The challenges facing Occupational Health providers are well known: an ageing OH workforce; not enough people training in OH and an increasingly competitive environment, where customers expect more for less, are just a few of the major issues that have to be addressed. Add to this the introduction of revalidation for nurses and pressure on training budgets and it’s clear that OH providers need to be smart and innovative to achieve a sustainable L&D solution that meets all these challenges at once.
Learning & Development for Impact
An obvious but often overlooked issue is ensuring that Learning and Development activity is designed for impact. Studies of training show a widespread tendency for organisations to spend money on Learning and Development activity that achieves no benefit to the individual or the organisation, (Barrington and Reid, 2007). It’s one thing to gather some “happy sheets” from learners immediately after a training course or learning session, quite another to evaluate how the learning objectives have translated into actual improvement in skills, knowledge and most importantly, how the service to patients and client organisations has improved as a result of that L&D intervention. In some cases, such as training for technical skills such as administering vaccinations, carrying out audiometry and so on, evaluation of impact might be related to zero errors in delivering the clinical intervention. However, many aspects of Occupational Health practice involve subjective judgements that are more difficult to evaluate properly.
The Business Case for Learning & Development
Most organisations understand the concept of the “business case” - the basic summary of the costs of an investment and the expected benefits to be realised for that investment. A smart and innovative approach to Learning & Development requires organisations to be clear about the business case for investing in L&D activities. “Will an OHA receiving HAVS training deliver sufficient volumes of this work to remain competent” is at the very easy end of a business case justification. At the more difficult end, “will our sponsorship of an MBA result in increased performance of the individual and organisation” (as well as other consideration such as staff retention, motivation etc). In between, there are the vast majority of Learning and Development interventions ranging from the online Health & Safety Awareness course to the intensive Client Relationship skills training and lots more besides, where the business case is often less clear and certainly more difficult to evaluate.
Evaluation: Clinical Quality and Service Quality
For most OH providers, the ‘provisional’ business case for Learning & Development expenditure is to achieve some notion of quality outcomes. This can easily be confused in terms of what we mean by clinical quality and service quality. By way of example, consider the handling of a referral to OH for someone on long term sickness. Clinical quality can typically be characterised in terms of predefined criteria such as good quality case notes, evidence based clinical judgements and a clear well written management report. Achieving clinical quality does not mean service quality has been achieved, because quality of service is usually defined by the level of satisfaction based on the customer’s subjective experience of the service, (OGC, 2010).
Implications for future OH Learning & Development
Increasingly, Learning & Development investment for OH professionals has to focus more on achieving tangible service quality benefits for customers as well as meeting clinical quality expectations of the provider. This means crafting L&D interventions that focus on contextualising clinical learning in terms of how to deliver service value. Dr Lucy Wright, Chief Medical Officer at OH Assist Ltd provides a current example: “OH Assist spends several million pounds each year on clinical Learning & Development but until recently we were not getting enough value from it. Following a comprehensive review, we are now investing in programmes that not only teach clinical skills but contain a large element of customer service and consulting skills as an integral part of clinical training. The measurable benefits of this change in approach include higher service satisfaction from customers and increased ability of OH Assist practitioners to deliver more high value consultancy assignments”
If OH providers are to attract more people to the profession, a new less clinical based approach is needed. Doctors, nurses and other practitioners equipped with management consulting skills can deliver enhanced service value whilst ensuring good governance of more junior staff to deliver routine technical services. A smart Learning & Development strategy, focused on measurable impacts in the workplace is a key component to make this happen.
Barrington H and Reid A, 2007 “Training Interventions”,
Office of Government Commerce, 2010, “Agile Project and Service Management”