Jain Holmes, Training Director and Anne Byrne, Clinical Director with Obair wrote an article for the Occupational Health Magazine that was published online on 3 May 2014 part of the Personnel Today essential HR news and guidance from the Xpert HR team.
Here is an excerpt of our article – if you want to read the whole thing then go straight to the article here.
Occupational therapists (OTs) and occupational health professionals are frequently mistaken for each other. OTs Jain Holmes and Anne Byrne aim to demystify what their profession does, and identify what they contribute to the workings of occupational health.
OT training centralises around understanding how a human being functions in everyday life (home, school, work and leisure) and we are medically dual-trained in physical and mental health and can therefore work with individuals who have problems in either or both areas.
Our approach is holistic, which means we look at the person, the tasks they want or need to accomplish and the environments in which they want or need to perform the tasks. Therefore, we spend a great deal of time during our training learning about how humans might function differently in various built (physical) and social environments, and how tasks and environments can be adapted to fit the person’s needs or their functional impairment in order to facilitate performance.
How does occupational therapy apply to OH?
OTs focus on where a health issue impacts on the individual’s capacity to do their job or remain in their job, and we can potentially be used to determine if the issue preventing return to work or remaining at work relates to work capability, the job tasks or the work environment.
We identify and translate the employee’s physical or mental health symptoms in such a way that describes the impact they have on that employee’s job, and employees and employers advise that this is often one of the most useful aspects of an OT evaluation.
Following an evaluation and analysis (dependant on the referral request), the findings allow OTs to recommend a variety of methods that will help an employee to stay at or return to work (RTW) in a safe and sustainable manner.
Ideally, together with the larger workplace team (OH, HR and line managers), we will chart an employee’s progress and solve issues if and when they arise to the point where functioning in the job role remains stable and the RTW is sustained.
Our core skills lie in evaluating human functioning – i.e. the whole person in the specific environment doing a particular task – and then improving function by building an individualised, goal oriented rehabilitation programme with the aim in OH of progressing a case-to-case resolution. Inevitably there is some overlap with other professionals in a broader OH team, and OTs view this positively as it allows us to understand roles and participate in the multidisciplinary team with greater effectiveness.
In a previous editorial on 2 April 2014, Julia Skelton, Director of professional operations at the College of Occupational Therapists echoed Jain and Anne’s sentiments about the value that OTs brings to OH, “Occupational therapists do, of course, work within OH already – but the numbers at the moment are still quite small. I think things will begin to change over the next five to 10 years and allied health professionals, including occupational therapists, will be more self-evident within these services. I do think the relationship will evolve”. The College, for example, is working with the Council for Work and Health and Anne Byrne is the representative for the College and has been discussing new innovations such as the Health at Work Service.
Anne Byrne is attending this week’s annual conference of the National School of Occupational Health in London and providing a workshop to look at how OTs and OH can work successfully together. Her workshop is entitled:
The Scotch Whisky Industry: The Role for Occupational Therapy
The Scotch Whisky industry employs 45,000 workers directly and indirectly and a large majority of these workers are engaged in manual work using traditional methods that can be difficult to adapt. It is therefore vitally important that the skilled workforce engaged in this industry, which accounts for £4.3 billion in UK exports, remain at work and the risk of injury and absence is minimised.
As an occupational therapist providing services to occupational health at a large manufacturer of Scotch Whisky there are a number of services aimed at reducing absence and the risk of injury that can be provided in order to add value to existing OH services. This workshop will give participants an overview of the Scotch Whisky industry and the services Occupational Therapy provides within Occupational Health and will use examples from manufacturing process to focus the workshop on job demands analysis and ergonomics. Through an interactive session we will review a number of principles and strategies to minimise the risk and facilitate performance that can be applied in any industry where manual work is carried out.
We will provide an update on Anne’s workshop in the coming weeks.
May 2014 saw Obair welcoming a new member of staff – Ann Shearer, who has taken up the new role of Clinical Manager. Ann is based in Obair’s head Office at Trident House in Paisley and her role will include leading on the support and supervision of Obair’s Vocational Rehabilitation Evaluators who deliver the range of Obair products and to work with the Clinical Director to continue to maintain the quality of services to our customers. Ann will also retain her practitioner role providing high quality, innovative and evidence based Vocational Rehabilitation evaluations, services and interventions.
Ann, who is an occupational therapist who qualified in 2000, comes to Obair with considerable experience in Vocational Rehabilitation and Occupational Health. Her skills and knowledge extend to working in both the private and public sectors within the UK in the clinical specialties of musculoskeletal conditions, mental health and neurological conditions. Ann’s clinical skills include assessments in the work setting covering work site assessment, job demands analysis and ergonomics. Ann also has experience undertaking past and future care Medico-Legal assessments and is an accredited Matheson functional capacity evaluator.
Ann is committed to supporting the Obair Evaluators to further build a world class team using evidenced-based assessments and interventions with individuals, who due to injury, health condition or disability, are demonstrating restrictions in their functional or vocational capacity for work, enabling them to successfully retrain or return to work.
Anne Byrne, Obair’s Clinical Director was invited to present at the Royal College of Physicians of Ireland, Faculty of Occupational Medicine’s Spring Conference on the 4th of April 2014.
The focus of the Spring Conference was Fitness for Work, and the title was “Fit for Work? Fit for What?” Topics covered in the conference included:
Anne was specifically requested to present on “Functional capacity evaluation and vocational rehabilitation in the assessment of and enabling successful fit for work outcomes”.
Anne’s 40 minute presentation considered the title in terms of international experience, practise and the literature and discussed functional capacity evaluation (FCE) in terms of what can be assessed and who can be assessed, and why Job Specific FCE is best suited to occupational health practise.
Anne shared her extensive experience as an occupational therapist working in occupational health in Canada where she helped set up and subsequently managed a highly successful, in terms of rehab and financial outcomes, an award winning employee rehabilitation unit. Drawing on her experience in Canada and her continued occupational health experience here in the UK, Anne’s main theme was to introduce Job Specific FCE using the Matheson approach to FCE and how it can be effective in objectively determining fitness for work and enable the timely and safe return to work. Anne discussed the evidence to support Job Specific FCE and what the evaluation entails, illustrating the use of an objective FCE and Job demands Analysis (JDA) to facilitate matching capacity for work to job demands.
Anne used a practical case example to illustrate what information can be gleaned from the evaluation and illustrated how Occupational Health practitioners can use the findings to:
Anne underlined the value and need for robust assessment in occupational health in order to ensure evidence based practise and to enable successful outcomes in return to work and maintenance at work.
For more information on how you can learn to use job specific functional capacity evaluations in Occupational Health please look at our training pages on our website.
The BBC reported this week that the new Health and Work Service (HWS) being developed by the DWP will cover England, Scotland and Wales and will involve non-compulsory health assessments and treatment plans (BBC News on 9 February 2014). Owain Thomas today (11 February 2014) from Workplace Savings and Benefits reports however that, “Employer participation in the new Health and Work Service (HWS) could become mandatory if its initial voluntary structure is not a success, the government has admitted.” He goes onto quote Minister for welfare reform Lord Freud saying, “It is strictly a voluntary service, it is not a mandatory service as it could have been and it may become (as the OECD recommended), but we want to see how it works first on a voluntary basis.”
“It is in the end a voluntary service and we are hoping that it can remain a voluntary service. That is one factor that we will monitor very closely.”
A mandatory service would indeed create an entirely feel to employers, employees and GP’s and may alter referral, assessment and intervention processes and arguably require a complete redesign. Are we heading for a UK version of Workers Comp?
We have been aware of such a recommended service since the Black and Frost report (Health at work – an independent review of sickness absence) on 21 November 2011 and that it may become a reality following the Government’s response (response to the sickness absence review’s recommendations on 17 January 2013) just a year ago. Since then we at Obair have been following developments and in our different voluntary roles with professional organisations (College of Occupational Therapists Specialist Section – Work and Case Management Society UK) and engaging with our colleagues where we can regarding the design and delivery of such a service. At present we understand that the HWS will support people who have been on sick leave for more than four weeks, back into work. Referrals will be made by the GP (who is the gate keeper to claiming statutory sick pay) and or the employer but the uptake of the referral by the employee will be optional at this stage.
The GP is primarily duty-bound to protect the health of the individual and there is a big question as to whether GP’s will initiate a referral to HWS. The Work Foundation discussed this in October 2013 looking at the motivation of GP’s and their conclusion was “If GP’s do not see return to work as in their patients’ best interests or important for their wellbeing then they are unlikely to motivate them to take up an offer of the HWS or any other type of vocational support. The success of the WHS depends heavily on the patient’s motivation to take up an offer to attend but also on the GPs motivation to refer their patients into the service.”
Following referral, it is envisaged that the employee would undergo an assessment by an occupational health advisor who could come from any of the following professional healthcare groups Occupational Therapists, Occupational Health Nurses and Physicians and Physiotherapists. Taking a case management approach, the specialist will undertake an assessment either via the telephone or face to face and then be guided as to appropriate next steps. We have no details of how screening will be operationalised or how people will be chosen to have more or less intensive interventions but the use of tele-assessments is something the DWP have recently published evidence on in their report “Telephonic support to facilitate return to work: what works, how, and when?” Their results indicate robust evidence supporting telephonic triaging, case management and some return to work interventions (including monitoring) and adequate evidence supporting telephonic-based signposting and self-management techniques.
The Work Foundation and Macmillan held an event to look at the HWS and long term conditions and specifically to:
Following the event a report was produced that is helpful in considering important aspects about the new HWS in relation to long-term conditions, which echoes our own concerns here at Obair. These concerns for us are not just related to long-term conditions but resonate with most conditions and would be pertinent for a voluntary or mandatory service. Our broad recommendations would include:
Once we know more information regarding the details of how the HWS will be operationalised, which service providers will be prime deliverers and any further information, we will blog about this again. Your comments are most welcome.
We have a new job opportunity that has just been developed to join our dynamic and experienced team. Might you fit the bill?
Obair means “work” in Gaelic and “work” is what we enable. We provide best-practice, end-to-end support for individuals following injury, illness or who have a health condition, helping them and their employers meet the challenges of their changed circumstances. We take a customised and objective approach to identify whether someone is fit or unfit for work, going beyond what is often currently offered in the UK. Our practitioners are world-class experts in the field of vocational rehabilitation with a detailed understanding of the elements required when considering capacity for work.
Are you ready for the challenge of continuing the quality service delivery for which Obair is recognised for? If so, we are looking for Clinical Manager – Vocational Rehabilitation to join us. Responsibilities will include:
If you consider you have the experience and skills to join us, we would very much like to hear from you.
Location: Head office Glasgow & Nationwide
Closing date: 14 February 2014
For application pack, please email: firstname.lastname@example.org
No agencies please.
Please note, all applicants must be legally entitled to accept and perform work in the UK.