Surge workforces in healthcare and social assistance

Guidance to help employers in healthcare and social assistance manage the risks associated with returning, new and redeployed employees entering the workforce to meet critical shortages.

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Introduction

Under the Occupational Health and Safety Act 2004 (OHS Act) employers have a duty to provide and maintain, so far as reasonably practicable, a working environment that is safe and without risks to the health of employees, including independent contractors and their employees. This duty applies to both the physical and psychological health and safety of employees.

Employers also have a duty to people who are not their employees. Employers must, so far as is reasonably practicable, ensure that their business activities do not put the health and safety of members of the public at risk.

Employees have a duty to take reasonable care of their own health and safety and the health and safety of persons who may be affected by their acts or omissions at a workplace. Employees must also cooperate with their employers about any action they take to comply with the OHS Act or Occupational Health and Safety Regulations 2017.

Initiatives to increase available staff

The healthcare and social assistance industry is the largest industry employer in Australia. Providing 13% of Australia's total employment, the industry includes hospitals, medical and other healthcare services, residential care services and social assistance services. At times, a significant event, such as the COVID-19 pandemic or other emergency may result in an increased demand for health and social assistance services. Federal and State Governments may introduce short term initiatives to increase workforce numbers in order to maintain current operations and provide additional services. These may be referred to as additional, alternative or surge workforces.

Surge workforce models may include:

  • experienced and qualified health practitioners who have had a period away from practising and are returning to the workforce
  • fast tracking international or domestic student training in a healthcare discipline
  • recruiting international workforce and fast tracking registration and relocation to Australia
  • redeploying staff to less familiar environments to meet critical shortages
  • changing workforce practices, such as ratios or work settings
  • sourcing workers from alternative industries or roles that have similar skill sets to healthcare (e.g Australian Defence Force, Life Saving Victoria, State Emergency Services)

Identifying hazards

Employers must identify hazards and assess the level of risk to the health and safety of employees and other visitors to the facility from redeploying employees or recruiting surge workforces. This must be done in consultation with employees and health and safety representatives (HSRs), if any, so far as reasonably practicable.

Evidence shows that people who are new to a workplace, or young and inexperienced are more likely to be injured in the workplace than other employees. Persons re-entering the workforce may also be more likely to be injured in the workplace than other employees.

Once an employer has assessed risks and identified ways to control the risks, they must implement these controls in order to protect health and safety.

Hazards and risks may include:

  • Employees not being familiar with the duties, tasks, environment and equipment, for example, portable lifting machines, overhead tracking and duress alarms.
  • Employees not being provided with or trained in the use and disposal of personal protective equipment (PPE) and respiratory protective equipment including donning and doffing procedures.
  • Employees not being familiar with workplace policies and procedures, for example, consultation, emergency procedures, security measures, medical records systems, technological systems, incident reporting and work related violence protocols.
  • Employees not being provided with, or trained in, new procedures that may be specific to the emergency situation, for example controls implemented to prevent transmission of COVID 19, such as entry and exit procedures and infection control procedures.
  • Psychological impacts of increased work demands, working remotely or in unfamiliar locations.
  • Increased work demands and related psychological effects for managers and supervisory staff due to additional responsibilities of supporting workers who are learning on the job.

Controlling risks

Where a risk to health is identified at a workplace, employers must, so far as reasonably practicable, eliminate the risk. Where it is not possible to eliminate the risk, it must be controlled, so far as reasonably practicable.

Consult with employees

Employers have a duty to consult with employees, independent contractors, and their employees and any HSRs, so far as reasonably practicable, on matters related to health or safety that directly affect, or are likely to directly affect them. This includes consultation on:

  • identifying and assessing hazards or risks
  • decisions about the adequacy of workplace facilities including amenities
  • decisions about how to control risks
  • proposing changes to the workplace, equipment and supplies, or work procedures
  • when and how health and safety information will be communicated and provided

The consultation should be conducted in accordance with any agreed consultation procedures.

Control measures

The types of control measures that will be considered reasonably practicable will depend on:

  • the likelihood of the hazard or risk concerned eventuating
  • the degree of harm that would result if the hazard or risk eventuated
  • what the person concerned knows, or ought reasonably to know, about the hazard or risk and any ways of eliminating or reducing the hazard or risk
  • the availability and suitability of ways to control the risks for each workplace
  • the cost of eliminating or reducing the hazard or risk

Control measures to help control risks for surge workforces include:

  • ensuring employees are suitably qualified and trained for the work tasks being allocated
  • ensuring employees have clearly defined jobs, tasks or roles, and have the necessary equipment and training, including PPE, prior to commencing work
  • ensuring employees are included in consultation processes
  • providing a full induction and orientation into the role, including training in equipment, PPE, emergency procedures and relevant policies and procedures including incident reporting
  • providing a supervisory period and ongoing monitoring to ensure each employee has support while gaining experience in the role
  • ensuring each employee is aware of who to speak to if they require assistance
  • providing an introduction to the relevant HSR and person responsible for occupational health and safety (OHS), and encouraging employees to take part in health and safety consultations and issue resolutions
  • having regular meetings with line managers to ensure support and feedback are consistently offered and there are opportunities for employees to raise health and safety concerns
  • offering peer-to-peer support
  • offering psychosocial and physical wellbeing support

Use the hierarchy of control

The hierarchy of control is a system for controlling risks in the workplace and can help employers eliminate or control risks to their employees and others. The WorkSafe website has information to help employers understand and use the hierarchy of control.

Legal duties

Employers have duties under the OHS Act, which include that they must, so far as is reasonably practicable:

  • provide and maintain a work environment that is safe and without risks to the health of employees, independent contractors and their employees
  • provide adequate facilities for the welfare of employees, independent contractors and their employees
  • provide such information, instruction, training or supervision to employees, independent contractors and their employees as is necessary to enable those persons to perform their work in a way that is safe and without risks to health, including, where appropriate, in languages other than English
  • monitor the health of their employees
  • monitor conditions at any workplace under the employer's management and control
  • ensure that persons other than employees are not exposed to risks to their health or safety arising from the conduct of the undertaking of the employer
  • consult with employees and HSRs, if any, on matters related to health or safety that directly affect, or are likely to directly affect them

A person with management or control of a workplace must ensure, so far as reasonably practicable, that the workplace and the means of entering and leaving it are safe and without risks to health. This OHS duty extends beyond an employer and can apply to any person, owner or otherwise, who has management or control of a workplace, such as a sole trader, for example.

Employees also have duties under the OHS Act, which includes that they must:

  • take reasonable care for their own health and safety
  • take reasonable care for the health and safety of persons who may be affected by the employee's acts or omissions at a workplace
  • co-operate with their employer with respect to any action taken by the employer to comply with a requirement imposed by or under the OHS Act

The OHS Act gives HSRs a role in raising and resolving any OHS issues with their employer, and powers to take issues further if necessary. For more information, see WorkSafe's guidance on the powers of HSRs.