EXECUTIVE SUMMARY
Occupational Health Support (OHS) had grown over the years, to include so many activities. Its importance in work places, is attributable to the losses experienced in businesses and countries GDP as a result of occupational health issues. Studies have shown that Small and Medium Sized Enterprises are major contributors to the GDP of any country, UK inclusive and therefore calls for a need to provide OHS as recommended by the Legislation (HASAW 1974) and Health and Safety Executive's model.
The report covers the research design which will be applied, to study the level at which Occupational Health Support is provided within selected SMEs. The study will be conducted through an Ethno-methodological qualitative approach by an interactive and micro-ethnography (triangulation) methods using qualitative interview, observation, focus group and survey are the data collection instruments . Collected data would be analysed and result interpreted with the aim of answering the research question and make recommendations towards the improvement of OHS levels in SMEs
SECTION 1: INTRODUCTION
Small and Medium Sized Enterprises (SMEs) are important players in the economy of many nations (MacEachen et al 2008, USE 2009) and actively involved in employment (56.8% of total employment in UK (Occupational Health Advisory Committee (OHAC), 2007). However, 82% of reported occupational injuries emanate from SMEs, and in some cases rises to 90% for fatal accidents (OHAC, 2007). This points to the occupational health and safety challenges and the level of occupational health support within SMEs.
Occupational Health (OH) is a term that conveys different meanings and includes several activities. Irrespective of the meaning, it is generally concerned with work effect on health, fitness for work and promotion of good health at workplace (Karen,1993). According to OHAC 2007, the trend of occupational health support particularly in the private sector, is changing from the traditional medical based services led by doctors and nurses, to multidisciplinary teams such as occupational hygienists, ergonomists.
Objectives
The objectives of this report are:
To understand the usage of research methodology (Qualitative, Quantitative and Mixed approach and design) on a research topic, carry out a literature review on the selected topic, and generate a research question (hypothesis).
To study the types of occupational health support utilised, the interaction level and efficiency within SMEs.
To render recommendations from study towards improvement of occupational health support.
1.2 Study's Context
A Long- Term Occupational Health Strategy launched by Health and Safety Commission and the Health and Safety Executive (HSC/E) in July 2000, aimed at 20% reduction in the incidence of work-related ill health and ill health to members of the public caused by work activity (Health and Safety Executive (HSE) RR 410, 2010).
A Strategy for Workplace Health and Safety to 2010 and beyond was launched in February 2004, by Health and Safety Commission and the Health and Safety Executive (HSC/E) to address occupational health and safety with strategic partnership and approaches. Aim was to reach the 20% reduction in the incidence of work-related ill health and ill health to members of the public caused by work activity target, of the long term occupational health strategy launched in July 2000. Strategy target was SMEs because research showed that only about 3% of people working in SMEs have access to comprehensive occupational health support.
Several strategies and interventions had targeted particularly SMEs in improvement of occupational health support and occupational health and safety. Therefore, there is a need to seek out how SMEs had integrated these interventions into their Occupational Health Support.
The research is to study how the occupational health support are provided in SMEs, in line with the objectives of the research.
1.3 Scope of Report
Section 2 of the report covers a review on occupational health support and its various forms, the legislative provisions, its need, forms and interaction level within SMEs.
Section 3 describes the methodology, research design and methods, data collection instruments and procedures, data analysis instruments. Limitations and ethical issues involved in research approach.
SECTION 2: LITERATURE REVIEW
2.1 Health and Safety Management
According to Health and Safety Executive (2008), Health and Safety is the protection of workers from harm or ill health by appropriate precaution and provision of satisfactory work environment. Health and safety management of any business is an important aspect of the business risk management, since the safety and health of the workers is necessary for business activities.
2.2 Occupational Health
Occupational health is a term that covers various activities, it is generally regarded as prevention and treatment of illness resulting from work. According to T. C. Aw et al (2007), occupational health is a multifaceted and multidisciplinary activity concerned with the prevention of ill health in employed population. However, OHAC 2007 report, recommended that occupational health embrace effect of work on health, effect of health on work, rehabilitation and recovery programmes, help to the disabled in securing and retention of work and illness management resulting from work and workers assistant in lifestyle decision making.
Occupational Health is important to businesses and nations, this is because business output is tied to the health and productivity of the workers. However the obtainable within any business is attributed to employers' and employees' attitude and awareness of occupational health issues (Bunt, 1993).
2.3 Occupational Health Support
Occupational Health support refers to processes or means through which positive outcomes (improved productivity) are obtained from workers and businesses. Occupational health (OH) support was defined broadly by Pilkington et al (2002) as hazard identification, risk management, and provision of information, and deeply as a process comprising the above three parameters including work modification activities, occupational health-related issues trainings, workplace hazards measurement and health monitoring trends. Health and Safety At Work Act 1974 and the Management of Health and Safety at Work Regulations 1999 makes it the employers' responsibility to provide occupational health support and promote safety at the work place.
In HSE RR 410 (2010), International Labour made recommendations that Occupational Health Support entails Surveillance of the working environment and worker's health, Information, education, training and advice, First aid treatment and health programmes and work and health condition improvement measures. However Pilkington et al (2002), acknowledged that hazard identification was the most likely practised form of OH support , followed by risk management, irrespective of company size, sector and region.
According to Smith (2004) stated in her report "Occupational Health and Safety Support Provision that in Securing Health Together (SH2) 2000 publication", it was concluded in support programme Action Group that OH &S support go beyond the traditional method of medical advice and intervention and incorporate full range of advice to employers and workers (see appendix 1).
2.4 Small and Medium Sized Enterprise
Small Sized Enterprise has been defined by EU, DfEE and HSE as a business with small 50 or less employees and Medium sized as business with 50-250 employees (OHAC, 2007). SMEs are over 19 million in European Union employing approximately 70% of Europe's working population (HSE, 2005), contributing enormously to UK' economy. SMEs accounts for 99% of private sector businesses, 53.8% of industry turnover, 45% of non public sector and a total of 56.8% of total employment (OHAC, 2007).
2.5 Occupational Health Support in SMEs
A major issue in the workforce of any society is work related illness. UK in 2002/03 recorded 2.2 million people were suffering from an illness caused or made worse by work and 82% of reported occupational injuries occurred in SMEs, with 90% rise for fatal cases (HSE, 2005). However, as stated in recommendations on improving access to occupational health support by OHAC (2007), the injuries incidence level could be linked to the health and safety management system in SMEs as revealed by a recent literature by HSE .
A survey conducted on the use of occupational health support by Pilkington et al (2002) , revealed that most companies within SMEs provide OH support through was provided by employees with health or safety based training, over a third provide OH support by external agencies and the type of OH support was usually determined by the Board of Management or the owner while in larger companies, the Occupational health or Human resources department make contributions on type and provider of OH support.
Lansdown et al (2007) stated that occupational health and safety issues in SMEs occur in the risk assessment context. OHAC report in 2007 supported Lansdown et al where it was stated that SMEs employers and Managers fulfils several roles, including speciality roles, thereby health and safety resources are concentrated on accident prevention rather than illness that develops over a long period.
The Chartered Institute of Personnel and Development (Cipd) 2010, occupational health support are provided through an occupational service provider as and when needed. Depending on the size and business activity, a full time occupational nurse supported by a part time doctor is employed as an occupational health support.
Smith (2004), remarked that SMEs are reluctant to contact HSE and are unaware of the provisions available and the capacity to utilise NHS specialist occupational health resources including NHS Plus is limited. As a result, SMEs is lagging behind in OH & S support, hence most needed. Interventions and delivery models on OH support all advocates for commitment and modification on the OH support available in SMEs in order to improve occupational health and business productivities.
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SECTION 3: RESEARCH METHODOLOGY
Overview
Research is a process of information gathering, to answer a question that solves a problem (Wayne et al, 2008). McNabb (2004), defined research as a means of data gathering, processing and interpretation intelligently and cogently communication of the result in a report that best describes what was discovered. According to Naoum (1998), research can be divided into three (3) major phases namely; Topic selection and Literature review, Research design definition (research methodology/approach and methods), Data collection, Analysis and Report writing. However, Gary & Kotler (2008), research involves four phases which are; research problem and objective definition, research plan development, research plan implementation result or findings interpretation and reporting.
Different approaches exist to which a research can be conducted, the choice of approach is influenced by several factors such; as theory, values, epistemology, ontology and practical considerations (Bryman and Bell, 2007). Irrespective of choice, limitations exist within available research approaches, this presents a need for limitations reduction means to barest minimal or overcome limitations where possible.
3.2 Research Definition
Review of literature shows that occupational health support through the traditional emphasis is outdated and is the commonly utilised process by SMEs. Literature review also showed that interventions and models for a better OH provision process with focus on SMEs. Research is to study the changes in OH support interaction level, which are resultant of the provision models and interventions within health and safety management of SMEs.
From the various research approaches, the most suitable approach would be utilise to ensure reliability, validity and credibility of the research.
3.3 Research Question
The Study is to inquire into SMEs OH support level, resultant from the implementations of the current interventions and make recommendations from the result obtained from the study
The general question of the study is ; What are the occupational health support interventions within SMEs management system?
The specific question to be answered is; how is occupational health support made available, within health and safety management of SMEs?
3.4 Research Design
Research design comprises of the methodology/ approach and methods through which the data will be captured and analysed. Marion (2004) classified research designs into categories based on the research question, these are: descriptive, differences, and relationship, while Silverman (2006), stated that several methodologies exist in social research and maybe broadly defined as qualitative or quantitative or narrowly defined as grounded theory or conversational analysis. However Colin (2002), stated that of the approaches to research in social world, qualitative and quantitative approaches are more influential.
What is Qualitative and Quantitative Research Strategy?
Proter (1993) as cited by Silverman (2006), defined qualitative research strategy as an approach, that calculates the relationship between two or more variables. Sackman (1992) argument as cited by Bryman and Bell (2007), was that an inductive (qualitative) research approach, is suitable for an investigation centred on the formation and existence of organisational subcultures, to enable generation of theories. However, Silverman (1993), argued that qualitative researches, are also involved in testing (deducing) theories.
Bryman and Bell (2007), gave insight to both strategies as defined below;
Qualitative Research strategy can be defined as an approach with emphasis on words rather than numbers in data collection and analysis, towards theory induction.
Quantitative Research strategy can also be defined as a research approach with a quantifiable (numbers) emphasis rather than words in data collection and analysis, towards theory deduction by the testing of theories.
Study can be categorised as a descriptive study, as presented by the research question. An ethno-methodological qualitative approach will be utilised to carry out study (fig. 1 below), which will seeks to understand the order / level of OH support provision and the resultant effects on employees and the business through interactivism and micro-ethnography (Bryman and Bell, 2007).
Research question
Ethno- methodological approach
Stratified Sampling
Interactivism & Micro- ethnography
Survey, qualitative interview, focus group
Data Analysis (Grounded theory)
Theory
Figure 1 Research Processes
Research Methods
An interactive process that would allow a mapping or combination of methods (triangulation) will be utilised to allow in data collection (Silverman, 2006). This is in attempt to cancel the limitations inherent in a method by using another method to ensure validity, reliability and credibility of data.
Sample
A Stratified sampling method will be utilised to obtain a theoretical reflection on data collection. This method is considered in order to ensure reliability and credibility of study. A small sample (2) cutting through each organisational levels within 5 SMEs (2 from primary business class, 2 from the secondary and 1 the tertiary business classes) in Trefforest.
Table 1: Stratified Sample
Occupational Level
Sample size
Total Number
Top Management
2
10
Mid level Management
2
10
Staff
2
10
Data collection
Data would be collected using the following instruments;
Qualitative interview
Observation
Focus group
Survey (Open ended questionnaire)
Qualitative interview: This is an interview approach that allows flexibility in an interview session. Interview will be conducted using an interview guide but will introduce questions in response to significant replies from interviewed. Replies will be recorded, to avoid misinterpretation of what was said. This process advantages are;
Interviewees' concerns are expressed rather than researchers concerns.
Insight into interviewees' feelings and opinions on research topic.
It is flexible and responds to interviewee's direction.
Detailed answers are obtainable.
There is room for repeat interview.
Observation: In the process of micro-ethnography, the role of an Observer-as- participant. In this role, researcher is mainly an interviewer but with intent observation and little participation (Bryman and Bell, 2007). This will method will be utilised on every encounter and along other processes (focus group and interview), taking note of body languages and tone of dialogue and deliberations.
Focus Group: This is a form of focused group interview with emphasis on interaction centred on the research question. Each group will consist of a maximum number of 8 people, from same sample group with an established understanding on the research topic. The session will be tape recorded and transcribed.
This method was decided upon to yield the following;
Researcher understanding to why people feel the way they do about the research topic.
It allows participants bring issues that they deem important an d significant to the research topic.
Argument which give room to more realistic account of peoples' thought .
Survey: This is a tool in cross- sectional research technique to which qualitative data will be collected through questionnaire or structured interview. Survey will be carried using an open ended questions meeting empirical criterion, will be administered on the sample groups (table 1 and appendix 2 for data collection questions).
Open ended questions have several disadvantages but will be adopted because of the following advantages;
Respondents are not forced to give answers in a particular term, answers are obtained in respondents term.
Unusual responses not contemplated are possible.
Certain answers are not suggested through questions.
Answers give rise to exploration of new areas.
Data Analysis
Data will be analysed with iterative approach of grounded theory strategy. Theoretic sampling, coding, theoretical saturation and constant comparison will be used as tools to obtain a formal theory from study.
Computer assisted qualitative data analysis software such as Concept mapping software, Microsoft word and NVivo would be utilised to enhance analysis.
Significance
The research is significant in revealing the changes that are resultant of the application of interventions and models designed by HSE and OHAC.
The research design and methods are significant in allowing validity, reliability and credibility through error reduction.
Limitations and Delimitations
Time: The main limitation to the study is time, which will be involved in the study. Hence the sample size considered (see table 1), since qualitative data analysis is time consuming.
Cost: Cost of research is also a limiting factor, this will be considered and SMEs within researcher's locality will be used.
Organisational Access: Organisational access is considered a limiting factor, since most organisations may not allow easy access, so as not to reveal lapses in the organisations. A backing letter for consent will be taken to the organisations to seek consent.
Experience: The researcher being a student and new to standard research processes, will act as a limitation. To reduce this effect, a professional view (senior colleagues and research supervisor) and supervision will be sought and followed through the research process.
Knowledge about the vicinity.
Ethical Issues
Informed consent: Informed consents will be sort after before the commencement of data collection in organisations, in order to promote the organisations involvement and support through the data collection processes.
Honesty and trust: Communication would take place in a way that would encourage the establishment of honesty and trust amongst participants.
Confidentiality and anonymity: This will be considered and put to practise in order to avoid harm to participants by excluding participant names and organisations' names.
Conflict of interest
SECTION 4: CONCLUSION
This research is designed to reveal the present level and means of providing Occupational Health Support in Small and Medium Enterprises. The result from the study after execution is to provide recommendation towards the improvement and interaction between occupational health support and the management within Small and Medium Enterprises. Study will provide an insight into the problems and benefits associated with the provision levels within SMEs.
The ethno-methodological qualitative approach utilising interactive and micro- ethnography role in the data collection process. The data collection processes will reveal the in-depth opinions, views of the respondents, taking into considerations the tone and reasons why people hold the views they hold into. The likely hood that research approach will give rise to issues outside researcher knowledge might arise. This will guide towards making recommendations on Occupational Health Support in Small and Medium Sized Enterprises.
