As many start their first tentative steps back to the workplace, the news the Health and Safety Executive (HSE) has not extended its deferral period for health surveillance means employers may once again face hefty fines if they cut corners. Phil Jackson-Taft outlines the challenges, and opportunities, facing OH in ensuring HSE compliance in a post-pandemic world.
Health surveillance, as occupational health (OH) practitioners will well know, is a legal requirement if you have employees who are exposed to specific workplace hazards, such as noise, vibration, radiation, asbestos, lead solvents, fumes, dust, and other substances hazardous to health.
Health surveillance
The role of screening and surveillance in occupational health
According to Health and Safety Executive (HSE) guidelines, employers must put in place ‘systematic, regular and appropriate procedures to detect early signs of work-related ill health among employees exposed to certain health risks, and act on the results’. For example, if employees are exposed to high levels of noise, then your employee needs to have regular audiometry tests.
The HSE responded to the limitations of lockdown by imposing a hiatus on health surveillance to protect both OH practitioners and employees from ‘non-essential’ contact.
Quite often, this kind of OH health surveillance work (such as, for example, spirometry) requires face-to-face appointments to be done effectively. Understandably, the focus at the height of the pandemic was to safeguard everyone from Covid-19 infection, so health surveillance found itself very much on hold.
However, as infection numbers have continued to drop and the vaccine rollout has progressed, that period of grace is now at an end. For employers this means a full return to completing regular health assessments for your workforce where a risk has been identified.
The problem with health surveillance is that it is not everybody’s idea of a thrilling subject and too often is viewed as a tick-box activity. However, thinking in that way can potentially have catastrophic consequences, as manufacturing giant Saint Gobain recently discovered to its cost.
Just weeks ago it was fined half a million pounds after several of its workers were diagnosed with hand-arm vibration syndrome (HAVS).
Saint Gobain was found to have failed in two key areas – failure to act on health surveillance information, and having “inadequate” health surveillance in place. The ‘failure to act’ point is crucial, as health surveillance depends on everyone understanding their responsibilities.
Health surveillance responsibilities
These responsibilities include that managers or health and safety representatives must be conducting suitable and sufficient risk assessments. They must be informing occupational health or management of the need for health surveillance. They must be ensuring all employees are registered on the appropriate health surveillance programme. They must be recording and maintaining health surveillance results and, finally, ensuring prompt referral to OH if employees report ill-health symptoms relating to their working environment.
In turn, OH providers must ensure the level of health surveillance is appropriate, report the results of all health surveillance carried out back to the employer, refer for appropriate clinical interventions, and advise about necessary workplace restrictions. Without wanting to drop in too much of a sales pitch, this is precisely what we at OH One aim to do through our health surveillance services, and you can find out more here.
It is important for OH professionals to report any occupational diseases identified through health surveillance to the HSE. Any breakdown in this vital chain of communications leaves employees at risk and employers open to heavy fines and future litigation.
It is important for OH professionals to report any occupational diseases identified through health surveillance to the HSE. Any breakdown in this vital chain of communications leaves employees at risk and employers open to heavy fines and future litigation.
The second charge levelled at Saint Gobain – its “inadequate” health surveillance – is something we are encountering more and more, from companies of varying sizes, from smaller SMEs to blue-chip businesses.
Employers at risk of falling foul of HSE
Keen to put a tick in the box, people are failing to ensure health surveillance is undertaken by accredited OH providers and fully qualified individuals. Anecdotally, we have even heard cases of local GPs offering health surveillance to companies.
This, self-evidently, puts employers at risk of not getting the right advice. Health surveillance is required for an ever-growing list of classifications of substances or environments and the knowledge to deal with this does not fall under a general practitioner’s remit.
By its very nature, health surveillance requires specificity and the ability to relate to a particular aspect of health or health risk.
To illustrate this peril in practice, in 2020 motor sales company Perry’s Motor Sales was fined, alongside its external health and safety consultants S & Ash Limited for safety breaches after a worker developed HAVS.
S & Ash Ltd (previously known as Sound Advice Safety and Health Ltd) was appointed by Perry’s to provide health surveillance for its employees. The HSE’s investigation found that, following the health surveillance, S & Ash Ltd failed to provide suitable and accurate advice to the employer and also did not inform the employee of the results of his health surveillance, even when he made a request to see his results.
After the hearing, HSE inspector, Heather Cunnington, said: “Occupational health providers are in a unique position in safeguarding the health of employees and must provide accurate reports to employers following HAV health surveillance. Employers must act on these reports.”
OH leadership on health surveillance
What the fate of Saint Gobain and Perry’s Motor Sales demonstrates is that you might have some form of health surveillance in place – but this in itself does not protect you from HSE sanctions. If your health surveillance is inadequate or advice is not acted upon, the fines will be equally harsh.
As lockdown lifts after a hugely testing year, there is a natural desire from most companies – and people – to return to business-as-usual.
The temptation is to ensure that workplaces are ‘Covid secure’ to get teams working and productive as soon as possible. But in the rush to resume normal operations and to tick the Covid-secure box, the inevitable backlog in health surveillance should not be overlooked.
The temptation is to ensure that workplaces are ‘Covid secure’ to get teams working and productive as soon as possible. But in the rush to resume normal operations and to tick the Covid-secure box, the inevitable backlog in health surveillance should not be overlooked.
Health surveillance specialists have spent the last year adapting their services and undertaking risk assessments to ensure that, once the HSE deemed it appropriate, professional health surveillance assessments could begin again in a Covid-secure way.
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With its grace period at an end, the HSE is resuming ‘business as usual’. With the threat of heavy fines also returning, it makes sense for employers to be seeking the advice of a fully trained and medically qualified team to deliver assessments on site, at times to suit them and their employees.
This, at its heart, is both the challenge and opportunity for occupational health practitioners as we, gradually, come out of the pandemic – to ensure workforces are fit to work and that employers are fully compliant. But it is a challenge and opportunity that OH must rise to.
