Julia Evans’ response to Public Health England (a UK Government Department)’s survey on ‘Healthcare Professionals: Work as a Health Outcome’

by Julia Evans on March 10, 2018

This text and link were sent to Dr Sarah Wollaston MP, Chair of the Health and Social Care Committee. A receipt was received on 12th March 2018 at 18:17 which confirms that this text will be dealt with as soon as possible.

A response from the Health and Social Care Committee was received on 18thApril 2018. Quote from the letter : I understand that this survey has now been de-activated. However, The Health and Social Care Committee would not have the power to ‘remove’ a survey being run by the Department of Health and Social Care or one of its arm’s length bodies, such as Public Health England. The Committee exists to scrutinise the policy, administration and expenditure of the Department of Health and its arm’s length bodies. …. Again, we have no formal powers to change the policies of bodies like Public Health England as a result of our work. …. End quote.

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Note: Public Health England is a UK Government Department which exist to protect and improve the nation’s health and wellbeing, and reduce health inequalities.

Question : Further to defending the nation from attack by others in war or from the use of nerve agents in Salisbury, is it the Government’s business to protect the nation’s health and wellbeing?

I have argued ‘No’ since the Health Professions Order was promulgated in 2001. See below for some of the material I have produced.

If you protect, you will do so from a superior position, and will be working towards what you define as the subject’s good. For example, the Inquisition protected your immortal soul by torture, murder and taking your goods away from you. Not far from this Government’s actions on those who exist on benefits.

Curiouser & Curiouser

(from Lewis Carroll ‘Alice in Wonderland’ — ‘Curiouser and curiouser!” Cried Alice (she was so much surprised, that for the moment she quite forgot how to speak good English).’)

– This survey is beyond words

– execrable, manipulative, using naked power to insert the UK Government’s will into practices used in healthcare,

do not begin to describe how disgusting this survey is.

– I found it difficult to answer as all the questions are of the variety: ‘When did you stop beating your wife?’ The UK Government is intent on blackening those, on benefits or unable to work and practitioners walking alongside them, as rejects and failures. My answers are below, and I feel I have exposed myself to Government censure by these responses which is scary. Fortunately, I am not dependent on Government benefits to survive. Whether a subject is in or out of work is not part of the way I diagnose. Neither is encouraging a subject back into work any part of the processes in place. Neither is being in work any part of the outcome of our time together, let alone a ‘success’ criterion as in the Government’s evaluation fantasy.

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For more information on evaluation as used by UK Government,

see Evaluation and Outcome Measurement here  &

Networking & Politics here

Also recommended:

Why is the Ideology of Evaluation Pernicious? by Jean-Claude Maleval on 14th April 2010 : See here

Important article on the UK Government’s imposition of work as a mental health outcome

http://www.independent.co.uk/voices/mental-health-treatment-tory-government-nhs-funding-access-work-benefits-a8037331.html

As a psychologist I see the fantasy of neoliberal values having a devastating effect on mental health treatment

The Tories may believe in the ‘dignity’ of work, but not everyone can function as expected. People with serious needs are being punished as a result

  • Jay Watts
  • Saturday 4 November 2017 12:15 GMT

Comment on the Government’s previous attempt to impose their diagnosis and success factor of work

Work capability assessments for those with NICE/DSM defined mental illness by Julia Evans on October 27, 2013 : Available here

This comments on Dr Sarah Wollaston MP’s text, published in the Guardian:

Work capability assessments are humiliating & tick-box methods of evaluation doomed to failure.

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THE SURVEY

Public Health England at https://surveys.phe.org.uk/TakeSurvey.aspx?SurveyID=HCPhealthwork#

Survey : Work as a health outcome

Healthcare Professionals: Work as a Health outcome

Participant information
WelcomePublic Health England (PHE) invites Healthcare Professionals (HCPs) (Doctors, Nurses, Allied Health Professionals and other health professionals) working in England, to participate in this survey on work as a health outcome. As trusted professionals, healthcare professionals are ideally placed to help people stay in work.Aims of the surveyThe survey aims to understand how HCPs see their role in engaging patients with health and work discussions. It aims to identify any current knowledge and skills gap, and how to address these. The survey also looks at the workplace health of NHS staff.How the survey worksThe survey will take approximately 15 minutes to complete.

The survey is voluntary and your answers are anonymous. You can stop completing the survey at any time – your answers up to that point will still be counted. Some questions may appear or disappear on certain pages in the online survey, depending on how you answer previous questions. This is done to make sure questions you answer are relevant to you. If this occurs, the page will reload and refresh. This may occur more than once on some pages.

How the survey will be used

The survey will help Government to develop a long-term strategy to support HCPs promote work as a health outcome. The results will also form the basis of a published report that will further contribute to the evidence base on health and work.

Privacy and confidentiality

PHE is committed to upholding your rights to privacy and confidentiality. Access to the information you provide is controlled and limited to the study team. It will not be disclosed to any third party or used for any other purpose. Personal identifiable data (such as name, address, etc.) will not be collected. IP addresses are not collected.

Queries

If you have any further questions or comments please contact Suado Nur (suado.nur@phe.gov.uk) and Emily Newton (emily.newton@phe.gov.uk).

 

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Page 2 of 18

How did you find out about the survey ?

[Ticked] Other

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Page 3 of 18

A few questions about your occupation

  1. What is your occupation group?*

Medical Doctor

Registered Nurse

Nursing or Healthcare Assistant

[Ticked] Allied Health Professional

Other, please specify

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Page 7 of 18

 

 

Allied Health Professional 

 

6. Which of the following best describes your occupation?
Occupational Therapist
Physiotherapist
Radiographer
Pharmacist
Clinical Psychologist
[Ticked]  Psychotherapist
Arts therapist (e.g. art, music, drama therapy)
Other qualified Allied Health Professional (e.g. dietetics, speech and language therapy, complementary therapy)
Support to Allied Health Professionals (e.g. support worker, therapy helper, therapy assistant or student)

 

 Other, please specify

______________________________

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Page 8 of 18

 

 

A few questions about your occupation 

 

7. Which part of the UK do you mainly work in?*
Please select the country you work in
 England
8. Please select your Local Authority.
 Kensington and Chelsea

 

9. Which of the following categories best describes your current professional status?
In training
[Ticked] Qualified
Retired

 

 Other, please specify:

 

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Page 9 of 18

 

 

Attitudes on health and work 

 

Questions in this section aim to assess your attitude, views and perceptions of the relationship between health and work.Your answers are confidential and so please answer honestly with your views.

 

Please indicate the extent to which you agree or disagree with the following statements:
10. Work is generally beneficial for people’s health
 Strongly Agree  Agree [Ticked] Neutral  Disagree  Strongly Disagree

 

 

11. Worklessness is generally detrimental to people’s health
 Strongly Agree  Agree  Neutral  Disagree [Ticked] Strongly Disagree

 

12. Return to work is an important indicator of success in the clinical management of people of working age
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

13. I recognise the difference between occupation and employment in relation to health
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

14. The NHS has a responsibility to support individuals working with health conditions in the workplace.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

_____________________________

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Page 10 of 18

 

 

Role of the healthcare professional 

 

Questions in this section aim to identify how you as a healthcare professional (HCPs) understand your role in engaging patients about health and work issues in routine clinical practice. 

 

Please indicate the extent to which you agree or disagree with the following statements:
15. It is part of my role to discuss the health benefits of work with patients.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

16. I am able to discuss the benefits of work with my patients.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

17. It is the role of the HCP to empower patients to make informed choices about work-related health.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

18. It is primarily the role of another HCP to discuss the health benefits of work with patients.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

______________________________________

 

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Page 11 of 18

 

 

Role of the healthcare professional 

 

19. What stage in the patient journey are conversations about work most important?Please select one
Diagnosis
Treatment/maintenance
Remission
Advanced disease

 

[Ticked]  Other, please specify

There is no standard ONE answer to this. It varies from never discussed to as relevant to the subject.

 

20. Thinking about the responsibility to discuss health and work issues with patients in routine clinical practice.Please rank the following HCPs in terms of their responsibility to discuss the health benefts of work with their patients.i.e which professionals do you think should be primarily responsible for having these types of conversations with patients.
  1   2   3   4   5   No opinion
General practitioner
Practice nurse
Pharmacist
Medical/Surgical consultant
Physiotherapist
Occupational therapist

 

[5 was ticked for all of these professionals, as it is not their responsibility. This will vary from subject to subject]

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Page 12 of 18

 

 

Thinking about your own clinical practice 

 

21. It is part of my role to signpost patients to work-related information.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

22. I only bring up a discussion about work if the patient does first.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

23. As part of taking routine clinical histories, I ask about employment status.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

24. I feel that I have the time to discuss work with patients.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

25. I would only initiate a work-related discussion once the patient has shown signs of recovery.
 Strongly Agree  Agree  Neutral  Disagree [Ticked] Strongly Disagree

 

26. I am prepared to challenge patients’ views about a return to work even if this jeopardises the HCP-patient relationship.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

__________________________________________________________

[Note: these questions are of the variety ‘When did you stop beating your wife?’ They assume that getting the subject back into work is a prime concern]

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Page 13 of 18

 

 

Knowledge around Health and Work 

 

Questions in this section aim to assess your confidence, knowledge and understanding of issues related to health and work. 

 

Please indicate the extent to which you agree or disagree with the following statements:
27. I feel confident discussing the health benefits of remaining in work, where appropriate.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

28. I feel confident directing patients to employment-related information and support.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

29. I don’t feel confident to discuss the benefits and barriers to returning to work with patients who are on long term or short term sick leave.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

30. I feel confident signposting patients to resources about reasonable adjustments for returning to work.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

31. I am able to discuss the benefits of appropriate work with patients who are long-term unemployed
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

32. I am able to signpost patients to relevant services for employment or meaningful activity.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

33. If I need to, I can signpost patients to relevant employment benefits.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

 

34. There are good local initiatives or services to which I can refer patients for advice on return to work, or work-based support.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

 

35. I can signpost patients to further support and advice when I identify an occupational work-related health issue.
 Strongly Agree  Agree  Neutral  Disagree  [Ticked] Strongly Disagree

_______________________________________

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Page 14 of 18

 

 

Thinking about your own skills in this area on health and work issues 

 

Questions in this section aim to identify gaps in skills around the relationship between health and work, and how we can better support health and work as a topic in clinical interactions where appropriate. 

 

36. During your professional undergraduate training have you received any training on health and work?
 [Yes]
37. During your postgraduate training did you receive occupational health training?
 [No]

 

38. Which of the following work-related health issues do you find most difficult to discuss?Please select one option.
Work-related stress/anxiety
Neurological issues (e.g. epilepsy, stroke)
MSK (e.g. lower back pain)
Respiratory conditions (e.g. asthma)
Skin conditions (e.g dermatitis)
Depression
None of these
Not applicable

 

 [Ticked] Other, please specify

All these are not necessarily originating in work. They are usually motored from elsewhere.

39. Can you tell as a bit more about what makes this issue more difficult for you to discuss in the context of health and work?

My trade is to cure people not to act as a Government work enforcer

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Page 15 of 18

 

 

Thinking about your own skills in this area on health and work issues 

 

40. Have you received any training in clinical conversations on health and work within the past 12 months?
 Yes [Ticked] No
42. Do you know where to find local resources to inform yourself about work and health in the clinical context?
 [Ticked] Yes No

 

43. Do you know where to find national resources to inform yourself about work and health in the clinical context?
 [Ticked] Yes No
44. Which of the following do you think would help support you in having clinical conversations about health and work with your patients?Tick all that apply.
E-learning
Face-to-face training
Information on local initiatives/services available
Information on national initiatives/services available
Research evidence
Clinical guidelines
Specific guidance from your professional body/royal college
Clinical infographics
Information on the benefits system
Contact with your local Jobcentre Plus

[Ticked] Other, please specify

I do not have clinical conversations about health and work with my patients. I work within a process based on the subject speaking not on my forcing my opinions manipulatively on them.

________________________________________

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Page 16 of 18

 

 

Workplace health for NHS staff

 

Questions in this section aim to explore your own views and attitudes to workplace health within your workplace in the NHS context.

 

45. Does your organisation take positive action on health and well-being?
Yes
[Ticked] No

 

Please indicate the extent to which you agree or disagree with the following statements:

 

46. My professional body (e.g. royal college) supports the health and wellbeing of its members
 Strongly Agree  Agree  [Ticked] Neutral  Disagree  Strongly Disagree

 

47. I feel it is part of my role as a HCP to practice and promote healthy working in my team.
 Strongly Agree  Agree  [Ticked] Neutral  Disagree  Strongly Disagree

 

 

48. I would feel confident discussing any personal health issues with my line manager.
 Strongly Agree  Agree  Neutral  [Ticked] Disagree  Strongly Disagree

 

49. I would feel confident discussing any personal health issues with staff that I line manage, should they raise it with me.
 Strongly Agree  Agree  [Ticked] Not applicable  Disagree  Strongly Disagree

 

 

50. Do you know where to find resources to support your own health and wellbeing?
 Strongly Agree  Agree  [Ticked] Neutral  Disagree  Strongly Disagree

 

51. Do you have access to occupational health support?
Yes
[Ticked] No

______________________________________

 

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Page 17 of 18

 

 

52. Please rank the following statements that summarise the relationship between health and work:
1 – Most favourable 5 – Least favourable[5 has been ticked for all the Government’s phantasies below]
  1   2   3   4   5   No opinion
Work is a health outcome
Work is a health-enhancing intervention
Working is a health health outcome
The value of work to help improve health and wellbeing
Health is an enabler of employment potential
53. Do you have any other thoughts or feedback on how we can best support healthcare professionals to take action in routine clinical care to enable patients to achieve their employment potential?

 

This whole survey is invalid as it contains the direction in which the Government wishes to target the health services – getting people in work. This is more dismal than the Soviets’ attempts to control dissidents by labelling them mentally ill and treating them with drugs. The most disgraceful fact about it is that Government will manipulate targets so ‘health professionals’ will be paid on target of getting people working. The Stasi used similar methods to ensure compliance.
Further information on national resources and how to receive the final report from this survey is available at the end of the survey

(Please click ‘Done’ to see this)

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Page 18 of 18

 

 

Other Demographic Information

 

We would like to know a bit more information so that we can compare the experiences of different types of HCPs. The below categories have been replicated from the NHS Staff Survey 2017.

 

54. How would you describe your gender?
Male
[Ticked]Female
Prefer not tosay

 

 Prefer to self-describe
55. What is your age?
18 or below
19 – 24
25 – 34
35 – 44
45 – 54
[Ticked]55- 64
65 or over

 

 

56. What is your ethnic group?
Choose one option that best describes your ethnic group of background.
[Ticked] White
Mixed/multiple ethnic groups
Asian/Asian British
Black/African/Caribbean/Black British
Other ethnic group

 

57. Please select which category best describes your White ethnic group background
[Ticked]British
Irish
Any other White

 

 

62. Which of the following best describes how you think of yourself?
Bisexual
Heterosexual
Gay Woman (lesbian)
[Ticked] I would prefer not to say
Gay Man
Other

 

63. What is your religion?
Jewish
Christian
[Ticked] I would prefer not to say
Muslim
Buddhist
No religion
Hindu
Sikh

 

 Any other religion, please specify
64. Do you have a long-standing illness, health problem or disability?

Yes
[Ticked] No
65.  Has your employer made adequate adjustment(s) to enable you to carry out your work?
Yes
No
[Ticked] No adjustment required

 

 

66. Have you ever been off work for more than a month due to work-related illness (e.g. stress)?
Yes
[Ticked] No

 

67. Have you ever been unemployed and received state benefit?
Yes
[Ticked] No

 

 

The end of the surveyThank you for your participation in Public Health England’s work as a health outcome survey.Please remember to click ‘done’ at the bottom of this page to submit your responses. Your views are important to us and will help shape future provision of training and support for healthcare professionals.

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Survey Completed

Thank you for completing the survey!Below are links to further information about health and work

If you have any further questions or any feedback on the survey to help us improve in the future, please contact Emily Newton or Suado Nur at healthandwork@phe.gov.uk.

—————————————————————————————————–

 

Julia Evans

Practicing Lacanian Psychoanalyst, Earl’s Court, London

 

Further texts

Evaluation & Outcome Measurement : Available here

Responses to Government CON-sultations : See here

Risk & Protection & Safety here

Use of Power here

Ethics here

Of the clinic : here

By Sigmund Freud here

By Jacques Lacan here

INDEX OF RELATED TEXTS

More information on evaluation as used by Government

Previous responses to UK Government CON-sultations:

Addenda

_____________________________________________________

For more information on evaluation as used by Government,

see Evaluation and Outcome Measurement here &

Networking & Politics here

Also recommended:

Why is the Ideology of Evaluation Pernicious? by Jean-Claude Maleval on April 14, 2010 : See here

Important article on the UK Government’s imposition of work as a mental health outcome

http://www.independent.co.uk/voices/mental-health-treatment-tory-government-nhs-funding-access-work-benefits-a8037331.html

As a psychologist I see the fantasy of neoliberal values having a devastating effect on mental health treatment

The Tories may believe in the ‘dignity’ of work, but not everyone can function as expected. People with serious needs are being punished as a result

  • Jay Watts
  • Saturday 4 November 2017 12:15 GMT

Comment on the Government’s previous attempt to impose their diagnosis and success factor of work

Work capability assessments for those with NICE/DSM defined mental illness by Julia Evans on October 27, 2013 : Available here

This comments on Dr Sarah Wollaston MP’s text, published in the Guardian:

Work capability assessments are humiliating & tick-box methods of evaluation doomed to failure.

Outcome measurement

The Government’s outcomes measurements – Education by Julia Evans on June 28, 2011 : Available here

_________________________________________________

Previous responses to UK Government CON-sultations:

Julia Evans’ contribution to the Department of Health’s October 2017 consultation by Julia Evans on January 18, 2018 or here

The National Audit Office’s investigation into the performance data of IAPT services.by Julia Evans on August 14, 2017 : Available here

Two letters for your attention: the bps tells Parliament why it should not be swallowed whole into the domain of the Privy Council & Earl Howe, the Government’s Standards Zsar within Health, commands a reply to 3 of my emails. by Julia Evans on November 13, 2012 : Available here

The exchange between Earl Howe, the Department of Health and Julia Evans during October. My reply will be posted shortly. by Julia Evans on October 30, 2012 : Available here

CHRE(PSA) trumpets its success in creating a ghetto of wellbeing practitioners who are compliant (for a fee) to the Government’s fantasy of safeguarding. by Julia Evans on October 3, 2012 : Available here

CHRE (PSA) reports on how they are progressing in their regulatory capture of ‘talking therapists’ onto their ‘voluntary registers’ regulated by statute……. by Julia Evans on September 17, 2012 : Available here

The ‘Fat Controllers’ in the DoH dictate THE law with the agreement of both Houses of Parliament by Julia Evans on August 13, 2012 : Available here

The CHRE/PSA receives over 400 responses to its CON-sultation on Accreditation Standards (Voluntary Registers) by Julia Evans on July 20, 2012 : Available here

The UK Government’s ethnic or practice cleansing of talking therapies: a response to CHRE/PSA consultation by Julia Evans on July 10, 2012 : Available here

Open Letter to the CHRE/PSA’s consultation on Accreditation Standards by Bruce Scott on July 5, 2012 : Available here

English context of Autism in relation to medical and other political formulations by Julia Evans on June 30, 2012 : Available here

The Law Commission’s consultation on regulation of health and social care professionals: a response: 31st May 2012: Julia Evans by Julia Evans on May 31, 2012 : Available here

For your action (UK):the Law Commission’s CON-sultation which closes on 31st May 2012 by Julia Evans on May 28, 2012 : Available here

For your participation: The CHRE CON-sults by Julia Evans on April 18, 2012 : Available here

Sadeian power, the UK Government……… & CON-sultations by Julia Evans on February 3, 2012 : Available here

So who is in bed with whom (part 1)? & further on the Government’s CON-sultation mechanisms by Bruce Scott on September 28, 2011 : Available here

Psychotherapy is imposed: Psycho-analysis© works: Psychoanalysis operates by Julia Evans on December 15, 2010 : Available here

Reply to CON-sultation: Equity and excellence: Liberating the NHS White Paper July 2010 by Julia Evans on October 9, 2010 : Available here

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Addenda

See Collaborators win: Putting the State Wellbeing Strategy to work….. by Julia Evans on February 8, 2011 : Availability here

Posts for the “Government White Papers & Reports” category : See here

See Category : Government as guarantor of Practice within Mental Health or here

‘Will you walk into my parlour?’ said the spider to the fly: An invitation from the Government-guaranteed supplier of risk-free treatments. by Julia Evans on December 1, 2012 : Available here

Category : Posts for the “Other Government actions” category : Available here :

What escapes when regulation is used to address risk… by Julia Evans on March 14, 2012 : Available here

Does rule through regulatory systems give protection from murderers? – No by Julia Evans on November 6, 2009 : Available here