12

Managing Health and Safety

Introduction

It is strongly advised that you read this chapter in conjunction with Chapters 17 and 19, in order to develop your health and safety management system.

The overall purpose of health and safety management should be to implement the dental practice’s commitment to health and safety as stated in Part 1 of the policy, ‘General Statement of Intent’. This should clearly express your intention towards making the working environment safe and healthy for employees and anyone else who may be at risk from your day-to-day activities. In addition to Part 1, the policy should say who is involved in making this happen and their specific role and responsibilities and finally, the arrangements you have in place to demonstrate that you mean what you say, that is, how you will put your commitment into action. This will not just happen on its own. Like any other business function, health and safety needs to be managed.

Legislation

• Health and Safety at Work etc. Act 1974:

  Employers are required to prepare a health and safety policy statement of commitment and as often as may be appropriate revise the statement with respect to the health and safety of employees. In addition state the organisation and arrangements for carrying out the policy.

• Management of Health and Safety at Work Regulations 1999:

  Employers are required to have effective arrangements in place to manage health and safety. These arrangements must ensure the effective planning, organisation, control, monitoring and review of health and safety.

• The Health and Safety (Consultation with employees) Regulations 1996:

  Where employees are not represented by safety representatives under The Safety Representative and Safety Committees Regulations 1977, the employer is required to consult with employees on matters relating to their health and safety at work.

• The Corporate Manslaughter (England, Wales and Northern Ireland) and Corporate Homicide (Scotland) Act 2007:

  The organisation must manage or organise their activities in order to prevent serious accidents which could result in death of an employee, and will be guilty of an offence if a person’s death amounts to a gross breach of a relevant duty of care owed by the organisation (employer) to the deceased.

Reasons for Managing Health and Safety

All dental practices are subject to external pressures and forces of change – never more so than now. This has led to significant transformations in the structure of practices and how they are managed in order to meet the increasing demands. ‘Managers’ are faced with how to deal with the changes, provide direction to others and help people cope with the changing environment. An effective management system, which is people centred, will assist greatly in helping practices through the transition of change. Employees have a right to work in a safe, healthy and supportive environment, one that actively promotes the health and well-being of people and strives to ensure that this happens. Equally so, employees have a responsibility to contribute; therefore, it is important that everyone understands the reasons for and the purpose of health and safety management in respect of their individual roles and the wider issues affecting the organisation. There are several reasons for managing health and safety but the following are probably the most recognised.

Legal

All of the activities undertaken in dental practices are subject to health and safety legislation. Employers and managers have a clearly defined responsibility and accountability for health and safety; therefore, they must comply with the minimum standards expressed throughout legislation. The results of non-compliance could lead to enforcement procedures which includes the issue of a legal notice or prosecution.

Moral

We have a sense of concern for our own well-being and that of others and we do what is possible to prevent the risk of injury, disease or harm. We do not intentionally carry out an action or omit to do something that could infringe on the health and safety of people.

Financial

The effects of accidents and ill health are staggering in terms of organisational disruption and the costs incurred. Some of the hidden costs are not immediately recognised and include sick pay, increased insurance premiums, repair or clean-up costs, replacement staff and damage to professional reputation. It is generally accepted that the costs of accidents and ill health far outweigh those of prevention.

Organisational

All dental practices have rules and acceptable behaviour standards that people must work within. These will be clearly stated in terms and conditions of employment, explicit in the Health and Safety Policy and enforced where necessary through disciplinary procedures. No organisation can allow employees to behave exactly as they wish.

Professional

Dental practices and dental personnel are expected to meet the requirements of the clinical governance framework by ensuring that the premises where dental care is undertaken are fit for the purpose. The General Dental Council (GDC) expects all dental professionals to put the interest of patients first and act to protect them.

Exemplar Employer

Employers who demonstrate a commitment to the health, safety and welfare of employees will benefit by retaining a motivated workforce who recognise their responsibilities to health and safety and work as a team to achieve good acceptable standards.

Quality Framework

A practice which has integrated health and safety management systems and procedures in place is able to measure performance against set goals. They are able to identify strengths and weaknesses and put realistic targets in place in order to achieve a desired outcome.

Health and safety management makes good business sense. It requires commitment from every member of the team and helps to reduce accidents and cases of ill health which gives everyone peace of mind.

Employer Responsibilities

The Management of Health and Safety at Work Regulations 1999 state what is expected of employers in order to manage health and safety as follows:

• Carry out a suitable and sufficient assessment of risk to which employees and others may be exposed.
• Identify preventive and protective measures required by law in order to control risks; risk prevention principles required by law are as follows:
  • Avoid risk completely by elimination.
  • Where avoidance is not possible substitute with something less hazardous.
  • Combat the risk at source.
  • Adapt the work activity to the person who is undertaking it.
  • Use advancement in technology and best practice guidance and analyse the way work is organised in order to develop prevention strategies.
  • Look at prevention strategies that aim to protect everyone and not just one person.
  • Ensure information and instruction are clearly understood by all employees.
• Make arrangements for putting into practice the preventive and protective measures, in particular, planning, organisation, control, monitoring and review.
• Provide health surveillance that is appropriate to the risk identified in the workplace.
• Appoint competent person/s to assist with health and safety (if the employer has the necessary competencies and time this may not be required).
• Set up procedures to deal with serious and imminent dangers including having sufficient and competent personnel to evacuate people from the premises.
• Establish contacts with external emergency services, for example, the local fire service.
• Provide employees with information concerning the risks they are exposed to and how these are controlled. The procedures for serious and imminent danger, the identity of the competent person and any risks have been identified and notified by others sharing the workplace.
• Employers who share premises or workplaces must cooperate with each other, inform one another on the risks arising from their activities and coordinate health and safety measures.
• If another employer’s employee is working in the premises, he/she must be provided with information on the risks they are exposed to, the control measures and the person responsible for emergency evacuation procedures.
• Health and safety training must be identified and provided to ensure that employees are capable of carrying out their duties safely.
• Locum/temporary workers must be provided with the necessary information in order to work safely. In addition, employers and self-employed persons must provide certain information to employment agencies before they start work.
• Risk assessment of activities for new and expectant mothers must be undertaken and the risk avoided where possible. If this is not possible the necessary controls must be introduced.
• If a new or expectant mother works at night and a certificate from a medical practitioner states that for health and safety reason she should not work those hours then she must be suspended with payment of wages.
• A new or expectant mother should be strongly encouraged to inform the employer in writing if she is pregnant, has given birth within the last 6 months, or is breastfeeding so that the employer can execute his/her legal duties.
• Risk assessments must be undertaken for young persons before they start work and activities prohibited where a significant risk remains which cannot be suitably controlled.

Leadership and commitment from the top should be clearly demonstrated, ownership of health and safety must pass through all levels of the practice and everyone should be held accountable for their actions. The next section explores the responsibilities of the whole team and describes their involvement in the management of health and safety.

Employee Responsibilities

The management of health and safety is concerned with people at all levels of the dental practice. However, realistically, each person or his/her position within the practice will determine the actual involvement, role, responsibility and accountability.

Delegation of health and safety duties is an essential part of the day-to-day running of a busy dental practice; no one person can make all the decisions and do all the work. Delegation is, therefore, where one person gives someone else the control and authority to perform the health and safety function/s. However, if that person is expected to accept this control and authority, it is essential they have the ability and capabilities to carry out the role competently and safely. The delegation and acceptance of the role means that the person also accepts accountability.

Accountability must be understood by all members of the dental team, and each person should be answerable for his/her actions when performing tasks and functions. However, all persons in the ‘chain of command’ are still accountable for the delegation of the tasks; delegation does not mean accountability ceases.

We now examine a typical organisational structure and identify specific roles and responsibilities for health and safety.

Managing Director, Owner, Proprietor or Employer

Whatever title is assigned to this person he/she will have ultimate responsibility for business planning, safety policy design, development and implementation. The person at the top of the chain of command is accountable for his/her actions, will have overall responsibility and vicarious liability for health and safety and should sign the Health and Safety Practice Policy. This person will usually delegate the day-to-day running of the dental practice including health and safety management to a competent person, for example, the practice manager. It is important to consider, that where the employer/occupier is not the owner of the premises and or equipment certain duties are imposed upon the owner (see Chapter 23).

Practice Manager

This person is responsible for carrying out specific health and safety duties. This includes ensuring that the practice policy is implemented and adhered to by all staff, safety procedures are adopted and equipment is used correctly to ensure safety; organising sa/>