1 August 2017 | For immediate release 

Press release Should OH be a fully integrated part of the NHS [opens in new tab]


Should the occupational health specialty be fully integrated into the NHS? Not according to respondents to the journal, Occupational Health [at Work]’s latest online Tea-breaker poll, with more than three-quarters of those polled opposing the idea (1),(2). One respondent described the proposal as ‘incredulously out of touch’.

Occupational health was left out of the NHS when it was created in 1948, but according to an editorial in the BMJ3 its omission should now be rectified. Occupational physician Ian Torrance and Faculty of Occupational Medicine president Richard Heron maintain that the nature of work has changed over the past 70 years and the focus of OH has been transformed to meet modern workplace health demands. ‘Integration of the clinical specialty of occupational health into the NHS is long overdue,’ they wrote.

The current system of OH provision in the UK disenfranchises people working for small businesses or who are unemployed, Torrance and Heron argued. And with the cost of ill health among working-age people put at £100 billion a year, the government ‘has a powerful economic incentive to pay for broader provision of occupational health services’, they wrote. ‘The most obvious route would be to integrate occupational health into NHS care systems.’

But what does the wider OH community feel about the possibility of integrating OH fully into the NHS? More than three-quarters (76.4%) of respondents to our Tea-breaker poll said that the speciality should not become fully integrated into the NHS. Just one in five respondents (20.0%) were in favour of integration, with 3.6% unsure.

Among those against integrating the OH specialty into the NHS, one respondent said: ‘I believe that employers should pay for this as they have a duty of care to their employees under law, and to expect an already stretched NHS to fund this would be inappropriate and criminal.’

‘It is important that OH remains independent and able to make important decisions about the workforce without any hint of concern about other factors involving an overarching organisation,’ said another.

Other respondents argued that the NHS would not be able to provide an integrated OH service ‘due to lack of resources and a lack of understanding of the role of the OH practitioners in industry and commerce’, that ‘money allocated to the NHS should be used for treating patients’, and that the NHS was generally a ‘reactive’ service responding to accidents and illness, whereas modern OH focused on prevention. The NHS ‘has enough on its hands’, said one.

But some respondents could see benefits of a fully integrated NHS OH specialty. ‘At long last people’s work is starting to become an essential aspect of today’s healthcare,’ said one respondent. ‘It is therefore only right that OH should become an integral part of the mainstream NHS to reflect this
improvement in person-centred care. The link between health and work was identified a long time ago, but we in the NHS are only just starting to acknowledge its importance.’

Another added: ‘If we do not integrate OH into the NHS, it will always be perceived as an optional extra.’

Others pointed out that any integration of OH into the NHS would mean creating more OH traineeships ‘for all OH disciplines’, and that ‘OH should be included in the training for all clinical staff’. One respondent said: ‘Work-focused outcomes should be part of all clinical outcomes, and integrating OH would enable clinicians to refer their patients for specialist advice.’

1. OH and the NHS: Tea-breaker: should OH be a fully integrated part of the NHS. Occupational Health [at Work] 2017; 14(2): 6–7.
2. The online poll was carried out between 19 June and 12 July 2017; 225 people responded.
3. Torrance I, Heron R. Occupational health should be part of the NHS. Integration would benefit people in and out of work, and the UK economy. BMJ 2017; 357: j2334. doi: 10.1136/bmj.j2334

Further information

Notes for editors

1. The results of the online poll are published in the August/September 2017 edition of the journal Occupational Health [at Work].

2. A total of 225 people responded to the survey, which was carried out between 19 June and 12 July 2017.

3. Occupational Health [at Work] is published by The At Work Partnership, London, an independent occupational health publishing, research and training organisation. www.atworkpartnership.co.uk/occupationalhealthatwork

4. Suggested citation: OH and the NHS: Tea-breaker: should OH be a fully integrated part of the NHS. Occupational Health [at Work] 2017; 14(2): 6–7.

5. In the same edition of Occupational Health [at Work], editor Dr John Ballard proposes a national framework to improve access to occupational health services, without overburdening the NHS.