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Standards & Accreditation for Occupational Health Services. Paul J Nicholson. Scope. Background Developing the standards Definitions The scope and aims The standards The accreditation process . Standards for Health. 2006 – Department of Health Standards for Better Health

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Standards & Accreditation for Occupational Health Services

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Standards & Accreditation for Occupational Health Services

Paul J Nicholson

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  • Background

  • Developing the standards

  • Definitions

  • The scope and aims

  • The standards

  • The accreditation process

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Standards for Health

2006 – Department of Health

Standards for Better Health

  • Require a rigorous approach to assessment and accreditation of providers of NHS services.

    2008 – Lord Darzi’s Report

    High Quality Care for All: NHS Next Stage Review

  • Confirmed Government support for provider accreditation schemes in the NHS.

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An integrated approach to working age health should be underpinned by:clear standards of practice and formal accreditation for all providers

Standards for Occupational Health

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Developing the standards

  • Faculty of Occupational Medicine led

  • 47 people represented 35 organisations

    • Occupational medical & nursing professional bodies [AOHNP(UK), RCN, SOM]

    • Commercial OH providers [including COHPA]

    • Employer representative bodies [BITC, CBI, CIPD, EEF]

    • Worker representative bodies [Unite, USDAW]

    • NHS Plus / HSE / DETINI

  • Benchmarking to avoid re-work (ISO, Network Rail)

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Key milestones



Pilot web tool


body chosen




& piloting


1st draft



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  • Standard

  • Minimum requirement

  • Accreditation

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A standard is something considered by an authority or by general consensus as a basis of comparison in measuring or judging adequacy, quality, etc

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  • Minimum requirements relate typically to existing professional guidance

    • They must be met to satisfy the standard

    • They are intended to be well-defined and easy to understand

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Accreditation is a self-assessment and external peer assessment process used to accurately assess level of performance in relation to established standards and to implement ways to continuously improve the healthcare system.

International Society for Quality in Health Care (ISQua)

Accreditation is a voluntary process.

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What does accreditation mean?

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The scope of the OHS standards

  • The standards apply to broad-based clinical occupational health services, be they:

    • in-house services in the public and private sectors

    • commercial occupational health providers from single handed providers to large organisations

  • They do not apply to non-clinical services, e.g. occupational hygiene, ergonomics, etc.

  • They reflect existing professional guidance

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  • Enable OHS to identify the standards of practice to which they should aspire

  • Credit good work being done by high quality OHS, providing independent validation that they satisfy standards of quality

  • Raise standards where they need to be raised

  • Help purchasers differentiate OHSthat attain the desired standards from those that do not

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The standards

13 standards are grouped into 6 domains:

  • Business probity

  • Information governance

  • People

  • Facilities and equipment

  • Relationships with purchasers

  • Relationships with workers

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The standards

Business probity

A1Conduct business with integrity

A2Maintain financial propriety

Information governance

B1Maintain adequate OHCRs

B2Implement systems to protect confidentiality


C1Ensure staff are competent

C2Ensure appropriate supervision

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The standards

Facilities and equipment

D1 Conduct business in safe, accessible and appropriate facilities

D2Ensure that medical equipment is safe and appropriate

D3Ensure that medicines are handled appropriately

Relationships with purchasers

E1Deal fairly with purchasers

E2Be customer focused

Relationships with workers

F1Ensure that workers are treated fairly

F2Respect and involve workers

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Standard A1An OHS must conduct its business with integrity

Minimum requirements:

The following minimum requirements apply to all OHS:

A1.1An OHS must only publish information about services which is factual and verifiable

The following additional minimum requirement applies to all OHS except single-handed practitioners:

A1.2An OHS must take reasonable steps to ensure that all of its staff are honest and trustworthy

The following additional minimum requirement applies to an OHS that

outsources work to another organisation:

A1.3 An OHS must maintain systems to check the qualifications of and monitor the standard of work that is outsourced to third party providers

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Examples of evidence

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Customer survey

E1.1 An OHS must provide purchasers & potential purchasers with clear & user-friendly information on fees

E1.2 An OHS must agree with purchasers the extent and scope of any business continuity planning that is required to protect service delivery

E1.3An OHS must agree with customers, at the outset, the processes for referrals to the OHS, case management and reporting of cases of occupational disease and any onward referral of workers for further investigation

E2.1 An OHS must be in touch with individual purchasers to understand their culture, values & needs based on reliable and recent information

E2.4An OHS must use formal & informal methods to regularly seek information about customer satisfaction from purchasers & referring managers

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Assessment & accreditation

Register for information

Register as a user / input OHS details

Upload evidence against minimum requirements

Perform self-assessment / develop action plans

Apply for accreditation

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Will include an attestation to:

  • meeting eligibility criteria

  • providing true and contemporaneous information

  • complying with all applicable laws and regulations and

  • having appropriate insurances

    Must be signed or co-signed by at least one registered health professional

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Assessment & accreditation

At least once

every 5 years

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What happens if an OHS fails?

  • It depends on what the challenges are

  • Clear recommendations

  • Timescales for improvement

  • Direct support from the SEQOHS office to attain full accreditation

We want services to pass,

it’s a supportive process

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Web-based tool

  • Online self assessment tool

  • Evidence record for external audit

  • Knowledge management system

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Knowledge Management System

Knowledge Management System


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How do I find out more?


Hard copy:

Faculty of Occupational Medicine

6 St Andrews Place

Regent’s Park

London NW1 4LB

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How do I find out more?


FOM Winter Conference:

1st December 2010

Royal College of Physicians

Regent’s Park



SEQOHS will have its own web address

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