OCCUPATIONAL HEALTH OCCUPATIONAL HEALTH NURSING NURSING

CONTRIBUTING TO THE CONTRIBUTING TO THE PUBLIC HEALTH AGENDAPUBLIC HEALTH AGENDA

The Strategic PlanThe Strategic Plan

Aims of the SessionAims of the Session

Highlight the role of the RCN OH ForumHighlight the role of the RCN OH ForumEngage support for future Forum activities Engage support for future Forum activities and ensure they are inline with member and ensure they are inline with member needsneedsShare ideas about how Share ideas about how ““access for allaccess for all””could be achieved in Walescould be achieved in WalesShare best practice and discuss concerns Share best practice and discuss concerns / positives facing occupational health / positives facing occupational health nursingnursing

RCN OH Welsh ForumRCN OH Welsh Forum

AIM:AIM:

““access to occupational access to occupational health for all in Waleshealth for all in Wales””

DO WE WANT TO ACHIEVE THIS?DO WE WANT TO ACHIEVE THIS?

Why is Why is ““Access for allAccess for all”” important?important?

-- to reduce inequalities in health due to to reduce inequalities in health due to access to servicesaccess to services

-- to empower the working population for to empower the working population for improved health managementimproved health management

-- to meet the public health agenda to to meet the public health agenda to improve health and reduce inequalitiesimprove health and reduce inequalities

-- to boost the Welsh Economy withto boost the Welsh Economy withhealthy people at workhealthy people at work

RCN OH Forum ObjectivesRCN OH Forum Objectives

Access to accredited training with funding Access to accredited training with funding Forum network to disseminate best practice and Forum network to disseminate best practice and offer peer supportoffer peer supportOH professionals playing a leading role in the OH professionals playing a leading role in the development of OH in Walesdevelopment of OH in WalesAppropriate resources for OH deliveryAppropriate resources for OH deliveryAll Wales OH standardsAll Wales OH standardsOH lead for interdisciplinary teamsOH lead for interdisciplinary teams

ARE THESE APPROPRIATE?ARE THESE APPROPRIATE?

OH Groups in WalesOH Groups in Wales

South and East Wales Occupational South and East Wales Occupational Health Group Health Group North Wales networkNorth Wales networkMid Wales networkMid Wales networkWest Wales GroupWest Wales GroupNHS GroupNHS GroupLA groupLA groupPolice/British GasPolice/British Gas

Current OH provision Nationally?Current OH provision Nationally?No statutory requirement i.e. COSHH, IR, Lead and Asbestos regulNo statutory requirement i.e. COSHH, IR, Lead and Asbestos regulationsationsNumbers and qualifications not clear 7,000 OHN, 3000 doctors?Numbers and qualifications not clear 7,000 OHN, 3000 doctors?(1985) Convention 161 the International Labour Organisation adop(1985) Convention 161 the International Labour Organisation adopted ted recommendation 171, National OH Policy and recommendation 171, National OH Policy and ““Access for AllAccess for All”” –– not the UK but is now not the UK but is now considering this again considering this again WHO WHO ““access to allaccess to all”” 19941994HSE Survey 1993/2002HSE Survey 1993/2002Good Health is Good Business (1995)Good Health is Good Business (1995)

2002 HSE transfers its responsibility to the DWP 2002 HSE transfers its responsibility to the DWP Pathways to Work 2004, New DealPathways to Work 2004, New DealNHS Plus 2001, 60 Million cash boost 2006 NHS Plus 2001, 60 Million cash boost 2006 –– not for Walesnot for WalesSpecialist centres Specialist centres –– Liverpool, Sheffield, LondonLiverpool, Sheffield, LondonOH projects in GP practicesOH projects in GP practicesConstructing Better Health Constructing Better Health –– pilotpilotOH and sick certificationOH and sick certificationCase managers Case managers –– 11 days training11 days trainingWork Place Health Connect Pilot 2006 Work Place Health Connect Pilot 2006 –– health and safety ledhealth and safety led

OH in WalesOH in WalesHSE NHS survey 2002 HSE NHS survey 2002 –– unqualified, insufficient numbers, no core standardsunqualified, insufficient numbers, no core standardsWAG OH survey 2006 WAG OH survey 2006 –– not trained, ltd access to SMEnot trained, ltd access to SMEResearch into OH provision for Primary Care 2002Research into OH provision for Primary Care 2002-- GP helplineGP helplineCorporate Health Standard 1996/2005/2007 x3 workplace health speCorporate Health Standard 1996/2005/2007 x3 workplace health specialist employed, cialist employed, development of an SME workplace health awarddevelopment of an SME workplace health awardRCN RCN –– Working Well TogetherWorking Well TogetherBetter Health Better Wales Better Health Better Wales Improving Health in Wales Improving Health in Wales –– NHS plan 2001NHS plan 2001WAG 2001, set up OH service WAG 2001, set up OH service -- Welsh Audit Office reduction from10 days to 8 in Welsh Audit Office reduction from10 days to 8 in absence saving absence saving ££££££Merthyr Merthyr –– public health project with SMEpublic health project with SMEManufacturing ForumManufacturing Forum““Health Challenge WalesHealth Challenge Wales”” –– umbrella umbrella Designed for Life 2004Designed for Life 2004Work Place Health Connect Pilot Feb 2006 Work Place Health Connect Pilot Feb 2006 Welsh Backs 2006Welsh Backs 2006

WHAT ELSE?WHAT ELSE?

Best PracticeBest Practice

WAG WAG –– 3OHN3OHN’’s : 7,000 employees ?yourss : 7,000 employees ?yoursMOD MOD –– joint primary care and OH servicejoint primary care and OH serviceAirbusAirbusUnilever Unilever –– study in health and productivity study in health and productivity and performanceand performanceWHO ELSE ????WHO ELSE ????

Solutions to Improve Access In Solutions to Improve Access In WalesWales

Increase Funding on OH projects in WalesIncrease Funding on OH projects in Wales–– compare with funding for Sports Councilcompare with funding for Sports CouncilStatutory minimum requirement Statutory minimum requirement –– Minimum (Mori Poll) as suggested by SME at Minimum (Mori Poll) as suggested by SME at ““Toward OH SolutionsToward OH Solutions”” HSEHSETax incentivesTax incentivesWAG sponsored OHN for SME to provide cost effective services to WAG sponsored OHN for SME to provide cost effective services to SMESME’’ssDevelop the use of OH delivery via Primary Care as part of QOF rDevelop the use of OH delivery via Primary Care as part of QOF requirementsequirementsPilots of OH Nurses in GP surgeryPilots of OH Nurses in GP surgery’’ssOH Nurse led specialist Occupational Health CentreOH Nurse led specialist Occupational Health CentreIIP IIP –– to include to include ““healthy business assessmenthealthy business assessment”” –– numbers in Wales to assess numbers in Wales to assess impact?impact?Increase OHN inclusion in Workplace Health Connect pilotIncrease OHN inclusion in Workplace Health Connect pilotAll Wales NHS OH serviceAll Wales NHS OH serviceAudit OH in the public sector to ensure adequately resourcedAudit OH in the public sector to ensure adequately resourcedLobby WAG for the aboveLobby WAG for the above

WHAT ELSE??WHAT ELSE??

TrainingTraining

Swansea Swansea –– full time redundant coursefull time redundant courseCaerleonCaerleon –– p/tp/t modular specialist modular specialist practitioner pathway practitioner pathway –– redundantredundantDr Dr DD’’AuriaAuria –– NHS Trust NHS Trust –– LlandoughLlandough ––internet based internet based –– not approved by NMCnot approved by NMCUniversity of Cardiff University of Cardiff –– ??funding for Sept ??funding for Sept 2007 start2007 start

NMC NMC –– Part 3 of the RegisterPart 3 of the RegisterSpecialist Community Public Health NursingSpecialist Community Public Health Nursing

““work with individuals and a populationwork with individuals and a population……taking decisions taking decisions on behalf of a community or population without having on behalf of a community or population without having direct contact with every individual in that communitydirect contact with every individual in that community””

How many SCPHN nurses in Wales? More needed to How many SCPHN nurses in Wales? More needed to deliver the Public Health agendadeliver the Public Health agenda

Portfolio route Portfolio route –– HOW MANY ARE CONSIDERING THIS?HOW MANY ARE CONSIDERING THIS?

RCN OH Competency FrameworkRCN OH Competency Framework

Assess practice competency Assess practice competency –– clinical clinical governance, qualitygovernance, qualityAssist with personal and professional Assist with personal and professional developmentdevelopmentLinked to career and pay progression Linked to career and pay progression –– agenda agenda for changefor changeInform curriculum developmentsInform curriculum developmentsCompliment RCNCompliment RCN’’s core Competency s core Competency FrameworkFramework

ANYONE USING THIS OR USED ANYONE USING THIS OR USED SUCCESSFULLY?SUCCESSFULLY?

Quality Issues in OH ProvisionQuality Issues in OH ProvisionAll Wales approved and standardised PolicyAll Wales approved and standardised Policy’’s s and procedures and procedures –– share standardsshare standardsCost effective servicesCost effective servicesResearch based Evidence Research based Evidence -- what do you use?what do you use?Access to qualified practitioners Access to qualified practitioners –– competencecompetenceNICE / NHS Plus /Cochrane NICE / NHS Plus /Cochrane Library/BOHRF/Scottish Intercollegiate Library/BOHRF/Scottish Intercollegiate Guidelines network Guidelines network www.sign.ac.uk/FOMwww.sign.ac.uk/FOMOH clinical Effectiveness Unit OH clinical Effectiveness Unit –– RCP /FOM 2007RCP /FOM 2007

ANY OTHER ISSUES?ANY OTHER ISSUES?

Ethical Issues?Ethical Issues?OH increasingly money orientatedOH increasingly money orientated--reduce absence reduce absence –– is this right?is this right?Confidentiality Confidentiality –– employer employer –– OH boundariesOH boundariesInvasion of privacy Invasion of privacy –– employee non participation employee non participation –– should they take should they take responsibility?responsibility?Non health professional involvement? OH to lead or be led?Non health professional involvement? OH to lead or be led?Fast tracking via the NHS? Does it happen in Wales?Fast tracking via the NHS? Does it happen in Wales?Is health screening beneficial and cost effective for organisatiIs health screening beneficial and cost effective for organisations ons (false positives(false positives--prostate/breast cancer)( part of a strategy for prostate/breast cancer)( part of a strategy for presenteeismpresenteeism--fully effective in work)fully effective in work)Moving away from the medical model to the BioMoving away from the medical model to the Bio--psychosocial model psychosocial model

ANY OTHER CONCERNS?ANY OTHER CONCERNS?

Useful informationUseful information

Book Prescription WalesBook Prescription Wales-- how many were aware how many were aware of this?of this?Welsh Backs Welsh Backs –– how many were aware of this?how many were aware of this?HSE manufacturing Forum HSE manufacturing Forum –– how many were how many were aware of this?aware of this?Work Place Health connect Work Place Health connect –– were you aware?were you aware?JiscmailJiscmail –– anyone registered?anyone registered?WAG Workplace Health Review booklet WAG Workplace Health Review booklet UnimprovidentUnimprovident Cardiff UniversityCardiff University

The Future for the RCN OH ForumThe Future for the RCN OH ForumAll Wales Network All Wales Network –– recruiting all recruiting all OHNOHN’’ss in Walesin WalesInternet pages / informationInternet pages / informationBiBi--annual conference annual conference Wales representation on FOHNEU / OH Managers Forum / SOHNWales representation on FOHNEU / OH Managers Forum / SOHNRepresentation at WAG for all work place health initiativesRepresentation at WAG for all work place health initiativesElect committeeElect committee6 monthly meeting with key stakeholders in OH6 monthly meeting with key stakeholders in OH--WAG/HSE/RCN/WCH/TUCWAG/HSE/RCN/WCH/TUCAnnual Newsletter of OH activity in WalesAnnual Newsletter of OH activity in Wales--lead in each area, all info lead in each area, all info welcomed welcomed –– especially pictures! (tell a thousand words)especially pictures! (tell a thousand words)Continue lobbying WAG to achieve aim and objectivesContinue lobbying WAG to achieve aim and objectivesCloser links with the NPHS with increasing role in workplace heaCloser links with the NPHS with increasing role in workplace health lth managementmanagementEncourage, collate and disseminate research amongst networkEncourage, collate and disseminate research amongst networkIdentify and work more closely with partners addressing workplacIdentify and work more closely with partners addressing workplace health e health issues issues –– job centre plus job centre plus ectect

ANY OTHER IDEAS?ANY OTHER IDEAS?

The Future for OH NursingThe Future for OH NursingOH provision a key contributor to success of the Public Health OH provision a key contributor to success of the Public Health Agenda, improving health and reducing inequalitiesAgenda, improving health and reducing inequalitiesLearn from the Scottish, Northern Ireland and England initiativLearn from the Scottish, Northern Ireland and England initiativesesLink OH initiatives to wider economic and social policyLink OH initiatives to wider economic and social policyStrengthened OH Forum with all Strengthened OH Forum with all OHNOHN’’ss in Wales working togetherin Wales working togetherWAG sponsored OHN for WAG sponsored OHN for SMESME’’ssNurse led occupational health specialist centre or mobile unitNurse led occupational health specialist centre or mobile unitInvestment in NHS OH departments as per NHS PlusInvestment in NHS OH departments as per NHS PlusIncrease links with industry Increase links with industry –– DTI to promote the benefits of OH DTI to promote the benefits of OH servicesservicesFull use of OH nurse skills in workplace health managementFull use of OH nurse skills in workplace health managementOH lead in Wales equivalent to Dame Carol Black the first OH lead in Wales equivalent to Dame Carol Black the first Workplace Health DirectorWorkplace Health DirectorIncrease RCN lobbying / working with WAG Increase RCN lobbying / working with WAG –– OH nurse involvement OH nurse involvement in strategic / policy developmentin strategic / policy development

CONCLUSION CONCLUSION ––RCN OH Welsh ForumRCN OH Welsh Forum

AIM:AIM:

““access to occupational health access to occupational health for all in Walesfor all in Wales””

Do you want to achieve and be Do you want to achieve and be part of this?part of this?

ANY FURTHER ANY FURTHER ACTIONS/SUGGESTIONS?ACTIONS/SUGGESTIONS?