In autumn last year, occupational health (OH) practitioners were disappointed when the profession was overlooked in the recruitment of a high-profile network of regional health, work and wellbeing co-ordinators, with some expressing worries that OH was at risk of being left on the sidelines as Dame Carol Black’s reforms gathered momentum.
This time around, the profession can have no such complaints. OH is at the heart of the Department of Health’s appointment of six health and wellbeing ‘champions’ for the NHS in England, with leading practitioners taking half of the roles.
Roles and remits
The champions, who were all appointed last month [May], will be tasked with promoting the implementation of the changes proposed by Dr Steve Boorman’s review of the health of NHS staff, published in November 2009. The three OH champions are:
Helen Kirk, OH nurse and managing consultant of HK Consulting
David Maslen-Jones, head of OH at Southend University Hospital NHS Trust; and
Dr Peter Verow, consultant occupational physician at Sandwell Healthcare Trust, West Bromwich.
Each champion is attached to one or two strategic health authorities (SHAs): Kirk covers North East England; Maslen-Jones covers London and East of England; and Verow covers East Midlands and West Midlands. The roles, which are expected to take them two days a week, are funded (for the moment) until March next year.
Boorman’s NHS Health and Wellbeing report made a number of recommendations, including advocating earlier intervention for staff with musculoskeletal or mental health conditions, the need for more accountability for staff health and wellbeing among senior managers, and for health and wellbeing to be incorporated in management training, development and appraisal.
Opportunity for OH
The fact that OH practitioners are among those chosen for these roles is extremely positive, both for the profession’s profile and because of what OH can bring to the debate in the NHS about the best course of action, argues Kirk.
“It is an exciting opportunity and it is great that OH people are in some of these positions. It is a good opportunity to move the health and work agenda forward,” she explains.
“The key is simply to try to influence trusts to put in place the recommendations from the Boorman report and help them to implement those recommendations. I am keen to make sure that OH is seen to be influencing the health and wellbeing of the trust,” Kirk points out.
“I think we all want to be putting in place something sustainable so that, even if the funding cannot continue in the long term, these champions, even just at a local level, will continue,” she adds.
The fact that funding is secure until at least March 2011 is positive, agrees Maslen-Jones. “The Department of Health is enthusiastic about this initiative and, while we don’t know what the new government is going to do in terms of future spending cuts, the department is enthusiastic about driving this forward this year and into next,” he says.
“I suspect we have six to nine months to make a real impression and start to drive change through. It is not just about OH, it is about the whole way trusts are managed and the way the NHS treats its staff. There needs to be a real focus on staff engagement,” he adds.
There may well be different emphases and approaches between trusts that will have to be accommodated, he points out, with some more likely to be working more through NHS “staff side” representatives and others possibly through OH departments or individuals nominated by OH.
A further key issue that may need to be addressed is the quality and consistency of OH provision and support, something that has long been recognised as variable in the NHS, at best, and patchy at worst.
But it will also be important for champions to work diplomatically and constructively, stresses Maslen-Jones, and definitely not to be seen as a threat or something confrontational. “My concern is that trusts start to look at Boorman as simply a drive to reduce absence, but it also needs to have a focus on supporting staff as part of the NHS Constitution,” he points out.
The fact there is a very deliberate mix of OH, HR and other health expertise among the champions is also important, argues Verow. The champions will inevitably have different approaches but that, in turn, may highlight different areas that need to be addressed as well as identify different solutions.
“The bottom line is that happier and healthier NHS staff deliver better quality care to patients,” stresses Maslen-Jones.
SHAs and OH
In practice, SHAs will identify trusts that require support, with trusts normally being required to approach their SHAs asking for advice and guidance on the Boorman implementation process. The champions will then be introduced directly to the trust by the SHA, with Maslen-Jones pointing out that he has already been asked to help five London trusts.
“We will then go into the trust and work with the executive team and, if necessary, the head of OH. We will speak to them about what sort of guidance they can get and offer advice,” he says.
“There will also be a range of tools available for them from the DoH, including presentations, case studies and examples of best practice throughout the country,” Maslen-Jones adds.
A key challenge will be for SHAs to decide what they are going to prioritise, which may not necessarily be OH, when it comes to promoting the health and wellbeing agenda, he adds.
Moreover, because whatever initiatives end up being put in place could be led by senior managers rather than necessarily having an OH lead, there may be a requirement for a degree of management training by OH services.
“I believe this secondment role will provide a major opportunity to raise the profile of OH and provide opportunities for OH to get more involved with the wider issue of how a trust is working,” adds Verow.
How will the wellbeing champions work with NHS Plus?
The new health and wellbeing champions attached to strategic health authorities are not to be confused with existing regional champions attached to NHS Plus, the network of OH services in the NHS. The NHS Plus regional champions are OH professionals who assist the network’s director of clinical standards, Dr Charlie Vivian, in sharing information about the work the network is doing, implementing outcomes and encouraging participation in future clinical audits.
The terms of reference of the NHS Plus champions clearly overlap with the remit of the new DoH champions, both regionally and in terms of their terms of reference, as both groups will be implementing changes that stem from the recommendations of the Boorman review.
Areas where the NHS Plus champions may overlap with the work of the DoH wellbeing champions are apparent on the NHS Plus website, which states the remit is to:
Provide regional leadership in furthering the NHS Plus agenda
Lead with quality and governance initiatives, including participation in audits arranged by or for NHS Plus
Liaise with other regional groups
Be a point of contact for other NHS Plus departments in the region and be able to provide advice and support to them.
The NHS Plus regional champions are:
Dr Geraldine Martell (East of England), consultant occupational physician, Cambridge Centre for Occupational Health, Addenbrookes Hospital
Dr John Harrison (London North), consultant in occupational medicine and clinical director for organisational health and wellbeing, Imperial College Healthcare NHS Trust
Dr Samuel Thayalan (London South), occupational health consultant, St George’s Healthcare Trust
William Fraser (North East), consultant occupational physician, North Tees and Hartlepool NHS Trust
Dr Jane Hitchins (South East Coast), consultant occupational physician, NHS, in East Kent
Amanda Hinkley (South East Central), occupational health and safety manager, Winchester and Eastleigh Healthcare Trust
Dr Charlie Vivian (South West), consultant occupational physician, NHS community in Gloucestershire
Anna Betts (East Midlands), OH manager, Nottingham University Hospitals NHS Trust
Ursula Ferriday (West Midlands), consultant in occupational medicine, Worcestershire
Dr John Shepherd (Yorkshire and Humberside), consultant in occupational medicine and director of OH services, Leeds Teaching Hospitals NHS Trust.