Law and Ethics in Occupational Health Flashcards
Equality Act 2010
This is the legislation that covers and protects people with disability at work.
Under this legislation, employers must take active steps to reduce discrimination against staff with a disability, impairment, mental or physical health condition, and make reasonable adjustments so the individual can make their best contribution at work
When does this apply
If the individual has a condition that:
1) Causes physical or psychological impairment
2) Has lasted, or is likely to persist for longer than 12 months
3) Has a ‘substantial’ (more than minor or trivial) impact upon daily functions and activities
What is the EA2010 definition of disability?
Disability is one of 9 protected characteristics set out by EA 2010.
You’re disabled under the EA 2010 if you have a physical or mental impairment that has a substantial and long term negative effect on your ability to do normal daily activities.
- Long term = likely to last >12 months, or terminal diagnosis
- Normal Daily Activities = mobility, manual dexterity, co-ordination, continence, ability to left/carry/move objects, speech, hearing, eyesight, memory, ability to concentrate/learn/understand or perception of risk/physical danger
- Substantial = more than minor or trivial e.g. it completes much longer to do a daily task, such as getting dressed
Progressive conditions such as HIV/AIDS, Cancer and MS are covered from point of diagnosis, regardless of symptoms.
Conditions that are intermittent/fluctuate also provide people with protection if the condition is likely to recur, even if in remission.
What is discrimination?
Treating someone ‘less favourably’ than someone else due to a protected characteristic such as:
- Age
- Disability
- Gender / Gender reassignment
- Marriage / Civil partnership
- Sexual orientation
- Race
- Religion of belief
Treating someone ‘less favourably’ means they are at a disadvantage. This may include excluding someone from opportunities/benefits, making it harder for someone to do their job, causing someone emotional distress, causing someone financial loss
Direct discrimination: less favourable treatment directly because of protected characteristics
Indirect discrimination: when everyone is treated the same, but this means people with a protected characteristic are disadvantaged
Harassment: unwanted or offensive behaviour related to a protected characteristic
Victimisation: negative treatment as a result of being involved with discrimination / harassment complaint
Examples of reasonable adjustments for mental health issues?
- Flexible working hours
- Altered working pattern
- Temporary reduction in workload / change in job duties
- Provision of a quiet space to work
- Additional support with certain tasks
- Phased return to work
What are reasonable adjustments?
A reasonable adjustment is a change to remove or reduce the impact of an employee’s disability or impairment, to allow them to do their job to the best of their ability.
Reasonable adjustments should be considered for both physical and mental health conditions.
What are some examples of reasonable adjustments?
- Providing adapted keyboard for someone with arthritis, to reduce discomfort / other adapted office equipment
- Phased return to work after period of absence due to severe depression. This allows development of stamina, rebuilding confidence and checking if additional adjustments required
- Reallocating job tasks and working practises e.g. assessing if meetings can be done via remote technology for a person with mobility issues
- Flexible working - e.g. additional breaks to overcome fatigue
- Change of location e.g. provision of a quiet space for individual who has difficulty with frequent interruptions and distractions in open office
- Accessible parking
Factors to be weighed up when making reasonable adjustments?
- How effective the adjustment is at minimising disadvantage
- How practical adjustment is e.g. time, effort and resources required
- The cost of making an adjustment / support with funding available
- Potential disruption caused to others
What is a personal emergency evacuation plan?
Can this person leave the building unaided in an emergency?
If no, they need an evacuation plan. This may be needed for mobility impairment, visual or hearing impairment, cognitive impairment or any other medical condition/injury which may cause someone to need assistance.
Requirement for PEEP may be temporary.
Manager is generally responsible for identifying individuals who require PEEP and implementing the PEEP assessment.
Who is protected by the EA 2010?
- Anyone who works for an employer
- Contractors / self-employed people hired for work
- Job applicants
- Former workers
What are the responsibilities of employers?
Employers have a duty of care to:
- Look after their employees
- Make sure they do not unfairly discriminate in any aspect of work
- Take active steps to prevent discrimination
- Do all they reasonably can to protect people from discrimination by others
Note anyone who discriminates against someone at work is also responsible for their actions - complaints and tribunal claims can be made against individuals, as well as employers
What is the Health and Safety at Work act 1974?
This is the primary legislation governing workplace health and safety in the united kingdom.
The act defines the general duties of employers, employees and owners/managers/maintainers of work premises to maintain health and safety within most workplaces.
There is further specific legislation, called statutory instruments, for business sectors that operate in higher risk environments e.g. construction, chemical manufacturing.
The Health and Safety at work executive (HSE) and local authorities are responsible for enforcing workplace health and safety legislation in the UK.
Under the Health and Safety at work act, workplaces must provide?
- Adequate training to staff to ensure health and safety procedures are understood and adhered to
- Adequate welfare provisions for staff at work
- Safe working environment, properly maintained and where operations are conducted safely
- Suitable provision of relevant information, instruction and supervision
What about responsibility for Health and Safety Policy?
Workplaces with 5 or more employees must have a written record of a health and safety policy. They must consult with employees and/or employee representatives on relevant policies and health and safety arrangements
Tell me about the workplace regulations of 1992?
Regulations applying to all aspects of the working environment and requirements for employers to provide a safe and suitable working environment. This includes:
- Provision for comfort and sanitation e.g. break areas, washing facilities, drinking water
- Appropriate working environments e.g. room dimensions, lighting, ventilation
- Provisions for safety in the workplace e.g. equipment maintenance, maintained walking routes/floor spaces, protection from falling objects
Display screen equipment regulations 1992/2002
For workers who use display screen equipment daily, for an hour or more at a time, employers must take steps to protect employees from health risks from DSE’s such as PCs, laptops, tablets and smartphones.
Employees must:
- Carry out a workstation assessment
- Reduce risks such as ensuring regular breaks, providing ancillary equipment
- Provide optician assessment free of charge for DSE user
- Provide training and information for DSE users
PPE regulations 2018?
Some working environments provide significant risks to employee health and safety e.g. falling materials, contact with hazardous substances, contaminated air, extremes of temperature.
The employer has a duty to provide workers with PPE to reduce the potential risk of harm, when it cannot be reduced or mitigated by other control measures.
Risk assessment must be carried out prior to providing PPE, to determine that risk cannot be mitigated through other control measures.
PPE includes: high vis clothing, protective footwear, safety helmets, eye protection, safety harnesses and respiratory protective equipment
PPE regulations 2018?
Suitable provision: suitable and appropriate PPE provision to the work task and associated risk. PPE must fit the user properly and be of proportionate size and weight. Equipment must be CE marked
Compatibility and effectiveness: PPE items must still be effective if multiple are required to be worn together e.g. they must not cause other items to be ill-fitting or ineffective
Maintenance and storage: PPE must be properly looked after, maintained and stored. Reusable items must be properly cleaned and kept in good condition.
Use and training: the employer has a duty to ensure employees have training on the correct use of PPE, the risks PPE is protecting them from and the responsibility of employer to maintain PPE
Employee responsibility: the duty of the employee is to use PPE in accordance with instruction and training + report damage, defects or loss of equipment if they are aware of this
Management of health and safety at work regulations 1999
An employer must assess work-based activities and implement any appropriate controls to manage risks to health, safety and welfare of employees.
Employers have duty to:
- Provide adequate / proportional health and safety training
- Ensure there are appropriate procedures in place in event of emergency
- Provide appropriate health surveillance in cases where employees may be exposed to e.g. noise, vibration, substances hazardous to health
- Suitable and sufficient assessment of risks to employees through operational activities
- Appoint competent persons to manage workplace health and safety
RIDDOR - Reporting of injuries, diseases and dangerous occurences regulations 2013
If death, injury or illness arises from work-related activity it is requirement for employers to report this formally
Manual Handling operations regulations 1992
Manual handling is moving of items by lifting, lowering, carrying, pushing or pulling. This comes with risk of injury.
Employers must:
- Avoid hazardous manual handling operations as far as reasonably practicable e.g. through redesigning the task, avoidance of moving the load or automation of the process
- Make suitable and sufficient assessment of the risk of injury from hazardous manual handling operations
- Reduce the risk of injury from operations so far as is reasonably practicable e.g. providing mechanical assistance with trolley or hoist
Tell me about the principle of confidentiality in medicine?
Patients have a right to expect that their personal and medical information be treated as confidential.
Confidentiality is essential for maintaining trust, which is fundamental for the relationship between patients and medical professionals.
Medical professionals must comply with the law when using, accessing or disclosing personal information.
When is disclosure of patient’s personal or medical information potentially justifiable?
- Disclosures to support direct care of the patient - e.g. where patient consents implicitly or explicitly for the sake of their care or explicitly for other purposes
- Disclosure is in best interests to patient who lacks capacity
- Disclosure is required by law e.g. serious crime
- Disclosures for the protection of patients and others e.g. transmissible illness
- Disclosures for other purposes
Act promptly where disclosure is required. Record decision and actions.
Eight principles of confidentiality in medicine
1) Use the minimum necessary personal information - using anonymous information where practicable
2) Manage and protect information - information held must be effectively protected from improper access, disclosure or loss
3) Be aware of responsibilities - e.g. in terms of info governance
4) Comply with the law - handle info lawfully
5) Share relevant info for direct care - unless patient has objected
6) Ask for explicit consent - to disclose identifiable information about patients (unless disclosure required by law or public interest)
7) Tell patients - about disclosures of personal information (unless it is not practicable or would undermine purpose of disclosure)
8) Support patients to access their information - respect + help patients exercise their legal rights to be informed of how their info will be used and have access to their health records
When disclosing information about a patient
- Use anonymised information where possible
- Be satisfied the patient has access to info about how their info will be used and that they have right to object + that patient has not objected
- Get the patient’s explicit consent, if identifiable information is to be disclosed for purposes other than their own care or local audit (unless disclosure required by law / in public interest)
- Keep disclosure to minimum necessary for purpose
- Follow all relevant legal requirements
Confidentiality in Occ Health
Occupational Health staff work to a strict code of ethics concerning confidentiality of consultations and medical records.
Staff cannot and will not disclose medical information of employees without the prior consent of those employees.
If OH needs more information from an employee’s doctor, the worker should be told the reason and asked to sign a consent form. The worker has the right to see the doctor’s report before it is sent to OH
Tell me about occupational health reports
An occupational health report can help the employer to understand what someone needs to feel better, return to work, be able to do their job and avoid anything that could cause further health or absence issues.
Patient consent must be obtained before assessment, examination or report writing.
The doctor must ensure that the patient understands what is to be disclosed, the reasons for disclosure and the consequences thereof
Doctors should offer to show the patient their report or give them copies.
If the worker declines, the report cannot be sent. In this case the employer will need to act without it, and OH may have to give an outcome from the assessment e.g. regarding fitness to work
Any information shared, with consent, in an OH report must be kept confidential by the employer, and should only be available to those who need to access it (e.g. HR or manager).
