OCCUPATIONAL
HEALTH MANAGEMENT MODEL
PILOT
The HSE
Construction Sector (Health Unit) has produced a draft Occupational Health
Management Model (OHMM) for the construction industry. This paper outlines the process of piloting
the model within the industry.
The pilot commences
on 1 April 2005 with a roll in period up to 23 December 2005. The pilot project will complete on 23 June
2006. Each pilotee will pilot the model
for a period of 6 months.
The OHMM pilot
project will be managed by HSE and evaluated by BOMEL Consulting.
The Construction
industry is one of the largest industry’s in the
The industry faces
many challenges: Around 98% of the
employing organisations are SME’s and micros employing fewer than 3
employees. Workers are peripatetic and
can work long distances from home, often resulting in staying away from home
during the working week. Employment is
often short term and can be part of the informal economy with a significant
number of migrant workers, some of whose first language is other than English.
It is also an industry which works people hard – it is physically challenging
and time pressured.
With these
challenges in the backdrop, the industry, during the HSC’s/Deputy Prime
Minister’s Health and Safety Summit 2001 set its own challenging health and
safety targets up to 2010:
To
reduce the incidence rate of fatalities and major injuries by 40% by 2004/05
and by 66% by 2009/10;
To reduce the incidence rate of cases of
work-related ill health by 20% by 2004/05 and by 50% by 2009/10; and
To reduce the number of working days lost per 100,000
workers from work-related injury and ill health by 20% by 2004/05 and by 50% by
2009/10.
HSC/E is committed
to working with the industry stakeholders to help them deliver these
targets: One of the key themes of the HSC’s ‘Strategy for Workplace Health and
Safety in Great Britain to 2010 and beyond’ is that “We need to do more
to address the new and emerging work-related health issues”.
Traditionally, the
construction industry has focussed on the management of safety issues, with
less attention given to the more chronic issues such as ill health. This fails
to recognise the significant levels of occupational ill health in the
industry. Although there is a
considerable under-reporting of ill-health, it is estimated [1]
that 96,000 people whose current or most recent job in the last year was in the
construction industry suffered from ill-health which was caused or made wore by
their job. The associated prevalence
rate was significantly higher that that for the all industry average.
The most prevalent
health issues in the construction industry include manual handling (or
musculo-skeletal disorders (MSD)), hand arm vibration (HAVS), noise induced
hearing loss (NIHL), dermatitis. MSD
affects 5% of the construction workforce (or around 90,000 people). The prevalence of HAVS is 6 times the all
industry average and NIHL is double the all-industry average. Also, around 10% of the bricklaying industry
leave their profession due to contact dermatitis from wet cement. It is acknowledged that stress may also be
inherent within the industry due the nature of construction business such as
working to tight deadlines, adverse environmental conditions and significant
resource pressures.[2]
Construction
workers often find it difficult to access primary health care or other forms of
support due to the transitory nature of their work. They are therefore unlikely to get medical
help for even routine health problems.
THE
OCCUPATIONAL HEALTH MANAGEMENT MODEL
This section
outlines the background to the creation of the model and lists the main aims of
the model. Detail on what the model
looks like and how to use is outlined in annexe 1.
Our contact with
the industry so far has shown us that the industry is, in the main, committed
to improving occupational health issues but is unclear about how to do it. Also, where organisations have approached
managing health issues they have focussed on individual health topics rather
than on the management of ill-health as a whole. There have also been inconsistencies in
organisations’ approaches at their different projects. This means that coverage is patchy and there
can be gaps in the provision. HSE has
also tended to produce separate guidance on each health topic and there is
little about the principles of managing ill health across the board.
It is important
that the worker has an accurate picture of their current health status. This is particularly important in
construction when workers are moving from one site to another and from one
organisation to another and they will need to take this information from one
project to another. This means that
their health must be managed in a coherent way.
The industry should aim to ensure that, where possible, workers are not
exposed to risks to their health and where necessary, steps are taken to manage
the risks including through entry health checks; risk control; ongoing health
checks and; back to work.
With this in mind,
the HSE Construction Sector has focussed its attention on producing generic
advice to the industry on the general management of occupational ill health
which includes active case management.
The overall
objective of the OHMM is to provide simple and structured guidance on the
management of occupational health.
The OHMM has four
main aims:
Internal stakeholders include HSE field inspectors. It will enable inspectors to feel confident
that they can provide consistent advice to organisations on health issues and
can also use the model as a useful benchmarking tool. External stakeholders include the industry
who will benefit from a single source of occupational health advice and should
feel more confident in ensuring legal compliance.
It is important that the OHMM is accessible to all organisations
especially in light of the significant proportion of SME’s/micro SME’s. It should provide enough detail for basic
legal compliance as well as further detail for those organisations who wish to
be exemplars and take themselves beyond compliance. It should be a practical tool which aids
management without unnecessary burden.
As discussed above, the OHMM looks at occupational health management in
general. However the user can also focus
on specific health issues for further detail.
The main
management processes are: entry health checks; risk control; ongoing health
checks and; back to work. These
processes aim to provide ways of controlling the health risks from
pre-employment screening to rehabilitation.
These processes are described in further detail in annex 1.
The OHMM is in the
form of a flow chart which the user follows from the top to the bottom of the
model and has guidance linked to each of the boxes. It is currently produced as a ‘Word’ document
with hyperlinks to the guidance and for the purpose of the pilot will be
circulated onto disc. A copy of the
current version will also be available on BOMEL’s website during the pilot
period. It is envisaged that once
complete it will be available on the HSE website free of charge to access or
download. Organisations can then use and
adapt as necessary to suit their needs.
HSE will be piloting the draft OHMM from 1 April 2005 with a roll in
period up to 23 December 2005. The
project will complete on 23 June 2006.
Each pilotee will pilot the model for a period of 6 months with a view
to evaluate its content and usability and provide further information to help
populate the areas of the model which remain incomplete. This will enable HSE to produce the final
version of the OHMM.
The OHMM pilot has
3 main aims:
1.
To
introduce the OHMM to the industry
The pilot period provides a good opportunity for organisations to
implement the model with direct support from HSE and other organisations taking
part in the pilot process. HSE
construction inspectors will be informed of those organisations taking part in
the pilot and can provide specific advice where necessary.
2.
To
obtain feedback on the OHMM’s content, structure and ease of implementation.
This feedback is an important aspect of the pilot in particular the
content and usability of the model. The
current model is a DRAFT and is likely to contain editorial errors. We will work towards addressing these for the
final draft. All suggestions will be
considered during the consolidation period.
3.
To
receive further guidance and information to populate the OHMM
It is acknowledged that the OHMM requires more information in a number
of areas. The gaps in the model are
highlighted in purple and any contribution in these areas would be particularly
appreciated. This may include questionnaires, photos, toolbox talks, management
procedures, personnel issues, standard letters etc.
Pilot Pack
The pilotees will be provided with:
1.
A copy
of the pilot paper with annex 1 and annex 2
2.
A CD of
the draft OHMM – or other form of the model if necessary
3.
Contact
details for HSE support
4.
A copy
of the baseline questionnaire which aims to identify your current occupational
health management systems, if any, before implementation of the model – this
should be completed before undertaking any changes to existing practices.
At a later
date, pilotees will receive a copy of:
5.
The
evaluation questionnaire which aims to identify any changes made to your
occupational health management systems as a result of implementing changes – this
should be completed at the end of the 6 month pilot period.
Pilot Process
The above information will help pilotees look at their current processes
and those suggested by the OHMM and decide what, if any, changes should be
implemented as a result. They can also
use the OHMM to benchmark against their existing systems. The OHMM is sufficiently general to cover all
health issues although it provides detailed guidance in regard to MSD, HAVS,
NIHL, dermatitis and stress.
It is not necessary for or expected of pilotees to implement the entire model
within the 6-month period. The pilotee
should identify which parts of the model and to what extent they can and will
implement within that timescale.
Pilotees may for example chose to focus on their ‘Safety Critical
Workers’ within their organisation as a priority. Or they may choose to focus on a specific
health issue which is relevant to their organisation. Following the pilot, they will then be in a
position to consider the rest of the workforce if appropriate.
Also, it is not expected that all pilotees will have fully implemented
such changes within the 6 months period but that they would have worked towards
integrating some elements of these changes.
All organisations will be different but all will need to have an
expectation of the breadth and degree of implementation before the start of
their pilot period.
Support
HSE will provide support and advice throughout the pilot period and
contact details are provided in annex 2.
You may also wish to contact other pilotees for practical advice. It is intended to be an open and transparent
process to benefit all those taking part.
What Next?
At the end of the 6 month pilot period, pilotees will complete the evaluation questionnaire which covers the pilot aims summarised above. Both the pilot process and effectiveness of the OHMM will be evaluated by BOMEL consultancy.
All pilotee comments, suggestions and contributions will be
considered for incorporation into the model.
Also, during the
period of April 2005 to June 2006, there will be a phase of internal
consultation with relevant HSE departments.
Again, any recommendations will be considered.
A final draft of
the model will then be produced, formally launched and published on the HSE
website.