Fit for purpose?

The occupational health industry needs to be less insular if it is fit for purpose says Mike Tyler, UK managing director, health and productivity, Buck Consultants

The pressure on business enterprises to deliver more with fewer resources is unrelenting and, while technology developments continue to drive the pace of change, the nature of work has changed out of all recognition compared to as little as 50 years ago.

As we examine these trends, we need to ask how today’s businesses are being supported by their Occupational Health (OH) service providers.

Are they keeping up with the changing demands of employees and employers? How well are they working to support the health challenge of employees in this new business environment and how are they collaborating with other business functions to ensure the best outcomes?

Before looking forward, let’s see where we’ve come from.

In the 1950s and 1960s industry was set up on the basis of manual workers with managerial oversight. OH was delivered by doctors, working on site on a part-time basis, whose expertise was gained from specific but often limited experience.

The trend away from manual towards white-collar roles that happened from the 1970s to the 1990s saw the emergence of CMO and senior occupational health professionals with specialised skills. These professionals were on site and formed part of senior management, and had full time roles, although often with multiple employers.

Since the 1990s we have seen a growth in employees in knowledge-based businesses, for whom OH delivery has been outsourced to specialists, delivering specific areas of expertise both on site and remotely.

We recently ran a seminar in conjunction with Kensington Occupational Health to review the issues and themes that companies are regularly reporting. These ranged from work performance affected by health, poor sickness absence identification and reporting, mental ill health and stress issues and legislative pressures to wellness and emotional resilience, demands on line managers, cost pressures, geographically disparate workforces, employee engagement and ROI.

Against this backdrop, we are finding that certain changes in approach towards OH are working well for business.

“In today’s business environment, the vast majority of OH professionals have never been directly employed in a commercial enterprise and are in danger of being very insular”

OH issues are typically being managed by a more junior OH professional, as a result of the more effective “triage” approach which enables cases to be allocated in terms of importance, based on outcome and process category. Not only has this improved cost but has also ensured that the allocation of scarce senior OH resource is prioritised for the most challenging cases.

In the meantime, systems for data collection and reporting have improved significantly, while the use of outsourced specialist OH providers has driven value through economies of scale, reinforced with more efficient consultations relying on telephone and other technology. In addition, we have seen improved links with providers in various specialist areas that produce better outcomes for the individual and the business.

Even as these efficiencies have helped to improve OH provision for businesses, in equal measure we recognise the loss of specialist insight and direct engagement. It is apparent that there is now less access to a known health professional with detailed knowledge of the specific business issues.

In the past, the engagement of a senior health professional with the executive group prompted informal alerts about potential health issues together with closer day-to-day management of the service delivery. In today’s business environment, the vast majority of OH professionals have never been directly employed in a commercial enterprise and are in danger of being very insular.

Looking to the future, we see more focus on access to an individual’s medical reports, following the General Medical Council guidelines on consent in relation to OH reports, issued in 2008. This has had the effect of slowing down progress when, in many cases, more pace rather than less would be helpful in effecting a solution for the individual with a better outcome for both them and the business.

How do we help businesses strike the balance needed to ensure that a company and their employees get the best from their OH services? We believe a best practice approach starts with understanding the provision already in place and establishing a clear strategy that prioritises employee health and wellbeing.