scheme has been designed by the Northern Ireland Centre for Competitiveness,
and encourages the pursuit of excellence throughout the public sector.1
OHS
initially committed to the programme in August 2001 and the first stage was to
complete a comprehensive submission document outlining how the organisation had
addressed the nine criteria of the EFQM Excellence Model.2
Work
to compile the formal submission was taken forward by an in-house
multidisciplinary team, comprising a medical officer, a nurse and two
administrative staff.
The
team quickly recognised the major commitment and effort required to
successfully complete such a project within the allotted timescale.
A
lot of hard work went into putting together the 79-page submission, which was
very focussed, tracing the history of OHS from 1993 and highlighting the many
improvement initiatives introduced since then.
The
document also contained a diverse range of trend data covering areas such as
performance results; staff attitude, customer satisfaction ratings and so on,
and highlighted how OHS was performing against each of the nine EFQM Excellence
Model criteria.
The
submission was invaluable in helping the team of external assessors gain a more
in-depth understanding of the role that OHS performs in supporting NICS
organisations and staff.
A
comprehensive portfolio of evidence containing key documents such as business
plans, annual reports and so on was also made available to the external
assessors.
Throughout
the process, all members of OHS staff were kept informed of progress through
monthly team briefing sessions as well as specially-arranged awareness
presentations. Some members of staff were also given a copy of the final
submission document.
The
submission was forwarded to the NI Centre for Competitiveness in September 2002
and was analysed by a team of trained external, independent assessors who
visited OHS in November 2002.
Ken
Addley, the OHS director, and the OHS management team, delivered a presentation
outlining the broad range of services offered by OHS; the challenges faced by
the organisation and how it was responding.
The
assessors carried out detailed interviews with eight members of staff as well
as speaking informally with others. The visit ended with a further in-depth
discussion with the director and management team.
After
the visit, the assessors presented their findings to a separate panel of judges
in the Centre for Competitiveness who decided on the level of recognition, if
any, to be given.
There
are three levels: bronze, silver or gold. Each level relates to the number of
points allocated through the assessment process.
A
detailed feedback report outlining the organisation’s performance against the
EFQM model including comments highlighting strengths and areas for improvement
was also given to each participating organisation.
On
receiving the gold award, Addley said: “OHS staff can feel justifiably proud of
this achievement and I would like to thank everyone for their contribution to
this success.
“This
award is recognition for many years of hard work by staff at all levels who
have helped OHS develop into an organisation associated with continuous
improvement.”
He
added: “By applying for recognition, we have gained an impartial, external
perspective on how the organisation is performing and we shall continue to
build on our strengths and look for ways to enhance the service we provide.
“But
it doesn’t end there – we need to continue to unite with staff and client
groups to build on this success.
“I
congratulate all my staff for their hard work over many years which has
contributed to and been reflected in achieving this award – it is an
endorsement of our commitment to multidisciplinary teamworking”.
The
quality journey
Various
government initiatives in the early 1990s encouraged the public sector to adopt
a more business-like approach and become more performance and customer focused.
This
acted as a change agent for our department, leading to a review of its
organisational structure with the aim of becoming more efficient and effective,
better able to meet the requirement of its customers.
A
board was set up in 1994 to fulfil a strategic management role and oversee the
operation of the OHS on behalf of the NICS. Business goals were defined,
performance feedback assessed and staff provided with defined areas of
responsibility and accountability.
An
OHS management team was established representing the three disciplines within
OHS, medicine, nursing and administration, and acts as a steering group dealing
with operational issues, quality control and financial management.
Since
1994, considerable efforts have been made within OHS to improve all aspects of
the organisation including: streamlining work processes; securing manpower;
developing multidisciplinary teams with varied and designated responsibilities,
and managing information through a bespoke IT system.
A
continuous improvement programme was launched for all of NICS in 1995. OHS
management saw this as a further opportunity to build on the good work already
done in-house and fully embraced this service-wide initiative, recognising that
important issues still needed to be addressed in the quest for quality and
effective teamwork.
The
key elements to be addressed by OHS to achieve quality and effective teamwork
using continuous improvement principles were:
–
Improving communication with customers
–
Introducing and validating organisational performance and customer satisfaction
measures
–
Creating client focused teams
–
Addressing staff development issues
–
Putting in place mechanisms to monitor and review all activities
Details
of some of the key issues and how they were taken forward are:
–
Communication with clients
An
OHS user group was set up in December 1994. This is a customer liaison forum
that aims to help establish and maintain OHS responsive to the user needs in an
atmosphere of mutual co-operation. The group meets quarterly.
–
Organisational performance and customer satisfaction measures
Customer
satisfaction measures were introduced, based on the concept of defining who
customers are, what they want, how those demands are to be met by the service
and how that process is evaluated and improved.
Having
identified our customers, we then had to consider those areas of performance
that were key to our success. They were operational and financial performance;
customer satisfaction and staff development.
The
OHS User Group in its role as a customer liaison forum in consultation with our
management team and with the agreement of the OHS board, were and are
instrumental in developing and validating the key organisational performance
and customer satisfaction measures.
–
Client-focused multidisciplinary teams
Following
discussion with customers, the work of the unit was reorganised to introduce
defined responsibility areas.
These
were seen as having a number of benefits, including giving ownership of work,
empowerment and ongoing continuity to specific individual members of the OHS
team.
–
Staff development
Getting
the best from employees was further enhanced with the creation of a staff
development policy.
It
aims to provide all members of the team with access to opportunities to develop
their skills in line with the competencies of their post; a means to recognise
and develop their potential; the opportunity to be fully involved in the work
of the OHS and to contribute to meeting its business objectives by producing
work of the highest standard.
Having
introduced a range of improvement initiatives, OHS was keen to find some way of
measuring what the organisation had achieved, with a view to consolidating
strengths and highlighting further areas for improvement. The Steps to
Excellence programme offered that facility.
Conclusion
Has
it been all worth it? Simply, yes. Our customers tell us they are satisfied and
we now have external validation of what we do. However, despite achieving the
gold award, OHS recognises that it cannot be complacent and work is already
under way to take on board recommendations for improvement identified in the
feedback report.
OHS
commends this process to others and is happy to share its experience.
Patricia
McQuillan RGN, OHN, BSc(Hons)
References:
1.
Steps to Excellence, NI Centre for Competitiveness, Belfast
2.
European Foundation for Quality Management, Brussels
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