Getting health on par with safety

Welcome to another episode of the RSSB podcast! This month we're joined by Tracy Orlandi, who is Head of Wellbeing and Occupational Health at East Midlands Railway. She talks about the progress being made in rail employee health and wellbeing, areas where gaps remain, and what it'll take to elevate health to the same level as safety in the rail industry.

Correction at 01.23: The RSSB mental health survey was conducted in 2021.

For more information on the health workshops Tracy mentioned, contact Clare.Forshaw@rssb.co.uk.

Transcript

Host [00.13]: Last month, we caught up with Thom Rawson about what we’ve been doing to protect the health of our planet. But this month, it’s all about human health. 

Following 20 years of safety success, we’re now aiming to replicate that progress in employee health. So, today, we’re joined by Tracy Orlandi, who is Head of Wellbeing and Occupational Health at East Midlands Railway. She also chairs the Occupational Health and Hygiene Advisory Group, which champions early intervention for work-related health risks.

Tracy has over two decades of experience in health and wellbeing roles and is committed to preserving employee wellness.

Tracy, welcome to the podcast, and thank you for joining us today!

It would be great to start with some stats for our listeners. What can you tell us about the current state of rail employee health and wellbeing?

Tracy Orlandi [00.53]: Hi Greg. Yes, of course. Sickness absence data from the RSSB health data hub project highlights that the lost time rate is 2.3 times higher in rail than the national average. The biggest known reasons for absence are mental health and musculoskeletal conditions, which contribute to an average cost of £2 ,214 per employee per year, which is £709 more than the national average. 

Just to expand on what we know about mental health, data from the RSSB mental health survey, which was conducted in 2021, highlighted than 1 in 3 railway workers have been found to experience symptoms of a diagnosed mental health conditions. And for me, to truly understand that data, I think it’s really important to compare that to the national picture, which is 1 in 6 of the workplace population. So, it’s significantly higher in rail than other sectors. And in addition to this, post-traumatic stress disorder has been found to be over twice of what we see in the general population, which makes it really important to consider on how we support employees who’ve been involved in traumatic events at work.

 Host [01.57]: Where have we been able to make improvements in recent years, and where do gaps remain? 

Tracy [02.01]: So, although these statistics I’ve just shared are concerning, I actually think it’s a massive step forward that we actually have this industry data, which is enabling us to take targeted and positive action. An example of this is the Railway Mental Health Charter, which was recently reviewed and updated utilising the data and feedback that we have from industry to ensure that we’re responding to the evolving landscape that we are operating within.

This is just one example where we’ve been able to measure improvements that have positively impacted on individual wellbeing but also organisational outcomes, for example improved attendance, morale, and productivity.

And in relation to the gaps, the recently published Rail Health and Safety Strategy sets out the key challenges for us all as an industry for 2024 to 2029 and highlights the actions that will be taken to address these issues. And I think an area where we can always improve in terms of the gap is engagement, and I’d love to see more people in railway organisations getting involved and helping us shape the future health of our workforce

Host [02.58]: Thanks, Tracy. It’s clear that all of us in rail need to collaborate to close some of those remaining gaps across the industry.

As I said earlier, one of our goals is to help industry achieve the same degree of improvements in health as we have in safety over the last 20 years, and that’s vital for a number of reasons. But in a nutshell, a healthy workforce is essential in our delivery of a high-performing network that’s safe to use, meets customer needs, and is financially sustainable.

Fatigue is one area the industry has worked hard to address, but it’s still a contributing factor in some errors, accidents, and incidents. What more do you think can be done here? 

Tracy [03.30]: So, the Fatigue Working Group are doing some great work in this space, and something they’ve identified is they need to embed practical training for how line managers respond to fatigue reports prior to, during, and after shifts, so the whole shift cycle. And to help train operators with this group, they’ve produced some new guidance, which includes how to start conversations with fatigued staff and a flowchart of activities that should be part of an organisational risk assessment of fatigue.

The Fatigue Group also recognises that another critical area for fatigue risk comes from rostering. The Group has run some practical workshops with members to get practice in reviewing rosters for potential fatigue risk and consider the ORR fatigue factors throughout this whole process. And I think all of these activities are really helpful in shaping the fatigue awareness and assessment across industry.

Host [04.20]: The Rail Wellbeing Alliance recently restructured, consolidating seven subgroups into just three. What benefits will this bring? 

Tracy [04.26]: I think on a really practical and quite a personal level, I wanted to be involved in all seven groups, but I just possibly couldn’t be in all of them at the same time, so consolidating them into three allows people like me who are interested in employee wellbeing or improving organisational outcomes that I mentioned earlier to really be involved in all three of those.

An example of that I think is sleep apnoea. So, the group I chair is looking at sleep apnoea from a clinical perspective, so the diagnosis and adjustments to enable people to remain in work. The Health and Wellbeing Group is looking at this from a prevention perspective, such as obesity and lifestyle choices. And the Fatigue Group that we’ve just spoke about are considering it from a practical implication in terms of managing fatigue and fitness for duty. And I think why this is all really important is it helps us, through those three groups, deliver a safe and effective railway. But again, even more importantly for me is to make an absolute difference to the individual lives of people who work in our sector. 

Host [05.23]: The group you currently chair is one of those three groups. I’m sure there’s a lot of great work happening there, but if you could highlight one top action for this year, what would it be? 

Tracy [05.32]: I’m glad you asked me that because it gives me a shameless opportunity to talk about the work we’re doing, and I’m going to take a little bit of liberty and try and highlight two, if I may. So, I’m the chair of the Occupational Health and Hygiene Group, and I work with a great group of people who are passionate about protecting the health, safety, and wellbeing of our workforce. We’ve got four key work streams that we’re focusing on this year, but if I can pick two that I’d share today, it would be the Exposure of Risk at Work Group and the development of the medical standards.

So, starting with the exposure to risk, I think we can all agree that nobody should go to work and develop a health condition that’s actually completely preventable. So, for example, I’m talking about skin conditions and occupational dermatitis, respiratory conditions such as occupational asthma, or even hearing loss. We’re currently working on an industry risk matrix profile, with targeted fact sheets for specific exposures, and a digital risk assessment tool, which will help organisations manage these risks more effectively. We’ll also be looking at other workplace risks that have the potential to impact on health, such as stress and musculoskeletal conditions

The other exciting workstream is the development of medical standards. Over the years, modern medicine has come on leaps and bounds, and conditions such as diabetes can be managed so much more effectively now in the workplace and at home. This review will allow us to update these standards and ultimately keep people in work, and productive in work, in roles that many see as a vocation and not just a job.

Over the next few months, we’ll be running some task and finish groups, and we’d really like to hear from people across the industry who are responsible for evaluating and deliberating if a safety-critical worker, such as a train driver, is actually fit for work. And if you’re interested, those three workshops will cover managing diabetes, chronic pain, and sleep apnoea. And you can find out more about these workshops by heading over to the RSSB website.

Host [07.18]: Thanks, Tracy. You mentioned earlier that collaboration will be vital in elevating health to the same standard as safety, but what are you planning at East Midlands Railway specifically?

Tracy [07.27]: That’s a really good question, and a great one to end with. So, for me, being a part of this group allows me to contribute to the three wellbeing strands with real issues that we face operationally within East Midlands Railway. But equally, it allows me to take learning and best practice from other stakeholders and use the tools that the RSSB are producing to complement our already existing strategy. So, this isn’t about creating more work; it’s about actually using the resources, the evidence base, and the examples to apply that practically within our organisation. 

So, one practical example of this is we’re currently reviewing the newly published Railway Mental Health Charter, and we’ll do a gap analysis to make sure that we still meet all the standards and take the appropriate action to respond to the changing needs of mental health within the current population.

Host [08.17]: Tracy, thanks again for joining us today. And thank you for listening. We look forward to you joining us for our next episode. In the meantime, mind how you go, and travel safely.