EDITORIAL |
The Health at Work Handbook
The Health and Safety Commission report on Health and Safety Statistics for 2004–05 indicates that 2 million people self-reported that they were suffering from ill-health which they thought was work-related and 576 000 of these were new cases in the last 12 months [1]. Of these, 2 million people just over half have musculoskeletal conditions, 509 000 have stress, depression or anxiety, 137 000 breathing or lung problems and 74 000 hearing problems. In addition, 35 million working days were lost of which 28 million was considered due to ill-health. Against this, each year between 2002 and 2004, an estimated 23 000 new cases of occupational or work-reported illness were seen by disease specialist doctors and occupational physicians who reported to the THOR surveillance scheme.
We also know that there are 2.7 million people on incapacity benefits which equates to 7.5% of the working age population. The main diagnosis causing inability to work is a mental health/behavioural disorder in 39% of people and musculoskeletal conditions in 
25% [2]. Despite the amount of self-reported work-related illness noted above, it is known that ‘worklessness’ (being unemployed or economically inactive and in receipt of working age benefits) causes poor health and health inequality [3]. There is strong evidence that being employed is associated with improved well-being and so returning to work following a period of prolonged ill-health is a desirable aim.
These statistics suggest that work-related ill-health is possibly grossly under recognized and that the majority of people who self-report ill-health they think is work-related do not have contact with specialists or occupational physicians. If they are in contact with health services it is likely to be members of the primary care team including their general practitioners. Given the paucity of academic centres of occupational medicine in the United Kingdom it is likely that the majority of general practitioners have not had undergraduate training in occupational medicine. Furthermore, poor communication between health professionals has been identified as a barrier to rehabilitation [3].
It is against this background that The Health and Work Handbook [4] has been published with contributors from the Society of Occupational Medicine, the Faculty of Occupational Medicine and the Royal College of General Practitioners. The intention of the handbook is clearly stated in the sub-title ‘Patient care and occupational health: a partnership guide for primary care and occupational health teams’. The handbook is an important addition to the information available to both occupational health and primary care teams. The handbook clearly defines the respective roles, responsibilities and ethical considerations relevant to both teams. It describes a best practice of communication between both teams and may go some of the way to achieving the interaction suggested by Beaumont [5] to achieve better rehabilitation for work. The handbook also describes how a general practitioner can use medical certification to communicate with an employer and work with occupational health to support rehabilitation of those on sick leave.
The advice provided for communicating with an employer who has written directly to a general practitioner for advice is especially helpful in considering the ethical requirements not to disclose clinical information without informed consent. This is vital as the majority of those employed in the United Kingdom do not have access to specialist occupational health advice. As such, requests from non-clinical employer representatives (such as human resources or health and safety advisers) for information should avoid clinical information that can only be understood and interpreted by a clinical member of an occupational health team but could be misinterpreted by others. The handbook includes useful information on sources of advice and support and suggests learning activities that would benefit general practitioners and occupational physicians and their respective teams. The information included in the handbook will also be of interest to other medical specialists as it can be adapted to the secondary care situation.
We hope that The Health and Work Handbook is used for the benefit of patients and the improvement in partnership working between primary care and occupational health teams. The handbook is available for download at the websites of the respective organizations and as an electronic appendix to this editorial at Occupational Medicine Online [6–9].
President
Immediate Past-President
e-mail: Eugene.Waclawski{at}renver-pct.scot.nhs.uk
References
- Health and Safety Commission. Health and Safety Statistics 2004/05. London: HSE Books, 2005.
- Department of Work and Pensions Press Release. DWP Supports Doctors in Helping People Back to Work. 8 September 2005.
- Sawney P, Challenor J. Poor communication between health professionals is a barrier to rehabilitation. Occup Med (Lond) 2003;53:246–248.
- The Health at Work Handbook. Patient Care and Occupational Health: A Partnership Guide for Primary Care and Occupational Health Teams. London: The Faculty of Occupational Medicine, The Royal College of General Practitioners, The Society of Occupational Medicine, 2005.
- Beaumont D. The interaction between general practitioners and occupational health professionals in relation to rehabilitation for work: a Delphi study. Occup Med (Lond) 2003;53:248–252.
- http://www.facoccmed.ac.uk/index.jsp
- http://www.rcgp.org.uk/
- https://www.som.org.uk/
- http://occmed.oxfordjournals.org/
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||