Written evidence from Society of Occupational Medicine (DEG0058)

SOM welcomes a focus on the important role for OH to reduce the disability employment gap.

Occupational health (OH) is uniquely placed amongst medical specialties to enhance the productivity of the nation whilst keeping workers healthy and safe. We note the strong evidence base for occupational health in return to work. Occupational health: the value proposition; Occupational Health: The Global Evidence and Value; The Value of Occupational Health Research, and The Value of Occupational Health to Workplace Wellbeing. We have also produced guidance leaflets for company directors and commissioners of services, line managers and HR professionals, and workers and their representatives.

Individuals with disabilities need conversations with trusted health professionals who understand their medical needs, which may be complex, and can refer to a range of support services; medical and non-medical. Employers need direct, individualised, and concise advice on how to support disabled people and people with long-term health conditions in their workplace. OH professionals are ideally placed to ‘join-up’ service access and advice between individuals, their health care professionals, and their employers.

There is a serious shortage of specialists in occupational medicine; in the NHS alone, numbers of consultants have declined from 80 to 60 over the past two years and we urge the Health Education England to invest in occupational health professionals to allow this scale up to occur. SOM is calling for universal access to OH - see https://www.som.org.uk/universal-access-occupational-health-oh.

A key ask is ensuring the government delivers on Health is everyone’s business consultation and:

• Health Education England and its equivalents in the devolved administrations invest in training of OH professionals such as OH nurses and specialist medical training posts
• There should be investment in expert OH advice in government, the establishment of an OH national data set and UKRI investment in a research Centre for Health and Work to translate evidence into policy
• Tax incentives by the Treasury so employers can invest in occupational health
• Access to OH for GPs
• A National Clinical Director for Work and Health to lead this work

SOM is also working with research funders to secure investment in the co-ordination and funding of academic research to provide answers to key questions related to workplace health. It is calling for a Centre for Work and Health.

The UK needs to raise aspirations for those with disability. Employment as an outcome should be the expected result of all work/health interventions for most people with a disability. The strong positive message about the beneficial impact of good appropriate work for those with disabilities and long-term health conditions should be promulgated, to the public and employers

Action is needed to implement a tiered approach, which delivers consistent generic advice for all patients but concentrates OH expertise on the most complex cases. Our suggested model would see:

1. Tier one: non-complex cases: Facilitate consistent advice about work and educate all health care workers about the benefits of good work for this group and support consistent messaging about return to work. Make work/occupation a measured clinical outcome for all patients

2. Tier two: complex cases: Funds rapid direct referral to OH by GPs, other clinicians, and work coaches. This should be accessible irrespective of employment status. One opportunity for providing this, subject to funding, would be to use existing NHS OH. Alternatively, this could be commissioned locally from within the private sector.

The impartial position of OH between the employer and employee is critical in managing the perceived bias by either party, or by outside agencies that would otherwise be an important barrier to work. OH could also support hospital clinicians by providing condition-specific guidance on fitness for work directly to patients through NHS clinical services.

About The Society of Occupational Medicine (SOM) - a multi-disciplinary professional society whose membership includes over 1,700 OH doctors, nurses, physiotherapists, occupational therapists, and technicians. SOM Patrons are Lord Blunkett, Dame Carol Black, and Sir Norman Lamb. www.som.org.uk.

December 2020