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"The
NHS in Scotland should set an example on
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3.1 Exemplar and Public Health Role
The NHS in Scotland must to play an exemplar role in the provision of OHSS
Employment and Health
There are clear links between employment and health. Having a secure rewarding job can do much to provide the social support and motivation so vital to good physical and mental health. Conversely non-secure, low reward, unsafe jobs can undermine the potential for good health. Employers, trade unions and professional organisations in the health service have a particular interest in developing the health of workforces, both to increase the well-being of employees and to reduce sickness and absence so as to improve the service to patients. In the NHSiS there are clear economic and material benefits for staff and for patients by raising the effectiveness and quality of patient services. Ensuring that all employees have access to a comprehensive and inclusive OHSS will protect patients and the public and additionally improve staff health and the ability to work effectively.
Exemplar Role
The health service has an important exemplar role as an employer. Because of its unique position of trust and respect in Scotland the NHS should set an example to all employers. The NHSiS should exemplify best practice to other employers and as such should openly publicise its OHSS. In line with the Green Paper "Working Together for a Healthier Scotland" and subsequent White paper, the NHSiS should work with and support the development of OHSS in Scotland and contribute to the health of the people of Scotland. NHSiS Organisations should have comprehensive occupational health services which are clearly visible and accessible to staff and to the local community. Occupational health and safety services are set up to care for NHS employees with a prime responsibility for the NHSiS. OHSS should as a priority actively seek to provide services to all parts of the NHSiS not at present receiving such services.
The NHSiS OHSS should aim to become a trusted and widely recognised source of comprehensive specialist occupational health and safety advice for employers in Scotland and should establish support through local networks and Health Boards for OHSS with non-NHSiS employers.
In accordance with their exemplar status NHSiS organisations must comply with Health and Safety regulations and ensure standards of performance go beyond the statutory standards. No NHSiS organisation should incur HSE enforcement action.
Action point
All NHSiS Organisations must:
OHSS should:
The figures in brackets relate to the Action Plan in section four
"Everyone
should be clear about their role in
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There should be clear and consistent roles and responsibilities for the management and organisation of OHSS in Scotland
Management Executive Responsibility
The Management Executive has a responsibility to ensure that NHSiS organisations are clear about their specific roles and responsibilities in providing a comprehensive, competent and integral OHSS for NHSiS staff. It also has a duty to ensure the NHSiS meets the challenges set in this report and to oversee and monitor OHSS performance in the NHSiS.
Employer Responsibility
In 1995 the NHSiS issued guidance on OHSS for the NHSiS, (GEN(1995)4). This clearly set out the responsibilities for all NHS organisations including Primary Care contractors to make OHSS available to their staff.
OHSS interact considerably with health and safety at work issues. The Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1992 identify that the primary health and safety responsibility rests with the employer.
Management Responsibility
Management has a responsibility for fully integrating OHSS into an overall human resource strategy. The responsibility for provision and standards of such services is clearly with the Management of the NHSiS who have statutory and legal responsibilities in this respect. NHSiS managers as individuals and NHSiS organisations as employers must be aware that they cannot delegate their responsibilities for health and safety of their employees. Management must however fully involve staff and their representatives in the development and determination of standards and provision of OHSS, personal safety policies and health promotion locally.
Staff Responsibility
Staff and their representatives should take the opportunity to involve themselves and to work with Management in the process to develop OHSS personal safety and health promotion policies locally.
Confidentiality
The OHSS must provide a confidential service to staff. Management must demonstrate a clear commitment to protecting the confidentiality of employee information obtained through the OHSS. OHSS policies and procedures must give staff confidence that the service exists to assist the individual and is not a tool of management. All staff should have access to confidential advice from an OHSS from outwith their immediate area if necessary.
Structure of OHSS
There is no defined optimum organisational structure for an OHSS although it should be managed by an Occupational Health or Safety professional. It is generally recognised that larger organisations are better able to provide a cost-effective service and to offer an increased range of quality services. It is considered that such services benefit from a broad range of staff working as a
team. This should include occupational medicine, occupational health nursing, health and safety, fire safety, occupational hygiene and counselling services. There are benefits to staff experience for OHSS being organised to support more than one trust or more than one service sector but the structure of OHSS should always be appropriate to the needs of the NHSiS workforce. OHSS should be structured and organised to offer an integrated seamless service to staff and to the organisation.
Fully Integrated Services
Each NHSiS organisation should ensure that their OHSS is fully integrated with other related issues affecting the health of staff. Specifically this should include accident and injury prevention, health and safety, health promotion, counselling, personal safety and the working environment within an overall strategy for human resource management. Personal safety of staff is key to overall safety policies. A strategy on OHSS cannot therefore ignore issues of personal safety. Strategies to minimise sickness absence should inform OHSS. Both these latter issues must form part of a comprehensive Human Resource Strategy in all NHSiS Organisations. In addition, all NHSiS Organisations must have in place policies and procedures which promote good working practices which are complementary to OHSS, such as family friendly policies and the Employment Service Two Ticks symbol. They must also have procedures in place to ensure that the policies work.
The Disability Discrimination Act 1995 gives people new rights in employment and other areas such as access to goods and services. This has implications for the NHSiS. The Act highlights that a disability should not bar a person from employment, unless it would genuinely and significantly impede that person from doing the work in question. The Disability Discrimination Act introduces new measures aimed at ending the discrimination people may face. Employers are required to take reasonable steps to reduce or remove any physical feature of premises or employment arrangements which pose a disadvantage to a disabled employee compared with a non-disabled person. Employers should make every effort to support current staff to remain in employment. OHSS have an important role in advising employers on fitness to work and on reasonable and cost benefit adjustments that can be made to the workplace.
Education and Training plans must be fully integrated with OHSS strategies. The NHSiS should adopt best practice procedures with the aim of reducing accidents and incidents for staff, patients and visitors. These plans should clearly enable staff to take equal responsibility for their own health and safety and for managers to receive appropriate occupational health and safety training. Plans should include induction training and life-long training and education to minimise and prevent risk to staff and patients and enable staff to take equal responsibility for their own health and safety.
Action point
The Management Executive must:
All Chief Executives and General Managers must:
All NHSiS Organisations must:
OHSS must:
The figures in brackets relate to the Action Plan in section four
"Staff must have access to a comprehensive, competent and confidential OHSS" |
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All workers in the NHS in Scotland must have equal access to a comprehensive, competent and confidential OHSS
Access to an OHSS
All staff in the NHSiS must have access to a comprehensive, competent and confidential OHSS. This will apply to anyone working in the NHSiS, including students, regardless of where they work in a hospital, in the community, in primary care general practice or for an NHSiS contractor. Those who work wholly in the NHSiS should be prime recipients of a quality service.
Primary Care and Independent NHS Contractors
Primary Care and Independent NHSiS contractors need to be aware of their responsibilities to provide access for their staff to comprehensive OHSS. They should ensure that whatever source OHSS are supplied from that the services provided are of comparable or better standards to that offered in the NHSiS. Past evidence shows that primary care contractors such as general practitioners have not consistently identified OHSS for their staff. In developing contracts with Primary Care or independent NHS contractors there will require to be explicit statements made in contracts about the relationship of OHSS to these independent contractors and their staff. It is recommended that an NHSiS OHSS should be equally available to all Primary Care staff and to the staff of independent contractors within the NHSiS.
General Medical and Dental Practitioners
The Management Executive should initiate a review of how OHSS costs for general medical and dental practitioners and their staff could be met.
Guidance
The current guidance NHS Circular GEN(1995)4 provides comprehensive information on OHSS for Scotland. It requires only minor amendments to reflect access to the OHSS by those in the wider NHSiS. It is recommended that the Management Executive clarify this issue for the Service.
Students and Contractors' staff
Students and Contractors' staff working or training in the health service are at the same risk as NHSiS staff with regard to occupational health and safety issues. Occupational health and safety services locally should ensure that they make available their services to anyone working or training on NHSiS premises. Such individuals should be aware where the OHSS is located and its responsibilities. Managers within the NHSiS must identify and be clear of their responsibilities to these people within an integrated OHSS Policy.
Action point
The Management Executive must:
All NHSiS Organisations must:
Primary Care and Independent Contractors working within the NHSiS must:
OHSS must:
The figures in brackets relate to the Action Plan in section four
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