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 MedicineWhat is it? Interface between work and health

Work affecting employees health

Health affecting employee’s ability to work

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

Occupational MedicineWhat do we do?

HASAW 1974 Implies duty to ensure that recruited staff can

perform their work

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

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

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

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

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

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 MedicineWhat is it? Legislation

RIDDOR [ Reportable diseases]

COSH

European Directives

Disability Discrimination Act

Liaison with / provision of occupational hygiene function

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

Occupational MedicineWhat is it?

COSHH

Occupational MedicineWhat is it?

COSHH

http://www.coshh-

essentials.org.uk/

assets/live/

indg136.pdf

Occupational MedicineWhat is it?

COSHH

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

Occupational MedicineWho 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 FeldmanPetersfield Screening