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Scott Brannon
Member - 2 posts
I wonder if anyone can help. I am the Health and Safety representative for a branch of a large company. One of our trade counter staff, who works face to face with customers every day is an insulin dependant diabetic. He has worked for us for about 2 years, and on the whole he is very good at his job. However over the past 6 months his diabetes doesn't seem to have been controlled aswell as before. He often has lows and we often have to remove him from the trade counter and sit him in the office and give him a sweet drink and wait for him to recover. We believe that he is taking too much insulin, but because we are not doctors we are not qualified to say anything. He never had this problem in the first 18 months he was here, I have spoke to him about it but he refuses to accept that something is not quite right. I spoke to his partner and she said that he is a lot worse at home now too and she has had to call an ambulance for him a number of times. We tell him to see his doctor and get some advice but he says there is no need. So we paid for him to go to an OH clinic. However that didn't really help because he just told them what they wanted to hear and they didn't offer us any help. They just aksed him questions about safety at work and the equipment he uses in his job. We understand that he has a medical condition and being a diabetic obviously isn't very nice for him. However we are trying our best to solve the situation and help him, but if he refuses our help and wont see his doctor, what else can we do? Some of our customers have made complaints about the service on the counter going down hill because of our chaps condition. We don't want to lose the employee, and we dont want to upset our customers either. What we want is for the employee to seek medical advice from his GP and then maybe he can help our employee. But we cant frog march him to the doctors surgery if he wont go. Can anyone offer any help?
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Phill S
Member - 69 posts
Its a shame he won't go back to his doctor, after all it may be a simple case of adjustment.
But the real shame is that he's lucky to work somewhere with this kind of management thinking, and by him not getting more advice he could let good people down.
All I can suggest is to keep trying to persuade him.
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Jennifer Chapman
Member - 27 posts
It's difficult - trust me, I'm a Type 1 (insulin dependent0 diabetic and have been for 36+ years.
When things are going OK no-one would even know - save for hosp appointments etc and the fact I've always been entirely upfront about it - if you keel over suddenly in the workplace colleagues need to know the reason this has probably happened and more importantly - what to do with me!
Because none of us wants to cause or employers any hassle and we never have, really, in the past - it's terribly difficult usually to admit that we have a problem in the first place. (Denial is absolutely RIFE in our community and only VERY recently has the medical profession realised the sheer amount of mental stress DEALING with this thing is, on an hour-by-hour basis.
My husband says being T1 automatically turns ALL of us into liars eg Are you alright? - Yes I'm FINE! - when you've just fallen off your chair.
What the general populace don't get is the fact that so many factors will change the body'd need for insulin. A couple of degrees warmer or colder will affect doseages. Even the slightest inection can do this. Any type of stress or worry (inside or outside work - even GOOD stress eg I'm going on holiday, I'm excited about something) will have effects. For this we have to increase or decrease doseages. It ain't a condition where you can just take the medication and carry on the same BY ANY MEANS.
Thing is until recently the NHS hasn't offered us anything in the way of training on what actually happens bodily and more importantly - what we can actually do about it SUCCESSFULLY when we need to (like, every day!)
Also - it's entirely possible that his body is now re-acting entirely differently to the medication he's on. That's quite common really - except of course THEY don't bother telling us that !
So what training has the guy had? Does he even know that it's available?
Many NHS Trusts now run courses either a whole week or a day a week for several weeks - I got mine January this year - hoorah. I seriously wonder how I've actually stayed ALIVE the last 35 years without it - O Level Biology was all I had to rely on really - no help at all, really! One of the courses is called DAFNE (Dose Adjustment for Normal Eating - but it covers FAR more than just that I assure you)
There are similar courses available for Type 2 diabetics - one is called DESMOND but don't ask me what that stands for.
The very best thing as am employer you could do is find out what they offer locally (a phone call to your hospital will tell you that!) and say to him someone told you about it, people reckon it's the best thing since sliced bread - and offer him the time to go on the course and you will pay him as normal when he goes, he doesn't need to take it as holiday.
A sympathetic non-judgmental employer is worth their weight in gold.
But if I know diabetics (and I know a lot of em) - PLEASE DO NOT CRITICISE.
We will not respond 'well'. LOL
There are one or two websites you could point him at -
www.diabetes-support.org.uk
might be a good place for him to start!
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Peter MacGregor
Member - 3 posts
DESMOND is Diabetes Education and Self Management for Ongoing and Newly Diagnosed. I was diagnosed as mildly diabetic (controlled with Metformin tablets and watching what I eat) a year ago and the Diabetes nurse at our surgery suggested I go on it. It was just two two-hour sessions but I found it worthwhile.
Couldn't you ask his partner to speak to his doctor and call him in for a review? This is one example of where "Data Protection" hamstrings us with privacy law. This employee may well be heading for serious problems and it would be far better to get help for him that watch him go downhill to who knows what.
If I were the employer I'd certainly contact his doctor direct and to hell with the consequences of breaking the Data Protection Act. The employee would probably thank me afterwards. We are all afraid when we have an incurable illness - which diabetes is - and it is controllable given the right help. He may be afraid of what is happening to him and be in denial.
I grew up in an age where helping ones fellows was more important than complying with the letter of idiotic laws (in this case) meant we had to let someone suffer and worse rather than step in and help.
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GLENN RAYBONE
Member - 21 posts
Hi Scott
Ideally this member of staff needs a Consultant review and they can then ascertain how the sugars have been and medication taken. They would need to agree and co-operate with this.
You could contact the GP, again you'd need consent. If you attempt to contact without consent as previously suggested, not only is this a breach of DPA but the GP would not respond anyway without written consent of the individual.
You mention that OH was not helpful, have you challenged this? Certainly if you've paid for a review and are not happy with the advice then you should challenge this.
Sadly, there is little you can do without the persons co-operation and being a supportive employer is perhaps all you can do at this stage.
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Lesley Scriven
Member - 2 posts
Erm - I understand your hooking this fella up for an OH referral but I have a question. Did you tell the OH people what you were trying to achieve for your employee or not? - unfortunate and inconvenient as it may seem OH are not psychic!
If you had wanted their support to "direct" your employee to a consultant referral for his own good (which I can see you are trying to do and applaud) you should have made this very clear to them. OH are accustomed to kicking butt on an employees behalf, as there are way too few employers who are actually either willing or able to support their employee (as the DDA behoves them too)
It's my view that you are now stuck with handling the situation you find yourselves in - which, if you reflect on it, is actually of your own making.
Number 1 the employee did no wrong - he is trying to come to work on time and every day and number 2, what you sorted out in an effort to offer support, was clearly, inadequate - and I do not think you can blame him for this as he did not get in a queue and say "Aw go on - I'll have a dose of diabetes"
Start again I'd advise ........
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Jennifer Chapman
Member - 27 posts
... and I know what you mean about trying to help - but if MY employer had the temerity to try to contact MY doc without me knowing - there'd be a riot (and of course a Court Case) before you could say Jack Robinson!
It's very sad - for those who won't listen - when their employer (for a change, I have to say!) seem to actually CARE.
If ONLY it was as easy as just taking a bit less insulin! - we'd all be VERY happy!
PS. There is no such thing as Mild Diabetes - that is exactly the same as saying someone is Slightly Pregnant. LOL Type 2 Diabetes (especially) is in fact progressive, I'm afraid. If you have the genes you are stuck with it. If it was steroid or gestation induced and continued - you are stuck with it. Beta Cells pedalling faster to stand still, then they wear out, poor overworked little souls. Ooops. LOL Type 1's cells die. Not end of story - just the beginning really!!!
Recommended reading, perhaps - 'Think Like a Pancreas' by John Walsh (I think that's his name)
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Scott Brannon
Member - 2 posts
Thank you very much for your responses people. Although I was a little bit upset by the person who said the problems we are having are of our own making. The comment has made me want to get on my soap box. We are trying to do the right thing. We always try and look after our staff, yes we may make mistakes but its with the best intentions. But I'm not a legal expert or a diabetes expert, I'm just an employee trying to do the right thing. But I don't know what the right thing is, thats why I am here! I find it sad that when you look for help, instead you find criticism. Thank you very much Jennifer for your advice, I shall look into the courses you suggested. We would never even dream of not paying the employee while he was on this course. We would give him full pay, and we would also pay for any travel costs that he incurred. It is very important to help employee's with any medical conditions they have and offer support. However the two difficulties that we have, is when the employee refuses your help. Also that we are not doctors and its very difficult to know the best course of action when you don't really know what you are dealing with. Also Jennifer I have already been on the website you suggested and I emailed them the situation looking for advice, but once again they jumped on the defensive for no reason. They started quoting things under the discrimination act, its like we live in a pre-programmed society that wants to threaten you with legal Paraphernalia even if you are trying to help your employee. I didn't mention one thing in my email regarding the employees future being at risk, but thats what I got back. Maybe we need as a society to start thinking outside the box. Instead of always looking for somebody to blame or somebody to sue. Maybe we should all just help each other
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Andrew Graham-Cumming
Member - 14 posts
Have some free occupational health advice.
Get his manager to interview him. Explain that his performance has been seen to become appreciably degraded and that the employer believes that this is a result of his diabetes becoming poorly controlled. Point out that his current level of performance is unacceptable and that, unles it improves, the Company will have to invoke its policy on performance and capability including formal warning etc which could result in dismissal. Explain that the Company does not want to do this, recognises that his diabetes may be a relevant factor, and is perfectly happy to allow him time off to see his doctor and to have any necessary treatment. Nevertheless, he is ultimately responsible for taking action to resolve his health problems and if he does not accept that he needs to seek medical advice, he must realise that the Company cannot accept poor performance indefinitely. Because of this, the Company urges him to see his doctor to discuss his recent problems with the control of his diabetes.
I do understand that his diabetes is likely to make him eligible for the protection of the DDA, but the Act only requires the employer not to discriminate and to be reasonable. The employee has to be reasonable in helping the employer to meet its obligations to make adjustments. Accepting unacceptably poor performance that damages the business is not a reasonable adjustment.
The earlier suggestion that he needs to see a consultant is somewhat over the top. Diabetes is normally managed in general practice. He would appear to need to speak to his GP about his poor control so that the GP can look into it, do any tests he thinks fit, and adjust his treatment. Only if the GP cannot get things settled will he need a specialist assessment.
How is contacting the GP a breach of the DPA? If an employee has a hypoglycaemic episode in front of other members of staff and a shop full of customers that is hardly confidential personal data. There may not be much point in contacting the GP, since he/she can't do much with the information if the man won't go to see him/her, but it would hardly be a reason to be hauled off in front of the Information Commisioner.
Ultimately, he must be seen as a competent adult. He can choose to seek medical treatment or not. If he chooses not to, and this makes him incapable of his work, then it would seem reasonable for the employer to dismiss on capability grounds.
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Anne McAllister
Member - 165 posts
I would also add that Health and Safety is everyones business and in the workplace it would over ride any notion of discrimination .
I can see how the employee may be afraid/embarrassed about his uncontrolled diabetes but the employer has to ensure that the workplace is as safe as can be.
Rights have to be used in conjunction with responsibilty.
Where would the employer be if this gentleman died on premises following a collapse?
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David Ransome
Member - 6 posts
Absolutely agree with Andrew and Anne directly above, Andrew's advice is totally correct, complies with legal requirements and, possibly more to the point, is common sense. There are times when you have to be hard to be kind, in this case 'firm but fair'.
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GLENN RAYBONE
Member - 21 posts
sorry folks but whether you consider contacting a GP without consent to be a breach of DPA or not, the fact is that no GP would discuss a patient without specific written consent.
Those who've made the comment that you would contact the GP, how would you feel if you discovered your manager had discussed your health with your GP of which you had no prior knowledge and had not given consent to?
It's not good practice and I don't know of any GP who'd comply. In fact even when I write with written consent some struggle to reply (and we're paying for the response too!)
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Andrew Graham-Cumming
Member - 14 posts
Glenn
I don't know what your background is, but you described yourself earlier as an OHP. There is a danger in abbreviations, since that one can have at least two distinct meanings. Since your name does not appear in the Medical Register, I take it that it doesn't mean Occupational Health Physician. In my case it does.
Your comment immediately above mine misses the point. Nobody has suggested discussing the employee's health with the GP. The suggestion was that the GP should be informed of the employee's apparently deteriorating health. That is a perfectly reasonable suggestion, would provide the GP with potentially useful information, and involves no breach of confidence. The only problem with it is that the GP can do nothing with the information if the employee refuses to go to see him/her.
Your other comment about medical reports is irrelevant and, I suggest, potentially offensive. GP's are under no obligation to provide reports to OH providers. They may choose to undertake non-NHS work in return for a fee. Given the derisory fees they are sometimes offered, I am surprised how many do oblige. They don't "struggle" to reply, but they may choose not to. They have no duty whatsoever to you unless they accept your fee.
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Gayle Richards
Member - 1 post
Further to the consultant vs GP debate.
The ideal person to provide some support in this situation is a Diabetes Specialist Nurse. In many areas they work with people with Type 1 diabetes to try to smooth out problems with insulin balance
There are many potential solutions that could be discussed not just less insulin, e.g. different insulins, continuous monitoring, maybe even an insulin pump
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GLENN RAYBONE
Member - 21 posts
Andrew,
can you point out where I said OHP as I can't recall doing so and can't find it in any posting by me. I am not a Physician and therefore do not appear on the medical register, but thanks for looking.
We'll agree to disagree on this, and whilst I have taken no offence from your comments please do not take any from mine in that, whilst I may not be a doctor I have an equally valid opinion and by being a doctor does not mean yours is more important or indeed correct.
The Ivory tower was knocked down some time ago, although some doctors still reside there!
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Andrew Graham-Cumming
Member - 14 posts
Glenn
You didn't look very hard
QUOTE
2 Oct 2008 7:58AM
GLENN RAYBONE
Member - 20 posts
Hi James,
getting OH is absolutely the thing to do, but as an OHP I would not do a home visit for a few reasons (my own safety being first!) but I would encourage him to attend OH as this would encourage some social interaction and actaully get him out of the house and back on work premises.
Without seeing him or having conversation with him it's difficult (from an OH point of view) to contact the GP as there'd be no consent.
UNQUOTE
I do not occupy an ivory tower, and your comment "although some doctors still reside there!" is offensive. You are perfectly entitled to have an opinion, but it could, from a professional perspective, only be valid if based on appropriate competences. Yours do not appear to include the management of diabetes and the ethics of communication between employers and general practitioners.
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GLENN RAYBONE
Member - 21 posts
was that in relation to this topic?
Thanks for your unique opinion, which I did not ask for.
Please for the sake of all concerned end this nonsense. I'm sure you've something more important to do, I know I have
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Alison Needham
Member - 1 post
Key thing would be for him to attend an accredited diabetes education course. If he's type 1 it would be DAFNE (Dose adjustment for Normal Eating) or BERTIE (similar) or other structured education course. DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) is for people with Type 2 diabetes. There's also XPERT and other locally accredited courses. Perhaps phone up your Primary Care Trust to see what education is available. given that there is something, then you can discuss the matter with him. He does have a responsibility to make an effort and you have a responsibility to support (as you clearly are doing). He might need some time off to attend - but what these courses will do is give him significant support in managing his diabetes on a day to day basis. M. Needham.
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