The stark reality, in this litigious age, is that the potential for future litigation must guide the practices and procedures of the OH department. This includes keeping accurate records as you may be required to act as an expert witness, Jane Fairburn
According to Stephen Covey: "To begin with the end in mind means to start with a clear understanding of your destination." It means to know where you are going so you understand better where you are now, so that the steps you take are always in the right direction.1
Unfortunately, in these litigious times, the end to have in mind is not always the successful resolution of management or employee work/health issues but the employment tribunal. When you look at recent articles in a variety of journals, the stark reality is that the awareness of legislation and the potential for future litigation must guide the behaviours, practices and procedures of the occupational health department.
All the more reason for so-called 'evidence-based practice', although unfortunately this can still be an everyday, sometimes uphill, challenge. When faced with a situation that has never been presented before, it is not possible to 'research' the best way to manage a situation - already at the other side of the desk - and for which the evidence/information has not yet been established.
An example of this problem is the path-finding Disability Discrimination Act - which illustrates the difficulty in basing practice on ever-evolving decisions. Recent articles in Occupational Health by Goldman and Lewis2,3 report the issues regularly arising at employment appeals tribunals - the latest being the discussion of the potential effects of 'psychological overlay'.
Do worms and cans spring to mind?
For those in OH, the World Health Organisation International Classification of Diseases is becoming more and more essential as a reference document. There are, in addition to the obvious professional considerations, measures that can be considered in the OH setting to ensure the adequate 'justification' of actions and show good evidence of when, where, why and how certain advice was given or actions taken.
During a recent training day on legal issues, there was a discussion regarding occupational health note taking. There was a clear division between those who cho