The Future of Occupational Health Provision Dr Paul Litchfield OBE OStJ FRCP FFOM Chief Medical Officer BT Group plc Energy Networks Association SHE Management Conference Glasgow - 15 May 2014
The world economy is changing GDP - 2013 Yearly change in GDP - 2013 Source World Bank / Goldman Sachs Source The Economist Is China about to overtake US as the world's largest economy? BBC Business News 30 April 2014
The world of work is changing Traditional industrial activity Modern agile working Hazards & risks different in nature and in scale
The world of health is changing Cumulative lost global output 2011-2030 by disease (Bloom et al., 2011)
Occupational Health issues in the 2010s Globalisation Migrant workers Ageing workforce Lifestyle issues Chronic disease Mental wellbeing 24/7 working New technology Sustainability Engagement Social exclusion
Occupational Health changed 20 years ago Outsourcing offered companies many advantages Menu of services Broader skill mix and experience Greater flexibility (scope, range, location) Independent professional service Contractual service levels Professional staff management externally Financial risk transferred or shared But the model has stagnated and ossified
The pillars of commercial OH activity Profitability Revenue Stream Revenue Stream Revenue Stream Revenue Stream Pre-employment Health Surveillance Management Referrals Medical Retirement Weak evidence base Discriminatory Engineered out Sunset industries Fit Note Health & Work Service Feature of DB schemes Equality Act Declining Declining Declining Declining Providers focus on declining transactional services
Rising expectations of service providers Works all the time no maintenance Simple and easy to use intuitive Integrates applications / services Automated and always getting faster Makes my life easier and saves time Delivers what, when & where I want Anticipates needs and provides them Gets better and cheaper year on year
The Health, Safety & Wellbeing Value Model This is where we influence the Board Strategy & Leadership Identifying key health issues for the business Securing investment in wellbeing Influencing organisational change Transformational (long term) Policies & Service Development Transactional Service Delivery Identifying innovative programmes Applying best practice Integrating products and services Transitional (short - mid term) Quality & Effectiveness Speed & Customer satisfaction Immediate Most of us operate here
Providing strategic direction in OH Having a diverse and global outlook Understanding the business and people strategies Expert knowledge of health, safety, wellbeing plus more Identifying hazards and risks (physical and mental) Turning H&S data into management information Having a commercial mindset with strong human values Calling out opportunities for growth as well as savings Contributing to organisational design and development
Evolution of a hybrid OH service Initial focus on solely strategy & leadership Separation of purchaser & provider functions Dissatisfaction with single service provider Growing use of niche providers for specialist services Awareness of need for better integration In-sourcing of integration capability Leveraging synergies between OH and other disciplines Drivers Business Needs, Quality & Cost
What does the future hold? Outsourced OH services for transactional activities Increased use of technology to drive down costs Focus by main providers on Government contracts Niche providers (in or out) for higher value services Strategic input in-house with consultancy support as required Growth of expertise in main consultancy houses Training opportunity for broader professional bodies / academia Blurring of boundaries between OH, Safety, Risk and HR Integration an area of development In-house activity for large organisations Risk management and actuarial approach Development of market beyond just brokering
There are significant risks Ageing OH workforce Skill shortages in integration & strategy Inability to attract talent Failure to perceive market opportunities Blinkered focus on State benefits Cost cutting and deskilling Spiral into contract cleaning status
There s a lot to play for But it could go horribly wrong
paul.litchfield@bt.com