Public services sector strategy 2012-15

Sector description

• The sector covers a range of areas including:
  • Health and social care
  • Education
  • Local and central government
  • Emergency services
• Public services employ 1 in 5 workers, many others in contracted out services
• Approximately 5 million full-time equivalent workers in 2010
• Mainly large employers, but increasing numbers of SMEs
• Majority of services are devolved in Scotland and Wales

Public services work activities have the potential to affect everyone delivering or using these services. This strategy therefore has a twin focus: to protect both workers and the public from risks arising from work activities of this sector.

The sector is dominated by larger employers but there are increasing numbers of smaller providers who do not necessarily have the same resources, understanding, networks or engagement.

Workers are generally highly competent and professional. Across most of the sector, there are good arrangements for induction and training, and ready access to quality in-house advice. While formal worker involvement is weaker in some subsectors, in most the arrangements are well established and employers, trade unions and other representatives generally collaborate.

Reductions in public spending are having a direct impact on the resources and scope of public service provision, and there are fundamental structural changes to the commissioning and delivery of services underway. These are significant factors and present opportunities and challenges to ensure health and safety is embedded in the delivery of public services.

Key stakeholders

• National representative organisations
• Trade unions and professional bodies
• Other regulators
• Other central and devolved government departments

Safety and health issues

Overall accident trends are consistent with the 'all-industry average', with higher rates of some work-related ill health (musculoskeletal disorders, dermatitis, and stress). The sector is generally aware of the importance of work-related ill health. Certain subsectors (eg Emergency services, Health care) record significantly higher rates of injury and ill health.

Although each subsector has its own health and safety issues, many of the root causes are common across the sector as a whole:

• Insufficient health and safety leadership through the service supply chain
• Varying levels of competence and understanding
• The need to engage both managers and staff in health and safety issues
• Challenges to achieve consistency across large and small service providers

Many of the challenges in this sector do not simply relate to high injury or ill health rates, but arise from issues such as:

• Misconceptions regarding risk and proportionate controls
• Balancing risks from operational duties with health and safety responsibilities
• Application of health and safety legislation to service users
• HSE's regulatory role in a multi-regulator setting

Even though not directly linked to accident / ill-health reductions, these issues are central to rebuilding the 'health and safety brand', effective future regulation and ensuring sensible and proportionate approaches to health and safety.

Health and social care

• Employs 11% of the workforce in GB
• Health and social care are devolved resulting in a wide range of regulatory regimes and complex enforcement
• Health care is dominated by the NHS and other large providers
• Social care is dominated by SMEs which are harder to reach, with an increasing trend to domiciliary care
• In both health and social care, the safety of non-workers is a major issue. There was an average of 39 reportable deaths a year over the last five years
• Non-worker risks include falls from windows, scalding and injuries while being moved
• In 2010/11, 4.7 million working days were lost due to work-related ill health or injury. This equates to 1.6 days per worker - higher than any other sector. Almost 90% of the lost days were due to ill health, with rates of stress in particular being significantly higher than the all-industry average
• The main causes of work-related injury and ill health are violence and aggression, slips and trips, moving and handling, and dermatitis
• Across the sector there is a need to focus on leadership and competence, partly by engaging with influential stakeholder and co-regulators
• In individual organisations there is a need to secure board commitment, leadership and staff engagement to embed occupational and general health and well-being in the core business
• Those who commission providers of health and social care services wield considerable influence over standards required and priorities in service delivery

Local government

• Approximately 2 million employees plus large numbers of contracted workers
• Some 400 local authorities in Great Britain
• Slightly higher levels of RIDDOR incidents than the all-industry average
• With increasing pressures to meet the national 'efficiency agenda' and 'do more for less', retaining an appropriate focus on health and safety management is challenging
• Potential for local authorities to influence health and safety standards in their supply chains, but some need to take a stronger leadership role in setting out health and safety considerations when developing contracts
• Although national representative organisations provide potential leverage, local authorities are diverse in their make-up, and have a wide range of local priorities
• Engaging leaders and senior managers on the sensible health and safety agenda is increasingly important
• The duty to manage asbestos present in local authority workplaces and public buildings is an ongoing challenge. Key staff need to be competent to recognise and manage asbestos-related risks, particularly in relation to contracted tradespeople
• Many services are either contracted out or managed in partnership with others. These organisations range in size from large companies to SMEs and strong leadership is important to ensure effective health and safety management throughout the system

Police and Fire & Rescue Services

• Relatively small numbers employed, but the nature of their operational activities means that workers frequently face serious work-related risks
• Recorded injury rates are high (over twice the all-industry average)
• Serious consequences of violence / manual handling of offenders (Police), or  exposure to fire (obviously), harmful substances or explosion (Fire Service)
• Underlying causes differ between the services:
  • Police - some view health and safety as a barrier to effective policing and treat it as a burden rather than integrating it into operational management practices. As a result, operational managers may show little recognition of their duty to manage occupational health and safety risks as part of their wider responsibilities, especially relating to incident response
  • Fire & Rescue Services generally recognise the need to manage health and safety risks as a key part of operational activity. Although in some services, shortfalls in assuring competence of incident commanders and firefighters (particularly retained firefighters) exist
• High-profile failures to balance the operational duties of the emergency services against the requirements of HSWA have been cited as contributing to the deaths of workers and the public
• HSE has worked with these subsectors to produce the Striking the Balance statements, which set out principles to help dutyholders make such judgements. These now need to be reflected in operational guidance and management so that they become embedded in the way emergency services are delivered

Education

• Employs approximately 1.4 million with an increasing number of staff not employed by local authorities in some parts of England
• Health and safety issues are politically sensitive – with a need to balance the protection of pupils while creating wider opportunities for them to learn
• Some parts of the sector needs help and reassurance to deter excessive risk aversion – and to encourage a proportionate and enabling approach to health and safety
• Frequent media attention has distorted understanding of 'sensible' risk management. Health and safety is not held in high regard, is often considered to include a wide range of issues related to other matters such as child protection, food safety etc, and is sometimes seen as a restrictive, bureaucratic burden to children’s education
• Higher rates of work-related mental illness in teaching than other occupations, despite good availability of practical advice and support available to help schools develop effective management techniques
• Presence of asbestos in school buildings generates concern, but where it is properly managed teachers and pupils are unlikely to be at risk. Dutyholders must be competent to discharge their responsibilities effectively
• Changes in delivery of education in schools in England are leading more schools to operate as SMEs. Head teachers and senior school staff are increasingly responsible for property maintenance and construction - they need to be able to effectively manage and control risks associated with these activities, especially as many will involve contracting outside labour
• Underlying causes of many incidents linked to insufficient health and safety leadership, with poor understanding of proportionate risk management Tendency towards excessive health and safety policies and practices, which can restrict teaching activities
• Local authorities and professional bodies have a strong influence on good practice in schools

Central and devolved Government departments

• Employ over half a million people
• Dominated by low-risk office work, though many have front-line services that involve more significant hazards (eg Border Control, Prison Service)
• HSE is currently developing strategic engagement with the Ministry of Defence (MoD) to ensure it learns from major incidents.
• In the Prison Service HSE is working with Government departments to ensure that national standards are effectively implemented at local level
• High-hazard activities are predominantly associated with MoD and its work with biological agents or flammable / explosive substances. HSE operates a 'permissioning' regime for sites working with the most hazardous pathogens. Although accidents are infrequent, the potential for catastrophic incidents remains
• Underlying causes of work-related injury and ill health trace back to insufficient health and safety leadership. Central health and safety policies tend to be good, but implementation at a local level is often less robust
• National key players remain hard to engage in health and safety at a senior level
• Competence varies across departments and the need for sufficient health and safety knowledge at all levels is not fully understood

Legislation and regulation

HSE has enforcement responsibility for the majority of the sector, although local authorities enforce health and safety legislation in residential care. Certain dutyholders (eg MoD and Ministry of Justice) have Crown immunity (ie they are subject only to the administrative sanctions of Crown censure) and cannot be prosecuted for health and safety offences in the courts.

Strategic regulatory and sector approach

Due to the nature of the risks, and the size, complexity and responsibilities of many organisations across the sector, there is a need for HSE to target its interventions towards collaborative working. At the same time, HSE needs to maintain front-line investigative and inspection skills to respond to significant health and safety failures across the sector. HSE's regulatory approach takes account of the following:

• High-level collaborative working is necessary to clarify roles and responsibilities, rationalise the regulatory burden, provide consistent priorities and expectations, and promote the sensible/proportionate health and safety agenda
• Given the sector networks and supply chains, targeted enforcement can drive up standards by highlighting key issues. There is potential for sharing lessons and information from investigations, and establishing benchmarks is important
• HSE's enforcement and investigation role is complex, as many other agencies and regulators inspect public services on wider 'public protection' matters that can overlap with health and safety legislation (eg IPCC, Care Quality Commission, Ofsted (and devolved equivalents)). A related challenge lies in judging when accidents to the public (particularly service users) require HSE investigation under HSWA (section 3).
• In the Police, and Fire and Rescue Services, HSE interventions need to take account of the high-level statements that set out an agreed understanding for balancing operational and health and safety duties
• Work involving high-hazard biological agents is undertaken in a number of the public services (eg research laboratories, hospitals etc) and is subject to a range of permissioning regimes

HSE has developed intervention plans for each of the subsectors. These set out the objectives and actions that HSE has decided upon to help deliver this strategy.

Future trends

Many of the service providers across the sector are becoming more autonomous (eg social care, education). In other subsectors, amalgamations of some locally provided services (Police and Fire and Rescue Services) are expected.

There will be increased contracting out of aspects of public services (eg prisons, prisoner and detainee transport, police premises and services). In addition some organisations are pooling resources and internal support functions, including provision of health and safety expertise.

Aims for 2012–2015

Securing justice

Employers and employees recognise the value of investigation and respond positively when enforcement decisions are made in accordance with HSE's Enforcement Policy Statement (EPS).

Leadership

Leaders demonstrate a risk-based and common sense approach to health and safety, both in their workplaces and across the organisations that they influence.

Competence

All leaders and managers (including those with a governance role), and employees, understand their responsibilities and have the necessary competence and confidence to fulfil their responsibilities consistently. They make common sense and appropriate decisions about the management of heath and safety risks.

Worker involvement

Leaders, managers and workers recognise the benefits from involving the workforce in helping to find and implement appropriate and common sense solutions to health and safety challenges.

Health priorities

Employers target key occupational health issues, and work with those bodies best placed to bring about a reduction in the incidence of work-related ill health.

Safety priorities

Employers set priorities to deliver a significant reduction in the rate and number of deaths and accidents, particularly to members of the public affected by work activities.

SMEs

Stakeholders and regulators collaborate to agree and set clear standards and guidance to help SMEs to understand and fulfil their legal obligations.

Major hazards

Dutyholders conduct their undertakings to reduce the likelihood of low frequency, high impact catastrophic incidents, for example, loss of containment of biological agents from laboratories.