Didnt mean to sound like teaching the whole sucking eggs procedure so glad it was some help.
In any good organisation don't you think sucha dialogue should be two way - after all we are meant to be the 'experts' on what we do and what we can do.
I believe that a lot of OH in the NHS can be inflexible and some suffer because they are too flexible. Getting groups of OH units to talk and share things helps to even out some of these things.
Trusts are driven by white papers and a lot of government drivel as well as lots of good stuff and sometimes you need to agree to do some of the fluff stuff (i.e. the bits with lots of opinion but not necessarily any clinical evidence) in order to keep doing the basics. Experience helps you prioritise it all or we could easily drown in if not careful.
For instance, NHS Employers (the group that sends all the missives on staff well-being to us - have their own website if you want a look at the stuff) are currently pushing hard to look as if they are helping the NHS save money by advocating getting rid of pre-employment health questionnaires originally using spurious hints that it is illegal under the Equality Act. It isn't illegal, there are timing issues and content issues but it isn't illegal. This was going to 'free up' all this time to focus on the more important 'well-being' that has now overtaken everything else, on the grounds that apparently nothing else we have focussed on has made an obvious difference to absence levels - is this lack of evidence I ask or stemming from unrealistic expectation, who knows.
I am lucky that I am old enough, experienced enough to be confident in communicating on tricky issues and trusted to make sound risk assessment judgments on what we need to be doing to satisfy the Trust that the need to consider the safety of the children continues to include pre-employment screening. Do you think the public are aware that the NHS has instructed us to stop screening the physical and mental health of staff who are going to be looking after their loved ones. I don't think so .
I have worked in the private out sourced sector and I think that makes big difference as you get use to user groups, presenting to boards, understanding strategic objectives and translating them into departmental objectives, cost effectiveness, the importance of customer service etc.
I wouldn't do any other job in nursing that's for sure.
regards
Sue
Susan Gorton Occupational Health Department Manager Occupational Health Department, Level 3 Ormond House, 26-27 Boswell Street, London WC1N 3JZ Mob: 07833294568 Tel: 020 7813 8554 Ext 0247 Fax : 020 7813 8355 Email: [log in to unmask] From Sept 2010 I am on study leave on Tuesdays throughout the academic year
>>> David Wadsworth <[log in to unmask]> 11/05/2011 09:55 >>>
Thanks Sue.
Co-incidentally, I was tackling a PESTEL last night! Your notes will
help me revisit this and no doubt improve my original effort.
How do you and other NHS OH managers align with Trust strategies? Are
your objectives made in line with top down strategy for health and well
being, or are you essentially guiding "above" on what should be done
without OH?
Thank you again for any input.
David
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On
Behalf Of Susan Gorton
Sent: 04 May 2011 18:22
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] Strategic use of OH
Have you ever done a PESTEL analysis as this is a good analytical tool
thought not all will apply and you will find the explanations as
follows.
PESTEL
Political factors are how and to what degree a government intervenes in
the economy. Specifically, political factors include areas such as tax
policy, labour law, environmental law, trade restrictions, tariffs, and
political stability. Political factors may also include goods and
services which the government wants to provide or be provided (merit
goods) and those that the government does not want to be provided
(demerit goods or merit bads). Furthermore, governments have great
influence on the health, education, and infrastructure of a nation.
Economic factors include economic growth, interest rates, exchange rates
and the inflation rate. These factors have major impacts on how
businesses operate and make decisions. For example, interest rates
affect a firm's cost of capital and therefore to what extent a business
grows and expands. Exchange rates affect the costs of exporting goods
and the supply and price of imported goods in an economy
Social factors include the cultural aspects and include health
consciousness, population growth rate, age distribution, career
attitudes and emphasis on safety. Trends in social factors affect the
demand for a company's products and how that company operates. For
example, an aging population may imply a smaller and less-willing
workforce (thus increasing the cost of labor). Furthermore, companies
may change various management strategies to adapt to these social trends
(such as recruiting older workers).
Technological factors include technological aspects such as R&D
activity, automation, technology incentives and the rate of
technological change. They can determine barriers to entry, minimum
efficient production level and influence outsourcing decisions.
Furthermore, technological shifts can affect costs, quality, and lead to
innovation.
Environmental factors include ecological and environmental aspects such
as weather, climate, and climate change, which may especially affect
industries such as tourism, farming, and insurance. Furthermore, growing
awareness of the potential impacts of climate change is affecting how
companies operate and the products they offer, both creating new markets
and diminishing or destroying existing ones.
Legal factors include discrimination law, consumer law, antitrust law,
employment law, and health and safety law. These factors can affect how
a company operates, its costs, and the demand for its products.
If we had to wait for UK approved empirical clinical evidence for what
we do in OH we'd still be twiddling our thumbs as some of it is a long
time coming but that doesnt mean it shouldnt be done.
e.g chickenpox vaccine has been licensed in New Zealand for primary
childhood vaccination for 27 years. - its only just been licensed for
the last few years for use and is not yet on the primary vaccination
scheduel for children.
CBT as a therapy for everything psychiatric or psychological has been
inplace since someone came up with the idea and is still undergoing
clincal validation as we speak.
Do we eat eggs or not -how is your cholesterol.
What I mean by this is that it is sometimes easy to put too much in the
nice to do as if it is all just fluff and can therefore be discarded
when times are tough but I wold advise some caution against saying that
there must be clincial evidence or it's not worth doing.
And particularly for OH in the NHS there is a strong element of
political 'compelled by government' driving OH work even though there is
little or no clinical evidence' cos as Paul knows we have to thank NHS
employers every day for adding more to the list without regard for
priority
Cheers
Sue
Susan Gorton Occupational Health Department Manager Occupational
Health Department, Level 3 Ormond House, 26-27 Boswell Street, London
WC1N 3JZ Mob: 07833294568 Tel: 020 7813 8554 Ext 0247 Fax : 020
7813 8355 Email: [log in to unmask] From Sept 2010 I am on study
leave on Tuesdays throughout the academic year
>>> "Darcy, Paul" <[log in to unmask]> 04/05/2011 10:33:57 >>>
Hi David,
I think you've also described OH practice too:
Must do (legal)
Should do (evidence based)
Nice to do (no/ limited evidence base but feels good to do)
Paul
Paul D'Arcy
Clinical Nurse Leader
Imperial Health a+ Work
Imperial College Healthcare NHS Trust
2nd Floor
Hammersmith House
Hammersmith Hospital
Du Cane Road
London
W12 0HS
P: 020 3313 1543
F: 020 3313 3395
E: [log in to unmask]
W:
www.imperial.nhs.uk<blocked::BLOCKED::BLOCKED::http://www.imperial.nhs.u
k/>
From: [log in to unmask] [mailto:[log in to unmask]] On
Behalf Of David Wadsworth
Sent: 04 May 2011 10:28
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] Strategic use of OH
Thank you to everyone who replied to my original email.
I think the summary of replies so far would suggest that OH services
fall into three categories:
Must have (legal)
Should have (business)
Nice to have (morale)
....and that any OH service should be delivered in line with a
service level agreement (SLA). Most importantly, the SLA should be
specific to particular business strategies within the Trust or Company.
Again thank you to those who have replied. I remain very interested in
any further input, especially from those who have had experience of
service delivery being agreed in line with specific business strategy.
Best Regards
David
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On
Behalf Of sharon naylor
Sent: 28 April 2011 12:59
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] Strategic use of OH
In the days (0ver a decade ago) when I worked for a provider I was part
of a pilot study commissioned by a government dept. The remit was to
look at what on site OH in 7 sites could do to address 3 issues,
reducing sickness absence
implement an occupational vaccination service
assist with ensuring legislative compliance
The various sites had an OHA assigned to them for 2 days a week for 12
months. A big ask, some might say - to achieve such lofty ideals on 2
days a week.
Not a surprise but sad to say that not all sites were that successful at
the end of the 12 months for a variety of reasons, but some were highly
successful. My personal view was that the brief was too broad and
largely depended on the skills/experience of the OHA rather than a clear
strategic direction on behalf of both the provider and the commissioner.
Roll on 10 years and now this govt dept has a contract with a major
provider to put an OHA in each of their sites to address basically the
same issues, time spent on site varies from 2 days per week to maybe
once a fortnight dependant on the number of employees. We shall wait and
see how successful this is.
On a slightly different tangent (but IMHO there is a link) I attended a
business seminar recently and one of the speakers was a marketing and
business guru - she was very adamant that many people try to be "Jacks
of all trades" and spread themselves too thinly, therefore overall
quality of the product/service suffers as you can only achieve a
medium/mediocre level, rather than delivering a streamlined body of
excellent products/services to a target customer base. She argued that
in this way yoiur business will thus stand out in an already
overcrowded marketplace.
Food for thought?
> Date: Thu, 28 Apr 2011 11:10:35 +0100
> From: [log in to unmask]
> Subject: Re: [OCC-HEALTH] Strategic use of OH
> To: [log in to unmask]
>
> Hi David
>
> I think this is a brilliant hypothesis and would be very interested to
read the final thesis. My view, particularly with trusts and other
public sector organisations is that they often don't have a particularly
clear remit for their own existence and therefore are not able to
provide a clear remit for their own support services. We all presume
that the NHS is there to provide healthcare, free at the point of need,
but in reality that means a vast number of different things to a vast
number of people, which makes the priority list so large as to be almost
unmanageable.
>
> One thing that is clear is that in order to do whatever they do,
trusts need large numbers of people. People occasionally get sick for
all sorts of work and non work related reasons, sometimes play games
with their employers pretending to be sick, fall out with colleagues,
are overworked, underworked, highly praised or dumped on from a great
height. All human behaviour is there and when health is an issue, OH
should be there too.
>
> I remember posting something on this list many years ago about the 3
reasons for Occupational Health - Moral, legal and business. It's proved
to be a very good starting point for me and others have used similar
models. It provides a very simple starting point for any organisation
wanting to refocus on how it looks after its employees.
>
> Let me know off list if you want me to dig it out of the archives.
>
> Thanks
>
> Lindsey
>
> Lindsey Hall
> Independent Occupational Health Adviser
> Split Dimension Ltd
> 07771 596111
> Phone/Fax 01454 852715
> www.splitdimension.co.uk
>
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>
> -----Original Message-----
> From: [log in to unmask] [mailto:[log in to unmask]] On
Behalf Of David Wadsworth
> Sent: 27 April 2011 14:34
> To: [log in to unmask]
> Subject: [OCC-HEALTH] Strategic use of OH
>
> Hi all
> I am writing an assignment on "Corporate strategy" for my certificate
in management and have decided to look at how businesses use OH.
>
> My gut feeling is that businesses/hospital trusts do not have a clear
strategy for OH when they engage their services, but do it for a variety
of reasons, health surveillance, sickness absence, health promotion,
back care, training, vaccination, "always had it" etc. This wide remit
then leads to the OH dept providing a broad range of services, rather
than focusing and contributing to clear business strategies. Something
my literature refers to as "strategic drift" - in that OH provide too
broad a service to be able to measurably and effectively contribute to
corporate strategy.
>
> I may be wrong.... but I have decided to start with this hypothesis!
>
> I would be very interested in others people views, especially if you
have already looked at this within your business/trust.
> Any pointers towards relevant studies/literature would also be greatly
appreciated.
>
> Many thanks in advance for any feedback.
>
> David
>
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