Supporting industry back to work

Resource for occupational health nurses - supporting non health care workplaces return to work

This resource provides the key principles, information and guidance for workers and organisations re-opening businesses outside of healthcare. 

It aims to support good working practices during the COVID-19 outbreak and identifies the support that the RCN can provide. It is is for non-health care settings, it does not address considerations for health care settings where people are managing or supporting people with COVID-19 infection.

Introduction and background

The SARS-COV2 virus which is causing this coronavirus (COVID-19) pandemic has led to unprecedented demand on health and care sectors but also on the wider population. Closure or ‘lockdown’ of many parts of society have been implemented in order to try and minimise population exposure to the infection and therefore reduce transmission rates. As the Government permit a gradual reopening of businesses many workers are understandably concerned about the risks of coronavirus transmission as social interaction increases with the return to work.

RCN support for you

You may be asked to support your workplaces in ways that you have not previously been asked to. It is important that you are clear about your professional responsibilities and seek support from the RCN if you feel you are being asked to compromise your standards or work outside your competencies.

The RCN website has lots of information that will be relevant – and you can call RCN Direct on 0345 772 6100 if you need further advice or support.

Also see the RCN clinical pages on occupational health for further information. This includes guidance on consent and confidentiality and record keeping. 

Working in partnership with union Safety Representatives

Employers will want to utilise all available expertise in ensuring safe working practices and this should include recognised Trade Union Safety Representatives. Trade Union Safety Representatives should be consulted on any measures that impact on the health and safety of their members. For further detail on the role of Safety Reps and information resources available to them see the HSE.

Consulting employees on health and safety and the TUC representative guidance: Safety representatives and worker involvement.

Reopening workplaces

The Society for Occupational Medicine (SOM) and British Occupational Hygiene Society (BOSH) have developed specific COVID-19 guidance and frameworks for occupational health around returning to the workplace:

These resources focus on supporting best practice for workplace health and wellbeing and managing the physical, psychological and mental wellbeing implications for the workforce returning after lockdown. Whilst there is a need to minimise the amount of time and contact individual workers have with each other to reduce the risk of viral transmission, there is also an emphasis on the importance of reviewing and maintaining existing organisation risk assessment strategies.

Supporting the workforce returning to work

Please see the RCN clinical pages on occupational health for further information. This includes guidance on consent and confidentiality and record keeping. 

COVID-19 occupational risk assessment guidance

The Scottish Government has published risk assessment guidance and a tool for staff across all industries which should be used by employers to support staff and line managers to understand and carry out effective risk assessments. See: Coronavirus (COVID-19): guidance on individual risk assessment for the workplace.

Five key steps

The DHSC have identified Five key steps for working safely during coronavirus (COVID-19):

1. Carry out a risk assessment. The HSE have interactive tools available to support risk assessment processes
2. Develop cleaning, handwashing and hygiene procedures
3. Help people to work from home
4. Maintain 2m social distancing, where possible
5. Where people cannot be 2m apart, manage transmission risk

Any organisational and individual risk must also consider disease incidence and transmission.

COVID-19 secure Occupational Health

Disease incidence

While the known numbers infected from coronavirus in the UK are likely to be in the hundreds of thousands and many have sadly died as a result, it is important for occupational health nurses to bear in mind that a high proportion of the population will not be infected.  Of those who are, most will be asymptomatic or have a mild / moderate disease.

The full understanding of coronavirus risk factors are still not fully understood. The emerging evidence indicates those who tend to be more seriously affected are:

  • older people 
  • have underlying medical conditions
  • are obese
  • from a BAME background 
  • male.

Organisation and Individual risk assessment must therefore consider the workforce demographic and the likely impact of the factors which contribute to severe illness.  These risk factors need to be considered as part of an overall risk assessment for how the organisation and each individual employee is supported to return to work.  As the evidence is still emerging, the risk assessment can not be exact on how much weight needs to be given against each potential demographic.  

Organisations will need to promote individual self-care responsibilities within the workplace and provide access to reliable workforce information including coronavirus symptom recognition, when to self-isolate and how to maintain social distancing (see the published PHE advice and guidance for the public or the NHS advice). 

Spread and transmission

The infection is primarily spread outside of hospital and care settings via droplets from an infected person coughing, sneezing, and transmitted directly to another individual via their mouth, nose and possibly eyes (i.e. direct contact with mucus membrane). Droplets from coughs and sneezes will carry on average as far as one metre, occasionally slightly further, see WHO advice for public. Droplets containing the virus can also land on surfaces and then transmit back to individuals when they touch their face.

Social distancing has been the key to reduce transmission. This reduces the possibility of droplets being carried from one individual to another.  Social distancing in the workplace during coronavirus (COVID-19): sector guidance sets out how this should be achieved. The two metre distancing rule is at the heart of this: 

  • people cannot reach each other and therefore not spread infection by direct touching
  • allows space for exhaled droplets to dissipate reducing the likelihood of inhaling them. 

Risk assessments for spread and transmission should consider:

Homeworking for the workforce wherever possible remains essential      

  • support for how to maintain physical, psychological and mental health and wellbeing
  • promoting a culture for workers to maintain work life balance with adequate time off and employer support. Encourage regular exercise and options for wider self care.

Where people need to return to the workplace

PPE

PPE is important but it is not the only issue that needs to be considered (see 5 steps above).

The PPE guidance is regularly updated and available via the PHE PPE hub here If the workplace requires the use of PPE, see the section on ‘Non Health and Social Care settings’.

If social distancing is not possible or easy to facilitate, the use of a face covering may be a consideration. While the evidence suggests that wearing a face covering does not protect the individual, it may protect others and prevent droplets being transmitted from one person to another or landing on surfaces for onward transmission. 

If a risk assessment recommends face covering consider publishing corresponding advice on how to put the face covering on and take it off as well as washing advice, see: Working safely during coronavirus (COVID-19