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AMD newsletter
for Radboud University
Issue 5, march 2023
In this newsletter, our colleagues from the Occupational Health & Safety and Environmental Service (AMD) inform you about the latest developments in the field of occupational health and safety. In this newsletter, we provide you with more information about the deployment of the AMD’s occupational health  support worker within Radboud University.
National shortage of occupational health physicians

The Netherlands currently suffers from a serious shortage of occupational health physicians. A shortage that is expected to persist in the years to come, due to a significant number of occupational health physicians retiring and too few young physicians joining their ranks. On the other hand, demand is high, not only for absenteeism counselling but also due to the growing need for more prevention. 

As in other national (internal and external) occupational health and safety services, this greatly affects structural staffing within our Occupational Health & Safety and Environmental Service (AMD). It no longer seems realistic for AMD to provide the required medical and other services through deploying occupational health physicians alone. This situation has compelled us to rethink our approach so that we can guarantee AMD’s expert services to Radboud University, now and in the future.
Waiting time to see occupational health physicians

In recent months, we have witnessed longer waiting times for an initial interview with the occupational health physicians, and not all units have had a permanent occupational health physician. This has been an undesirable situation for both Radboud University and AMD.

In the meantime, we have expanded our occupational health physician capacity, and we are nearly back to full strength. Despite this positive development, we still need to adjust our approach. 
Occupational health support workers

In May 2022, we entered into dialogue with Radboud University on how we could adjust our approach. We discussed a proposal to support occupational health physicians by deploying occupational health support workers (medisch ondersteuners bedrijfsartsen MOB). These support workers perform delegated tasks under the supervision of a registered occupational health physician. They consist of occupational health and safety nurses and occupational health support workers.  
What can the occupational health support workers do, and what can they not do? 

The occupational health physician is permitted to delegate specific tasks related to absenteeism counselling and reintegration to another person. This is set out in detail in the national Werkwijzer Taakdelegatie (Task Delegation Manual). It was drafted by parties in the field such as professional associations of occupational health physicians and occupational health and safety services. The Ministry of Social Affairs and Employment provided support for this process. 

Within the process of task delegation, the guidelines define very specifically which tasks can and cannot be delegated. The occupational health support worker may conduct the intake interview and where possible the consultations in the follow-up process to monitor reintegration progress.


Delegating is a matter of customisation. The occupational health physician vouches for the quality of the support worker and determines which tasks can be delegated when, and which cannot. The occupational health physicians therefore retains control and supervision and remains ultimately responsible for the socio-medical absenteeism counselling throughout the entire period of absence. 

Contact with the occupational health physician in case of absenteeism 

A staff member who is absent for a longer period of time always has at least three appointments with the occupational health physician. One to perform a problem analysis, one to assess the situation at 11 months of absence, and one in the period between 87 and 91 weeks to draft the “Medical Information” and “Current Opinion” forms. Note that these are certainly not the only times that the occupational health physician is involved with a staff member’s case.

If, in the course of absenteeism counselling, it becomes apparent that the employee’s problems require the expertise of the occupational health physician, the occupational health support worker will refer the staff member to the occupational health physician. Examples include a situation in which the support worker suspects an occupational disease or that the work itself may be at the root of the staff member’s symptoms. But also in the event of a labour dispute, or if recovery or work resumption is stagnating. 
The occupational health support worker will also refer the staff member to the occupational health physician at the request of the staff member or the employer (voluntary decision), as well as in the event of a breach of trust between the staff member and the employer or support worker, or if the occupational health support worker is of the opinion that the occupational health physician should examine or review the situation. 

Impact for the staff member

How does this task delegation between the occupational health physician and the occupational health support worker affect Radboud University staff members? For staff members, this shift in our approach means that they may encounter both the occupational health support worker and the occupational health physician as part of the counselling process. The occupational health physician is and remains ultimately responsible. But by also deploying occupational health support workers, we can provide staff members with absenteeism counselling more quickly. Also, staff members can get answers more quickly to their questions about prevention.  

Once we receive an application, the first step is an intake with the occupational health support worker. This applies both to applications for absenteeism consultations and for preventive consultations.   
The occupational health support worker explains what their role is and how the process may unfold. If necessary, the support worker can also refer the staff member to the Occupational Social Worker (BMW). 
If the staff member’s absence is expected to last longer, the occupational health support worker schedules an appointment with the occupational health physician to establish a Problem Analysis. If the staff member’s supervisor involves the occupational health support worker at an early stage, this problem analysis can be scheduled in good time (after approximately 6 weeks of absence). 

For employees who are already in a sick leave counselling programme and have so far only been seen by the occupational health physician, the occupational health physician will carefully consider whether the occupational health support worker can partially or fully take over the counselling. This is always done in close consultation with the staff member.
Our priority at all times is making sure that people receive the most appropriate guidance and that a staff member always has the right to see an occupational health physician.
Start of new approach  

Radboud University, including the participational bodies, has approved this new approach. This means that we will start deploying occupational health support workers from 15 March 2023. In this context, we will be working in pairs, with a permanent occupational health physician and a permanent occupational health support worker per unit. An overview of these permanent duos per unit can be found on the intranet.  

The permanent duos will introduce themselves during a policy SMO (Sociaal Medisch Overleg, Social Medical Consultation) at the relevant unit. We consider it important that the administrative director of the faculty or unit attends this meeting. The occupational health physician and occupational health support worker will explain their own role in the context of absenteeism and other counselling.

If you have any questions about this newsletter, please contact:
Anke Boumans – d’Onofrio, Customer Manager AMD  

© Radboudumc Geert Grooteplein 10 Nijmegen, 6525 GE Netherlands
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