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Occupational Medicine Health Screening

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

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Occupational Medicine Health Screening

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  1. Occupational MedicineHealth Screening How they can help your business Dr Mark Feldman

  2. Who am I ? • Senior partner general practice • Trainer in general practice • Petersfield Screening • Health Screening • Occupational Health • Private General Practice

  3. Who am I ? • Stress lecturing • Hypnotherapy • President of BAMH • Practice • Teaching

  4. Customers • Pharmaceuticals • Aventis Pharma • Martindale • Sanofi Winthrop • Biotechnology • Argenta discovery • Synexis

  5. Customers • Chemistry • Rhodia • Champion Photochemistry • Electrical Generation • Thames power • Finance • Mcartney and Dowie

  6. Customers • Education • Peniel academy • Automotoive • Axial • Agriculture • Embrex • Construction • Noble and Taylor

  7. Occupational MedicineWhat is it? • Interface between work and health • Work affecting employees health • Health affecting employee’s ability to work

  8. 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

  9. Occupational MedicineWhat do we do? • HASAW 1974 • Implies duty to ensure that recruited staff can perform their work

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. Sickness absence • Fair dismissal • conduct • capability or qualifications • Redundancy • Statutory restriction • Some other substantial reason justifying dismissal [ withholding of medical data on PEQ, absenteeism]

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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

  21. Disability Discrimination Act • Requires reasonable adjustments • Size of firm • Amount of resource • Practicality • All employers covered [ except forces ] • All employees – inc temporary, part time

  22. 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 ]

  23. Occupational MedicineWhat is it? • Legislation • RIDDOR [ Reportable diseases] • COSH • European Directives • Disability Discrimination Act • Liaison with / provision of occupational hygiene function

  24. Occupational MedicineWhat is it? • RIDDOR http://www.riddor.gov.uk/info.html deaths· major injuries· accidents resulting in over 3 day injury · diseases· dangerous occurrences. gas incidents

  25. Occupational MedicineWhat is it? • COSHH

  26. Occupational MedicineWhat is it? • COSHH • http://www.coshh-essentials.org.uk/assets/live/indg136.pdf

  27. Occupational MedicineWhat is it? • COSHH

  28. Cases from practice 50 year old phamaceutical inspector with wrist pain 28 yr old secretary with CFS 38 yr old woman with Bradford factor of 1000

  29. Occupational MedicineWho do you need? • Competent person • As defined by Employment Medical Advisory Service of HSE • Diploma in Occupational Medicine

  30. Disease Prevention • Health Screening • Full History and examination • Blood pressure • Exercise stress ECG +cardiac risk assessment • Liver function tests • Renal function tests • Thyroid • Diabetes

  31. Health Screening • Visual acuity • Glaucoma check – commonest cause of blindness • Grip strength • Hearing • Prostate Specific Antigen for carcinoma prostate

  32. Health Screening • Lung function tests • Cervical Smear • Mammography • Aortic aneurysm > 55 yrs

  33. Health Screening • Faecal Occult blood if family history bowel cancer • Skin cancers

  34. 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

  35. Why Petersfield Screening • Better reporting • All of the tests • Thyroid • Exercise stress testing • Abdominal ultrasound • OKP • Follow through • Ongoing support

  36. The END Dr Mark Feldman Petersfield Screening

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