This chapter covers the key points involved in setting up an occupational health service across a range of settings. A standard ‘off-the-shelf’ package cannot be slotted into any organization – the service will meet the needs of the employer and employee only if care and attention is paid to their particular requirements while implementing the health-related legislation relevant to the workplace in question. A systematic appraisal of the needs of particular organizations is required, which should involve consultation with them. This can be followed by the development of individualized services.
A structured approach is essential when setting up a new service or changing the focus of an existing service, and this chapter gives some guidelines and practical suggestions for achieving this. Good diplomacy and communication skills, coupled with expert knowledge and experience are crucial in establishing a successful occupational health service.
As organizations become leaner and are affected by rising costs, such as employers’ liability costs, sickness absence and claims on pension funds for early retirement due to ill health, they are beginning to look more critically at their occupational health service: how is it resourced, what is it doing and, most importantly, how is it benefiting the organization? The occupational health department will increasingly be measured in the same way as any other department within the organization and will have to demonstrate the quality of the service it provides; the speed with which it delivers its service, i.e. responds to its customers; the dependability with which it delivers the service it has promised; the flexibility that may be demanded to respond to the organization’s changing needs; and the cost of delivering the service.
Understanding Organizations
Most organizations still do not have an occupational health service. Whether you are setting up a new service or changing the focus of an existing one, a structured approach will assist in achieving this.
Organizations may vary in size, culture and structure, but the initial approach to establishing the type of occupational health service appropriate to a particular organization is often the same. Some essential questions need to be asked to ensure that an occupational health service meets the needs of the organization. What are the business objectives of the organization? What are the business objectives of individual departments? What are the key health and safety legislation issues? Are there any litigation concerns? How can employee health affect the foregoing?
It is also important to understand the culture of the company, along with how it is structured to achieve its objectives. The culture of the organization affects the style of communication – formal written communications or oral contact; the dress code – formal or casual; decision making – whether through committees and senior management or individuals retaining some autonomy; management style – whether they expect obedience or individual initiative; and so on. The culture is also likely to affect the structure of the organization; it may have many levels of management or it may have achieved a ‘flat’ structure. Irrespective of the style of structure, it is important for the occupational health professional to understand the lines and levels of communication.
As already mentioned, it is important that an occupational health service understands and is subject to the same business criteria as the rest of the organization. All too often an occupational health nurse can be heard to say: ‘My manager does not understand what occupational health does!’ Should not that nurse instead be asking, ‘Do I understand what the organization needs?’, it being all too easy simply to implement a program because ‘it seemed like a good idea’ as it follows the broad principles of occupational health. Therefore, it is essential that the setting up of an occupational health service is carefully planned and communicated. This is equally important whether the organization is a large multinational or a small local family firm, with the approach remaining the same. One approach discussed in this chapter has separate elements involving five stages: assessment, planning and control, endorsement, implementation and monitoring.
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