by Pamela Gellatly, IIRSM member and CEO of Healthcare RM

Humans may all be very different, but our DNA suggests that we are actually all 99% the same. It seems, therefore, that 1% of our DNA can make all the difference. Is this why we often ignore individual differences, especially when it comes to provisions in the workplace?

Visible and invisible health risks

This year, a remake of the film The Invisible Man was released, with the tagline, ‘What you can’t see can hurt you’. This absolutely applies to organisational risk management and invisible risks.

Globally, and especially in the Western World, ill health is often underpinned by personal risk factors. These can include:

• Inactivity

• Excess weight

• Poor sleep

• Smoking/alcohol

• DNA and epigenetics

• Psychosocial factors

• Clinical symptoms

• Other underlying issues

However, these factors are seldom assessed when an individual falls ill. Not only this, but we collect an awful lot of data from the ill, but very little from the well, leaving us with data that above all else, incomplete. For several years now, industry has failed to address health in the context of behavioural change and is this because we have insufficient data to understand how to change behaviour and or is it because we are dealing with a societal change that is far more complex to address?

Where does this leave us?

There are many consequences to this attitude towards public health; we tend to over-diagnose and over-treat, we spend without truly understanding the return on investment (ROI) and we rarely measure outcomes over the medium to longer term.

What does the future of healthcare look like?

The future of healthcare should focus on the streamlining of personalised care, within both the NHS and the private sector. This means more focus on guided self-help – encouraging people to take responsibility for their own health.

Data is the new gold – robust, quality data will prove critical to healthcare management in the future.

How does this affect the future of risk management?

For this reason, Healthcare rm has developed a framework known as The Whole Person Model, listing everything that organisations should be taking into account in their risk management and the rich nature of the data, both quantitative and qualitative, that can be gathered as a result of this (with the right data protection procedures in place, of course). The benefit of this, as mentioned earlier, is gathering data on the health of the well – not just the health of the ill.

On an organisational level, this include collecting data from:

• Administration and management of  healthcare plans

• Sickness absence 

• Management referrals

• Case management

• Health surveillance

• Physical & psychological risk assessments

• MHFA training and supervision

• Manual handling with S&C 

• EAP services

• Musculoskeletal services such as physiotherapy

• Psychological services such as CBT/executive coaching which may be within or outside of EAP provision

• DNA/Epigenetics – (if used)

• Nutrition services

And on an individual level this can include:

• Assessing physical & psychological risks

• Both occupational and personal related

• Measuring outcomes of clinical and non-clinical assessments and interventions

• Understanding implications of genetic and lifestyle vulnerabilities 

• Measuring generically or individually (via appropriate providers) lifestyle risks and the outcomes of any interventions to establish whether Wellbeing programmes are effective.

• Measuring effectiveness of guided self-help versus professional interventions to address personal & occupational stressors 

• Understanding social influences including work, hobbies etc

Take, for example, an HGV driver. You would, of course, conduct a risk assessment of the job and the tasks that it involves, as well as an HGV driver medical, but does this provide the organisation with enough data to accurately ascertain this person’s ability to perform their job safely? There are a number of other factors, both visible and invisible, that could come into play. These are…

Visible

• Does their weight increase the risk of sleep apnoea or a cardiac arrest?

• Does their weight and the excess load on their knees and ankles increase the risk of them being able to break safely especially in an emergency?

• Does an apparent lack of fitness have a bearing on their ability to lift, push and pull safely?

Invisible

• Are there potential health issues that impair their ability to react and concentrate?

• Does their choice of food increase the risk of drowsiness?

• Are they drinking?

• Do they have any medical conditions that we are aware of?

• What are the demands of the job, and how do they cope with these demands?

• Do they have any negative attitudes or beliefs about work?

• Do they have any genetic risks?

There are, of course, a number of assumptions that many organisations are guilty of making when it comes to health and safety due, in part, to a lack of data. For example, it is often assumed that those in highly skilled or senior management roles are less prone to be harmed.  This does not, however, account for factors such as invisible illness, neurodiverse condition or stressors outside of the workplace, such as the ill health of a loved one.

The solution

There is clearly much to be done in terms of legislation and potentially even redefining risk management as a whole, it is suggested as risk management professionals can do on both an organisational and an employee level.

On an organisational level…

• Be aware of these underlying risks

• Measure them

• Decide who is responsible for them

• Consider who assesses them

• Consider introducing fitness standards

• Consider quality of medicals

• Plan how you are going to address 

• Capture robust data

And for employees…

• Make employees aware of their Duty of Care

• Help employees to understand their risks

• Provide support to help them address their risks

• Link with your Health and Wellbeing provision

• Work closer with HR to understand the issues

• Work closer with OH/providers to address these issues

• Use data to ensure continuous improvement

• Integrate your data across health services

To summarise, the future of risk management must focus on employers taking responsibility for their risks, whilst employees must take responsibility for that which only they can control. We must also gather as much data as possible on the invisible risks, for, as mentioned earlier, what you can’t see can hurt you.

Dr Pamela Gellatly is CEO of Healthcare RM, a IIRSM member and Chartered safety and health practitioner with 40 years' experience in health risk management. 

Dr Gellatly has an MSc in Occupational Safety and Health, an MSc in Exercise and Nutrition and a PHD in Workplace Musculoskeletal disorders: Understanding the Cause and Contributory risk factors (which includes psychosocial factors).