How has Covid-19 has changed OH practice?
In March 2020, like most health professionals, I had to adapt my practice overnight. Training moved from face to face to online delivery as Trusts were unable to release delegates to attend in person and were inundated with health declarations. I found myself poring over the emerging COVID-19 pandemic data and information to update the remaining courses to address and incorporate the immediate changes to operating procedures and clinical decision-making.
I joined the NHS COVID response to assess and interpret the emerging evidence and develop Occupational Health (OH) policies, protocols and procedures to protect and support the NHS and the SME employers I advise.
What have I learnt?
I don’t think anything could have prepared or trained me better for evidence-based practice than the last 22 months. OH has never had a higher profile, nor a greater challenge. We’ve had to adapt very quickly. This has led to the early adoption of a multidisciplinary team approach and the expansion of OH.
As a fellow member of iOH, I’ve been privileged to be able to share observations and learnings from emerging evidence and to participate in the joined-up thinking and innovation that has been taking place across our professional networks.
We continue to see unprecedented demand for occupational health risk assessment to identify and recommend:
- Health Protection arrangements to:
- reduce vulnerabilities and impairments affecting or affected by work
- improve COVID vaccine confidence through informed discussion of the WHO vaccine tracker
- Health Education as part of supportive and therapeutic consultations plus case management and rehabilitation for those unable to manage their symptoms or treatment effectively
Health Promotion through wellbeing advice to access lifestyle and health interventions in an accessible and timely manner
Health Information to enable individuals to understand and manage their health risks effectively
OH Advice to help individuals and their managers to consider reasonable adjustments and arrangements
COVID has led to several changes in the way public health is governed. The new agencies are listed below:
COVID-19 in the UK: The official UK government website for data and insights on coronavirus (COVID-19).
Health improvement and disparities: Break the link between community and ill-health
The ALAMA COVID age tool is one of the most ground-breaking applications of emerging data and innovations with life-saving potential since Ramazzini quantified the relationship between workers and lung disease. The Medical risk assessment is undertaken alongside the UK regional prevalence tool.
The guidance for people previously considered as clinically extremely vulnerable is also useful.
Their work has inspired me to develop a vulnerable worker risk reduction assessment and checklist that can be saved as a portable PDF on any worker’s phone or imported into a reasonable adjustment passport, applying these learnings and capitalising on increased employer awareness of risk assessment.
This government tool, Health impact assessment, is a practical approach used to judge the potential health effects of a policy, programme or project on a population. This is useful if your organisation is bringing in or has brought in any new or revised policies on COVID 19.
Rehabilitation assessment and monitoring tools
WHO advises that “These patient assessment measures were developed to be administered at the initial patient interview and to monitor treatment progress. They should be used in research and evaluation as potentially useful tools to enhance clinical decision-making and not as the sole basis for making a clinical diagnosis.2
 Ahran, T., Karwowski, W. Evaluation and prevention of work-related musculoskeletal disorders in Hungary. (2012). Advances In Physical Ergonomics And Safety, 209-216. doi: 10.1201/b12323-27
 WHODAS 2.0 (World Health Organization Disability Assessment Schedule 2.0): 36-item version, self-administered © World Health Organization, 2012. Measuring health and disability: manual for WHO Disability Assessment Schedule (WHODAS 2.0), World Health Organization, 2010, Geneva.
 Hill, J., Kang, S., Benedetto, E., Myers, H., Blackburn, S., & Smith, S. et al. (2016). Development and initial cohort validation of the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open, 6(8), e012331. doi: 10.1136/bmjopen-2016-012331