OH Today Volume 31 Issue 2 - 2024

Partners of OH Today

From the President

Lynn Pratt

Dear Members,

It’s my pleasure to bring you this latest edition of OH Today.

I was reflecting on the recent Health and Wellbeing at Work conference at the NEC and the iOH Ruth Alston Memorial Dinner and lecture with Professor Neil Greenberg. Both events were huge hits, and it was great to connect with lots of new and established members from physiotherapists, occupational therapists, nurses, doctors and wellbeing professionals. Thank you to our iOH speakers Janet O'Neill , Libby Morley-Hassanali, Mandy Kelly and Karli Gibson who delivered insightful presentations. We will be starting to plan for 2025 shortly. Placemark your diaries for 11 & 12 March 2025.

There is a lot going on in the OH space right now. For the nurse members in our group, I would like to highlight that the Nursing and Midwifery Council have decided to proceed with regulating Advanced Practice (AP) for nurses. They aim to unite the varying standards of Higher Education Institute programmes and provide clarity to nurses. You can explore more on the iOH blog here.

iOH acknowledges Prime Minister Rishi Sunak’s proposal to review the fit note system. As multi-disciplinary and dedicated advocates for employee health and well-being, we recognise the importance of optimising fit notes to support individuals to remain at and return to ‘good’ work. In this Position

Statement, we outline our evidencebased perspective on the matter.

We are delighted to welcome new partners PAM Group, Occupational Health and Wellbeing Professionals, OH Staffing, Orchid Live, Gel Resourcing and The University of the West of England. Thank you also to our long standing partners Vitalograph and Cordell Health and Health and Wellbeing at Work As a registered charity, our generous partnerships help to keep our membership fees low and helps us offer educational grants to members.

The next iOH webinar on OH Education and Training is on 20 June at 7.30pm and will explore what is available and where we are heading. Book on Eventbrite.

Finally, thank you to those who completed our iOH member survey. We had a good response and will publish the results shortly. Meanwhile if you would like to express an interest in behind-the -scenes support for iOH, please follow this link and add a little more information.

Lynn Pratt, President iOH

Doing the right things to deliver quality

By Mandy Murphy

When we provide our services to purchasers or commissioners of occupational health (OH), how do they know that we deliver what we say we do? How will they know it’s good enough, for their employees and their business? Or even how does it compare to other services in the industry? After a long career in the speciality these questions still throw up widely varied responses when I ask them.

Employee health and wellbeing is still high on the business continuity agenda. OH is seen as a critical enabler to supporting this agenda, and even more widely regarded since the pandemic. And now more than ever we need to be able to demonstrate that we are relevant, do what we say we do and deliver value to employers and employees. While the understanding about occupational health as a term is widely accepted these days, there are still gaps in understanding of what we do and how we do it, not helped by a weak evidence base regarding our impact in comparison to other clinical specialities in healthcare.

Provision of OH services in our marketplace has inconsistent approaches and are variable in quality which is why it is crucial to protect the speciality itself and establish strong trust in those who buy in, commission, and use our services.

Since its inception in 2010, the SEQOHS (Safe, Effective, Quality Occupational Health Services)

accreditation scheme set out to support services and commissioners alike to plug this gap in quality and articulate what good occupational health service provision looks like. Since its launch, it rapidly became an integral part of the OH landscape and widely regarded and accepted as the recognised standard for the industry.

The scheme has recently been through a major review, with standards and processes for accreditation under the spotlight and revised to meet the evolving needs of the speciality and the employment landscape. It was quite an undertaking and no stone was left unturned, ensuring that not only are the standards relevant to everybody who delivers OH services (from single handed practitioners to large, multi -site and commercial providers) but it continues to be of value for how the speciality is evolving. A wide number of stakeholders were consulted to consider levels of quality and standards that would be expected of us now. The revised scheme was launched in December 2023 and the changes have been well received so far.

What is the SEQOHS Accreditation Scheme?

Before we talk about some of the changes to the scheme, it might be worth recapping on what the SEQOHS accreditation scheme is and how it works.

SEQOHS stands for Safe, Effective, Quality Occupational Health Service and is the formal

recognition that an OH service has demonstrated its competence to deliver services against the criteria set out in the standards. The standards are a recognised industry standard for the elements it is accrediting.

The standards are categorised into 6 Domains, where domains 1-5 are applicable to everyone who applies. Domain 1 is Governance and Leadership, Domain 2 is Resources and Processes, Domain 3 is Outputs and Outcomes, Domain 4 is Information and Communication and Domain 5 is Quality Assurance and Improvement. Domain 6 is now a sector specific standard with the aim of including specific standards here for different industries, such as NHS which is currently applied in this Domain (6.1).

There are three stages to the process; application and self-assessment against the criteria, review of the evidence submitted and interview process with two trained assessors from the team.

Accreditation is awarded for 5 years, subject to successfully complying with the criteria of the standards, and with an annual submission to confirm continued compliance with the standards. Services may have actions post accreditation which are based on industry best practice, and some are formally congratulated for explementary practices in OH.

What has changed or new with the 2023 SEQOHS Scheme?

Firstly, the review set out to enable all providers to demonstrate that they meet accepted standards of occupational health delivery. To achieve this, the review focused on the key processes and outputs of OH delivery, removed duplication and strengthened the support

and advice offered to OH providers, employers and employees. .

The evidence guide, which supports OH services to know what kind of evidence they might include in their selfassessment, also went through a rigorous overhaul, with involvement of key

stakeholders including the NHS and commercial OH providers. It is again set out to support reducing the duplication of effort across the standards and describes examples of suitable evidence to demonstrate fulfilling the criteria of the standards, with links to national standards where appropriate.

Perhaps the biggest development in the scheme is the new focus on outputs and

outcomes, most of which can be demonstrated in Domain 3. This provides an opportunity to measure deliverables and so strengthen the evidence base regarding the value and impact of OH.

The criteria in this standard were developed with the evolving needs of the speciality in mind, and involving stakeholders in their development, including the Health and Safety Executive (HSE). This was particularly so for the new standards 3.1 and 3.2. For example, there is a focus here on how a service understands a client’s OH needs and acts as a competent person to assist clients to meet their legal obligations for safe working.

Dr Robin Cordell, who led the review commented that

“the emphasis on outputs and outcomes has built on the original standards, enabling accredited providers to move from not only showing that they are doing things right, but that they are doing the right things.”

This will bring a lot of benefits to accredited services and commissioners alike. We can demonstrate that we do what we say we do and add value. It’s removed what might be seen as a “tick box” approach to standards. The emphasis now is to show the quality of your service rather than saying ‘we have a policy for that’. If you have a policy or procedure, do you know it’s working? How do you know? Do you evaluate it? What do you do with the results of that review? If you find it’s not working, what would you do to rectify it?

The other intended benefit of moving the emphasis towards outputs and outcomes has also had the effect of making the standards more generic. There is no longer a separate format for occupational physiotherapy services and this supports and reflects the multidisciplinary working nature in occupational health.

There is now a specific Domain 6 for specialised OH services, with the first being an NHS standard, 6.1. This was developed in partnership with NHS Health at Work Network and the Growing OH and Wellbeing Together (OHWB) strategy team. It complements the standards in Domains 1-5, with a directed focus on the requirements to deliver specific OH services in healthcare. In the future we may add other specialised OH Service provision to this domain, for example for OH delivery to the Police.

The insider perspective

I worked in the NHS when our service at the time achieved SEQOHS accreditation in 2012. I was on the other side of the accreditation process, gathering and uploading evidence. Achieving accredited status felt like a great accomplishment. The team felt very proud of being able to prove that services we provided then (and the hard work) for our clients was recognised and meets industry standards - if not exceeding them in places. Not only was the feedback of meeting the standards hugely powerful, but going through the process ourselves gave us the opportunity to look at

what we did, benchmark against the standard and propel us to strive forward with our ambitions for OH service delivery.

As someone who has now joined the SEQOHS team, I now have the privilege to see the other side, - behind the scenes if you like. I am regularly impressed by the level of work and intellectual consideration (lots of discussions) that goes in to ensuring the process is responsive to the diverse needs of the organisations who go for accreditation, the care and attention of our assessors who at the heart of it all want services to put their best selves forward and everyone ensuring that safety, effectiveness and quality remains at a level we expect for our speciality.

I make no secret that I have been a cheerleader for SEQOHS Scheme since its inception and now I have been on both sides of the accreditation process, there are four really important factors that this scheme brings to OH. We don’t often talk about them. For me, they are a reminder of the importance of participation in a quality scheme such as SEQOHS:

• Relevance – this is a way we can demonstrate that we do what we say we do, we know what matters to our stakeholders, and a commitment to be closely connected and appropriate to the evolving needs of our clients.

• Reputation – having spent many years delivering OH services at a commercial level and seeing how good quality OH services have been undercut by aggressive cost-cutting bids, this tarnishes the reputation of OH. Building and maintaining a reputation of good quality OH services – that add real value - is more important than ever. Our reputation among purchasers is one thing, but also our reputation in the wider world of healthcare and as a clinical speciality, working to agreed standards

gives credibility to our ‘raison d'être’ - why we provide OH.

• Representation – what we do and how well we do it is a representation of who we are as OH. Using evidence and outcome measures to guide our practice, demonstrating value and competence builds trust that as a speciality we are as good as our word.

• Recruitment – as we reflect out to the world, like a mirror, that we have industry standards, provide good quality, safe and effective standards of care, we are also attractive to those healthcare workers who hold similar values and want to explore a career in OH. There is no doubt that the more we do to showcase the good work in OH, the more attractive and competitive our speciality is as a career option for many healthcare workers.

The SEQOHS accreditation scheme remains a cornerstone in promoting quality in occupational health and supporting services to demonstrate their value and competence against industry standards. As we embrace the revised scheme, the commitment to safe, effective, and quality occupational health services is stronger than ever. For both professionals and businesses, achieving SEQOHS accreditation is not just a recognition of excellence; it is a testament to the unwavering dedication to promoting, protecting and supporting the health and well-being of the workforce.

For more information about the SEQOHS accreditation scheme and process, go to our website: SEQOHS (https://www.seqohs.org/)

And if you are interested in joining the assessor team and would like to know more about the role, you can contact Mandy Murphy by email at mandy.murphy@fom.ac.uk

Mandy Murphy | Linkedin

Mandy is the SEQOHS Quality Lead for Assessors at the Faculty of Occupational Medicine and is a board director for the Council for Work and Health.

Mandy also runs her own independent business as a Senior Coach Practitioner often supporting career transitions, new leaders and teaching coaching skills to other professional groups and parents.

Ensuring Competence and Quality Care: Why

SCPHN OH Nurses need to revalidate to the New Standards

By Neil Loach University of Derby

The Standards for Specialist Community Public Health Nurses (SCPHN) (2022) for Occupational Health (OH) represent a renewed and comprehensive framework that outlines the core competencies and professional behaviours expected of nurse practitioners in a unique and specialised field. These standards, developed by the Nursing and Midwifery Council (NMC), provide guidance for Occupational Health Nurses (OHNs) to deliver high-quality leadership and care, to promote health and wellbeing in the workplace. These new standards build upon the foundation of previous iterations while incorporating updates to reflect the

evolving landscape of OH practice. They emphasise the importance of evidence-based practice, ethical decisionmaking, and holistic approaches to address the diverse health needs of employees across various industries. The comprehensive competencies can be found in the standards. All standards are required to be met in practice to be admitted to the register and confirmed by a Practice Assessor and Academic Assessor. Key components of the SCPHN (2022) standards for OHNs include:-

Health Promotion and Prevention:

• The promotion of health and wellbeing in the workplace through education, advocacy, and the implementation of preventive measures. This involves collaborating with employers and employees to identify health risks, develop tailored interventions, and foster a culture of health and safety.

Risk Assessment and Management:

• Conducting comprehensive risk assessments, sometimes in collaboration with subject matter experts, to identify occupational hazards and mitigate potential health risks. They utilise evidencebased tools and methodologies to assess workplace environments, evaluate health outcomes, and implement strategies to prevent work -related injuries and illnesses.

Occupational Health

Surveillance:

• Monitoring and evaluating the health status of employees, identifying trends and patterns, and implementing surveillance systems to detect emerging health issues. They collaborate with interdisciplinary teams to collect and analyse data, assess health needs, and develop targeted interventions to address OH concerns.

Collaboration and Advocacy:

• Collaborate with employers, employees, regulatory agencies, and

other stakeholders to promote a collaborative approach to occupational health. OHNs advocate for policies and practices that protect the health and well-being of workers, promote social justice, and address disparities in OH outcomes.

Professional Development and Leadership:

• Engage in continuous professional development to enhance their knowledge, skills, and competencies in OH nursing practice. They demonstrate leadership qualities, contribute to the advancement of the profession, and serve as advocates for excellence in occupational health care and delivery of the public health agenda.

Overall, the new SCPHN standards for OHNs underscore the importance of maintaining high standards of competence, professionalism, and ethical practice. By adhering to these standards, OHNs can contribute to creating healthier and safer work environments, improving employee well -being, and promoting public health.

Updating skills and competencies to the new standards is essential for ensuring that OHNs are equipped to meet the evolving needs of public health practice. The new standards provide a framework to deliver high-quality care and promote health and well-being within communities. Aligning to these standards involves assessing current capabilities, identifying areas for development, and engaging in continuous professional development, including, but not limited to:

The Nursing and Council (NMC) update the revalidation process to professional standards enhance the quality delivered by nurses, including specialising in health on Part register.

1. Assessment and Health Needs Identification:

• Strong assessment skills to identify the health needs of individuals, families, and communities.

• Competencies such as conducting comprehensive health assessments, utilising appropriate screening tools, and analysing data to identify health disparities and priorities.

• Alignment includes proficiency in assessing the health needs of diverse populations and employing culturally competent approaches to care delivery. Culturally competent care involves taking the individuals beliefs, views, and behaviours into account. This could be as simple as ensuring that religious or spiritual practice is considered during the period of Ramadan for a worker referred for OH advice.

2. Health Promotion and Education:

simply providing information in different formats.

3. Partnership Working and Collaboration:

• The ability to work collaboratively with multidisciplinary teams, community organisations, and stakeholders to address public health challenges.

• Competencies include building partnerships, engaging stakeholders, and advocating for the needs of communities.

• Alignment involves fostering teamwork, communication skills, and leadership abilities to facilitate effective collaboration and achieve shared goals. This could be in partnership with the work or another health care or safety professional.

4. Policy Development and Advocacy:

• Skills in developing and implementing health promotion programs and educational initiatives to empower individuals and communities to improve their health outcomes.

• Competencies include designing evidence-based interventions, delivering health education sessions, and facilitating behaviour change.

• Alignment with training in health promotion strategies, communication techniques, and health literacy to engage with diverse audiences. Diverse strategies could include those workers who may use different communication techniques or have differing learning needs by and Midwifery (NMC) plan to revalidation to uphold standards and quality of care by registered including those in occupational Part 3 of the NMC register.

• Knowledge of public health policies, legislation, and regulations that impact health outcomes and influence health equity.

• Competencies include analysing policy documents, advocating for policy change, and participating in policy development processes.

• Alignment involves providing nurses with opportunities to engage in policy discussions, develop advocacy skills, and advocate for policies that promote health and social justice. Social Justice is about providing support and policies to transform lives. Incentivising and supporting positive behaviours within a drug and alcohol policy would be a good example of this.

5. Evaluation and Quality Improvement:

• Demonstrate proficiency in evaluating the effectiveness of public health interventions, programs, and policies.

• Competencies include collecting and analysing data, assessing outcomes, and implementing quality improvement initiatives.

• Alignment involves incorporating principles of evaluation and quality improvement into practice, fostering a culture of continuous learning and improvement with research as an integral driver of best practice. Ensuring that policies are regularly updated with research that is valid and considers the Issues of quality, accuracy, relevance, bias, reputation, and credibility before adoption into a new policy is essential.

Renewing skills and competencies requires a strategic approach to professional development and training. By assessing current capabilities, identifying areas for growth, and providing opportunities for skill enhancement, nurses can ensure that they meet the requirements of the new SCPHN practice and contribute effectively to population health outcomes.

The significance of revalidation for OHNs in line with the new standards should not be underestimated.

For OHNs revalidation is particularly crucial due to the dynamic nature of their role. They must stay abreast of changing legislation, emerging occupational hazards, and advancements in healthcare to effectively promote a safe and healthy work environment. Revalidation ensures that these nurses maintain the competencies required to address the diverse needs of employees, employers, and other stakeholders across various industries.

The SCPHN standards serve as a benchmark for specialist community public health nursing practice, outlining the core competencies and professional behaviours expected of practitioners (Nursing and Midwifery Council, 2022). Revalidation complements these standards by providing a mechanism for OHNs to demonstrate their adherence to SCPHN OH

principles and evidence their existing or updated proficiency in key areas such as health promotion, disease prevention, leadership, emerging technologies, risk assessment and the, now too often forgotten, principles of the public health agenda. Through the revalidation process, OHN’s need to reflect on how they have met the standards in their practice and provide examples of their work that align with these criteria. This ensures that their professional development activities are relevant to their role as specialist practitioners in OH and contribute to the achievement of new SCPHN outcomes.

Revalidation promotes professional accountability and ethical practice by requiring OHN to uphold the NMC's (2018b) “The Code” and other relevant professional standards. The revalidation process prompts reflection on adherence to ethical guidelines, consideration of ethical dilemmas encountered in practice, and demonstration of how challenges are addressed while upholding professional standards. This fosters a culture of accountability, transparency, and ethical decisionmaking , enhancing public trust and confidence in OH practice. Central to revalidation is evidencebased practice, i.e. use of the best available evidence, and research to inform decision-making and enhance the quality of care. OHNs must engage in reflective practice, critically appraise research findings, and apply evidence-based interventions to optimise health outcomes in the workplace. By integrating this into the revalidation process, OHNs should evaluate the effectiveness of their interventions, identify areas for improvement, and implement changes to enhance the quality of care delivered. This cyclical process of reflection, evaluation, and improvement aligns with the principles of continuous professional development and ensures that OHNs remain at the forefront of evidence-based practice.

There are challenges and future directions to consider. While revalidation offers benefits for OHNs, it is not without challenges, especially for those unfamiliar with the requirements of the new standards Practitioners may find the revalidation

requirements time-consuming or resourceintensive, particularly those working in busy clinical settings or remote locations. It may be challenging for those that are employed purely in case management when the focus of their role does not encompass all the areas of proficiency.

Consequently, there is a need to integrate revalidation into the professional development pathways for OHNs and explore innovative approaches to facilitate the process. Leveraging technology, peer support networks, and collaborative learning platforms can enhance engagement and participation in revalidation activities, ensuring that everyone can demonstrate their competence and commitment to high-quality care. Forming a Community of Practice (CoP) within a locality

References

would help to facilitate the barriers to successful adaption of the new skills and competencies that are required.

In conclusion

Revalidation plays a critical role in maintaining the competence, professionalism, and quality of care delivered by OHNs in line with the 2022 NMC SCPHN standards. By engaging in reflective practice, evidence-based learning, and ethical decisionmaking, nurses can demonstrate their ongoing commitment to professional development and uphold the trust and confidence of the public. Moving forward, it is essential to address the challenges associated with revalidation and continue to support nurses in meeting the evolving needs of occupational health practice.

Nursing and Midwifery Council. (2022). Standards of proficiency for specialist community public health nurses. Available at: https://www.nmc.org.uk/standards/standards-for-post-registration/standards-of-proficiency-forspecialist-community-public-health-nurses2/ (Accessed: 30 April 2024)

Nursing and Midwifery Council. (2018a). Revalidation. Available at: https://www.nmc.org.uk/revalidation/ (Accessed: 30 April 2024)

Nursing & Midwifery Council. (2018b). The Code. Available at: https://www.nmc.org.uk/standards/code/ (Accessed: 30 April 2024)

Neil Loach, FHEA, FRSPH Senior Lecturer, University of Derby

Neil is the Immediate Past President of iOH. He was on the NMC working group for the new SCPHN Standards. He is the Pathway Lead for Occupational Health at the University of Derby on the SCPHN OH Programme. He is an experienced lecturer across both pre and post registration nursing disciplines. He is the current Programme Leader for the PG Cert in Leading Interprofessional Practice Education Programme. This is an online course for Practice Educators to become skilled and proficient in leading all aspects of practice education, including, learning, teaching, assessment, and building & leading quality driven curricula fit for an interprofessional audience. There is also an apprenticeship version of this for any interested parties.

Why organisational reputation rests on employee wellbeing. An opinion piece.

By Suzanne Clarkson

What matters is that wellbeing is considered essential, as opposed to a nice

to have.

It’s my belief, after 20+ years working in reputation management, that an organisation’s reputation largely rests on the wellbeing of its people. Not on expensive advertising and marketing campaigns or glossy company reports full of bold statements. The wellbeing I’m talking about is the kind that comes from a sense of satisfaction, purpose and belonging, in other words, culture! Alongside are benefits, interventions, Human Resource (HR) policy and risk management practices.

Everything works together for the benefit of people and, from there, for business. People first.

It is simple. Employees will say good things to each other, peers, friends, family, potential future employees, and customers if they’re happy, healthy, and thriving. And of course, the opposite if they’re not happy, healthy, and thriving.

Wellbeing is a crucial long-term business value driver and, therefore deserves a permanent, high-level, place on the Board agenda. This can be achieved by ensuring wellbeing forms the foundation of the Environmental Social Governance (ESG) strategy, or, the latest term, Human Sustainability. To an extent, labels don’t matter. They often serve to just confuse matters and dilute important, complex matters down to a set of standardised frameworks and common metrics, but that’s one to explore another day!

What matters is that wellbeing is considered essential, as opposed to a nice to have.

That arguably won’t be achieved in its current siloed format; a format that often ends up detached from employee engagement (also called culture or

behaviour). This is an essential, evidenced, precursor to wellbeing that remains so painfully misunderstood in organisations (admittedly not helped by academics that keep coming up with different definitions).

There’s now a growing understanding that wellbeing doesn’t work when it’s considered in isolation. Benefits, interventions, campaigns, training & workshops, policy & practice, employee experience & engagement, diversity equity and inclusion tend to be managed in isolation, from top down, and often by different functions. This reflects the traditional ‘command and control’ structure of most traditional organisations.

Culture: Reputational and so much more

There’s growing evidence, over recent years, from the likes of the National Institute for Health & Care Excellence and the University of Oxford Wellbeing Research Centre, that the key to employee wellbeing is getting the foundations (the culture) right first and foremost.

It is culture that will lead to recruitment. People trust other people when deciding where to work. And if people are happy, healthy, and thriving, they’ll share that.

It is the culture that will retain a diverse workforce. People love the feelings of satisfaction and inclusion that come from feeling heard, working in a supportive team and for a great purpose. And it is culture that’ll pave the way for working and training differently, meeting the changing needs of different generations in the workforce and recovering business productivity.

Behaviours create culture, not the other way around.

So why, despite all the investment into wellbeing, training and development, diversity equity inclusion (DEI) aren’t we moving the needle on culture?

I argue it is because it is all top-down. The removal of the negative, the risks, and the application of top-down policies and practices are all necessary (especially for preventing and reducing ill-health) but they don’t naturally bring about positive feelings and functioning. I.e., they don’t naturally bring about wellbeing.

Social copying, mirroring, social movements. This is how real change comes about / how culture change comes about, from the bottom up. The grassroots. Get the foundations, the culture right and the return on investment by organisations into everything wellbeing-related might be realised.

I’ve learnt from Dr Leandro Herrero, Author, Founder of Viral Change and Chief Organisational Architect/CEO at The Chalfont Project, that the outputs needed to create authentic and lasting cultural change are all linked to injecting the right behavioural inputs into the system. Dr Herrero designed Viral Change to help deliver largescale, sustainable, behavioural, and cultural change. This is based on the science of social movements; change from the bottom-up. It involves five principles: non-negotiable behaviours; peer-to-peer influence; informal social networks; storytelling; and backstage leadership.

Balancing ‘do no harm’ with ‘actively do good’

The behavioural, bottom-up, and cultural aspects are arguably largely missing from the wellbeing equation. For example, there seems a current trend towards mental wellbeing sitting in Occupational Health & Safety, under the catch-all term for both mental illness and mental wellbeing, namely psychosocial risk. There needs to be a better balance here. Wellbeing isn’t only about the absence of the negative, e.g. high workloads, evidence suggests it’s more correctly defined as the presence of positive feelings and functioning. This is recognised in the risk management world, with the emergence of Positive Organisational Psychology (POP). However, even with POP, interventions are still arguably very topdown, heavily leaning towards things like workshops, wellness audits and promises from leadership to staff about the perks of working at a job (otherwise known as the Employer Value Proposition).

Academics all appear to play in their lane, just like business functions! I think if the psychologists got together with those in the know about what employee engagement is (a state of being – see this really insightful paper by Gifford & Young (2021) for the CIPD), how it comes about (employee contribution and challenge is a huge factor), and the outcomes that can be achieved (one of those being wellbeing), then all of this would be a completely different story. Thankfully there are some pockets of interconnected thinking out there in academia . But they’ve yet to make their way into business thinking and practice.

For example, the quote below by Schaufeli et al (2004) evidences that work meets important psychosocial and wellbeing needs. But not just any work. They’re talking here about “good work” – an environment where people can thrive. And that’s all about culture, behaviours, and engagement. It is a strong argument for balancing ‘do no harm’ with ‘actively do good’. One that requires good cross-discipline collaboration.

“The fact that burnout and engagement exhibit different patterns and possible causes and consequences implies that different intervention strategies should be used when burnout is to be reduced or engagement is to be enhanced.”

Meanwhile, Anthony-McMann (2014) found that a sense of teamwork and camaraderie can even help tackle workplace stress. A focus only on ‘removing the risk’ or on applying top-down interventions, would arguably miss the vital importance of employee engagement here. In other words, culture.

“The relationship between workplace stress and positive, interpersonal relationships at work (both a foundational aspect of employee engagement and a job resource) may also exhibit positive tendencies because, in the face of workplace stress, such interpersonal relationships can foster both camaraderie and a sense of shared experience leading to the positive effect of having accomplished something together”

Culture, engagement, and wellbeing are completely interrelated. Culture provides the place where engagement happens. Wellbeing is an outcome of engagement, if you follow the thinking from academia, and not just from the engagement survey providers who’ve ended up making employee engagement an end, as opposed to a state of being.

Finally, I’m not suggesting that top-down values, edicts, policies, practices and risk management no longer have a place. What I’m saying is that all that needs to be better balanced with bottom-up behavioural change. As humans, we have an inbuilt instinct to copy and mirror the behaviour of others, people like us, and those who influence us. It’s how we form relationships, form opinions, make decisions, and change our behaviour. All of that simply doesn’t happen through being told what to do and how to behave by leaders. Neither does it happen through appraisals, workshops, training, reward, and recognition systems, not in any real or sustainable way.

By Suzanne Clarkson, Managing Director

at Coach House Communications and Partner at The Chalfont Project. Masters in Internal Communication, Communication specialist. Reputation management | S in ESG | Employee Wellbeing

Suzanne is a communication specialist with 25 years of experience across internal and external communication disciplines. She is on a mission to help employers better understand their people, translating insights into strategy, action and measures that encourage joined up thinking on employee engagement, wellbeing, DEI and ESG. And, crucially, all this in a way that works for people and businesses.

EOPH is here to support the professional development needs of the occupational knowledge and insights with easy access to subject matter experts for their adviceFurther information : EOPH – Education

health profession. Our objective is to build a community of best practice, sharing designed for occupational health professionals, by occupational health professionals Education for Occupational and Public Health

Mental Health and Menopause: A Case Study

By Rachel Martin

Menopause is a natural part of ageing that usually occurs between 45 and 55 years, as oestrogen levels decline, and can include symptoms of hot flushes, night sweats, difficulty sleeping, low mood or anxiety and problems with memory and concentration. Perimenopause is the natural transition into menopause and can present as early as the mid-thirties, with symptoms having a significant impact (NHS, 2022).

“Surgical menopause” (BMS, 2021), where both ovaries are removed, and certain medication treatments for endometriosis (NHS, 2022), can cause a sudden oestrogen deficiency with associated symptoms.

These hormonal changes can cause mood swings, low mood and anxiety, sometimes making underlying mental health conditions worse (Mental Health Foundation, 2021), and can be the first signs of menopause.

Occupational Health (OH) Case Study:

I received a referral for an employee, working as an administrator in the healthcare sector, with anxiety, low mood, and management concerns at work. Janis (not her real name) had been struggling at work due to overwhelming anxiety and low mood for several months, finding it had reached a crescendo. Upon seeing her GP,

Menopause:

she was prescribed a selective serotonin reuptake inhibitor for mood and after disclosing to her manager, was referred to Occupational Health (OH).

It is important within OH, to have an underpinning knowledge of menopause when undertaking case management referrals to support the employee and the manager.

During the management referral, Janis presented as upset and explained she had never experienced anything like this before and had no history of mental

ill-health or anxiety. She felt she was not able to control her symptoms. The consultation included a clinical, functional, and biopsychosocial history. A menopause rating scale (MRS) and mental health assessment were completed. The history, plus assessments and age consideration, indicated her symptoms may be related to a hormonal imbalance associated with menopause. According to the Menopause Charity (2021) low mood, anxiety, or mood swings can occur during perimenopause and menopause and can commonly be misdiagnosed as depression. It can take up to three years to receive a correct diagnosis when women attend their GP after experiencing low mood or heightened emotions. Evidence that SSRIs effectively ease menopause-related symptoms is limited, with the BMS (2018) indicating that there is less than a 50% benefit, which may be why Janis had not noted any improvement.

Validated assessment tools are useful within OH to help identify self-reported symptoms, which we can marry with the biopsychosocial and functional history and relate to work and also assist with understanding the clinical history and supporting appropriate signposting, such as to a GP, who will be familiar with them.

The MRS was developed as a self-assessment tool to evaluate symptoms (Heinemann et al. 2004) and is evidenced as a highquality scale that assesses the severity of symptoms. The MRS has further proven to demonstrate excellent reliability and validity following a worldwide and historic study, including in Serbia (Gazibara et al., 2015), Persia (Jahangiry et al., 2020), and India (Rathnayake et al., 2018; Ramya and Radhika, 2020). However, Chou et al. (2014) consider that the MRS does not provide a high sensitivity in detecting impaired quality of life. Despite this latter argument, the evidence for use is impelling, especially in OH where we need to understand the severity of symptoms to marry with the tasks within work.

Saunders et al (2023) identify the evidence-based, 9-item patient health questionnaire (PHQ-9) and 7-item generalised anxiety disorder scale (GAD-7) as routine tools used in clinical practice to measure mental health. Pranckeviciene et al. (2022) believe the PHQ-9 and GAD-7 assessment has sufficient psychometric properties, however, due to reduced specificity and high ‘false positive’ values, it’s clinical value as a diagnostic tool is limited. They support their uses as an initial screening tool to recognise individuals with increased mental disorders, which is how the tool is used within OH.

According to Baral and Kaphle (2023) there is a requirement to

pay proper attention to factors including smoking, alcohol use, and physical activity, to improve the health of menopausal women and this is supported by Ezzatvar et al. (2021) who also demonstrated that lifestyle factors can influence workability.

During the consultation, lifestyle was discussed, and guidance was given to support Janis’ wellbeing. Exercise and nutrition are of utmost importance due to menopause-related health problems including osteoporosis, weight gain and cardiovascular disease. Declining levels of oestrogen levels during menopause, result in quicker absorption of bone minerals and can reduce bone density. Regular exercise can slow the loss of muscle mass, common during ageing, reducing risks of fractures from falls, a risk which is increased with a reduction in bone minerals.

Lower levels of oestrogen can increase the risk of heart disease, and exercise can support heart health by controlling blood pressure and maintaining cholesterol. Exercise also plays a key role in supporting mental wellness, by reducing stress, increasing energy levels and motivation, and providing a general lift in mood.

Eating a healthy diet, combined with regular exercise, can help to reduce menopausal symptoms. Smoking can increase the severity and frequency of hot flushes, cardiovascular disease, osteoporosis and alcohol use is linked to appetite stimulation, weight gain, and disrupted sleep.

Sleep and awake times, regulated by hormones can be disrupted, therefore adopting regular bedtimes and wake-up times creates a consistent bedtime routine.

Janis was signposted to a resource pack for menopause which I had developed (see appendix) and advised to discuss the

outcomes from the OH review along with the completed MRS with her GP. It is common for OH to encourage individuals to share the OH report with their GP as that helps to close the triangle of care.

Potential adjustments were discussed with Janis, to support sustained attendance at work. These included flexible working, the ability to adopt comfort breaks when she felt her symptoms were affecting her significantly, time off to attend medical appointments, managerial support through regular one-to-ones, reducing her workload to account for the impact of her symptoms, and use of the Wellness Action Plan (WAP) to identify triggers to mental ill-health, and strategies to manage this, as far as practicable.

WAPs are evidence-based (Peterson et al. (2021) and provide a structured approach to managing mental ill-health and can support employee retention. A small study (Onley and Emery-Flores, 2017) identified that WAPs provide a positive attitude to recovery by promoting hopefulness, awareness of early warning signs and triggers, and a plan for dealing with symptoms. WAPs support employees to take ownership of their symptoms, enabling accountability for health by increasing insight.

Research indicates that one in ten employed women leave their jobs during menopause due to the severity of their symptoms (The Fawcett Society, 2022). 44% of women identified that reduced concentration, confidence, memory, and hot flushes had affected their work and led to reduced job satisfaction, lower productivity, and time management issues. The Health and Safety at Work etc. Act (1974) identifies the employer's responsibility for the health and safety of all staff. For employees affected by

menopause, this includes ensuring their symptoms are not made worse by the workplace and making changes to support employees in managing their symptoms whilst conducting their working role (Faculty of Occupational Medicine (FOM) 2016; ACAS, 2022).

A risk assessment to address workplace influences that exacerbate symptoms could include temperature and ventilation of the workplace, the material and fit of any required uniforms; suitable areas to rest such as access to a quiet room; ease of access to toilet facilities; availability of cold drinking water and managerial and supervisorial training on health and safety issues relating to menopause.

Better working environments are linked with better health. Establishing interventions that create a systematic approach to support the employee and improve workplace design, organisation, and workplace management is important (Society of Occupational Medicine, 2023). By instilling preventative interventions, the employer can identify and remove or reduce the effects of the potential risk of exacerbating symptoms. Supportive and restorative interventions for the employee facilitate self-care and empowerment, mitigate the effects of poor working environments, and focus on rehabilitation for workers struggling with their mental health and so embrace a systematic and holistic approach.

Menopause is not a protected characteristic within the Equality Act (2010) however, there is the potential to fall within a combination of the protected characteristics; age, sex and disability. Cases such as Best v Embark on Raw Ltd, Rooney v Leicester City Council and Lynskey v Direct Line demonstrate the possibility of being considered disabled within the Equality Act (2010).

Several very influential bodies provide advice on the menopause. The Government (2022) acknowledge the significant impact menopause can have on physical and mental health, workplace participation and personal relationships. ACAS (2022) recommendations include offering employee assistance programmes (EAP), menopause “champions”, developing a menopause policy, raising awareness and other practical workplace adjustments.

Regular conversations to understand employee needs are advised alongside consideration of how the employee's job and associated responsibilities can pose challenges when dealing with menopausal symptoms. In Janis’ case, for example, long shifts and being unable to access facilities regularly were problematic. Developing training can empower managers to feel more confident to talk with employees about menopausal effects on work and provide a level of understanding of how the law relates to menopause.

The involvement of OH can assist the employee to better understand and manage their own health. The use of well-validated assessment tools, signposting to relevant resources, support and provision of advice can empower individuals to become an expert patient. Advice employers receive on how the health of their employees can affect their work, how work can impact them and what support could help, can be an invaluable insight and tool in people management. OH can help improve employee relations and understanding which in turn improves morale. OH sits in a vital and honoured role, making a difference.

Menopause

Website Resources

Women’s Health Concern (WHC)

Menopause Matters

The Daisy Network

The British Menopause Society (BMS)

Queer Menopause Resources

Books

Kate Muir (2022)

Dr Louise Newson (2021)

Davina McCall with Dr Naomi Potter (2022)

Provides a confidential, independent service to advise,

An independent website providing information about during and after menopause, what the consequences

A charity for women with premature ovarian insufficiency

A specialist authority for menopause and post reproductive on menopause and all aspects of post reproductive health.

A group of queer, trans and non-binary folks working stream menopause education and information.

Davina McCall with Dr Naomi Potter

Preparing for the Perimenopause and Menopause

Menopausing: the positive roadmap to your second Work

Support

NHS England

A guide for NHS organisations, line managers and those Supporting our NHS people through menopause: guidance

ACAS Managing Menopause at Work

FOM

Factsheets

NICE

Guidance on menopause and workplace links: http://www.fom.ac.uk/wp-content/uploads/Guidance

https://www.nice.org.uk/guidance/ng23 (expected publication

NICE https://www.nice.org.uk/news/article/nice-sets-out-

WHO https://www.who.int/news-room/fact-sheets/detail/menopause

Rachel Martin | Linkedin

Rachel Martin is an RGN, qualifying in 2007. She moved into remained. She values the knowledge and skills gained within gained a first. She is passionate about health promotion, effects of work on health and health on work. Caring, compassionate her toes and she enjoys dog walks. Rachel is a strong believer

Description

advise, inform and reassure women about their gynaecological, sexual, and post-reproductive health about menopause, menopausal symptoms, and treatment options. Includes information on what happens leading up to, consequences can be, what you can do to help and what treatments are available. insufficiency (POI) causing early menopause. reproductive health in the UK educating and guiding healthcare professionals, working in both primary and secondary care, health.’

working to make menopause resources more inclusive and relevant to LGBTQIA+ people, who are generally left out of mainspring

those working in the NHS to understand menopause and support flexible working. guidance for line managers and colleagues content/uploads/Guidance-on-menopause-and-the-workplace-v6.pdf publication updated February 2024) -further-details-on-menopause-guideline-update sheets/detail/menopause

into Occupational Health 3 years ago, joining PAM OH with whom she has within this time along with the support in obtaining her BSc in OH, for which empowerment and knowledge for employees and employers regarding the compassionate and hardworking, she has three young children who keep her on believer that work is good for health!

Progression –

A career in OH series

Part 1

Pivoting Professions: A Sport Physiologist's Path into and up in Occupational Health

By Laura Jordan

Laura Jordan is Commercial Director at PAM Wellness, part of PAM Group, and has chartered a remarkable trajectory within the workplace health and wellbeing industry. From beginning a role in professional sport, to her current position as trailblazer in the wellbeing industry, Laura’s journey is one of determination and unwavering commitment to improving employee health and wellbeing and showcases how a degree in Sports Science can land you in Occupational Health!

The Early Years: Building Foundations

Fresh out of the University of Chester, and armed with a master’s degree in Sports Physiology, I started my journey by volunteering as an Assistant Sport Scientist with the England Handball Association, supporting young and upcoming athletes…far from the world of Occupational Health! Initially, I thought that I would have a career within professional sport, so I spent three years working with the England Handball squad, alongside two years supporting rugby league team, Warrington Wolves. I volunteered during both my undergraduate and post-graduate studying and I honed my skills as an applied practitioner and

completed an Accreditation with the British Association of Sport and Exercise Sciences in Physiological Support and became a Chartered Scientist. These experiences were a pivotal time, laying the foundation for future endeavours in the field.

Top tip: I was fortunate that I had a lot of applied experiences available to me during my studies. For me, it was important that I could apply the theory that I had been taught to different athletes; so, for anyone currently studying, my top tip would be to get as much experience as you can under your belt. Say yes to opportunities you’re presented with, certainly at the start of your career even if it does sidestep into a different field!

Swapping Sports Jersey’s for Stethoscopes

In May 2014, I joined Nuffield Health, a leading name in the health and wellbeing industry, and began applying my practical skills from university by delivering health screening, workshops and health promotion events, as a Health & Wellbeing Physiologist. I changed direction from sport to public health after seeing a job advert for a Physiologist and decided to try my hand with the ‘general population’. Here, I completed a Level 7 Advanced Professional Diploma in Health & Wellbeing Physiology; learnt how to conduct and read electrocardiograms; discovered how to run a pathology laboratory and conduct in-house testing, and became familiar with audits with the Care Quality Commission (CQC). Working alongside Health Assessment Doctor’s and GPs was a great privilege in understanding corporate health and wellbeing, and allowed me to support one of the UK’s supermarket giants with their provision of health and wellbeing support for colleagues.

Rising Through the Ranks at PAM Wellness

After two and a half years with Nuffield, I joined PAM Wellness, part of PAM Group, known for its holistic approach to complete occupational health (OH) and wellbeing provision. I joined the business in a team of two, and a Health & Wellness Expert covering the South of England and support PAM’s clients with proactive health and wellbeing support which included delivering workshops, webinars, and health screening. This was my first time working with a multidisciplinary occupational health team… in fact, my first time working in occupational health at all! It was interesting to learn about workplace health and the role of OHA’s (Advisors), OHN’s (Nurses), OHT’s (Technicians) and OHP’s (physicians), but to also begin shaping how OH and physiology could work together. As a Physiologist, we’re skilled in screening to determine one’s health and wellbeing status, but then trained in motivational interviewing and lifestyle prescription

i.e. how can we support someone’s health and return to work through their nutrition, physical activity, stress management and sleep hygiene, to name but a few, whilst still trying to reduce disease risk and improve overall health. Often, the role of a health and wellbeing physiologist within occupational health can be overlooked, but our focus is on prevention rather than cure, and aiding employees with the tools to take ownership of their health, through their lifestyle so there truly is a place for this role within the realms of occupational health. Employee health is so much more impactful when it’s viewed from all angles and by working closely with colleagues across multiple disciplines including occupational health, as well as psychological services, employee assistance programmes and neurodiversity solutions.

Innovation and Impact

One of the hallmarks of my career with PAM Wellness has been the agility and freedom to be creative and innovative with wellness programming, and being able to champion strategies that are not just aimed at improving physical fitness, but also mental wellbeing and stress management.

1. Projects: One of my favourite projects has been developing, training and embedding Mental Health Champions for a Government Department – over 1200 Champions were trained when this project was rolled out in 2018 -2020, starting in the Northeast, and then being widely recognised across England.

2. Awards: In 2022, the our Wellness Team at PAM achieved the ‘Wellbeing Initiative of the Year’ Workplace Saving & Benefits Award for the implementation of DNA and epigenetics screening. This advanced testing allowed the team and I to take health screening one step further by truly analysing the blueprint of employee health by assessing their biological versus their chronological age, and addressing how the environment and individual’s lifestyle can change our DNA. This could also be an

exciting development and the next frontier in occupational health and wellbeing.

3. Speaking: I also enjoy presenting and delivering webinars for PAM Wellness and PAM Group, both single-handedly and with other disciplines to showcase the efficacy of health and wellbeing physiology more widely across the industry. Most recent examples include:

a. A framework for upskilling managers to support wellbeing with Janet O’Neill (PAM Occupational Health);

b. Reducing the impact of ‘toxic masculinity’ on men’s health with Kathy Cox (PAM Occupational Health), Janet O’Neill (PAM Occupational Health) and Lisa Allan (PAM Occupational Health);

c. The Stress-DNA Connection: the Link Between Stress and Our Genetic Makeup

Mentoring the Next Generation of Health & Wellness Experts

Beyond my personal achievements, I am deeply committed to nurturing talent within the organisation and supporting other Physiologists with a career in Occupational Health. PAM Wellness started as a Team of two, and now has 20 clinicians

in Corporate Health with wider colleagues in psychological and neurodiversity solution business units.

Following a successful internal training course, I have recently started implementing the PAM Elevate Programme – a career pathway designed to attract, retain, and grow PAM’s people right across the business, and help them not only progress within their own roles, but understand how they can grow within other disciplines. I truly believe that if you look after your employees, they’ll look after your clients (thanks for the quote, Richard Branson!), so this programme aims to show a genuine commitment to supporting employees reach their full potential and excel in their own roles.

In conclusion, I’ve been fortunate to land a career at PAM Wellness and showcase how physiology and occupational health can genuinely make a difference to employee health and drive proactive workplace wellbeing. When passionate people from different disciplines collide their expertise and passion, great things happen in the space of employee wellbeing!

Laura Jordan is Commercial Director of PAM Wellness, BASES Physiologist; Chartered Scientist; FRSPH with many years of experience in the world of Occupational Health and Wellbeing.

Laura Jordan | Linkedin

Promoting Health as an Occupational Health Practitioner at the RGU

By Lynda M Bruce

Like many OHP (Occupational Health Practitioners), I have been educated to look for opportunities to offer health promotion to clients. But while in my professional practice I have had many opportunities to offer health promoting information and activities on a one-to-one basis there have been few opportunities to practice this on a grand scale.

I started my training in Occupational Health in 1985 and our main text at that time spoke about Health Education as being defined as educating the employee, employer, and trade unions in all aspects of health, to enable each to protect their colleagues optimum physical and mental wellbeing and to ensure a safe

working environment (Slaney, 1985) . Nearly 30 years later maybe the main change is the name.

I also have a part-time role as a lecturer in Occupational Health in the School of Nursing, Midwifery and Paramedic Practice at RGU (Robert Gordon University). RGU is in Aberdeen and has 16,500 students. In the summer of 2023 the Dean, Professor Susan Dawkes offered me the opportunity to increase my hours by one day a week to follow-up and develop well-being health-promoting activities to support the wider healthy university initiatives. This article is about these events

and the benefits derived from such activities.

We selected health promoting topics and offered them to our students, staff and contractors and other people visiting the campus including residents in the local community. We decided to deliver the topics on campus utilising the skills of our students, supervised, and facilitated by academic staff who are also qualified healthcare professionals.

Nursing students have the added benefit of being able to achieve recorded practice hours for the time spent learning about the health promoting topic and then supporting the activities. All student volunteers can log their hours annually with the RGU (Robert Gordon

ensuring success.

September

University) student’s union and the hours are then logged onto their HEAR (Higher Education Report) records which allows future employers to see the added extracurricular activities to which they have contributed. The students can also print off a certificate as proof of volunteering which is useful as a supporting document within their résumé.

The students have enjoyed taking part in the events and their feedback has been positive and joyful saying their wish to contribute further. We have been well supported by the Students Union, Grampian NHS resources, the NHS Grampian Public Health Team and RGU Sport. The active help, support and encouragement from the Dean and other staff members has been magnificent

World Heart Day-teaching CPR and Choking first aid as well as using a static bike from RGU Sport for a riding challenge. The footfall was high- about eight hundred people and we had prizes donated by the British Heart Foundation for the winners of our competitions in two categories-most effective at CPR, and how far can you travel in five minutes on the static bike.

October Sexual Health event where we issued a lot of advice and information as well as free condoms and other gifts and we achieved a footfall of around one thousand.

November

November

Book Harvest - a fabulous scheme where our academic staff donate books (no longer needed) to a local charity who come on site for a day to collect and then redistribute the textbooks to our students and then donate the remaining books to overseas charities. In 2023 the remaining books were scheduled to go to the libraries of Sri Lanka but in addition some nine hundred books were issued to students who were passing by.

Blood borne virus testing - seven nursing students supported two NHS Public Health nurses and we collected samples of blood from ninety-three candidates who elected to be tested. For interest there were twenty new HIV diagnoses in Grampian in 2023 (compared to 14 in 2022). As part of our on-site testing process some Hep B core antibody positives were found which then needed further investigation. Clearly early identification and treatment is beneficial.

December

March

Planned next

Alcohol Awareness event -This was a pre-Christmas event designed to ensure that all attendees could enjoy safe Christmas outings. The students Union gave us drink spiker test cards to distribute and the local Health Promotion unit lent us Beer Goggles-which change your view of the world completely and make walking a straight line impossible! We had fun and a footfall of 200-300.

Sleep Friendly Campus- we were incredibly lucky that a local furniture company delivered a lovely comfortable bed for the day with two advisers. Many people got advice about the best bed to have, and we also issued advice and resources around effective sleeping and good exercise. We distributed walking/cycling maps of the local areas. The footfall was about six hundred.

Wellbeing event-Students to see other students, staff, contractors, and site visitors for mini health check including blood pressure and other measurements with referral to GP (General Practitioner) if needed.

I can honestly say I have thoroughly enjoyed the activities. The response from the students has been inspirational. The students have told me how much they have appreciated the events and how it has helped their confidence and their ability to engage in the challenges that come with ongoing practice. My colleagues have been supportive and generous with their time and have enjoyed a different sort of interaction with the students. I would recommend these types of activities to any OHP in any work area as an opportunity to promote our values and engender good feelings in all. I would be happy to provide further information or detail if this would help anyone.

References

Slaney, B. (1985) Occupational Health Nursing. Croom Helm

Lynda M Bruce

RN, Specialist Community Public Health NurseOccupational Health Fellow of Royal Society of Public Health Associate Fellow of the Higher Education Academy: PR100918. NMC (Nursing and Midwifery Council) Pin Number: 70l4237E

Upcoming

Lynda M Bruce

The Interview

Feature Interview with Tracy Turner

iOH Director of Professional Development, Janet O’Neill, caught up with Tracy Turner to find out about her journey into an independent OH business owner.

How did you land in OH?

After my nurse training in 1981, I worked in theatres, A&E, and ITU. The demanding schedule of night shifts did not fit well with my responsibilities as a mother and therefore I looked for an alternate role. Occupational Health (OH) seemed a good fit and I started a role in the NHS in 2006. I wanted to undertake the Specialist Community Public Health Nurse certification (SCPHN) in OH but there wasn’t an option for funding. A move to a private OH company offered a higher salary therefore enabling me to self-fund the University of the West of Scotland course.

How tough was the course?

At that time, it was 18 months long and included double modules in the second year. Studying was challenging,

alongside work and mothering duties. I was delighted when I completed the course with a distinction in 2009.

How did the curse help you?

Once qualified, I was presented with numerous opportunities for exciting roles and was able to gain a diverse range of knowledge and experience.

What made you take the plunge as an independent practitioner?

I was working in a senior leadership position at a large occupational health company. The extensive travel and long hours were taking a toll on my wellbeing. As a result, I decided to retire.

However, after a week, I realised I still had a passion for working and wanted to continue gaining knowledge and

experience, which led to registering my own Tracy Turner Ltd. Company. I had the freedom to choose my own projects and work on my own terms. This allowed me to thrive and find fulfilment in my career once again.

How did you go about setting up independently?

I built relationships with colleagues on Face Book, LinkedIn, and other OH companies. I joined iOH and the Society of Occupational Health Medicine (SOM) to help with networking. By taking on contracted work for other OH companies, I gained experience in different ways of working and expanded my skills. This enabled me to find her unique way of working, which I believe has led to the growth and success of the business.

Any snags along the way

We have faced some real challenges such as a scam, a costly refurbishment, and the Covid pandemic, but we overcome them with IT investment, resilience, and innovation which have paid off.

How has the business grown?

At the initial stages, investing in a website and advertising services via LinkedIn helped me to attract clients. As our clients grew, so did the need for me to deliver new services. First substance abuse testing, which enabled me to bring my son into the business, and then the need to carry out safety-critical health assessments. This meant investing in office space! Having a physical office provided a more professional image to clients and allowed for face-to-face meetings,

which helped to build trust and strong relationships.

Following Covid, we began to further expand and diversify our services. My son’s training in ear wax micro suction and foot care has allowed us to offer these services to the community and I now employ my daughter-in-law too. We have since changed the business name from Tracy Turner Ltd to Turners' Occupational Health. Increasing work led to the need for an administration team and business administration apprenticeships and for one, a promotion.

To meet demand, we employed and funded the training of an OH technician and DSE Assessor. We have expanded our OH team with a SCPHN-qualified and a diploma-qualified nurse. More recently we have employed a clinician who we are supporting through the back to nursing course. It is a great feeling to be able to support our employees to grow and develop.

In February 2024, we obtained the prestigious SEQOHS (Safe Effective Quality Occupational Health Service) accreditation. It has ensured policies are in place to provide a professional and supportive environment for both staff and clients.

What are your next steps?

We are moving to larger premises and plan to increase our range of services to Mental Health First Aid (MHFA) training, Emergency First Aid, counselling, and physiotherapy. A far greater offering to our clients and community.

What have you learnt?

By diversifying services, employing, and training new staff, and obtaining the prestigious SEQOHS accreditation I have learned the importance of investing in and taking care of staff, training and keeping up with evidence-based practice, and prioritising working with local businesses.

Retirement is in the distant future, and I look forward to seeing how the Turners Team evolves in the coming years.

Tracy Turner | Linkedin

Tracy is Clinical Director and Business Owner of Turners Occupational Health. She commenced her nursing career in 1981 working in theatres, ITU and A&E before specialising in Occupational Health in 2009 gaining a degree in Specialist Community Public Nursing. She has since completed training to teach Mental Health First Aid and has a certificate in Occupational Health Law.