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Perhaps she needs to sit down, have a realistic chat with her managers regarding family friendly hours/part time working or similar? It appears to me that what this lady needs is a lon g term practical solution, and finding that solution may not necessarily sit within OH remit ________________________________ From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Carr Barnes Sent: 10 June 2012 22:16 To: [log in to unmask] Subject: Re: [OCC-HEALTH] case advice HI Kate I think this is one of those where you talk about the client having episodes of distress manifesting as symptoms of fatigue, feeling overwhelmed, anxious etc due a mismatch between the client's coping skills and the situation. As management are aware this has been managed by periodic reductions in hours in the past to help the employee cope with fatigue. As the situation is ongoing and likely to continue for the foreseeable future you have advised the client to consider sources of support (GP, support groups, info services, EAP etc) as you feel their needs in the medium to long-term would be better served by identifying more sustained and effective ways of increasing their resilience. Also at this time there is no evidence of any medical condition e.g. anxiety disorder, depression etc. but that if the client does not find strategies to help them cope more effectively there is increased risk of ill-health outcomes. Then say that in the short term, if the employee feels they are not coping while they access these services, you have advised them to approach management to discuss ways in which they may be able to concurrently manage work and home demands effectively. That way you say there are issues affecting work but you hand it back to management and client without becoming too paternalisitic? Carr On 10 June 2012 21:57, kate owen <[log in to unmask]> wrote: Your opinions welcomed. I saw a client recently. Seen OH x 6 in the last 4 years due to domestic issues causing stress. Each time the OHP or OHA has advised adjusted hours to accommodate for their difficulties - lasting the 12 weeks until it then effects pay and they then returned to full hours. I saw them and ....they have a history of never accessing evidenced based treatments for 'reactive depression/anxiety' with no GP involvement. They told me they are 'not coping' 'not sleeping' 'not eating' and 'struggling to concentrate on journey to work which involved a near miss'. The domestic situation continues to cause angst and they felt that no treatment was required just adjusted hours. They also felt that the only solution to their obvious distress was the domestic situation changing. In my view this of course would help but it would be highly unlikely based on the circumstances. I decided to change tack. Partly because I feel strongly that if you advise recuperative hours or restricted duties to support an individual then you have to be able to justify why they are then no longer required later down the line and in this case I feel the history suggests that in 12 weeks time (again) they will be as much needed as now. I also felt that work should not be the the only one that makes the effort as there was no change planned by the client and finally I also felt that it was time the GP knew what was going on and especially if she was at risk driving to work (They may have laid it on thick here) ....I couldn't say she was fit to be at work. I advised that they attend the GP and then if the GP felt appropriate they would either be off sick or on 'adjusted hours'. I advised management that I wanted them to see GP before giving more prescriptive advice re:hours etc. My concerns are that I haven't helped anyone. They will possibly see their GP and tell them a whole different story and be signed 'fit for adjusted hours' and management will end up adjusting their hours anyway and they will carry on expecting reduced hours every time it 'all gets to much' without any change from them. I do know they went straight back to their department and said I didn't care. How vulnerable am I for not suggesting to management that they should make adjustments? They are clearly suffering (and I am by no means suggesting that I would want to be in their position) but I just feel that I am condoning the persisting situation. Please let me know if I should view things differently for the clients sake or mine (an ET is almost my worst nightmare) Many thanks Kate From: sharon naylor <[log in to unmask]> To: [log in to unmask] Sent: Sunday, 10 June 2012, 19:46 Subject: Re: [OCC-HEALTH] back pain I had to defend myself the other way round, not pleasant. ET didnt go in employers favour but it was noted that my opinion was indeed valid Date: Sun, 10 Jun 2012 18:38:44 +0100 From: [log in to unmask] Subject: Re: [OCC-HEALTH] back pain To: [log in to unmask] Hi I recently heard of an OHA who successfully defended her judgement in assessing someone as unfit to work (against the GP's fit note saying the individual was fit to work) at an ET. Janet On Sun, Jun 10, 2012 at 6:04 PM, sharon naylor <[log in to unmask]> wrote: Your advice is spot on, you just cant do it all for them unfortunately. I still find it hard when people just dont listen, but individuals have their own responsibilities in such situations. I do think that employees and managers alike sometimes expect us to wave a magic wand, all ailments will be cured, everyone will be happy or alternatively given the boot and there will miraculously be no ET because OH will have covered every angle.......we are maybe victims of our own success and knowledge? > Date: Sun, 10 Jun 2012 12:54:59 -0400 > From: [log in to unmask] > Subject: Re: [OCC-HEALTH] back pain > To: [log in to unmask] > > Hi > I have advised that H&S should ensure a full risk assessment to see if > the expectations of lifting 25kg is appropraite. I have also advised > regarding the Equality Act. I think it is just when you are on your own > and the simplist of decisions sometimes look hard. That is why I am so > thankful for this site and the wealth of knowledge I am able to access. > Thank you again. > > > -----Original Message----- > From: sandra glenn <[log in to unmask]> > To: OCC-HEALTH <[log in to unmask]> > Sent: Sun, 10 Jun 2012 15:15 > Subject: Re: [OCC-HEALTH] back pain > > > Hi Tracey > Depending on how long he has had his condition, if likely to be > long-term and the impact it has on his activities of daily living etc, > you may need to consider advising the employer re the possibility his > condition may come under the Equality Act, if you haven't already done > so. This would be then be about suggesting possible reasonable > adjustments to the employer whilst acknowledging it is a > manager/business decision what adjustments can be accommodated or not. > > > The other consideration is aggravation of his symptoms/condition from > his work duties which seems a real possibility if repetitive lifting > 25kg for prolonged periods- this comes under health and safety law (eg. > MHSAW and Man handling regs) with employer having duty of care to > avoid/reduce harm to him from work duties as far as reasonably > possible. If he has a long term back condition, he should probably be > considered to have an increased vulnerability of further or increased > MSD symptoms if undertaking heavier manual handling. Again, you have > given your advice but the employer then decides what action to take > weighing up all factors including your OH advice, business needs and > legal obligations. > > sounds like you have done the right thing to get A GP report for > further medical evidence with the possibility of his job being at risk > if very limited opportunities for alternative duties. It would be > expected by an employment tribunal if someone is at risk of losing > their job for a health condition. > Kind regards > Sandra > > > > > > > > Date: Sun, 10 Jun 2012 09:02:16 -0400 > > From: [log in to unmask] > > Subject: Re: [OCC-HEALTH] back pain > > To: [log in to unmask] > > > > Hi > > > > I suppose I am fearful of giving advice and he looses his job and > then > > he finds someone who states my advice was wrong therefore I supose I > am > > looking for some one to support my advice. Thanks for your > comments. > > It good to know there is not much else I can do as I am sticking by > my > > opinion but would like the GP report to confirm his diagnosis. I am > not > > quite comfortable with what I have been told by the employee so at > > least if things do go pear shaped I have consulted other medical > advice. > > > > Thanks again Tracy > > -----Original Message----- > > From: Carr Barnes <[log in to unmask]> > > To: OCC-HEALTH <[log in to unmask]> > > Sent: Sun, 10 Jun 2012 9:50 > > Subject: Re: [OCC-HEALTH] back pain > > > > > > I agree about giving advice and leaving it there but in this type of > > case where there is potential issues about plausibility of report I > > would get GP report on known history of back condition, including > > copies of any specialist reports etc. Then a final report advising of > > what you feel aggravating factors at work could be that could > increase > > risk of absence .....then step back and leave it to HR > > Regards, > > Carr > > On Jun 10, 2012 9:43 AM, "sharon naylor" <[log in to unmask]> wrote: > > > > We all have similar difficulties with the odd case, where people just > > dont want to engage, are wary, stroppy or rude. > > > > I think rather than comment on the specifics of this case I would ask > > "What is it that you want to achieve with this?" > > > > You have an opinion, which you have offered. He disputes your opinion > > as is his right. I am wondering of what use is further reports/info > > from his treating clinicians? Are you hoping that they will back up > or > > further inform your opinion - because it might, but would still leave > > you in the same position I think. > > > > In similar cases I have offered my opinion, have shared it and even > > discussed it further in the form of a case conference with the > > individual/manager/unions. However - my opinion always stands, if the > > individual or management choose to disregard it - well its their > call. > > Your guy needs to take some personal responsibility for his health, > > sounds like he is doing what he is as he knows his P45 might be on > the > > table > > > > > > > > > Date: Sun, 10 Jun 2012 09:28:05 +0100 > > > From: [log in to unmask] > > > Subject: [OCC-HEALTH] back pain > > > To: [log in to unmask] > > > > > > Good Morning. Please can you offer your opinions on this case I am > > finding quite difficult. A 52 year old gentleman works in as a > > production op in meat factory.He is a poor historian. Reports that an > > MRI scan confirmed multiple slipped discs and arthritic spine - He > > states that nothing can be done but has been referrred to pain > > management. The specialist advised morphine patches but his GP has > > stated that he is too young for these and has presribed gabapentin > with > > positive results. He was complaining of 11/10 pain and I advised him > to > > refrain from work and see his GP. The GP placed him on sick leave and > > then stated 2 weeks lated he could be placed in an adapted role. I > > recommended that he was not placed in a role where he was standing in > > one position as this reportedly exacerbated his condition. A role was > > found for him and I undertook a work place assessment. The new role > > involved him lifting 25kg meat trays repeatedly. I watched him slide > > the meat trays to the end of the line and swing them to the large > > dolavs to transfer the contents. I asked him why he did not pick up > > with both hands and he said it was heavy for him and easier to do it > > this way. I was concerned that this was not safe and if he was having > > difficulty he shoud not be lifitng it.The Business could not > accomodate > > him in any othe role and so he remains off work. He is being paid > > whilst waiting for a GP report. He has only seen a pain speciaist and > > this speciaist states he does not write reports. The gentleman states > > that he is fit to work and should be allowed to. He says even though > he > > expereinces 11/10 pain and walks with a limp due to the pain it > shoudl > > be his decision. I have said that I need further advice as I feel > that > > work would be exacerbating his condition if he continued to lift the > > 25kg repeatedly. He is a very difficult patient and has fallen out > with > > 4 of his doctors. He has also contradicted what he has told me > although > > i have written the information down and he has agreed for management > to > > be advised. I get a bit warey when the patient impplies that I am > lying > > and so would prefer this gentleman was seen by an OHP. I also feel > that > > if he is seen before the GP report is recieved that the OHP will not > > have the full information. The GP report is likely to take another 4 > > weeks ( if all goes well) > > > > > > ******************************** > > > Please remove this footer before replying. > > > > > > OCC-HEALTH ARCHIVES: > > > http://www.jiscmail.ac.uk/lists/occ-health.html > > > > > > CONFERENCES AND STUDY DAYS: > > > http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH > > > > > > ********************************Please remove this footer before > > replying. > > OCC-HEALTH ARCHIVES:http://www.jiscmail.ac.uk/lists/occ-health.html > > CONFERENCES AND STUDY > > DAYS:http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH > > ********************************Please remove this footer before > > replying. > > OCC-HEALTH ARCHIVES:http://www.jiscmail.ac.uk/lists/occ-health.html > > CONFERENCES AND STUDY > > DAYS:http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH > > > > > > ******************************** > > Please remove this footer before replying. > > > > OCC-HEALTH ARCHIVES: > > http://www.jiscmail.ac.uk/lists/occ-health.html > > > > CONFERENCES AND STUDY DAYS: > > http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH > > > ********************************Please remove this footer before > replying. > OCC-HEALTH ARCHIVES:http://www.jiscmail.ac.uk/lists/occ-health.html > CONFERENCES AND STUDY > DAYS:http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH > > > ******************************** > Please remove this footer before replying. > > OCC-HEALTH ARCHIVES: > http://www.jiscmail.ac.uk/lists/occ-health.html > > CONFERENCES AND STUDY DAYS: > http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH ******************************** Please remove this footer before replying. 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