FPC3 Tutorial 2 - Sustainability, Resilience and Occupational Health (A&B Groups) Flashcards

Question

what is an occupational history?

Answer 1

* An occupational and environmental history is a chronological list of all the patient’s employment with the intention of determining whether work has caused ill health, exacerbated an existing health problem or has ill health had an impact on the patient’s capacity to work * A shortened history is possible within a GP consultation if the problem is acute and likely related to current work

Answer 2

* A description of the present and previous jobs from leaving school. * Identifying any exposure to chemicals or other hazards e.g. stress, overwork, adverse working environment, in this situation is the fact that role largely sedentary exacerbating or causing his back pain? * Did the symptoms improve when not exposed / not at work e.g. at weekends, holidays? * Determine the duration and intensity of exposure e.g. was it so noisy it was impossible to communicate * Is personal protection used e.g. what kind of mask? Or equally is an appropriate chair / desk provided? * What maintenance is in place for the protection measures? * Do others suffer similar symptoms? * Are there known environmental hazards in use? * Any hobbies, pets, worked overseas, moonlighting?

Answer 3

This replaced the ‘sick note ‘ in April 2010. It’s purpose is to facilitate earlier discussion about returning to work and about rehabilitation. It now includes items of consideration for employers when signing a patient’s return to work. It can only be completed by a Doctor It is advice to patients as employees, is not binding on the employer and does not affect Statutory Sick Pay It is required if the patient has been off more than 7 consecutive days ( including non working days)

Answer 4

For patients who are off for longer periods of time or with more complex needs, referral to a specialist occupational health service is an option. •Occupational health specialists are ideally and uniquely placed to support and help people stay in work and live full and healthy lives They play a key role in ensuring the health and well being of the working population by preventing work-related ill health and providing specialist rehabilitation advice They provide independent, impartial advice to employers and employees on the effects of work on health and the effects of health on work

Answer 5

* Phased return to work - Start with reduced hours each day and build up - help build capacity again and allow time for rehab * Altered hours - Work at different times of day e.g. are early mornings hardest? * Amended duties - Change in work practice or content e.g. less time sitting or breaking up the day differently to allow more movement - shorter surgeries, built in breaks etc * Workplace adaptation - e.g. changes to seating to support back better

Answer 6

* There is a strong association between worklessness and poor health. This may be partly a health selection effect, but it is also to a large extent cause and effect. There is evidence that unemployment is generally harmful to health, including: * Higher mortality; * Poorer general health, long-standing illness, limiting longstanding illness; * Poorer mental health, psychological distress, minor psychological/psychiatric morbidity; * Higher medical consultation, medication consumption and hospital admission rates * There is evidence that re-employment leads to improved self-esteem, improved general and mental health, and reduced psychological distress and minor psychiatric morbidity. The magnitude of this improvement is more or less comparable to the adverse effects of job loss

Answer 7

The Cambridge Dictionary defines sustainability the ability to be “Able to continue over a period of time”

Answer 8

This could be looked at in a couple of ways. It could be looked at in relation to low carbon clinical care and the environment. It could be looked at in relation to the ability of the NHS to “Continue over time” In Scotland we have a National Policy Document “Realistic Medicine” that in part relates to this. We will cover this next term.

Answer 9

Prioritise Environmental Health Substitute harmful chemicals with safer alternatives. Reduce and safely dispose of waste Use energy efficiently and switch to renewable energy. Reduce water consumption Improve travel strategies Purchase and serve sustainably grown food Safely manage and dispose of pharmaceuticals Adopt greener building design and construction. Purchase safer more sustainable products

Answer 10

Be better at preventing conditions Give greater responsibility to patients in managing their health. Be leaner in service design and delivery Use the lowest carbon technologies

Answer 11

Transport accounts for almost 25% of all fossil fuel greenhouse gas emissions Cutting emissions through walking and cycling and less vehicle use brings large health benefits e.g. reduction in diabetes, CV disease and depression

Answer 12

Reduce the need to travel: teleconferencing, video conferencing for follow-up appointments where clinical examination not needed. One stop clinics where consultation, diagnostic testing and management plan all done on the same day in the same facility. Multiple clinics on the same day – coordinating care between different specialities for the same patient Better ways to travel: car pooling, car sharing, fuel efficient vehicles (hybrid or electric), health service transport e.g. buses to transport patients to and from clinics and hospital Institutional plans e.g. providing facilities for people to cycle to work, utilise bus services. Incentivise active travel – reduce car parking spaces, cycle to work schemes to provide for the purchase and use of bikes, encourage walking to work or incentivise use of public transport