Roles of a Back Care Advisor

National Back Exchange » Roles of a Back Care Advisor

From NBE Essential Back-up, Revised 2002: An employer's guide for setting up and maintaining an effective Back Care Advisory Service.

• Strategic and Management
  • Formulation of MH strategy - there should be a coherent management strategy to control, monitor and audit risk reduction measures for WRMSD. The BCA will work with senior management to develop and formulate the MH strategy to achieve the aims of the BCAS. Clear management systems will need to be established to control risks. Reference should be made to the Management of Health and Safety at Work Regulations (MHSWR 1999) and the guidance offered by HSE
  • Advise on formulation of a MH strategy and contribute to relevant policy development - there is a requirement for providers and employing authorities to have a manual handling policy. This will extend the Health and Safety Policy, set overall principles and reflect current legislation, good practice and safe systems of work. Codes of Practice (COP) will be drawn up by the Moving and Handling Committee to define desirable practice and identify unacceptable practice. Each work area or department may be required to define their own COPs to address specific needs in their area, identified by risk assessment. This could include standard operating procedures. The policy must be dated and signed off by the chief executive. A review date must also be set.
  • Participation in risk management functions including clinical governance, controls assurance and risk assessment
  • Set standards
  • Establish effective communication systems with staff, managers and clients
  • Establish contingency plans - for foreseeable emergencies and high risk handling situations contingency plans will be needed e.g. mechanical breakdown (lift, bed, hoist etc), Emergency evacuation, Heavy patients
  • Ensure comprehensive documentation including the maintenance of accurate records - cotemporaneous accurate, complete records must be kept of :-
    • Assessments
    • Workplace advice and recommendations
    • Education and training
    • Equipment
    • Audits
    • Protocols, standards and procedures
    
    These are required to demonstrate legal compliance and will be used in the event of litigation.
  • Manage a Back Care Advisory Service
• Advisory Role
  • Advise managers, staff, clients and their carers as and when required
  • Work in partnership with other agencies to ensure unity - where more than one agency delivers care to the same client the MHSWR require the commissioning organisation to pass on to the other providers any information gained during a care assessment that may have implications for health and safety. It is therefore important that when more than one agency is involved good communication exists and that standards are agreed for risk assessment and safe systems of work, especially where there are complex care packages. There are examples of positive inter-agency working e.g. Derbyshire Interagency Group, All Wales MH Group, Buckingham Interagency Protocol. The joint provision of equipment is outlined in the Guide to Integrating Community Services (2001) and must result in joint provision by 2004. BCA's should be involved in joint equipment stores regarding the provision and choice of equipment.
  • Make recommendations regarding safe systems of work, based on risk assessment and evaluation
• Ergonomic Role
  • Ergonomic approach to risk assessment (TILE) and setting up safe systems of work. The MHOR 1992 require that :-
    • Hazardous manual handling operations should be avoided or mechanised so far as is reasonably practicable
    • A suitable and sufficient assessment must be carried out for hazardous operations that cannot be avoided
    • The risk of injury from those operations is reduced to the lowest level reasonably practicable
    
    The overall approach to risk reduction is based on ergonomic principles which optimise the match between the worker and the work system. The provision of a safe system of work, incorporating the use of equipment and good management systems is paramount.
    Training must be seen as a useful complement to, and not an alternative for, a safe system of work. Work places will have to be assessed, risk identified and analysed and the environment and systems of work modified accordingly. The possible cost of these changes will be offset by improved performance.
  • Environmental design and / or modification including workstations. Environmental factors, especially lack of space, are major causes of accidents, cumulative damage and inefficiency. When areas are being designed, equipped or up-graded, ergonomic considerations should be paramount. The provision of a suitable working environment is indicated in many guidance notes and legislative documents e.g. NHS Health Building Notes are produced periodically. The BCA, end users and other relevant personnel should form a design team to ensure that all work environments are safe, functional, and ergonomically suitable for all. The input of the BCA may not be limited to areas involving lifting and handling, but may involve other areas such as offices, workshops, community settings, stores and transport where posture is compromised.
    • Many sources of information may prove useful during the design process e.g
      • NHS Health Building Notes (periodical)
      • Care Standards Act (2000)
      • Disability Discrimination Act (1995)
      • Human Rights Act (1998)
      • Guidance for public buildings and space
    • Considerations may include
      • Working with and informing architects
      • Use of access consultants
      • Ergonomic solutions e.g. space utilisation and planning, working with the equipment provider in its provision and compatibility
      • Housing adaptations for private domestic homes, the availability of resources and the inadequacies of funding
  • Task analysis
• Equipment Evaluation Role The MHOR 1992 require employers to avoid or reduce the risk of injury from manual handling operations to the lowest level reasonably practicable. The provision of equipment is essential to this (see chapter 8 in Essential Back-up for additional details)
  
  The BCA's responsibilities in relation to equipment :-
  • Carry out initial and ongoing equipment audits
  • Be aware of the range of equipment that is available for both client and load handling and ensure that this complies with British and European standards
  • Monitor the care and maintenance of equipment
  • Ensure appropriate training is delivered, e.g. in conjunction with the manufacturers
  • Liaise with relevant professionals and clients in the assessment, selection and use of equipment. Trials and comparative evaluations may be warranted in some situations
  • Assess the compatibility of equipment with the environment
  • Advise on priorities for action
  • Attend national equipment exhibitions, keep updated and seek advice when necessary e.g. through NBE networking and liaison with other agencies
• Problem-Solving Role
  • Problem-solving and the completion of complex risk assessments
• Education and Training Role
  • Act as a role model to promote best practice
  • Plan the training programme
  • Ensure the delivery of training programme
  • Assess competencies
• Work Support Role
  • Instruction and supervision in the workplace
• Investigation Role
  • Investigate and follow up adverse incident reports and MH complaints - Staff are legally required to report incidents. These reports should be copied to the BCA and others according to the local policy. Prompt investigation and follow up action is required. This enables trends to be identified and control measures to be implemented. The risk register should be reviewed against these.
• Occupational Health Role
  • Support of occupational health, safety and welfare programme - whilst the BCAS is directed primarily towards staff care (prevention of ill health and maintenance of health, safety and welfare), other interventions within the service may well be considered desirable, for example a rehabilitation programme. This will enable work injured staff to return safely to work. The actual details of this process will depend on local circumstances and needs close liaison with the Occupational Health Department. Considerations include early referral for assessment and treatment, occupational health assessment before returning to work, possible modifications to the work place, changes in tasks, hours and possible redeployment.
  • Health promotion - for back care and injury prevention may include :-
    • Exhibitions and displays
    • Back awareness days
    • Media events
  • Workplace rehabilitation
• Auditing Role
  • Monitor performance, analyse data, audit the process and review the strategy including quality control and benchmarking - Systems need to be established to actively monitor adherence to protocols, standards and training in the organisation. This will involve the collection and analysis of data. Accurate record keeping is vital if this is to be achieved. An initial audit to establish a baseline prior to implementation is important to allow comparison and highlight achievements. Ongoing audits must be conducted to ensure that practice is consistent with the standards published by NBE (appendix 2) and other relevant bodies and can be benchmarked against other service providers. Reviews will evaluate costs and assess benefits. Results should be reported via the risk management structure.
• Research Role
  • Participate in research and development - data should be collected and may be used for research. Research studies would be subject to each organisation's research protocol. National Back Exchange is an association which has a network that could provide links for suitable collaborative research in conjunction with other professional or statutory bodies and universities
• Income Generation
  • Once the service is established and all internal organisational needs catered for, it may well be possible to use the BCAS to generate income by selling services externally. In order to do this extra staff will need to be recruited and allocated to this role.
    
    If additional resources are not allocated, income generation will be an unwelcome distraction and a poor substitute for a properly funded and resourced service.

The management of change is common throughout all these roles.

For further information and full references refer to NBE Essential Back-up, Revised 2002: an employer's guide for setting up and maintaining an effective Back Care Advisory Service).

A copy of Essential Back-up can be purchased from National Back Exchange. Contact the office using the contact details on the Contact Us page.