People increasingly refer to the health agenda, but surely preventing ill health at work has always been a major part of HSE’s remit? Over the years we have progressively and successfully tackled exposure to hazardous materials, such as lead and asbestos, so what now? This note explains the shifting emphasis of the health agenda, why it has become even more important, and what it means for the way we work.
HSE’s 2004/05 statistics showed that, of the 35 million working days lost each year to injury and ill health at work, ill health accounted for 28 million (80%). Two million people suffer from work related ill-health and HSE has estimated that this may cost the economy as much as £11.6 billion, including the cost of individual suffering. Of the days lost to ill health, work-related stress (12.8m days) and musculoskeletal disorders (MSDs) (11.6m days) account for the large majority. These figures are a key reason why the HSC Strategy places so much emphasis on occupational health, and why any preventative programme must give high priority to stress and MSDs.
Health has always been harder to tackle than safety since cause and effect are often not clearly linked. But where the link is established and exposure can be measured, such as dealing with lead poisoning, then our traditional intervention techniques have worked well. The view of occupational health has now widened from exposure to hazardous materials and agents to cover common health problems, such as depression and backache. These problems are not just work-related and include helping people to remain in work or return to work. The HSC Strategy recognises that HSE cannot resolve these matters alone. The challenge of modern occupational health demands a more strategic and partnership based approach.
This Strategy, launched on 19 October 2005, focuses on the needs of the working age population. It forges a cross Government partnership between DWP, DH and HSE, linking our agendas and helping to break down the traditional demarcation between occupational and public health. Its vision is to gain recognition for the benefits of work to health and well-being – there has long been evidence that, overall, those in work are healthier than those not in work. It also stresses the importance of preventing work’s adverse effects. Another important objective is to ease the transition into, or back into work, for those with pre-existing or work-related health conditions – in fact promoting the idea that work can be part of the cure. Most HWWB workstreams are not new but the crucial feature is the integrated approach between the three partner organisations. This integration will be reinforced by the appointment of a National Director for Occupational Health by mid 2006. HWWB will provide added impetus to HSE’s preventative mission and to the key HSE projects within our health agenda.
The Fit3 Strategic Programme has been developed in line with the HSC Strategy to recognise the occupational health challenge, to try new ways of intervening, and to concentrate our work on the priorities that will best deliver the Revitalising targets. Individual programmes deploy a mix of the four themes of the HSC Strategy - partnership, support, priorities and enforcement, and communications - as appropriate for each topic. For ill health and working days lost key programmes are:
The programme has given better definition to this condition, identifying six key areas of working life that can cause it. Building on this, the team has worked with an innovative range of partners to develop and test out the Management Standards approach – a toolkit that allows organisations to assess their levels of risk from stress and provides pointers as to how they might reduce them. Further practical information and advice has also been developed which is available on the HSE website along with the Management Standards.
This programme prioritises back pain and upper limb disorders, looking at prevention and at early reporting, treatment and rehabilitation. It has commissioned research and produced various advice and support materials. It has devised campaigns in order to reach the large numbers necessary to make a difference, the most recent being Backs! 2005. The next stage of the campaign is planned for October 2006.
This programme is targeting three disease areas: to reduce the incidence of occupational asthma; to develop risk reduction interventions for work related Chronic Obstructive Pulmonary Disease (estimated 4500 deaths per year); and to tackle the risk of asbestos exposure to some 1.3 million maintenance workers. Also the Contact Dermatitis project is targeting a wide variety of hard-to-reach occupations ranging from chefs to cleaners. Programme activities concentrate on close contact with key stakeholders and using different forms of communication to raise awareness and improve understanding of risks.
This programme targets loud noise at work (over 2 million people in Britain regularly exposed) and hand arm vibration at work (2 million at risk). It has long-term objectives to eliminate new incidence of occupational noise-induced hearing damage by 2030 and sufficiently control new incidence of HAV syndrome by 2015. It will promote new Regulations on noise and vibration at work and develop projects on control measures and solutions for target sectors, supply chain initiatives, worker involvement and guidance for the music and entertainment sectors.
The main purpose of this work is to help employers, employees, and their representatives manage long term sickness absence and to help those absent, whatever the cause, to return to work. It has identified the importance of early intervention, with individuals quickly receiving appropriate advice and treatment. The team has worked closely with DWP on their Framework for Vocational Rehabilitation and produced guidance setting out a good practice approach. A number of the business case studies on the HSE website illustrate these issues.
The purpose of this Programme is to facilitate the delivery of our targets in the public sector and provide leadership for other organisations. The Programme gives priority to sickness absence management and offers the potential to make a major contribution to meeting the national target for reducing sickness absence. It also emphasises the contribution of a healthy workforce to improving the efficiency of public services and the public sector. A key focus of this work is the Ministerial Task Force for Health, Safety and Productivity, for which the Programme team provides the secretariat. There are close links to the other programmes mentioned above.
It follows from what is said above that health needs a different approach. It needs stronger partnerships, both in sustaining programmes and for inspection activities. It needs advice and support provision which is more accessible, better targeted and better co-ordinated across HSE, and which complements the work of Workplace Health Connect. But advice is only effective for those willing to follow it. Inspection and enforcement also remain essential, but it needs to be better directed to priority areas and towards maximising the deterrent effect. All these activities must be built on effective communications, whether raising awareness of specific health problems or extracting maximum impact from enforcement action. In short, we need to understand the health agenda better and work more cohesively across our organisation to stimulate continuing improvements in workplace health standards.
HSE’s 2004/05 statistics marked the half way stage in delivering the Revitalising targets. These show that the target for a 10% reduction in the incidence rate of ill health was probably met, and that we are close to meeting the target for a 15% reduction in working days lost. These figures offer encouragement that our new Strategy-based approaches are having an impact.
The demanding Revitalising and PSA targets require continuing co-ordinated effort and innovation across HSE on health. The essence of HWWB is DWP, HSE and DH (and Scottish/Welsh equivalents) coming together to benefit the health of the working age population. Each Department has its own agenda, and ours is set out above. But each believes that its agenda will be better delivered by pooling efforts into the HWWB workstreams. For instance, we will benefit if GPs have a better understanding of work-related health problems, but it is the Department of Health that is best placed to influence them.
So we face an exciting and demanding agenda: delivery will depend on contributions from across HSE, on intervening smartly, on effective communications and above all on working with and through others.
Social media
Javascript is required to use HSE website social media functionality.
Follow HSE on Twitter:
Follow @H_S_E