Access to the service would remain the same, but an ongoingprogramme of developing partnerships with the workforce would take place toreduce inappropriate attendances. The programme would include presentations tomanagement about OH, highlighting the relationship between work and health, andhow by working together we can help them to manage and control work-relatedill-health. From our customer survey we learnt that people felt weprovided a professional service but they did not really understand what ourmain role within the company was, and could therefore be forgiven for thinkingthat we were in some ways a substitute GP service. They liked having ease ofaccess and not having to make an appointment. Many occupational health professionals promote OH as aservice that will be more use to its employer if it operates proactively ratherthan reactively. If more time were given to staff welfare at work, then lesstime would be needed to deal with the consequences of ill-health1. 1 Position assessment As a nurse working in occupational health for Boots in theEast Midlands, I work as part of a team providing a treatment service to theheadquarters site staff. However, our service is now only accessed by aminority of employees because we chose Managing For Value (MFV) as our tool topromote the OH service. Through MFV we have dramatically reduced inappropriateattendances by re-educating all levels of the workforce. As a result, we areable to direct more of our efforts and skills towards minimising work-relatedill-health. Option 2 – no treatment service It provides the best opportunity to ensure continuingcontact between the service and employees that would not be likely if theservice was removed or restricted. Work-related health problems that couldotherwise go undetected would be treated appropriately and any trends investigated. At this stage, it should be possible to identify thefundamental reasons for the process which are known as the key drivers. Three-tier system Past failings Managing For Value – originally named Value Based Management– is a “systematic approach to managing companies to achieve the governingobjective of maximising wealth creation and shareholder value overtime.”4. It is a management tool to generate the greatest wealth forshareholders, which is how a company’s success is measured. Past attempts at reducing inappropriate attendances hadfailed in several ways: An example of a reactive function is the treatment service.This facility usually comprises of a walk-in surgery which employees can attendwith any health problem. This may be a useful means of detecting work-relatedhealth problems, but the treatment service also attracts less appropriate casessuch as those where the condition is self treatable, or needs the attention ofa GP. It was clear that the service needed to be restructured butmore importantly, occupational health needed to develop active partnershipswith management and employees that would agree the needs of the customer, andmarket OH services. How Boots employed the business principles of MFV to addvalue to its occupational health service. By Sheila Collins A strategic plan is formed and used as the vehicle forimplementing and monitoring value through the key drivers. In addition, the treatment of work accidents would be morecostly for the company if employees had to go to their GP each time, and therewould be less control over accidents if reporting was inadequate. GPs may notalways liaise with occupational health to discuss relevant cases and may evenlose respect for the department as their surgeries become overloaded. 4 McTaggart et al (1994) The value imperative/managing forsuperior shareholder return. MacMillan 1994 Re-educating the workforce MFV: the four-step procedure An appointment system would be encouraged and the hoursrestricted. This would coincide with health promotion activities that aim toeducate management and employees about self care. Occupational health timewould be pre-planned and reactive time would be reduced considerably. Workaccidents and emergencies would always be seen immediately. 2 Options formulation A breakdown of surgery attendances showed that only 20 percent were work related. The other 80 per cent was made up of minor ailments orconditions that should have been treated by a GP. 1 Robinson, M (1997) Proactive Practice Versus RolePerception. Occupational Health vol 49 no. 8 p296-298 The service at that time added value because work-relatedhealth problems were seen that would otherwise not be detected during thenurses’ normal workplace activities, and employees spent less time away fromwork by not having to go elsewhere for treatment. Little value was achieved,however, for OH or the employer, by using qualified nurses to treat nonwork-related problems, particularly where employees could self-treat. Having identified the key drivers, what remains is a shoppinglist of components that can be assessed individually for their value contentand either exploited or revamped accordingly. We put forward possible options for improving the value ofthe treatment service: Option 4 – disseminate the service into the workplace Forward thinkingOn 1 Oct 2000 in Personnel Today – Placement of the nurses around the site within certainfactories and warehouses for a few hours per day had the opposite effect ofthat hoped for. We had made ourselves even more accessible and therefore onlyencouraged employees to attend with non work-related ailments. It also requiredmore nursing and medical support staff. Lessons had been learnt from these failed attempts, but thefact remained that the quality of the occupational health service was stillbeing jeopardised due to the high demand of customers attending with minorailments. Enter MFV. First we reviewed our current situation within the treatmentservice and the value content of each component. A three-tier system existed: 4 Strategy definition and implementation planning – OH devised a leaflet encouraging employees not to attendwith non work-related conditions and distributed it throughout the site. It didnot work. OH had acted in isolation. We only considered what was valuedestroying to us and not to the company. We did not consult with our managersin person to listen to their needs 3 Atwell, C (1999) Yes, We Do Add Value to the Business.Occupational Health vol 51 no. 3 p12 This refers to outsourcing of the service. Again, permittingmore time for proactive work forms value, but an external provider without thesame knowledge of the company and with its own business financial interestscould conflict with the company’s needs. Previous Article Next Article 2 An on-site service to fewer employees based off-sitebut within the Nottingham area. Very few off site personnel attend.Occasionally telephone advice is required. OH nurses believe that reducing minor treatments to allowmore time for minimising work-related ill-health will save money for thecompany2, and improve the health and wellbeing of the workforce. The challengeis to prove this to the employer who is asking OH to demonstrate where they addvalue3. This looks at all aspects of the current process by breakingit down into its component parts. What is being provided and to whom? How muchdoes it cost? Who benefits? How much time and whose time is needed to run theprocess? During the assessment it is necessary to determine customer perceptionof the process by carrying out surveys, and to benchmark against othercompanies. References Taking action Nursing Adviser time was allocated to run the service butlittle or no control was allowed as an appointment system was not used exceptfor repeat treatments and referrals. Medical support staff were also requiredto work reactively. Since rationalisation began in 1999, the number ofattendances to the treatment service has fallen by 60 per cent. Fifty per centof attendances seen in 1999 were inappropriate, compared with 80 per cent in1997. The greatest value was realised not by changing the service, but byestablishing OH within the company as essential to the business function. No service available. In this way OH time would becompletely dedicated to proactive work. This adds value because prevention ofill-health at work will reduce costs to the employer. However, value may becomedesolate if employees were to regard the occupational health service asinaccessible and uncaring. There would be a tendency not to report work-relatedhealth concerns. – Predecessors among the nursing staff had promoted a nannyservice. They wanted employees to feel cared for and consequently tended totheir every need. Indeed, OH was a company perk We already knew from past experience that this would notwork. 2 Stokes, B (1997) Occupational Health Nurses – Training andDuties. Croner’s Management of Health Risks. Issue 8 p4 The principles of MFV can be applied to any process,service, task or decision within business however small or large the effect ofthat process. A four-step procedure is used and includes factual informationwhere possible. Assumptions are also made. 3 No treatment service provided to approximately 70,000employees based outside Nottingham and throughout the country. This option showed the greatest potential to implement theoccupational health service key drivers, which are identified as sickness absence,underperformance, staff turnover, ill-health retirement and medico-legal. Moretime would be available for the nurses to be proactive and carry out activitiesthat target the key drivers such as risk assessment and control. 1 An on-site treatment service to approximately 8,000employees at the headquarters site in Nottingham. This is a walk in servicebetween 08.00 and 16.45 Monday to Friday and is staffed by qualified and nonqualified OH nurses. Work related and non work related cases are seen. Firstaid cover is available throughout the site for out of hours incidents MFV is not only a tool but also a philosophy at Boots. Itencompasses a set of principles that are used to approach strategic businessplanning, guide decision making at all levels and identify where value can becreated. “Value” should not be confused with cost. MFV is not drivenby the monetary worth of an idea or service, but by its benefits and how theymight increase the wealth of the company’s shareholders in the long term. Forexample, if a company were to launch a new product, MFV would consider theinitial cost of the launch, but not be constrained by it. All the optionsrelating to cost, alternative products, markets, advertising etc would be investigated,and an eclectic option likely to give the greatest return selected. Option 5 – rationalisation of the current service Value is created by allowing better use of nurses’ time forproactive work and medical support staff time for pre-planning. Employees areencouraged to take more responsibility for their own health, thus reducing thetime they spend away from work. An appointment system also allows management tobe aware of their employees whereabouts. Option 3 – an external OH service provider 3 Options evaluation Employees would recognise the role of OH but still beassured access to health professionals if problems arose. Some employees maycontinue to want the service available to them all day because they can’t ordon’t understand the role of the service. Related posts:No related photos. Leaflets and other health promotion tools that offerself-help advice, one-to-one advice given as people attend and grouppresentations where necessary are also included. Management would be encouragedto make appointments for staff to be seen in OH for non-urgent cases, ratherthan relying on the walk-in route. Under its original name, MVF was created by an Americanconsultancy and engaged by Boots in 1991, being one of the first UK companiesto do so. It was introduced to the company’s occupational health service in1997 and now drives its strategy. MFV principles have been successfully appliedwithin the treatment service which previously attracted a high number ofinappropriate attendances, and compromised preventative care. Option 1 – a restricted treatment service Comments are closed. From the shopping list a component is chosen and assessedfor its value content by using steps 1 and 2. The options for that componentare considered. For example, what would be the consequences of completelyremoving it? Should it be outsourced or would it be better to hand it over tothe business to manage it themselves? The options that capitalise on the keydrivers are chosen.