The role and work of occupational health services in the MPS

Report: 7
Date: 2 February 2006
By: Commissioner

Summary

This report provides information to the Committee on attendance management issues; recuperative and restricted duties (with reference to the Disability Discrimination Act); audio testing arrangements for the Notting Hill Carnival; updates on work with vulnerable groups, the Spend to Save Scheme, and Health Promotion activity.

A. Recommendation

That members acknowledge and support the work of Occupational Health in the MPS.

B. Supporting information

Attendance management

1. A summary of sickness rates and performance targets for the four main categories – police officers, police staff, PCSOs and traffic wardens (TWs), covering the past 12 months, is attached at Appendix 1. Police officer sickness is on track to exceed the target of eight days per officer. Police staff sickness is marginally above the 9 day target. Traffic warden and PCSO sickness levels both remain above the target levels but progress has been made in recent months and both groups now show distinct downward trends. Pressure will continue on all groups to ensure further reductions.

2. Police staff sickness remains static at 9.3 days against a target of nine. Work continues to remove long-term cases from the system with advice being given to managers on appropriate action when interventions other than health related ones are appropriate.

3. Traffic warden sickness across the three units (Heathrow, Westminster and the Traffic OCU) has been varied. Each unit has specific problems that are being addressed through tailored activity at each OCU, e.g. the TWs at Heathrow have now been informed that they will convert to Traffic Police Community Safety Officers (TPCSOs), following months of uncertainty. This greater certainty should have a positive impact on attendance patterns over coming months as new roles and responsibilities are clarified.

4. The largest group of traffic wardens work within the Traffic OCU, where robust management action has started to reflect in a significantly reduced number of days lost. All three traffic warden units are now showing signs of a downward trend, based on actual days lost per calendar month that will, by March 2006, be fully reflected in the rolling 12 month PIB figures. The absence rate for all traffic wardens for November shows a 1.2 reduction over the September 2005 figure.

5. High levels of PCSO sickness are focussed on a relatively small number of OCUs and a concerted effort has been made to address the problem. An action plan is in place to provide a focussed approach and this is starting to reflect in a downward trend since August 2005 – down by 0.4 days. Further reductions will be achieved in the coming months.

6. Occupational Health (OH) has contributed to the strategic work looking at the evolution of the PCSO function and will continue to tailor its services to the changing needs of the PCSO role.

7. Actions to reduce sickness absence in collaboration with local OCU managers have included:

• A targeted approach at problem locations (hotspotting).
• Training provided by OH to Human Resource Managers (HRMs) and line managers on attendance management procedures and on the non-medical options for bringing difficult and contentious cases to a conclusion, e.g. use of disciplinary measures, where appropriate.
• Stress management training for managers and PCSOs at locations deemed vulnerable by reference to sickness reasons shown on PIB stats. (Workshops facilitated by OH for PCSOs identified a number of stressors within the role. These were addressed by further workshops attended by 378 PCSOs from nine poor performing OCUs).
• Facilitation of case-conferences by senior OH mangers to ensure all options for case conclusion are considered, and action plans agreed and drawn up by local managers.
• Attendance by senior OH managers at Business Group meetings to market and promulgate good practice to OCU senior managers and to encourage effective management of health related attendance issues.
• Providing time and resources for medical officers to meet with HRMs to agree a way forward with difficult and non-progressing cases.
• One to one reviews with HRMs at problem locations on all long-term cases.
• Provision of on-site practitioners at problem locations to allow in-depth activity to be undertaken on site on a temporary but continuous basis, i.e. guaranteed three days per week on site for three months, with tasking by local management under a Service Level Agreement with OH.
• OH input to HRM induction days to focus attention on attendance management.

8. Strategic actions to improve attendance management include:

• Development of improved compliance models with Group Business Managers. This has started with TPHQ and allows for OH to identify problem areas to TPHQ management - structures, compliance with procedures and OH recommendations for action, and staffing issues at specific sites that would benefit from a further in-depth review by TPHQ staff.
• Working with Police Advisory Board to change Police Regulations that work against the attendance management policy. Current proposal is to remove allowances from officers who are off pay and long term sick, pending resolution of case.
• In addition to health promotion activity designed to offer a pro-active service to staff (see paragraphs 22 and 23 for further details), OH has undertaken training at OCUs on attendance management issues aimed at line managers and HR units. Stress awareness courses have also been provided at those units where stress related issues have been identified as a particular problem. Workshops have also been given to over 100 staff on the use of efficiency regulations to address poor attendance.

Recuperative and restricted duties

9. Recuperative duty is designed to be a short-term arrangement not exceeding 12 months, to allow officers seriously ill or injured the opportunity to have a staged return to work.

10. There are currently 1104 police officers on recuperative duties, as of 12 December 2005. Of these officers, 59% are working full hours but not necessarily a full shift pattern or undertaking the full range of duties. The figure of 1104 represents a reduction of 193 on the September 2005 figure of 1297. An action plan to reduce the number of officers on recuperative duty has been implemented with a target to reduce numbers to 900 by 31 March 2006. The action plan is designed to reduce the number of officers entering the system and to address the long-term cases that need to be brought to a conclusion. Although no formal target has yet been set for the period up to 31 March 2007, the expectation is that numbers should be no more than 500 officers at any one time, with less than 50 exceeding the 12 month recuperative limit, due to exceptional circumstances, e.g. awaiting final clearance following major surgery.

11. Activity to reduce the number and extent of recuperative duty has focussed on three areas:

• Administrative action to cleanse and update data on MetHR.
• A review of all long-term cases to ensure that cases have an end date.
• Renewed marketing of recuperative policy and procedures to reduce the numbers returning to work on recuperative duty needlessly (shifting the culture of the MPS away from officers’ expectations of automatic recuperative duty).

12. A number of cases have been reviewed and officers either returned to full duties, submitted to the Selected Medical Practitioner (SMP) for the question of permanent capability to be considered or recommended for administrative action, such as efficiency regulations. Officers approaching ten months recuperative duty will be subject to a fundamental review by the Senior OH Physician.

13. Restricted duty officers work full hours and undertake roles requiring police skills and experience. The major restriction within this group is an inability to undertake Officer Safety Training, which impacts on an officer’s ability to become involved in activities where physical harm or violence may occur. A number of officers will be covered by the DDA and the restrictions in place equate to a reasonable adjustment to allow the officer to continue in post utilising their police skills and experience. It is likely that the number of restricted duty officers will increase, as more officers on long-term, full hours recuperative duties are re-classified as restricted. This will be partially offset by an increase in ill health retirements as opportunities for those officers with serious physical and psychological problems diminish.

14. Restricted duty numbers are 630 as at 12 December 2005. This represents an increase of 46 from the 15 November 2005 figure. This is in line with expectations as the current exercise has identified a number of cases where officers are working full hours but unable to undertake the full range of police duties, mainly those where risk of injury is high.

Ill-health retirements

15. A summary of ill-health retirements for the period 1999 to 2005 is attached at Appendix 2. Significant reductions in ill-health retirements over the past few years have brought retirements of this nature down to a level where further attrition is unlikely. Further reductions are unlikely given the need to address DDA issues for those officers wanting to remain in service, although this may be partially offset by a more liberal approach to ill-health retirements necessary to ensure adequate operational resilience across the MPS. Costs obtained from Capita show that the average cost of an ill-health retirement, based on retirements over the past 12 months, is £12,800 pa per officer, which excludes one-off lump sum payments which average £59,000 per officer.

Notting Hill Carnival

16. 1,876 officers were audio tested for Carnival deployment and 501 provided with specially made hearing protectors. Both groups of officers were deemed to be operating in high noise environments. All other officers deployed were provided with standard hearing protectors. Post carnival, and from within the 1,876 officers tested, 18 officers were invited for audio testing within 24 hours of attending Carnival for assessment of their hearing and to test whether the arrangements put in place had been successful. Thirteen officers attended and were tested, 12 passed and one was referred in to the hearing conservation programme for on-going monitoring.

17. The bulk testing was undertaken at a number of sites across London where appropriate testing facilities existed. The MPS vehicles were not used, as concerns existed about the audio environment for the tests, particularly where generators were to be used. It is, however, the long-term aim of OH to utilise the OH vehicles for testing and for other OH activity – such as on-site support during major incidents, but noise and vibration issues will need to be satisfactorily addressed.

18. The testing arrangements this year were arrived at following discussions with the Federation and the Gold Commander around the need to reduce abstractions to a minimum while maintaining the quality and efficacy of the tests within a suitable environment. Previous attempts to undertake testing at OCUs had proved difficult due to the lack of suitable accommodation. Poor testing environments had rendered some tests worthless as the acoustic environment was outside acceptable limits and this resulted in further tests having to be arranged.

19. Arrangements for the 2006 Carnival will commence shortly. Consideration will again be given to minimising abstractions for testing purposes.

Spend to Save (Surgical)

20. For the year 2005/6, £150,000 was allocated to this scheme. The allocation is now fully committed and will fund 32 operations (one police staff member and 31 police officers). Opportunity cost benefits are estimated at approximately £542,000 based on days saved in getting officers back to work.

Spend to Save (Psychological)

21. For the year 2005/6, £40,000 was allocated to this early intervention scheme enabling 40 officers to be put forward for cognitive behavioural therapy. 27 police officers and 13 police staff have been included in the scheme. A full evaluation of the scheme will take place around March 2006 on completion of all treatments. Previous programmes of a similar nature have yielded an 80-90% return-to-work rate within three months of completion of therapy.

Health Promotion

22. The 2005/6 health promotion has been the most intensive to date and due to unprecedented demand has been extended to June 2006, by which time up to 20,000 members of staff will have been screened at a cost of approximately £22 per officer. Initial findings indicate that 50% of attendees have been found to have raised cholesterol levels and 25% have borderline or raised blood pressure. These are hidden risk factors that if identified early can significantly reduce the risk of developing heart disease or stroke.

23. The cost of the promotion (£440,000) has been met from the Home Office’s final year’s funding under the four year National Strategy for a Healthier Workforce. Although OH would wish to continue with further MPS-wide health promotion activity, resources may not permit this and other options will be explored, including localised activity to address specific problems and other funding streams.

Stress Initiatives

24. A training package is being developed for all authorised firearms officers (AFOs), aimed at de-stigmatising stress and providing AFOs with the knowledge and practical skills to deal with their own stress and to recognise stress in colleagues. The package will be launched in March 2006. The objective is to destigmatise stress and to promote an environment within which AFOs will feel enabled to recognise and acknowledge stress in themselves and in their colleagues. The aims are to raise AFO awareness of:

• Potential causes of stress
• The signs/symptoms of stress in self and others
• The impact of unresolved stress on self and others
• Support services and procedures available.

25. At the conclusion of the training students will be able to:

• Define stress – normal (positive) and prolonged (negative)
• Identify stressors (triggers) in work and life
• Identify and state the potential signs of stress in self and others
• Recognise that individuals react to stressors and stress differently
• Identify and state suitable approaches for resolving stress
• Acknowledge individual and cultural blocks to recognising and resolving stress
• Explain and highlight the signs of progression from stress to depression and depression to suicide
• State suitable interventions for dealing with depression and suicide.

26. A managers tool-kit is being developed to provide MPS managers with practical advice and guidance to manage in such a way as to proactively prevent recognise and address work-related stress in their staff. The tool-kit should available by June 2006. The objectives, with some overlap with the above objectives, are to:

• To equip managers with the knowledge and practical skills to proactively deal with stress in their staff.
• To provide practical advice and guidance on what managers can do to prevent, recognise and address work-related stress.
• To comply with HSE requirements regarding prevention of work-related stress
• To enable early advice to be given when managers deal with bereavement, divorce, health problems etc.

27. Work with vulnerable groups continues to develop, with new additions to the groups being supported through pre-selection activity and on-going monitoring through one to one annual consultations. The majority of staff within the vulnerable groups are those working in areas of child protection and sexual offences. The groups also include police staff who deal with sexual abuse images stored electronically and which need to be accessed for evidential purposes.

C. Race and equality impact

1. All OH services are available to all staff. The main implications relate to the Disability Discrimination Act when considering a member of staff’s ability to return to work or when returning to work following the implementation of reasonable adjustments. OH staff are fully cognisant of their responsibilities under the Act and provide advice and guidance to managers on disability issues, whether explicitly covered by the Act or not.

2. Sickness absence does have a gender bias in that female staff account for disproportionately more sickness absence than male staff across the four categories of police officers, police staff, traffic wardens and PCSOs. The variation is between 8 – 10% across the four groups. Work will be undertaken to determine the reasons for this bias, including the impact of gender specific illnesses, carer responsibilities and appropriateness and understanding of staff support policies, such as that around carers leave etc.

D. Financial implications

Success in reducing sickness absence provides opportunity costs benefits to the MPS of circa £10m for every one day saved per year across all staff categories – police, police staff, traffic wardens and PCSOs. This figure includes the cost benefits arising from the spend to save scheme (para 20 refers)

E. Background papers

None

F. Contact details

Report author: Paul Madge, A/Director of People Development and Bob Crawley, Business Manager, Occupational Health.

For more information contact:

MPA general: 020 7202 0202
Media enquiries: 020 7202 0217/18

Appendix 1: Summary of attendance management targets and performance for police officers, police staff, traffic wardens and PCSOs

Table 1. Targets for occupational health average working days lost

Table 2. Performance

Appendix 2: Ordinary and Ill Health Retirement Figures 1999-2005

Table 3. Ordinary (Ord) and ill health retirement (IHR) figures 1999–2005

* IHR dates are set by the Police Authority with 37 days notice. We are therefore able to give figures up to end of December.

Send an e-mail linking to this page

Feedback