DELEGATES DEBATE HOT OH ISSUES

In a debate, delegates and speakers discussed the role of OH technicians, OH education, tax incentives for employers who provide OH services, and sickness certification.

* OH technicians: Given that healthcare assistants are now doing vaccination administration in general practice, should OH practitioners now be delegating some procedures to OH technicians?

Cynthia Atwell, chair of SOHN, said: "There is no problem with this in principle. We can't do it all ourselves. Our role is to interpret the results. Providing they are properly trained, there are no limitations…There might need to be a supervising nurse trained in anaphylactic treatment…It's got to be a way forward."

David Maslen-Jones, member of the Nursing and Midwifery Council (NMC), added that there were moves to have healthcare assistants regulated, and that it is almost as if a second tier of nurse is being developed

* OH education: OH nurses could be missing out on training for core skills, such as dealing with hand arm vibration syndrome, or lung function testing.

Anne Harriss, OH course director, London South Bank University, said there was not the capacity to provide specialist training in such areas.

Atwell questioned whether the current OH curricula were fit for purpose. "What is that [fit for purpose]? The NMC says we've got to educate nurses to degree level, but are we really looking at the skills nurses need to undertake the work? It needs a review. All of OH need to get involved, including the NMC and the universities."

Maslen-Jones said the NMC "had no understanding of what OH nurses do on a day-to-day basis" before changing the registration of nurses so that OH nurses were listed on the same part of the register as public health nurses. However, he said OH educators had won the battle for an OH pathway in education and development.

* Tax incentives: Should employers get tax incentives for investing in OH?

Bill Gunnyeon, director of health, work and wellbeing at the Department for Work and Pensions, said: "The DWP has suggested to the Treasury that this is an area worth looking at."

The key issue for the Treasury is to ensure that employers are not given tax breaks for providing private medical insurance that they would have given anyway. Gunnyeon said the £10m sum announced for NHS Plus in November 2006 was to be used on a loan basis to encourage the NHS to invest in better OH services for small businesses.

Professor Dame Carol Black argued that there was a bigger issue for small firms which could go out of business if they had a major OH problem.

* GP sicknotes: Should the link between sickness certification and statutory sick pay be severed so that there is less reliance on GP sicknotes?

Gunnyeon argued that staff would still need to see their GP whatever the relationship to sick pay. Harriss said problems included lack of understanding of work processes among GPs, and disincentives for GPs to refuse a sicknote, including their role as patient advocate and the risk of being threatened or attacked by patients. Atwell said Unions were suspicious of reforms to sick notes and lawyers might encourage staff to take extra time off work to win tribunal claims.