Getting expert help

There will be times when you will need outside help from a specialist, eg an occupational health practitioner, ergonomist or occupational hygienist. To make best use of their services you need to be aware of what they can and should do and consider how their work can contribute to your management of occupational health. You cannot devolve the management of health risks to others - these specialists can only contribute to your overall health and safety management.

• Involve your workers
• Decide what you need
• Responsible persons 
• What to look for and where to go
• Where to get occupational health advice

Every employer is expected to have competent help to manage occupational health risks effectively and comply with health and safety law. However, you don't necessarily need to appoint a specialist member of staff or use an external consultant. You could appoint:

• yourself, but only if you know enough about the risks and how to control them successfully; or
• an employee, provided you give them enough time and training to do the job properly.

Where the health risks are straightforward and well understood you may be able to do a lot in-house, but if you require medical or detailed technical advice you might need external input.

Before seeking external help, try to clarify the nature of the problem - there is little point paying for services that don't need specialist qualifications, or that you are competent to do yourself.

Involve your workers

It is good practice to engage workers to identify or clarify problems, and seek solutions. They might be able to suggest how to tackle issues without the need for outside help. Workers may be well placed to comment on changes that you plan to implement, and involving them often means that a solution is more likely to succeed.

There are times when you will need outside help, eg you may need a specialist to help design a health surveillance programme, carry it out, and interpret the results. Where the checks involve clinical/physical examinations or biological monitoring, you will probably need input from a qualified occupational health practitioner. A practitioner should be able to help you develop a programme that suits the work that you do and advise on workers' ‘fitness for the job'.

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Decide what you need

You need to be clear about what you are paying for and what is expected in return - writing a specification is a good idea. You could include:

• information about your firm and its business, ie what sort of things you do;
• how you go about it;
• the problem and why you cannot deal with it yourself;
• what service you want from the specialist;
• what feedback you and your employees need;
• how the specialist will deal with confidentiality;
• when you need the work done by and how often ongoing checks will be done;
• how records will be kept;
• how and when you need reports;
• action that will be taken if an individual is found to be unfit to work;
• the resources you can offer, including a named contact point to support the specialist, any facilities or premises that are available etc; and
• how you plan to use the advice or support.

It is good practice to involve a worker representative when you write the specification. 

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Responsible persons 

In some circumstances, eg where you have some limited internal expertise, you could get an employee to shadow a specialist so that they can learn what needs to be done and then offer local advice.

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What to look for and where to go

Make sure you get the right help as well as value for money. Consider the following when you select a specialist:

• Approach business and supply chain contacts for a recommendation, eg your trade association, Constructing Better Health, local business advisory service or principal contractor might have some suggestions.
• Find out whether the specialist and/or their company belongs to a relevant professional body.
• Does the specialist have relevant qualifications?
• Ask for names of existing customers and follow these up.
• Write down clearly what you want the specialist to do.
• Make sure that the specialist is able to do what you need - ask for examples of when they have done it before.

You may need advice from more than one type of specialist. Table 1 indicates the breadth of relevant expertise that is available. Each group has its own professional body that may be able to advise on selection of a suitable specialist and appropriate qualifications.

Some professional bodies focus on specific risks or aspects of work-related ill health, others offer a wider range of services. Several professional bodies keep a register of reputable practitioners.

Remember that qualifications alone do not confirm that a person is competent - a specialist will also need experience of putting their knowledge into practice in construction. 

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Where to get occupational health advice

Constructing Better Health has a list of registered practitioners who will deliver to the CBH standards and be audited by CBH.

The Employment Medical Advisory Service

Your local HSE Employment Medical Advisory Service (EMAS) office should be able to help by providing general advice and will have details of doctors appointed to provide statutory medical surveillance under those regulations that require it.

EMAS is part of HSE and is staffed by specialist occupational health professionals - both doctors and nurses. They can give free expert advice on work-related medical matters to employers, employees, trade unions and other healthcare professionals.

EMAS doctors (medical inspectors) and nurses (occupational health inspectors) can provide advice in relation to any work premises. As well as giving advice, they have a responsibility to ensure that employers and others comply with legal duties.

Table 1 Specialists and their expertise

Specialist	Expertise
Ergonomists	Advice on: field of vision, sight lines, manual handling repetitive tasks, workspace layout, body size, aspects of guarding and containment, demands of tasks/equipment on people; the equipment used and whether it is appropriate for the task; the effects of the physical environment including lighting, temperature and humidity on people.
Health and safety management	Help with: policy development and planning; performance monitoring; involving employees in decision making; training and communication.
Microbiologists	Assessment of biological hazards and advice on risks and control measures to prevent or control health risks. Sampling for micro-organisms.
Noise and vibration specialists	Measure levels and advise on causes, elimination and practical solutions to reduce exposure.
Occupational health professionals (doctors and nurses)	Diagnosis and treatment of work-related disease (doctors). Assessment of risks to health and advice on managing these risks. Health surveillance and other health checks. Fitness-for-work issues. Advice on pre-employment health screening, sickness absence and ill-health retirement. Providing health education, advice on rehabilitation after illness or injury.
Occupational hygienists	Assessment and practical advice on the prevention or reduction of risks to health from chemical, biological and physical agents arising from work activities. Environmental monitoring.
Physiotherapists	Provide treatment and rehabilitation advice. Advice on the prevention of musculoskeletal disorders.
Radiation protection advisors	Advice on complying with legislation covering the use of ionising radiation in the workplace. Conducting environmental monitoring

• Minimum competencies for occupational health providers

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