Tackling health and safety difficulties within the NHS

Kath Burke finds out about the daily stresses and strains faced by all
levels of NHS staff and the new strategy that the Department of Health hopes
will turn things around

The problems of stress are becoming chronic, accident rates are very high
and the risk of being attacked by violent drunks now poses a serious everyday
risk. Add the chance of injury due to sharp instruments or lifting heavy
objects, and a career in the NHS hardly sounds like a recipe for health and
well-being. This admission comes directly from HR chief Andrew Foster.

Speaking at last month’s National Audit Office (NAO) conference, Foster came
clean about the NHS’s occupational health and safety woes. But he strongly
defended the NHS against criticisms from two recent NAO reports, and the
parliamentary Public Accounts Committee.

Foster admitted that the current sickness absence rate was still 0.3 per
cent higher than it should have been in 2001, at 4.6 per cent. But he insisted
that it was coming down.

He went on to dismiss spiralling accident statistics as a blip caused by
increased reporting rates.

"It’s a 24-hour, seven-days-a-week service. There are lots of dangers
around, whether it’s violence, sharp instruments or patients to be
handled," he said.

Although Foster indicated the NHS’s first occupational health and safety
strategy would be out for consultation by the end of November, Personnel Today
has since learned it has now been delayed until after Christmas.

Foster’s remarks were in response to two critical NAO reports on the NHS
earlier this year – one on health and safety risks in general and the other
focusing on violence against staff.

Health & safety register

Karen Taylor, director of health value for money at the NAO, and author of
official reports on health and safety and violence against employees, suggested
the NHS should tailor targets to individual trusts and set up a national
requirement for health and safety staff to be registered in the same way as
doctors and nurses.

The NAO report found wide variations in health and safety standards across
NHS trusts, with some falling below the statutory minimum. Only 43 per cent of
health and safety staff are members of the Institute of Safety and Health, and
18 per cent have no relevant formal qualifications.

"There’s no central registration body to guarantee the level of
competence of health and safety staff," Taylor said.

"Obviously it would improve the status of health and safety and its
influence within trusts if there was some assurance about their

Progress on the health and safety strategy may have been hampered by a massive
37 per cent downsizing operation at the Department of Health, as many staff
will move to a new employer’s body that will handle pay negotiations, and
health and operations.

Occupational health (OH) is another crucial area. Julian Topping, the
Department of Health (DoH) official who is currently writing the strategy,
explained that it should help improve standards of patient care. It will set
out staff accountabilities and responsibilities for occupational health and
safety, while monitoring progress through the DoH’s Improving Working Lives
(IWL) targets.

"The department recognises that unless managers in the field invest
their time, interest, energy and money in managing OH effectively, then their
staff are not going to be at work," said Topping. "And if their staff
aren’t at work, then trusts do not deliver on their targets."

The Association of Healthcare Human Resources Management (AHHRM) hopes the
strategy will focus on violence against staff and tackling workplace stress,
and will encourage employers to develop agreements with trade unions and
professional bodies.

AHHRM’s president Elaine Way is upbeat about the future – even envisaging
the NHS as a model for first-rate occupational health. But she also conceded
that much work still needs to be done.

"Employers need to be better at making workplace modifications and
facilitating phased early returns," she said. "This depends on
detailed analysis of the compatibility of certain health conditions with

Improving the NHS’s occupational health and safety record – including manual
handling injuries, slips trips and falls, stress levels and violent assaults –
will be crucial if trusts are to reduce their absence levels to meet Government

Despite the obvious problems, many HR professionals are pleased that staff
safety and well-being issues now have a higher profile. London Ambulance
Service’s corporate HR manager Kevin Aylward said he now feels more confident
bidding for slices of the trust’s overall budget.

"HR can only influence, and the fact that we now have a higher profile
allows us to influence an operational organisation, so the board are with us
because they can see the benefits," he said.

Climbing the ladder

London Ambulance Service has just committed to buying 130 new vehicles
specially designed to reduce the risk of staff getting back injuries from
lifting patients, and all frontline staff have been issued with ‘stab’ vests
which must be worn on high-risk calls. The service has now been promoted to the
middle level of the IWL kitemark ladder after making rostering more flexible
and introducing a variety of staff counselling and feedback services.

"There have been years when you felt the organisation was rudderless –
you certainly don’t feel that now," Aylward said. "These are things
that a lot of people in HR have believed in for a long time, but it’s easier to
get things done with central support from strategic health authorities as
you’ve got other colleagues to share information with."

Topping, the DoH’s long-standing lead on occupational health and safety,
wants to reassure HR specialists that better care for staff is a crucial step
towards improving the nation’s health.

He insisted the latest drive for better employee care was more than a
passing trend, and now forms a crucial trench in the future of the NHS.

"So many staff are off sick, leaving, retiring or injured that if we
were to halve the number of staff we lose each year just to back pain, it would
have a huge effect on patient care and the patient’s experience.

"The occupational health and safety strategy is something we have got
to do, and we have to keep on hammering away at it."

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