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Doing the right things to deliver quality

By Mandy Murphy

Published 13 May 2024

Doing the right things to deliver quality

By Mandy Murphy 

When we provide our services to purchasers or commissioners of occupational health (OH), how do they know that we deliver what we say we do? How will they know it’s good enough, for their employees and their business? Or even how does it compare to other services in the industry? After a long career in the speciality these questions still throw up widely varied responses when I ask them.

Employee health and wellbeing is still high on the business continuity agenda. OH is seen as a critical enabler to  supporting this agenda, and even more widely regarded since the pandemic. And now more than ever we need to be able to demonstrate that we are relevant, do what we say we do and deliver value to employers and employees. While the understanding about occupational health as a term is widely accepted these days, there are still gaps in understanding of what we do and how we do it, not helped by a weak evidence base regarding our impact in comparison to other clinical specialities in healthcare.

Provision of OH services in our marketplace has inconsistent approaches and are variable in quality which is why it is crucial to protect the speciality itself and establish strong trust in those who buy in, commission, and use our services.

Since its inception in 2010, the SEQOHS (Safe, Effective, Quality Occupational Health Services) accreditation scheme set out to support services and commissioners alike to plug this gap in quality and articulate what good occupational health service provision looks like. Since its launch, it rapidly became an integral part of the OH landscape and widely regarded and accepted as the recognised standard for the industry.

The scheme has recently been through a major review, with standards and processes for accreditation under the spotlight and revised to meet the evolving needs of the speciality and the employment landscape.  It was quite an undertaking and no stone was left unturned, ensuring that not only are the standards relevant to everybody who delivers OH services (from single handed practitioners to large, multi-site and commercial providers) but it continues to be of value for how the speciality is evolving. A wide number of stakeholders were consulted to consider levels of quality and standards that would be expected of us now. The revised scheme was launched in December 2023 and the changes have been well received so far.

What is the SEQOHS Accreditation Scheme?

Before we talk about some of the changes to the scheme, it might be worth recapping on what the SEQOHS accreditation scheme is and how it works.

SEQOHS stands for Safe, Effective, Quality Occupational Health Service and is the formalrecognition that an OH service has demonstrated its competence to deliver services against the criteria set out in the standards. The standards are a recognised industry standard for the elements it is accrediting.

The standards are categorised into 6 Domains, where domains 1-5 are applicable to everyone who applies. Domain 1 is Governance and Leadership, Domain 2 is Resources and Processes, Domain 3 is Outputs and Outcomes, Domain 4 is Information and Communication and Domain 5 is Quality Assurance and Improvement. Domain 6 is now a sector specific standard with the aim of including specific standards here for different industries, such as NHS which is currently applied in this Domain (6.1).

There are three stages to the process; application and self-assessment against the criteria, review of the evidence submitted and interview process with two trained assessors from the team.

Accreditation is awarded for 5 years, subject to successfully complying with the criteria of the standards, and with an annual submission to confirm continued compliance with the standards. Services may have actions post accreditation which are based on industry best practice, and some are formally congratulated for explementary practices in OH.

What has changed or new with the 2023 SEQOHS Scheme?

Firstly, the review set out to enable all providers to demonstrate that they meet accepted standards of occupational health delivery.  To achieve this, the review focused on the key processes and outputs of OH delivery, removed duplication and strengthened the support and advice offered to OH providers, employers and employees. .

The evidence guide, which supports OH services to know what kind of evidence they might include in their self-assessment, also went through a rigorous overhaul, with involvement of key stakeholders including the NHS and commercial OH providers. It is again set out to support reducing the duplication of effort across the standards and describes examples of suitable evidence to demonstrate fulfilling the criteria of the standards, with links to national standards where appropriate.

Perhaps the biggest development in the scheme is the new focus on outputs and outcomes, most of which can be demonstrated in Domain 3. This provides an opportunity to measure deliverables and so strengthen the evidence base regarding the value and impact of OH.

The criteria in this standard were developed with the evolving needs of the speciality in mind, and involving stakeholders in their development, including the Health and Safety Executive (HSE).  This was particularly so for the new standards 3.1 and 3.2.   For example, there is a focus here on how a service  understands a client’s OH needs and acts as a competent person to assist clients to meet their legal obligations for safe working. 

The emphasis on outputs and outcomes has built on the original standards, enabling accredited providers to move from not only showing that they are doing things right, but that they are doing the right things.

This will bring a lot of benefits to accredited services and commissioners alike.  We can demonstrate that we do what we say we do and add value. It’s removed what might be seen as a  “tick box” approach to standards.  The emphasis now is to show the quality of your service rather than saying ‘we have a policy for that’. If you have a policy or procedure, do you know it’s working? How do you know? Do  you evaluate it? What do you do with the results of that review?  If you find it’s not working, what would you do to rectify it?

The other intended benefit of moving the emphasis towards outputs and outcomes has also had the effect of making the standards more generic. There is no longer a separate format for occupational physiotherapy services and this supports and reflects the multidisciplinary working nature in occupational health.

There is now a specific Domain 6 for specialised OH services, with the first being an NHS standard, 6.1. This was developed in partnership with NHS Health at Work Network and the Growing OH and Wellbeing Together (OHWB) strategy team. It complements the standards in Domains 1-5, with a directed focus on the requirements to deliver specific OH services in healthcare. In the future we may add other specialised OH Service provision to this domain, for example for OH delivery to the Police.

The insider perspective

I worked in the NHS when our service at the time achieved SEQOHS accreditation in 2012. I was on the other side of the accreditation process, gathering and uploading evidence. Achieving accredited status felt like a great accomplishment.  The team felt very proud of being able to prove that services we provided then (and the hard work) for our clients was recognised and meets industry standards – if not exceeding them in places. Not only was the feedback of meeting the standards hugely powerful, but going through the process ourselves gave us the opportunity to look at what we did, benchmark against the standard and propel us to strive forward with our ambitions for OH service delivery.

As someone who has now joined the SEQOHS team, I now have the privilege to see the other side, – behind the scenes if you like. I am regularly impressed by the level of work and intellectual consideration (lots of discussions) that goes in to ensuring the process is responsive to the diverse needs of the organisations who go for accreditation, the care and attention of our assessors who at the heart of it all want services to put their best selves forward and everyone ensuring that safety, effectiveness and quality remains at a level we expect for our speciality.

I make no secret that I have been a cheerleader for SEQOHS Scheme since its inception and now I have been on both sides of the accreditation process, there are four really important factors that this scheme brings to OH.  We don’t often talk about them. For me, they are a reminder of the importance of participation in a quality scheme such as SEQOHS:

  • Relevance – this is a way we can demonstrate that we do what we say we do, we know what matters to our stakeholders, and a commitment to be closely connected and appropriate to the evolving needs of our clients.
  • Reputation – having spent many years delivering OH services at a commercial level and seeing how good quality OH services have been undercut by aggressive cost-cutting bids, this tarnishes the reputation of OH. Building and maintaining a reputation of good quality OH services – that add real value – is more important than ever. Our reputation among purchasers is one thing, but also our reputation in the wider world of healthcare and as a clinical speciality, working to agreed standards gives credibility to our ‘raison d’être’ – why we provide OH.
  • Representation – what we do and how well we do it is a representation of who we are as OH. Using evidence and outcome measures to guide our practice, demonstrating value and competence builds trust that as a speciality we are as good as our word.
  • Recruitment – as we reflect out to the world, like a mirror, that we have industry standards, provide good quality, safe and effective standards of care, we are also attractive to those healthcare workers who hold similar values and want to explore a career in OH. There is no doubt that the more we do to showcase the good work in OH, the more attractive and competitive our speciality is as a career option for many healthcare workers.

The SEQOHS accreditation scheme remains a cornerstone in promoting quality in occupational health and supporting services to demonstrate their value and competence against industry standards. As we embrace the revised scheme, the commitment to safe, effective, and quality occupational health services is stronger than ever. For both professionals and businesses, achieving SEQOHS accreditation is not just a recognition of excellence; it is a testament to the unwavering dedication to promoting, protecting and supporting the health and well-being of the workforce.

For more information about the SEQOHS accreditation scheme and process, go to our website: SEQOHS (https://www.seqohs.org/)

And if you are interested in joining the assessor team and would like to know more about the role, you can contact Mandy Murphy by email at mandy.murphy@fom.ac.uk

 

Mandy Murphy | Linkedin

Mandy is the SEQOHS Quality Lead for Assessors at the Faculty of Occupational Medicine and is a board director for the Council for Work and Health.

Mandy also runs her own independent business as a Senior Coach Practitioner often supporting career transitions, new leaders and teaching coaching skills to other professional groups and parents.

 

OH Today Volume 31 Issue 2 2023
Read original article here

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