Download - Occupational Medicine Health Screening
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Occupational Medicine
Health Screening
How they can help your business
Dr Mark Feldman
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Who am I ?
Senior partner general practice
Trainer in general practice
Petersfield Screening
Health Screening
Occupational Health
Private General Practice
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Who am I ?
Stress lecturing
Hypnotherapy
President of BAMH
Practice
Teaching
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Customers
Pharmaceuticals
Aventis Pharma
Martindale
Sanofi Winthrop
Biotechnology
Argenta discovery
Synexis
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Customers Chemistry
Rhodia
Champion Photochemistry
Electrical Generation
Thames power
Finance
Mcartney and Dowie
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Customers Education
Peniel academy
Automotoive
Axial
Agriculture
Embrex
Construction
Noble and Taylor
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Occupational MedicineWhat is it? Interface between work and health
Work affecting employees health
Health affecting employee’s ability to work
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Occupational MedicineWhat 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
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Occupational MedicineWhat do we do?
HASAW 1974 Implies duty to ensure that recruited staff can
perform their work
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Occupational MedicineWhat 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
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Occupational MedicineWhat is it? Management of sickness absence
40% of employers believe some of their
workers absence is malingering
27% of small businesses have a problem
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Occupational MedicineWhat 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
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Occupational MedicineWhat is it? Management of sickness absence
Bradford factor 100 Warn 140 SSP
Clear policies
Early intervention
Liaison with the NHS
Making it happen
Rehabilitation
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Occupational MedicineWhat 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
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Sickness absence Fair dismissal
conduct
capability or qualifications
Redundancy
Statutory restriction
Some other substantial reason justifying dismissal
[ withholding of medical data on PEQ, absenteeism]
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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
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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
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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
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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.
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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
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Disability Discrimination Act Requires reasonable adjustments
Size of firm
Amount of resource
Practicality
All employers covered [ except forces ]
All employees – inc temporary, part time
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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 ]
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Occupational MedicineWhat is it? Legislation
RIDDOR [ Reportable diseases]
COSH
European Directives
Disability Discrimination Act
Liaison with / provision of occupational hygiene function
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Occupational MedicineWhat is it?
RIDDORhttp://www.riddor.gov.uk/info.html
deaths
· major injuries
· accidents resulting in over 3 day injury
· diseases
· dangerous occurrences
. gas incidents
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Occupational MedicineWhat is it?
COSHH
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Occupational MedicineWhat is it?
COSHH
http://www.coshh-
essentials.org.uk/
assets/live/
indg136.pdf
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Occupational MedicineWhat is it?
COSHH
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Cases from practice50 year old phamaceutical inspector with
wrist pain
28 yr old secretary with CFS
38 yr old woman with Bradford factor of 1000
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Occupational MedicineWho do you need? Competent person
As defined by Employment Medical Advisory
Service of HSE
Diploma in Occupational Medicine
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Disease Prevention Health Screening
Full History and examination
Blood pressure
Exercise stress ECG +cardiac risk assessment
Liver function tests
Renal function tests
Thyroid
Diabetes
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Health Screening
Visual acuity
Glaucoma check – commonest cause of blindness
Grip strength
Hearing
Prostate Specific Antigen for carcinoma prostate
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Health Screening
Lung function tests
Cervical Smear
Mammography
Aortic aneurysm > 55 yrs
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Health Screening
Faecal Occult blood if family history bowel
cancer
Skin cancers
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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
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Why Petersfield Screening Better reporting All of the tests
Thyroid Exercise stress testing Abdominal ultrasound OKP
Follow through Ongoing support
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The END
Dr Mark FeldmanPetersfield Screening