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The Future of Occupational Health

27th March 2018

From increasing rates of self-employment through to remote and digital working, the world of work is changing fast. But what might these potentially profound changes mean for the future of occupational health and wellbeing and how it is delivered and accessed?

Employee health and wellbeing – what will an increasingly fractured workplace mean for the future of Occupational Health?

Automation and digitisation are profoundly changing the workplace and therefore the future of occupational health. The impact automation will have on how, where and even if we continue to work remains one very much open for debate.

In January, for example, the think-tank the Institute for Fiscal Studies highlighted that the rising cost of the National Minimum Wage and National Living Wage could eventually lead to employers automating as many as 10% of the more “routine” occupations, such as retail cashiers and receptionists.

Thinktanks, such as Future Advocacy, and academics (for example here from Oxford University) have warned for quite some time now of the growing impact automation is likely to have not only have on how we live our lives, but also on what work will be available for us to do in the future – and what sort of jobs may as a result disappear.

Of course, changing business models, technologies, demands and expectations has meant jobs and roles have always evolved.

After all, where nowadays are the copy boys or compositors who were once ubiquitous in newsrooms, the gas lamp lighters who were a common sight on our streets at dusk, perhaps making their way round the also now extinct crossing sweepers?

Engaging with new forms of working

It is not just in automation, however, where the advance of technology is having a profound impact on models of working. Last July, the chairman of the Royal Society of Arts Matthew Taylor published the government’s Review of Modern Working Practices.

Taylor had been primarily tasked with looking at how society should respond to the rise of self-employment-based “gig economy” working, often app-based, as pioneered by the likes of Uber and Deliveroo, and whether such new ways or working are fair or exploitative.

His central recommendation was for the creation of a new category of worker, a “dependent contractor”, who would be somewhere between being an employee and a self-employed worker, but could still be eligible for basic employment rights, such as sick and holiday pay and the minimum or living wage.

His recommendations also threw up some intriguing discussion points, not just for the world of work but for how occupational health and wellbeing may need to adjust and adapt to this evolving, fast-changing working world.

For example, he argued that statutory sick pay (currently, of course, paid from the fourth day of absence for up to 28 weeks) may need to be rethought to become a basic employment right, much like the National Minimum Wage or National Living Wage. This would mean it would be available to all workers from the first day of their employment.

Insecure and casual models of working

Taylor also suggested that anyone returning to work after a long period of sick leave should have the right to return to the same or similar job so long as, he argued, they have previously engaged with the government’s Fit for Work service. The fact that this, too, is now set to disappear is therefore somewhat ironic.

The rise of more casualised, insecure ways of working is creating its own range of new health challenges.

Last July, for example, the think-tank the IPPR and Business in the Community published an analysis of Britain’s increasingly flexible labour market and concluded (perhaps unsurprisingly) that younger workers in temporary and insecure jobs, such as zero-hours contracts, are 29% more likely to experience mental health problems compared with those in permanent jobs.

Clearly, there is going to be a challenge here for the future of occupational health and wellbeing practitioners. After all, if occupational health has historically struggled to reach and engage with employees in small and micro businesses, how much harder will it be to support a growing, disparate and fluid population of self-employed workers?

Digital and telehealth tools

Another facet of this revolution is how technology may change how people, whether employed or self-employed, want to access healthcare, and this too will create challenges and opportunity for occupational health.

Take, for example, the new GP at Hand app-based digital GP service being rolled out across zones 1-3 in London. This has the attraction of offering people quicker and easier access to GPs, especially given the fact that pressures on primary care (and the NHS as a whole) is meaning more and more employees may be having to take time off work to see a GP.

But is this the right, or even a good, solution? GP at Hand may well be convenient, but the fact you have to delist from your existing GP means there is a risk people do not fully consider the long-term ramifications of doing this, and end up with less good healthcare support in the long run.

There is also the question of whether such digital alternatives are the most appropriate way to manage complex medical conditions, even whether they have the capacity to do so, or whether there will always be a risk of something more serious being missed as a result?

To that end, while the convenience and speed (and cheapness) of digital solutions can make them a compelling business case, it may well be that occupational health in the future has an increasingly important role, much like GPs, as the “gatekeepers” of the multi-layered, multi-disciplinary, expert workplace health diagnosis.

As Lucy Wright, Chief Medical Officer at Optima Health argues: “The way people work is changing, along with many of the traditional employer/employee models. Combined with an ageing and increasing sedentary workforce this is likely to create significant challenges for workplace health professionals in the future. It is a debate we will all need to be engaging with in the future.

“As a profession, while we obviously need to embrace and maximise technology change, we also need to be careful to ensure that employers and employees alike recognise and understand the limitations of digital and telehealth solutions if they want to look after the health of their employees in the most effective way. Digital tools and solutions are great for some things, but they certainly are not a replacement for a bespoke, holistic occupational health and wellbeing service.”