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Working safely during the COVID-19 pandemic as community restrictions ease (8 July 2021)

Council for Work and Health guidance for employers as of 8 July 2021

Working safely during the COVID-19 pandemic as community restrictions ease.

As set out in their guidance at: https://www.gov.uk/government/publications/covid-19-response-summer-2021-roadmap/covid-19-response-summer-2021, the Government have announced that they intend to remove all legal restrictions to stop the spread of COVID-19 in England from 19 July 2021. This does not however change the employer’s responsibilities to provide a safe place of work.  In this guidance the Government have made clear that “Working Safely: guidance will be updated to provide examples of sensible precautions that employers can take to reduce risk in their workplaces. Employers should take account of this guidance in preparing the risk assessments they are already required to make under pre-pandemic health and safety rules”.

The Council for Work and Health, comprises members from the broad range of organisations involved in health and work.  The aim of this briefing note is to provide guidance to employers on how they can protect the health of employees and others affected by the activities of their organisation, in the context of rising levels of COVID-19 infection in the community, and the potential disruption to business continuity through loss of manpower through self-isolation.

Whereas the requirement for self-isolation for contacts who are double vaccinated and children is to end from 16thAugust (at: https://www.gov.uk/government/news/self-isolation-to-be-eased-for-fully-vaccinated-adults-in-step-4), there are likely to be significant numbers of employees unavailable due to existing legal requirements to self-isolate following notification by NHS test and Trace that they are a contact (at: https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works).  Keeping transmission of infection in the workplace as low as possible will promote health of the workforce, and the business.

 

The Health and Safety Executive (HSE) guidance on making the workplace COVID secure is the principal reference, at: https://www.hse.gov.uk/coronavirus/working-safely/index.htm.  HSE intend to update this guidance on 19thJuly, but the following principles would endure:

We recommend all employers review their workplace risk assessment, to review known hazards and to identify new potential hazards to health, and any change in the likelihood of employees and others coming to harm as a result.

Hazardsinclude a biological hazard, COVID-19, and specifically the Delta variant causing the current third wave, and which is known to be more transmissible than the Alpha variant dominant until now.

In considering those who may be more vulnerable, employers may have taken advice from occupational health professionals on those people who may be more vulnerable to COVID-19.  Factors increasing risk of individuals coming to harm if infected include age, gender, ethnicity, obesity, and health conditions the evidence shows increase vulnerability, and particularly in combination.

There are also potential psychological hazardse.g. from those who have been working from home during the pandemic anxious about coming into the workplace, or those in public facing roles.

In the context of risk assessment, it is important for employers to consult with employees and/or their representatives. Where feasible coproduction of this risk assessment is likely to identify the potential hazards and the associated risk, for employees, and others affected by the organisation’s activities.

Having considered hazards and the risk posed by these hazards, risk management controls should be reviewed. These are best considered within the “hierarchy of controls”.  We are pleased to note that the Government are adopting this approach in their guidance, for example updated guidance on risk assessment for schools at: https://www.gov.uk/government/publications/actions-for-schools-during-the-coronavirus-outbreak/annex-a-health-and-safety-risk-assessment:

  1. Elimination. To stop an activity that is not considered essential if there are associated risks.
  2. Substitution. Replacing an activity with another may reduce the risk. e.g. home working. It is important to note that substitution can create another risk, and there are mental health implications that have been seen through isolation over this last year or so. There are also physical hazards, and we have seen significant numbers of people who have work-related upper limb disorder due to unsuitable display screen equipment workstation setup at home.
  3. Engineering controls. These are ways to design out risk, or to use physical means to separate people from source of the risk. This will also include ventilation, fresh air being important to reducing the amount of virus that is in the air that people breathe in workplaces.
  4. Administrative controls. These include making space between people, and although the Government is likely to remove the legal requirement for social distancing, employers may consider whether it is necessary to have all employees within the office at one time. Keeping occupancy in the workplace below pre-pandemic levels will reduce the risk of transmission, and so reduce the likelihood of employees being infected in their work, or when commuting to and from work.
  5. Personal protective equipment. With the legal requirement to wear face coverings in shops and on public transport likely to be ending, businesses can still decide whether their employees should still wear masks or other PPE in the workplace. They also may require those visiting the premises wear to face coverings where risk assessment and control measures cannot reduce risk as low as reasonably practicable. In healthcare and in care homes, this is likely to remain a requirement in these settings for the foreseeable future.

Testing. Testing is an administrative control. Employers may consider introducing twice weekly rapid home testing if they are not already doing so.  Employees can order lateral flow device (LFD) tests through the Government website at: https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests. By taking an LFD test before coming to work, this allows those people who are infected, but do not know it, to avoid infecting others.  Positive or negative results should be reported whether positive or negative each time at: https://www.gov.uk/report-covid19-result. And of course, those who have symptoms must self-isolate, and obtain a PCR test as soon as possible. Those testing positive on LFD testing should also self isolate and obtain a PCR test as soon as possible (as at: https://www.gov.uk/get-coronavirus-test).

Immunisation.Immunisation may also be seen as a risk management control. The evidence shows that the vaccinations currently in use in the UK remained effective against the dominant Delta variant, although both doses are needed to gain maximum protection (as reported on 8 Jul 2021 by the REACT study at:https://www.gov.uk/government/publications/react-1-study-of-coronavirus-transmission-june-2021-interim-results. Being double vaccinated may therefore allow those who are more vulnerable to work in a public facing role, together with other risk management controls that the employer considers appropriate following risk assessment.  However, we do not know as yet whether being vaccinated substantially reduces the risk of passing the infection onto others. Therefore until otherwise, those who are vaccinated must still “follow the rules” in the community, and in workplaces.

Communication and training. It is essential that all staff are fully aware of the rationale for the risk management controls. The effectiveness of controls may be enhanced through coproduction where this is appropriate, but consultation with employees and/or their representatives is always needed.

Review. Risk assessment and controls should be reviewed at periods that the employer determines, and specifically when the situation changes.

Professional advice.  Advice on keeping risks to health in the workplace as low as reasonably practicable may be obtained through providers of occupational health and safety services, and from human resources, workplace mental health providers and other professionals represented by the broad range of members that form the Council for Work and Health at: https://www.councilforworkandhealth.org.uk/about/our-members/.

Council for Work and Health: statement on Long Covid

Council for Work and Health statement on Long Covid

For people with Long Covid, there needs to be workplace support for return to work.  There needs to be sustained joined up services to assist people with Long Covid who are at work to stay at work, through medical, biopsychosocial and workplace support and vocational rehabilitation.

Many employers have gone above-and-beyond to make sure their staff feel supported as the pandemic has unfolded, and this is essential for people with Long Covid who may benefit from slower graduated returns and ongoing accommodations due to their fluctuating symptoms.  Such support is the right thing to do after the pandemic but may also help organisations avoid talent leaving the workforce and even legal challenge.

We are particularly concerned about the impact of poor management support due to a lack of knowledge, skill and resources to effectively manage people with Long Covid.  Good line management of people with Long Covid is crucial. 

Employers have a duty of care to their staff and now more than ever, every employee with Long Covid needs to be treated with compassion, to be listened to and supported through difficulties that Long Covid presents with. 

As Long Covid is a new health issue, the patient perspective is particularly important e.g. with care taken on physical exertion until appropriate diagnostic tests have occurred.

The Council asks for evidence-based NHS services for people with Long Covid, across the nations of the UK that works with occupational and vocational rehabilitation specialists on return to work. 

The Council also wishes to ensure Long Covid is prevented, fundamentally by avoiding Covid-19 transmission. It notes the risk of workplace transmission at work.  The hierarchy of controls and effective risk assessments remain essential to keep the likelihood of exposure to COVID-19 as low as possible.

Resources:

 

Remploy – Supporting your employees at work

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Returning to work toolkits for employers and occupational health professionals

Returning to work toolkits for employers and occupational health professionals

Managing the safe return to the workplace of millions of UK workers needs careful planning.

Our toolkits, produced in partnership with the Advisory, Conciliation and Arbitration Service (Acas), the Chartered Institute of Personnel and Development (CIPD), Business in the Community (BITC), and Mind, the mental health charity, will help businesses plan to reopen shuttered workplaces.

Free toolkits

There are two toolkits: one for employers and one for occupational health professionals, who are supporting businesses make the workplaces covid-secure. You can download them for free.

Planning workers’ return

Here are five things any business needs to do before employees come back

  1. Contact workers about coming back to the workplace as far in advance of their expected return as you can
  2. Be prepared to have more than one conversation with your employee and use every contact to reassure them about the care you’re taking to open up the workplace
  3. Together with your employee, identify anything that might be an obstacle to their return. Obstacles can be personal, such as difficulty with childcare, practical, such as how they travel to the workplace, and even anxiety about catching covid-19.
  4. Agree with each member of staff a return to work plan which lists who will do what and when.
  5. If the obstacles identified are more than managers and HR departments can resolve, call in occupational health (OH) professionals. OH professionals support the well-being of workers, preventing ill-health, providing independent advice to organisations, facilitating steps to reduce sickness absence, and controlling infection risks.

Conversation starters

Not sure how to start conversations with your furloughed staff?  Here are some conversation starters you can use.

  • “How has life been?”
  • “Are you OK about coming back?”
  • “Do you feel safe coming back?”
  • “How we can make your job better?”
  • “Do you know who to talk with if any problems crop up?”

If someone has existing common health problems, questions could include

  • “Do you feel up to doing your usual job?”
  • “What parts of your job do you think you will find difficult and what can we change to help overcome the difficulties?”

Getting the UK back to work

Work is good for us and the country needs to get back to good, safe jobs, in which people are safe and feel supported. Our Returning to the workplace toolkits can help all kinds of business achieve this. Download them for free from the Resources section.

Vulnerability to COVID-19

Vulnerability to COVID-19

 

Dr Robin Cordell, a director of the Council for Work and Health, and a Fellow of the Royal College of Physicians has this week brought our attention to the following piece within the President of the Royal College of Physicians of London most recent update to members of the Royal College.

 

In this update, Professor Andrew Goddard MD PRCP highlights the importance of assessing those who are more vulnerable should they be infected with COVID-19, so informing individual risk assessment by management as to how such people may be protected in their work.

 

We were very pleased that the President of the Royal College of Physicians has highlighted the essential work done by occupational health staff, and that he made a specific point of thanking occupational physicians (the Faculty of Occupational Medicine being a faculty of this Royal College) and so by extension all those supporting health and work at this time.

 

This is the key part of this message from the President of the Royal College of Physicians:

“The creation of a list of 1.8 million people as a ‘clinically extremely vulnerable’ group who need ‘shielding’ from COVID-19 was both a mammoth task and one that all involved should be proud of. Risk, though, is not a binary thing. As our understanding of what makes people more vulnerable to the effects of COVID-19 improves, we may need to be a bit more flexible about who needs shielding and who does not. This will be especially true as the rest of the population comes out of lockdown and being shielded may be seen by some of the shielded as a curse rather than a blessing.

 

Such risk needs to take into account the susceptibility of an individual to infection and the severity of disease that results. Some of this will be defined by obvious parameters such as age, comorbidities, medications, ethnicity and sex. The risk will also depend on the exposure risk in the community (will we have a local COVID-19 level as we do for pollen, pollution and UV exposure?), occupation and means of commuting. Lastly, each of us has our own perception of what we will accept when it comes to risk. As we refine ‘shielding’ it will need to be as personalised and thought about as any shared decision we make about a treatment in clinic or on the ward.

 

The role of ethnicity remains something that many are rightly worried about. There are several pieces of work going on in both PHE and NHSE looking at this. Occupational medicine has a large role to play for us as physicians and the letter from Simon Stevens formally tasked trusts with risk assessing staff. Anne de Bono, president of our Faculty of Occupational Medicine, is working hard on this with colleagues, including the Society of Occupational Medicine. This is going to be a massive amount of work for an understaffed part of our workforce.

 

This week’s shout out therefore goes to them. Thank you to all our occupational physicians.”

 

 

WHU Consultation – Health is everyone’s business, proposals to reduce ill-health related job loss

WHU Consultation – Health is everyone’s business, proposals to reduce ill-health related job loss

Council for Work and Health members have actively contributed to the extensive research and debate resulting in this welcomed consultation initiative.  It is disappointing that many UK workers, particularly in small businesses, but even in large employers such as the NHS, have inconsistent access to good quality occupational health support when ill.  This exercise seeks to test ideas to enable more workers to get support when needed and hence reduce the numbers that face being unable to work due to resolvable issues. Council members will actively respond to this consultation and we urge as many as possible to contribute to this vital debate and support opportunity for change.

https://www.gov.uk/government/consultations/health-is-everyones-business-proposals-to-reduce-ill-health-related-job-loss

Consultation link:

https://getinvolved.dwp.gov.uk/work-and-health/consultation/