By Rachel Suff, Senior Policy Adviser, CIPD; Tony Vickers-Byrne, Chief Adviser HR Practice, CIPD; Andrew Walker FCIPD FCPFA, formerly Director General HR, House of Commons and Nick Pahl, Chief Executive, Society of Occupational Medicine
Occupational health (OH) and HR practitioners represent the two professional groups most concerned with the health and well-being of people at work. As such, the strength of the working relationship between the two at a workplace level is critical, and yet we suspect most OH and HR professionals would acknowledge there is room for improvement. At the very least, it’s time to evaluate whether a fuller appreciation of each profession’s role by the other could encourage stronger collaboration to achieve the mutual aim of a more strategic and preventative approach to employee health and well-being. HR as a profession has been changing and is hopefully becoming more firmly focused on the ‘human’ and health aspects of the workplace, which places it in a good position to help facilitate a closer partnership.
CIPD research consistently shows that people professionals regard OH services as a valuable resource with case management involving OH, HR and managers, and OH involvement viewed as the top two most effective methods of managing long-term sickness absence. However, the involvement of OH specialists in identifying and reducing work-related stress is ranked in just eighth place (30% of respondents) and in ninth place for managing mental health at work (also 30%). In terms of managing stress, approaches such as staff surveys and personal resilience training are ranked more highly; similarly, personal resilience training and having mental health first aiders – whose role is to signpost to expert support and who are not specialist health and well-being practitioners – are ranked more highly than OH. Just a third tap into the expertise of OH to develop an employee mental health policy.
These findings suggest that many employers, and HR professionals, tend to view OH as a resource for referral, to deal with complex cases of sickness absence when ill health issues have already escalated. But there can be clear benefits from involving OH in health-related issues at a strategic and practical level at an earlier stage.
Making fuller use of OH expertise
Many organisations, including some large employers in both the public and private sectors, outsource their entire OH function to one of the many commercial OH providers. The Society of Occupational Medicine has recently produced guidance on suggested steps to take when commissioning an OH service. Other employers will engage the services of a provider as and when needed while some organisations, particularly smaller ones, don’t have access to OH services. OH encompasses a range of professions from different disciplines. The two most visible are OH physicians and nurses, who have specialist qualifications and experience in either occupational medicine or OH nursing. Others include physiotherapists, occupational therapists, occupational psychologists, occupational hygienists, ergonomists and OH technicians.
Collectively, these practitioners represent a wealth of specialist expertise that, if available to an organisation, could be invaluable in developing its health and well-being strategy, as well as the policies and practices to help manage the risks to people’s health and prevent ill health. CIPD research also shows there is increasing responsibility on line managers to implement health-related policies in areas such as managing return to work, rehabilitation, making reasonable adjustments, spotting the early signs of mental ill health and having supportive conversations with employees. Managers and OH practitioners can worry that medical confidentiality will make dialogue between them meaningless; but it need not be so. Conversations between managers and OH about individual employees should of course focus on the employee’s fitness to work and any workplace adjustments they may need, rather than on confidential medical information. But there is surely scope for managers (and HR) to benefit from OH’s specialist knowledge to gain understanding about health-related issues and how to promote ‘good work’, for example by minimising the negative effects of work and helping to prevent risk.
Developing a closer working relationship
CIPD representatives had the opportunity to facilitate a lively workshop to discuss these issues, and the potential for a stronger working relationship, with occupational health professionals at the annual Occupational Health 2019 conference, organised by the Faculty of Occupational Medicine and the Society of Occupational Medicine. It was agreed that an important first step in developing closer collaboration was to gain an understanding of how each profession is perceived by the other. For HR, there will be an opportunity to do that in the next CIPD/Simplyhealth annual health and well-being survey. Meanwhile, some key observations made from the floor include the following points:
• There are some very good examples already of organisations where OH and HR work collaboratively at a strategic level, and these could be very helpful case studies showing how employee health and well-being is enhanced where health issues are addressed at an earlier stage.
• Patient confidentiality, and perceptions by employees regarding confidentiality, is paramount, although this should not be a barrier to closer collaboration at a strategic level. There is also scope for OH to ‘de-burden’ line managers and support them to manage health and well-being, for example via easy reference FAQs, guides and other accessible practical tools.
• Each profession needs a better understanding of the other’s, including a more in-depth appreciation by HR of the benefits of an OH service; further, in many organisations there needs to be greater trust in the other’s standards and professionalism; more effective inter-professional working, including better communication, could help to overcome this mistrust. The need for OH to remain impartial is paramount, but the perception by some employers (and HR) that OH is working purely in their interest as opposed to the patient’s, sometimes undermines this professional independence.
• There is an important role for the leadership and culture of an organisation to set the right expectations for an effective working relationship between OH and HR, with mutual trust and credibility at its core. There also needs to be a clear understanding of where the respective roles and responsibilities of HR and OH for health and well-being stop and start, as well as other groups in the organsiation such as leaders, managers, well-being champions and ‘mental health first-aiders’. The role of HR to champion ‘welfare’ would be welcomed.
• The importance of OH providing carefully crafted clinical reports with feedback links, as well as ongoing evaluation of whether the service was continuing to deliver to the expected standard including opportunities for professional evaluation, was mentioned.
• The potential for OH to provide more extensive health promotion initiatives in organisations to support a more preventative approach to health and well-being was debated, although the risk of seeing this as a ‘quick fix’ and detracting from OH’s core purpose, as well as the challenge of achieving this activity within the scope of finite OH resources, was noted.
The potential for HR and OH to work more closely together to enhance employee health and well-being was supported without dissent by delegates. This is explicitly recognised in the work led by the CIPD President Professor Sir Cary Cooper, Alliance Manchester Business School’s 50th Anniversary Professor of Organisational Psychology and Health and Dr Paul Litchfield, who lead The National Forum for Health and Wellbeing at Work. The Forum is a unique grouping, bringing together HR and OH in over 30 global companies. It would be an exciting and transformational development to see that strategic national collaboration replicated by OH and HR teams at an organisational level in all UK workplaces where the two professions are represented, and to see more employers investing in their workforces by engaging OH support and advice. We hope that advocating and developing a more collaborative model would also encourage those organisations without a current OH service to invest in occupational health.
This SOM publication outlines the value of occupational health services and three leaflets have been produced alongside the report:
Occupational health: A guide for company directors and commissioners of services
Occupational health: A guide for line managers and HR professionals
Occupational health: A guide for workers and their representatives
