And on the subject of pipedreams, wouldnt it be lovely if there was an Occ
Health Service attached to the GPs so that the GPs could refer a patient to
where they suspect an occupational related injury or disease.
All Britain's workforce would be able to access advice and information from
this profession, not just employees of companies with the services.
OH professional could offer advice to the employee and, with permission of
their employer report on the improvements to the individual's working
environment so to reduce the impact of the workplace on the disease/injury.
I know we would have to iron out problems such as access to workplaces,
funding, negative impact on the patients (sacked as adaptations cost too
much) etc, but isn't it nice to dream!
Amanda Dowson
> ----------
> From: Kate
> Venables[SMTP:[log in to unmask]]
> Reply To: Kate Venables
> Sent: Monday, October 14, 2002 8:18 PM
> To: [log in to unmask]
> Subject: Re: GP and OH Professionals
>
> Dear list - I'm not actually saying that an OP is necessary for all these
> actions. But I am saying that inter-disciplinary working between doctors
> and nurses (and others) is essential. And, w.r.t. doctors, I am saying
> that specialisation in general practice is not the same as specialisation
> in occupational medicine.
>
> In the UK, many OHAs (and OPs) work in isolation. But this is not
> necessarily the case in other countries. So the question is, what is the
> optimal service we should be providing to the UK workforce? Wouldn't it
> be better for OH professionals to be working in multidisciplinary groups?
> My rather broad-brush understanding of what goes on in many other European
> countries is that OH is quite often delivered from large regional or
> sectoral services. This sort of set-up would allow an essentially OHA-led
> and delivered service in most organisations (as in the UK) but would
> facilitate career progression and professional development for OHAs and
> encourage interdisciplinary working with the very much smaller number of
> OPs, occupational hygienists, and other relevant professionals. It would
> also allow GPs to receive better experience in OH, to everybody's benefit.
>
> My pipe-dream before signing off for the night - Kate
>
>
> >>> diane romano woodward <[log in to unmask]> 14/10/02 19:25:16
> >>>
> Dear All
> I am not sure that an OH physician is really necessary for all of the
> actions outlined by Kate.
> If, for example, an employee working on a computer developed a tendonitis,
> I
> think it would be appropriate for the OHA to liaise with GP for specific
> information on diagnosis, advise employer on work modifications and on
> reporting under RIDDOR. Many OHAs work in isolation without the benefit of
> specialist OH physician advice, perhaps with only a GP with OH diploma. I
> might feel that the appropriate referral in this case would be to a
> specialised physiotherapist/osteopath/ disability employment advisor
> rather
> than an OH physician.
> Where they are essential is if litigation is anticipated,(no matter how
> simple the case) and commonly for ill health retirement cases(although
> some
> schemes will accept GP report/opinion)
> I am in a lucky position to work closely with OH Physicians, I generally
> write all letters ,and draft the more complex ones and show to OHP to
> discuss before posting.
> Diane
> ----- Original Message -----
> From: "Kate Venables"
> <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, October 14, 2002 11:21 AM
> Subject: Re: GP and OH Professionals
>
>
> Dear list - sorry, I need to expand. If the issue is diagnosis of
> occupational disease, medical assessment for fitness to carry out
> particular
> work or in relation to adjustments in the workplace etc, the employer
> really
> should be asking an occupational physician for an opinion. If it is a
> question of obtaining copies of test results or hospital summaries, the
> employer again needs input from an occupational physician. This leaves a
> third area, of asking the GP to clarify a diagnosis or treatment where the
> patient is unsure. I agree that the GP should communicate clearly with a
> colleague and it does not matter if that colleague is another doctor or a
> nurse.
>
> Have I missed something out? - Kate
>
>
> >>> Amanda Dowson <[log in to unmask]> 14/10/02 10:33:44 >>>
> I appreciate that you may feel that getting an Occ Physician to write to
> GPs
> rather than OH nurses, may elicit a better response. But isnt it a sad
> state
> when the initials after a persons name is all that is required to get an
> appropriate and professional report on a patient.
>
> By doing this are we acknowledging the OPs superior letter writing skills,
> interpreting of report skills, or a general superciliousness on the part
> of
> some GPs when responding to nurses ?
>
> Amanda
>
> > ----------
> > From: Kate
> > Venables[SMTP:[log in to unmask]]
> > Reply To: Kate Venables
> > Sent: Friday, October 11, 2002 11:40 AM
> > To: [log in to unmask]
> > Subject: Re: GP and OH Professionals
> >
> > Dear list - the, admittedly rather narrower issue, of request for
> > pre-payment of fees for doctor-to-doctor communications, has been on the
> > agenda of the BMA Occupational Health Committee, was raised at the BMA's
> > Annual Representative Meeting last year, and has been discussed by the
> OH
> > committee's chair with the Chair of the GPs committee. Susan Robson
> (OHP,
> > Manchester University) is the OH committee chair. Can I suggest that
> the
> > authors of all of the excellent, creative and practrical comments posted
> > to this list should copy them to Sue [log in to unmask] ?
> >
> > There are some very important issues here around the responsibility
> within
> > a GPs NHS terms and conditions of service to provide information
> relevant
> > to the patient's health and welfare in the workplace.
> >
> > Lindsey - maybe you need an occupational physician for the information
> > required?
> >
> > Best wishes to all - Kate
> >
> >
> > >>> <[log in to unmask]> 11/10/02 09:56:14 >>>
> > Having not logged on for a few days, I have had the chance to read the
> > original email and all the replies (twice) and thought I would add my
> own
> > thoughts. Sorry Bashyr, good try at calling a truce, but this one
> drives
> > me nuts - (my professional opinion!).
> >
> > 1) There are some brilliant and caring GPs out there, but there are also
> > far too many who really let the side down. All too often our OH service
> is
> > hampered by poor quality, slow, costly reports that are of no benefit to
> > anyone - particularly the employee/patient. And that's when they
> arrive.
> >
> > 2) I've always regarded services as things you pay for once you have
> > received them. I don't ask a plumber to mend my taps and pay him an
> hours
> > wages before he turns up. And if GPs don't like being compared to
> > plumbers, I would treat lawyers in the same way.
> >
> > 3) Although I am aware of the pressures on GPs and the NHS in general, I
> > find it unacceptable that this sort advice, which is not sought free of
> > charge, is often not available to support Occupational Health
> Departments
> > in their role as a small but important part of the primary healthcare
> > team. There has been much research recently to show the benefits of the
> > workplace on health and recovery. Should we not receive the support we
> > seek, employees may well deteriorate and place an even more onerous
> burden
> > on other services, particularly if they lose their job.
> >
> > 4) Mark, I'm sure your information about Government contracts and
> > expectations is true but it staggers me. Not only do we now have a
> > Government that expects its own departments and NDPBs (Quangos) to be
> > leaders in OH, while threatening to tax any OH initiative that has the
> > slightest bit of imagination attached to it, they are now telling us to
> > manage absence with the best of British industry, yet don't even
> > officially provide the avenue for a major, and arguably, the most
> > important source of health information.
> >
> > Beyond the rant, please take this as another request for the Hallam
> Street
> > information and address. I'll also lay down a challenge to the GPs on
> the
> > list. How about getting this issue on the Royal College of GPs agenda.
> > I'm sure you will have plenty of volunteers on the list willing to
> address
> > their next conference. Count me in.
> >
> > Lindsey Hall
> > National OH Manager
> > Environment Agency
> >
> > PS Great Debate - These sort of issues really need one.
> >
>
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