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Monthly Archives: May 2020

Returning to work toolkits for employers and occupational health professionals

18th May 2020

Returning to work toolkits for employers and occupational health professionals

Managing the safe return to the workplace of millions of UK workers needs careful planning.

Our toolkits, produced in partnership with the Advisory, Conciliation and Arbitration Service (Acas), the Chartered Institute of Personnel and Development (CIPD), Business in the Community (BITC), and Mind, the mental health charity, will help businesses plan to reopen shuttered workplaces.

Free toolkits

There are two toolkits: one for employers and one for occupational health professionals, who are supporting businesses make the workplaces covid-secure. You can download them for free.

Planning workers’ return

Here are five things any business needs to do before employees come back

  1. Contact workers about coming back to the workplace as far in advance of their expected return as you can
  2. Be prepared to have more than one conversation with your employee and use every contact to reassure them about the care you’re taking to open up the workplace
  3. Together with your employee, identify anything that might be an obstacle to their return. Obstacles can be personal, such as difficulty with childcare, practical, such as how they travel to the workplace, and even anxiety about catching covid-19.
  4. Agree with each member of staff a return to work plan which lists who will do what and when.
  5. If the obstacles identified are more than managers and HR departments can resolve, call in occupational health (OH) professionals. OH professionals support the well-being of workers, preventing ill-health, providing independent advice to organisations, facilitating steps to reduce sickness absence, and controlling infection risks.

Conversation starters

Not sure how to start conversations with your furloughed staff?  Here are some conversation starters you can use.

  • “How has life been?”
  • “Are you OK about coming back?”
  • “Do you feel safe coming back?”
  • “How we can make your job better?”
  • “Do you know who to talk with if any problems crop up?”

If someone has existing common health problems, questions could include

  • “Do you feel up to doing your usual job?”
  • “What parts of your job do you think you will find difficult and what can we change to help overcome the difficulties?”

Getting the UK back to work

Work is good for us and the country needs to get back to good, safe jobs, in which people are safe and feel supported. Our Returning to the workplace toolkits can help all kinds of business achieve this. Download them for free from the Resources section.

Vulnerability to COVID-19

7th May 2020
Vulnerability to COVID-19

 

Dr Robin Cordell, a director of the Council for Work and Health, and a Fellow of the Royal College of Physicians has this week brought our attention to the following piece within the President of the Royal College of Physicians of London most recent update to members of the Royal College.

 

In this update, Professor Andrew Goddard MD PRCP highlights the importance of assessing those who are more vulnerable should they be infected with COVID-19, so informing individual risk assessment by management as to how such people may be protected in their work.

 

We were very pleased that the President of the Royal College of Physicians has highlighted the essential work done by occupational health staff, and that he made a specific point of thanking occupational physicians (the Faculty of Occupational Medicine being a faculty of this Royal College) and so by extension all those supporting health and work at this time.

 

This is the key part of this message from the President of the Royal College of Physicians:
“The creation of a list of 1.8 million people as a ‘clinically extremely vulnerable’ group who need ‘shielding’ from COVID-19 was both a mammoth task and one that all involved should be proud of. Risk, though, is not a binary thing. As our understanding of what makes people more vulnerable to the effects of COVID-19 improves, we may need to be a bit more flexible about who needs shielding and who does not. This will be especially true as the rest of the population comes out of lockdown and being shielded may be seen by some of the shielded as a curse rather than a blessing.

 

Such risk needs to take into account the susceptibility of an individual to infection and the severity of disease that results. Some of this will be defined by obvious parameters such as age, comorbidities, medications, ethnicity and sex. The risk will also depend on the exposure risk in the community (will we have a local COVID-19 level as we do for pollen, pollution and UV exposure?), occupation and means of commuting. Lastly, each of us has our own perception of what we will accept when it comes to risk. As we refine ‘shielding’ it will need to be as personalised and thought about as any shared decision we make about a treatment in clinic or on the ward.

 

The role of ethnicity remains something that many are rightly worried about. There are several pieces of work going on in both PHE and NHSE looking at this. Occupational medicine has a large role to play for us as physicians and the letter from Simon Stevens formally tasked trusts with risk assessing staff. Anne de Bono, president of our Faculty of Occupational Medicine, is working hard on this with colleagues, including the Society of Occupational Medicine. This is going to be a massive amount of work for an understaffed part of our workforce.

 

This week’s shout out therefore goes to them. Thank you to all our occupational physicians.”

 

 

Informing risk assessment for the more vulnerable

5th May 2020

Informing risk assessment for those employees who may be more vulnerable to COVID-19

Robin Cordell, Director, Council for Work and Health

Our experience as occupational health clinicians over this last few weeks has revealed understandable anxiety among employers, employees and their families over the risk to those employees considered to be more vulnerable if they were to contract COVID-19.

Towards the end of March it became clear in published Government policy (now updated as at 1 May) at:https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others/full-guidance-on-staying-at-home-and-away-from-othersthat among those considered more vulnerable, which is broadly similar to those who have a ‘flu’ jab under NHS arrangements due to specified health conditions, there are those who are considered to be extremely vulnerable.

People in this very high risk group, about 1.8 million people, have been advised by the Government to be “shielded”, as at: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

Therefore there are three groups of people identified by Government in terms of the level of risk of a serious outcome.

At the top end of the scale, those at very high risk, who have been told they must not leave home for 12 weeks (or longer if the Government advises this).

The largest group is those at the standard level of vulnerability for the population as a whole.  The whole population are required to follow the enforceable measures introduced on 23 Mar 2020, as at: https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others/full-guidance-on-staying-at-home-and-away-from-others.  These social distancing measures include working from home wherever possible.

There is a substantial group in the middle, who have conditions that make them more vulnerable, and so are at increased risk, but who do not have the health conditions that make them extremely vulnerable and at very high risk of a serious outcome if infected.

Employers will all know that (at: https://www.hse.gov.uk/workers/employers.htm#) they have a legal duty to protect the health of their employees, and other who may be affected by their activities.  Employers must do whatever is reasonably practicable to achieve this.

Some employers have directed all employees who are more vulnerable to remain at home.  This is an effective social distancing measure, and will enable organisational outputs to continue if these employees can work entirely from home.

However, many organisations are engaged in essential work that cannot be done from home.  This includes healthcare and social care workers, those in local authorities, working with the most vulnerable people in society and providing essential services, and those in logistics. A risk management based approach has been undertaken by these clients.  Occupational health clinicians can advise on the vulnerability of their employees, and to suggest how the increased risk in more vulnerable individuals might be mitigated. Government provides guidance to employers on social distancing in the workplace at: https://www.gov.uk/guidance/social-distancing-in-the-workplace-during-coronavirus-covid-19-sector-guidance

Following referral by clients, a short occupational health teleconsultations is undertaken with employees followed by a short report is sent (with consent) to the employer.

The outcome of these assessments is tailored advice, given the employee’s individual health conditions and work circumstances, in order to inform the employer’s risk assessment.  We have found that “shading” the level of vulnerability within the more vulnerable group has been helpful, as our experience is that some in this middle group are more vulnerable than others.  We now use a GREEN-YELLOW-AMBER-RED risk indicator.

The following risk management table is based on Government guidance on social distancing at,and professional consensus documents, including those provided by the Faculty of Occupational Medicine (FOM), the Royal College of Obstetricians and Gynaecologists (RCOG).  Assessment of ethnicity as a risk factor is also included, in view of the observed disproportionate number of deaths among those of BAME ethnicity as at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30922-3/fulltext,.

Description Level of risk of severe illness if contract COVID-19  as compared to the general population Risk Mitigation the employer is advised to put in place
Those under 70, who may have underlying health conditions, but based on occupational health assessment do not have conditions defined in Government guidancethat would place them in the more vulnerable group if they were to contract COVID-19. STANDARD

(GREEN)

 Social distancing – the standardrisk mitigation advised by the Government for the population
Those considered to be more vulnerable to serious illness if they contract COVID-19.  These are people over 70, or those under 70 with the underlying health conditions listed.  Occupational health clinicians will advise specifically on the vulnerability of those who are pregnant, depending on the environment where they work. INCREASED

(YELLOW)

 Social distancing, stringently applied (as specific to each workplace)
There will be some people the occupational health professional making the assessment considers highly vulnerable. These may be those more severely affected by one of the conditions the Government advises makes that person more vulnerable, or those who have a combination of conditions that further increases their vulnerability.  This is co-morbidity. Occupational health clinicians will also advise on whether other factors might further increase vulnerability among the more vulnerable, including ethnicity, age and gender, and smoking. HIGH

(AMBER)

 Social distancing, stringentlyapplied. Occupational health clinicians may provide further advice on controls on a case by case basis as needed.
Those considered to be extremely vulnerable.  People with conditions set out in Government guidance on shielding, and who will usually have had a letter from the NHS advising them of this. VERY HIGH

(RED)

 Shielding for 12 weeks, or longer period as advised by Government

Robin Cordell, Director, Council for Work and Health

Over 2 million people are living with an illness or injury caused by their work. We need to work together to both prevent this happening and also support those who are made ill through work, that is why there is a need for a multi-disciplinary approach that seeks to address the issues at source.

Hugh Robertson Senior Policy Officer for Health and Safety, TUC