Staffing and Infrastructure:

The (corporate) institutional setting of a OH Service is a Company Health Centre which functions in liaison with the Risk management officers, environmental control and human resource departments, and the health and safety representatives.

The Company Health Centre is typically staffed by:

• An occupational health sister (nurse practitioner).
• A part time occupational health doctor (medical practitioner). This appointment is usually part time, and the incumbent is preferably an occupational medical practitioner, as defined.
• Depending on the size of the workforce, an assistant nurse practitioner or staff nurse/nursing assistants and administrative assistants.

The Risk Management function will be staffed by permutations of (depending on the size of the workforce):

• A Risk Manager, whose's portfolio usually carries responsibilities in a variety of "risk" issues, such as health and safety, security, environmental management and fire control.
• A Risk Officer. This is the "Safety Officer", who reports to the Risk Manager, if a manager exists. Hence the terms "Manager" and "Officer" here are merely hierarchical terms.
• Assistant/s.

The Environmental Control function is staffed by:

• An occupational hygienist, supported by assistants.

Note that, in the vast majority of cases, this latter function is outsourced to project-based services of an Approved Inspection Authority.

All service providers should be appropriately qualified to perform their function, as defined in the previous page.

Staff Development:

Of central importance to the running of the OHS is the need to have the correct staff levels and ensure that they are competent and adequately trained. The qualifications listed above (excepting for those described for the Risk Officer, are prescribed by various Regulations in the Occupational Health and Safety Act, as well as the Mines Health and Safety Act. Note that there are no qualifications stipulated for hygienists - this constitutes a serious quality problem.

In South Africa, Continuing Medical Education (CME) is mandatory for doctors, but not (yet) for nurses. Hence staff members should be encouraged to remain up-to-date in the practice of their disciplines by being allowed to attend conferences and seminars.

Professionals working in factory-sited clinics run the risk of "stagnating" because of their relative isolation. They do not automatically obtain the same kind of peer review and on-going academic training that, for example, occurs in a hospital setting. For this reason it is important that the staff, at all levels, be given the chance to constantly update their knowledge and skills, including ongoing training to develop specific skills for performing their roles satisfactorily eg. Audiometry, spirometry, chest x-ray, computer literacy, clinical refresher courses etc.

Evaluation and Audit:

The occupational health service must be subject to a process of ongoing evaluation and audit. This involves a systematic approach to peer review of health care in order to identify opportunities and provide mechanisms for improvement in patient care, education and professional standards. This process also provides information on the efficiency and cost effectiveness of the service and provides an opportunity to evaluate satisfaction of the recipients of the service.

Both internal and external audits should be an ongoing feature of the occupational health service to maintain and ensure quality control.