Health check: Constructing Better Health visit Galliford Try site

Contract Journal is working with Constructing Better Health to highlight occupational health issues on site. Rebecca Froley finds out how the scheme works in practice on a visit to Galliford Try's Northampton Schools PFI scheme.

The three-year, £192m Northamptonshire Schools PFI project for construction work on 41 schools has been described as a "benchmark investment in schools" by local councillor Joan Kirkbride. For Galliford Try, the main contractor, it's a significant and prestigious project. The firm hopes it will prove a flagship, not just in terms of the work itself, but also with regard to the health and safety of the workers getting the job done.

"We wanted to raise the bar in everything we're doing," says Andy Pearson, project manager for the whole of the Northampton Schools PFI contract. While safety has long been a major concern within the construction industry, Pearson believes there hasn't been enough focus on workers' health outside specialist sectors such as nuclear and asbestos handling.

Pearson says: "When we were setting our project objectives, one was to consider health. The Constructing Better Health (CBH) programme provided an ideal opportunity."

Free talks

The CBH pilot programme (see CJ 17 May) provides free-of-charge toolbox talks on health and safety and on-site occupational health checks tailored to the construction industry. Through Pearson's invitation, the CBH team has been able to give talks on eight of the nine current Galliford sites across Northampton.

Two sites have also played host to a visit from the mobile health check unit (see panel). One was the site of specialist music college, Northampton School for Girls. On this site alone, where around 80 operatives are working on a typical day at this stage, 65 workers attended a toolbox talk, from management down to the site administrator, and the health check unit is fully booked, with 11 appointments happening on the day of CJ's visit.

The majority of workers on site are employed by subcontractors rather than directly by Galliford. There is a mixture of specialist workers, including reinforced concrete, steel frame, steel erection and groundwork subcontractors. CBH has welcomed Galliford's help in enabling it to reach further down into the supply chain, towards smaller companies that wouldn't normally have access to health-check facilities. Pearson hasn't found it difficult to get subcontractors on board. Having written to them to introduce the health-check scheme, he attended the first talk, together with the subbies' supervisors, to ensure they would take the initiative seriously, and found their reaction very positive.

Clive Bailie, project manager on the Northampton School for Girls' site, backs this up. In his weekly meetings with the supervisors, they all praised the aims of the CBH scheme and the way Galliford is trying to look after its workforce through involvement in it.

He reports that take-up on site has been very good and that even people who perhaps wouldn't go and see their GPs for a general check-up have attended the health checks. Overall, he believes: "It's been a very worthwhile tool and will hopefully reap some rewards on site."

Both Bailie and the site's health and safety advisor, Steve Finnigan, believe the scheme's independence of Galliford has helped ensure the high turnout. Any initial scepticism from the subcontractors was overcome once it was explained that the talks and van would be run by external specialists.

With regard to the health and safety talks, Finnigan says workers can "become a bit blasé if it's the same person every week, but bringing an outside professional in to add a different perspective makes them sit up and take notice".

Over the week since the CBH visit began, he's already noticed a change in attitude, with workers using concrete being a bit more "respectful" of the substance after seeing the horrific pictures of concrete burns featured in CBH consultant Polly Begy's talks.

Check-ups

As well as providing general guidance on occupational health hazards and early warning signs of health problems, the talks are used to promote the check-ups. By the end of one talk, a worker whose initial reaction had been "I haven't got time for that" had changed his mind and was asking how to book in order to "have a crack and find out how rough I am!"

The CBH team says that the experience is typical. The combination of talks, enthusiastic site management staff and word of mouth from those attending the check-ups means that although they have occasionally been faced with a two-hour wait for the first participant on a site to enter the van, often a queue forms later.

It's site manager Mark Grimes who best sums up the benefits of the scheme. Having known several people who have had to leave the industry with occupational health problems, including one with asbestosis, he suspects a lot of workers don't know enough about their own state of health. "There could be lads out there now with lung problems and so on. If these checks are done regularly, problems could be flagged up before it's too late, lengthening their working career. It's an excellent programme and should be rolled out countrywide."

The health check in detail

The "mobile occupational health" van at Galliford Try's Northampton School for Girls site is a little like the Tardis: inside is a surprisingly well-equipped health check station. It could intimidate, but Alan Craig, occupational health nurse with the Constructing Better Health (CBH) programme is good at putting people at their ease: "You greet them as though you've known them all your life, try to relax them, have a laugh, have a joke - and 99% of people respond to that," he says.

A typical half-hour health check starts with a chat between Craig and the site worker. Craig takes the operative through a questionnaire covering basic details about their job role, health history, any medication they may be on and the hazards they face at work.

Check-ups are voluntary and confidential, so the worker can choose which tests to undergo. Generally though, they will go through checks to assess their body mass index (BMI), blood pressure, lung function, vision and hearing, together with a urine analysis test to check for the presence of sugar and protein, and a visual check for skin problems.

While site supervisors are not given details of individuals' health, they do get a generic report identifying any problems or hazards affecting a number of people. This allows them to take any action required, for example, improving site hygiene if problems are found with cleanliness.

Only if a safety critical issue is discovered, where there is a moral obligation for both their safety and their workmates' safety, does the team inform supervisors about an issue concerning an individual. To date, though, there have been no such problems.

Typical health issues revealed by the checks have included high blood pressure, suspected diabetes, hearing difficulties and pulmonary (lung) function problems. One man, a non-smoker, was alerted to lung problems that required hospital treatment. He later came back to the team to thank them, saying: "If I hadn't come to the van I wouldn't have known till it was too late."

Dust and chemicals on site mean the lungs are a typical risk area for construction workers and so the health unit has specialised equipment to assess respiratory function. Blood pressure and skin checks are conducted just as they would be in a GP's surgery

With noise another major risk factor on building sites, the audiometric hearing-test booth is vital. About the size of a small wardrobe, it contains just enough room for one person to sit inside. Once the door is closed, a seven-minute programme is run to check hearing quality. For the nervous or claustrophobic, it's even possible, though not ideal, to do an indicative test with the door open.

The weight and height check used to calculate whether or not an individual's BMI is in the healthy range is straightforward, but Craig finds it's often the area where most diplomacy is called for in terms of giving the results: "We tend to tell them they're under-tall rather than overweight!"

In the project's early days, the least popular test was the urine analysis, and the team found that disappointingly few workers obliged them with a sample. Craig believes "people were apprehensive as to what we were testing for". It's now made clear to workers that it's not a check for drugs and alcohol, but rather for signs of health problems such as diabetes. As word of mouth has spread, more of those being screened have brought samples with them. This has resulted in a number of men being referred to their GPs with suspected diabetes, an intervention that could save them from greater problems down the line.

Whatever the outcome, a written record of the results is given to the individual immediately at the end of the check-up. Craig says: "I'd love for everyone to come through that door and to be able to hand them a clean piece of paper, saying everything's fine."

However, if a check reveals a potential problem, the worker is advised that it's in their interests to see their doctor for a full diagnosis.

The team helps people to take action, for example, writing a referral letter to a GP on behalf of a worker with English as a second language, and phoning men whom they've flagged up as having a possible problem to check whether or not they have done as advised.

Craig's advice to site workers is simple, to make use of similar schemes and of local GPs: "It's your health; take responsibility for it."

CBH pilot scheme: facts and figures

• 2,500 workers have attended a toolbox talk
• 1,500 workers have had on-site health checks
• One-third of workers who had health checks were found to have problems
• Health checks were provided by specialist consultancy Sypol
• Funding from industry, trade unions, the Health and Safety Executive and other bodies meant the talks and check-ups in the pilot programme were offered free-of-charge to sites and workers
• The pilot scheme ran from June 2005 to June 2006
• The HSE will publish an evaluation of the pilot in 2007
• 450 companies and traders have taken part, including Galliford Try

[Contract Journal, 2 August 2006, p, 18-19]