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The personal communication from Dr Verow referred to the relative cost of a much more comprehensive service than the one we evaluated, i.e. cost comparisons would not be comparing like with like, but the letter usefully gives more detail about how much more comprehensive the Sandwell service is. The evaluation and the previous needs assessment upon which the London service was based, identified ‘advice on health and safety law’ as a priority for service users. As our service was limited to one session a week of consultant time, this need was covered through the inclusion of telephone advice. I agree that there may be better ways of covering this, where resources allow, such as the provision of a health and safety professional as part of a more comprehensive service. Benchmarking would highlight such disparities and guide best practice.
Occupational Health Unit, Royal Free Hospital
e-mail: paul.grime{at}royalfree.nhs.uk
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