Transcript Occupational Medicine Health Screening

Occupational Medicine
Health Screening
How they can help your business
Dr Mark Feldman
Who am I ?
 Senior partner general practice
 Trainer in general practice
 Petersfield Screening
 Health Screening
 Occupational Health
 Private General Practice
Who am I ?
 Stress lecturing
 Hypnotherapy
– President of BAMH
– Practice
– Teaching
Customers
 Pharmaceuticals
– Aventis Pharma
– Martindale
– Sanofi Winthrop
 Biotechnology
– Argenta discovery
– Synexis
Customers
 Chemistry
– Rhodia
– Champion Photochemistry
 Electrical Generation
– Thames power
 Finance
– Mcartney and Dowie
Customers
 Education
– Peniel academy
 Automotoive
– Axial
 Agriculture
– Embrex
 Construction
– Noble and Taylor
Occupational Medicine
What is it?
 Interface between work and health
– Work affecting employees health
– Health affecting employee’s ability to work
Occupational Medicine
What do we do?
 Pre employment questionnaires
– To assess suitability for job
 Pre employment examination
– Key workers
– Basis for ongoing screening if required
 Medical assessments
– If at risk ie exposure noise, toxins, mechanical
stress
Occupational Medicine
What do we do?
 HASAW 1974
– Implies duty to ensure that recruited staff can
perform their work
Occupational Medicine
What do we do?
 Review of specific medical problems
– How they affect work
– Second opinion
 Referal
– NHS
– Private
 Expediting treatment
– Advice to management
 Capability
 Capacity
– Physical
– Psychological
Occupational Medicine
What is it?
 Management of sickness absence
– 40% of employers believe some of their workers
absence is malingering
– 27% of small businesses have a problem
Occupational Medicine
What is it?
 Management of sickness absence
 10% of workers take > 7 days per yr
 9.5% of these take more than 1 episode of 7 days
 Bosses average 3.3 dys per year
 Workers average 10 days per year
– Most small companies loose on average 31
days due to dubious sickness absence
Occupational Medicine
What is it?
 Management of sickness absence
– Bradford factor
 100 Warn
 140 SSP
– Clear policies
– Early intervention
– Liaison with the NHS
– Making it happen
– Rehabilitation
Occupational Medicine
What is it?
 Management of sickness absence
– Different from GP
 Quicker back to work
– Knowledge of job
– Knowledge of company requirements
– Knowledge of other work that could be done
Sickness absence
 Fair dismissal
– conduct
– capability or qualifications
– Redundancy
– Statutory restriction
– Some other substantial reason justifying dismissal [
withholding of medical data on PEQ, absenteeism]
Sickness absence
 Fair dismissal
– Capability
– Evidence of ill health – from Occ physician
 Date of return to work
 Any residual problems
 Permanent or temporary
 Will employee render regular efficient service
Sickness absence
 Fair dismissal
– Can disagree with GP if
 Patient has been examined
 Clear report
 Risk to others if stay in employment
 Specialist report sought if seen consultant
Sickness absence
 Fair dismissal if in
– Absenteeism [ frequent short absences ]
 Absence records accurate, assessed, investigated
 Warnings given sympathetically, problems looked for
 OP opinion taken
 Employee hearing given
Disability Discrimination Act
 May not discriminate on grounds of disability
– Long term > 12 months physical or mental problem , substantial
affect on ability to carry out normal day to day activities
– Make reasonable adjustments to workplace
– BUT can refuse to employ if discrimination is ‘ material to the
circumstances of the case and substantial ie typist with
Rheumatoid.
Disability Discrimination Act
 Not allowed to discriminate on recruitment
 Includes
– AIDS, MS
– insulin dependant diabetes
 Excludes
– Drugs, alcohol, hay fever, voyeurism
– Tendency to steal and set fires
Disability Discrimination Act
 Requires reasonable adjustments
– Size of firm
– Amount of resource
– Practicality
 All employers covered [ except forces ]
 All employees – inc temporary, part time
Disability Discrimination Act
 Importance of good written policies
– Eg when will dismiss for absence
– Can dismiss if take time off work due to
disability IF would have dismissed anybody who
took a similar time off work [ Disability related
discrimination ]
Occupational Medicine
What is it?
 Legislation
– RIDDOR [ Reportable diseases]
– COSH
– European Directives
– Disability Discrimination Act
 Liaison with / provision of occupational
hygiene function
Occupational Medicine
What is it?

RIDDOR
http://www.riddor.gov.uk/info.html
deaths
· major injuries
· accidents resulting in over 3 day injury
· diseases
· dangerous occurrences
. gas incidents

Occupational Medicine
What is it?
 COSHH
Occupational Medicine
What is it?
 COSHH
 http://www.coshhessentials.org.uk/asset
s/live/indg136.pdf
Occupational Medicine
What is it?
 COSHH
Cases from practice
50 year old phamaceutical inspector with
wrist pain
28 yr old secretary with CFS
38 yr old woman with Bradford factor of 1000
Occupational Medicine
Who do you need?
 Competent person
– As defined by Employment Medical Advisory
Service of HSE
– Diploma in Occupational Medicine
Disease Prevention
 Health Screening
– Full History and examination
– Blood pressure
– Exercise stress ECG +cardiac risk assessment
– Liver function tests
– Renal function tests
– Thyroid
– Diabetes
Health Screening
 Visual acuity
 Glaucoma check – commonest cause of blindness
 Grip strength
 Hearing
 Prostate Specific Antigen for carcinoma prostate
Health Screening
 Lung function tests
 Cervical Smear
 Mammography
 Aortic aneurysm > 55 yrs
Health Screening
 Faecal Occult blood if family history bowel
cancer
 Skin cancers
Cases from practice
 45 yr old man with mole 3x3 cm on R calf
 47 yr old man with glucose of 18mM
 48 yr old man with alcohol problem
 40 yr old woman with abnormal
mammogram
Why Petersfield Screening
 Better reporting
 All of the tests
– Thyroid
– Exercise stress testing
– Abdominal ultrasound
– OKP
 Follow through
 Ongoing support
The END
Dr Mark Feldman
Petersfield Screening