In November last year I was inspected by an OH Inspector and a HSE Inspector. They were with me most of the morning and went through everything I did. They were telling me that they are actively looking for incompetent OH Providers and will prosecute. The reason they saw me was they wanted to know that the OH providers on their patch (Yorkshire) were competent as they were seeing some bad practice out there. They got my name from one of my clients where I had recently set up a health surveillance programme, and they had inspected the company.

 

In conclusion they were happy with what I was doing (I’m nurse led) found no problems and in the end it was actually a positive experience. My advice to any Independent OH Providers out there is to make sure you get your house in order, don’t take on work you are not competent to do and be prepared for a HSE visit if you work for a range of clients.

 

Karen

 

 

Interesting posting Jane. Was this  the belief of the HSE or a personal view of the HSE inspector? I suspect the latter and in my opinion it is surprising, short sighted and outdated. A number of OHNs have set up very successful and competent consultancies and to my knowledge they would be very reluctant to be supervised by a doctor.

As an illustration: Nichola Elvy was an HSE inspector for the construction sector in the past. She is now the MD of Building Health – an award winning consultancy specialising in construction and demolition – both highly hazardous working environments. Nichola  would be familiar with  the stance of the HSE re nurse lead service. She would not put herself in a vulnerable position, particularly as she specialises in one of the most hazardous work places in the UK.

Recent conversations with Nichola indicates that she does not have an OH physician overseeing her practice but she does employ the services of an OH Physician when required – eg for statutory medical surveillance, (such as asbestos medicals or when employees may be exposed to chemicals such as lead) or when a specific medical opinion is required. The NMC code requires us to practice within the boundaries of our competencies – there is no mention about supervision by a physician. In addition to occupational health nursing qualification Nichola also has a degree in occupational hygiene, a PG Dip in health and safety and has attended HSE CPD programmes in relation to her work as an inspector for the construction setting. I assume that there are very few occupational health physicians who can match Nichola’s breadth of knowledge and practice experience of the construction industry. The NMC are correct to require nurses to practice within the boundaries of the competency. The competencies the OHN has depends on the quality of  their basic OH education, ongoing CPD and professional experience.  

Does my posting concur with the  view of other nurse consultants who contribute to the list?

Anne Harriss
Course Director
London South Bank University


On 18/1/08 12:04, "Jane Fairburn" <[log in to unmask]> wrote:

Hi
 
My experience of an “HSE Inspector” was to say that HSE also don’t approve of “Nurse Led services” or nurses working as “self-employed OH consultants”. This person was also a nurse!!?? When I said we consult with OH doctors as and when required – and its actually not that often in our particular experience - she stated this was outrageous and I should have a doctor on my books to oversee everything I do……...
 
Take it with a pinch of salt and use your own good knowledge & experience to guide your practices. I don’t know that “NMC guidelines” impacts that much on OH in any event???
 
I though Friday was a chill out day anyway – anyone got a funny story?
 

With regards,
Jane
Jane Fairburn BSc (Hons) RSpCPH (OH) CMIOSH
Occupational Health Services Director

Mobile 07770 638 268
Office  01925 227 000
Direct  01925 294 775

J Save Paper - Do you really need to print this e-mail?

 

From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Frank Oakes
Sent: 17 January 2008 18:22
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] Ambient noise levels during audiometry


It really does not seem to matter what we think, like the highway code we have to follow the rules and I was also reminded that as nurses on the NMC register we must practice within guidelines.  The crux of the subject is the reproducability of the environmental noise during the test and as quite rightly mentioned we do not diagnose but screen.   I was given examples of tests done where the OHA had written across the test that there were high levels of noise hence the poor resul;ts and it was thought that this was okay.  Hey, I have done this too so what has changed for me. 1.  I now know different.  2. The HSE now know I know different.  I imagine this makes a difference for how most of us practice.  I suppose it will also make a big difference for the companies who have gone to the great expense of purchasing mobile screening units who are constantly undercut by those of us who don't ending up at a competitive disadvantage because we choose to 'turn a blind eye' to the guidance that while confusing is already available so it could be said that we would have no defence if challenged..



I am sure this debate will continue but if you require absolute clarification contact your local HSE OH Inspector.  The young lady I spoke to said she will be more than willing to discuss this with anyone and if you want her details please ask.



Cheers



Frank

----- Original Message ----
From: Annie Anderson <[log in to unmask]>
To: [log in to unmask]
Sent: Thursday, 10 January, 2008 5:10:30 PM
Subject: Re: [OCC-HEALTH] Ambient noise levels during audiometry

I totally agree with you Jane,

We are carrying out a screening test only, looking for any deviation from
the expected or any change in the results from previous ones.
We are not doing any diagnosing and if we have concerns then the person is
referred to the GP or ENT department for consultation and appropriate
testing.
When hearing tests are carried out in a quiet office the sound does not
differ that much from year to year.


Regards
 
Annie
Telephone 07788667506
 
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-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On Behalf
Of Jane Fairburn
Sent: 10 January 2008 15:57
To: [log in to unmask]
Subject: [OCC-HEALTH] Ambient noise levels during audiometry

Hmmm - so even if an audio is normal then HSE don't believe it is???

Clearly we need to remember we are screening healthy people not diagnosing
deafness and prescribing hearing aids!

A sound booth is only used to attenuate the interference of extraneous
sounds during a hearing test and whilst they reduce, they do not wholly
eliminate reverberant and ambient noises in any event as far as I am aware.
One of our sites has a booth situated adjacent to the changing rooms & we
can't test during shift change! Its simply not as clear as booth or no
booth.

It seems like common sense to 'screen' people and then consider if further
testing is required in a booth - or indeed with appropriately attenuated
headset. We should not be seeing new cases of NIHL these days and if we are
then something is wrong and its not the OH screening......

Thanks Frank Look forward to your posting the new HSE guidance.

Regards,

Jane

Jane Fairburn
Occupational Health Services Director
Mobile : 07770 638 268
Office :  01925 227 000
www.people-am.com <http://www.people-am.com/>

________________________________

From: [log in to unmask] on behalf of Frank Oakes
Sent: Thu 10/01/2008 15:15
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] Ambient noise levels during audiometry


A very timely post.  

Late last year I was privvy to a meeting with HSE who stated that they would
not accept a hearing test as being valid unless it was either done in a
sound reduction booth or the tester recorded the sound levels during the
test with a sound meter and when the levels peaked over a certain level, I
am waiting on further details of this, then the test had to be stopped and
restarted so it seems that the rule of thumb 'quiet room' is a thing of the
past as we can not accurately reproduce the environmental noise levels.  I
confirmed this via telephone again this week with HSE and they tell me there
is new guidance out shortly.  As soon as I get the noise levels etc. I will
post them here as like myself  I am sure this will make an impact on how we
practice. Oh yes,  they also informed me that they were investigating a
number of OH providers/ companies for a variety of bad practices and they
are very keen to hear of any more.  Oh yes, please remember when replying I
am the messenger.

Frank


----- Original Message ----
From: "Hawkes, Lynda" <[log in to unmask]>
To: [log in to unmask]
Sent: Wednesday, 9 January, 2008 11:57:49 AM
Subject: [OCC-HEALTH] Ambient noise levels during audiometry

List,

Please can someone advise me what the maximum ambient noise levels should be
when conducting audiometry without a sound-proof booth?  I have looked at
"Acoustics - Audiometric test methods BS EN ISO 8253-2:1998 but have to
confess that I don't fully understand what I am reading.

Thanks
Lynda

Lynda Hawkes
Occupational Health Advisor
Thales
Aerospace Division
Scudamore Road
Leicester UK
LE3 1UA

Tel: +44 (0) 1162 594030
email: [log in to unmask]
www.thalesgroup.com

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