Why do RISQS audit medical providers?
During every day (and night) of the year there will be work undertaken across the UK railway. Workers will don their brightly coloured uniforms and be set to task in a safe, and secure, working environment.
Much of the work RISQS is best known for is of course auditing railway suppliers to ensure Construction, Design, and Management (CDM) Sentinel, and Safer Work Planning protocols are fully adhered to, which includes alcohol and drug testing.
However, there is another layer to the work RISQS undertakes which precedes workers arriving onsite.
This involves auditing medical suppliers who provide occupational health assessments for employees working on the rail infrastructure, and the drug and alcohol testing services.
Occupational Health Assessments
Before a railway worker is allowed onto the infrastructure, they need to have been assessed by a medical provider.
A pre assessment questionnaire is completed by the railway worker, then a nurse or occupational health technician or a doctor would review that form. The railway worker would then come in for their medical assessment, which will include measuring their blood pressure, their hearing, urinalysis, vision testing, colour blindness, mobility, weight, height, and so on.
This assessment provides a fitness to work level where employees are categorised into a numbered band (from 1-6). The band doesn’t determine how ‘fit’ the employee is but is instead used to clearly designate the scope of work an employee can or cannot do within the railway infrastructure.
This to keep the railway worker safe from injury or out of harm’s way. For example, the employee may have a pre-existing injury which limits the scope of manual labour they can perform, or they may have a medical condition (such as colour blindness) which may mean they can only operate in certain areas.
Our lead medical auditor, Amna Khan, explains what her role is when it comes to auditing:
“Our role is to ensure auditable medical providers have the correct practices and management systems in place. This helps to correctly assign employees to the right medical level that correlates to the correct fitness level in line with Network Rail standards.
While that naturally includes the criteria used for the assessment itself, we also examine other areas such as the training competency within the medical provider, document control systems, how they manage non-conformance, and what procedures are in place to stay up to date with standards.
With respect to standards, it really is important for medical providers to examine each notification that comes through and assess the changes against their own practices. Not doing this correctly can lead to non-conformances being raised. “
Drugs and Alcohol Testing
Drugs and alcohol testing is important to ensure railway workers are fit and able to work safely on the network.
The RISQS audits, led by Amna, focus on every stage of the testing process, from start to finish.
“It might sound like a basic step, but even though drugs and alcohol testing are random, once a railway worker has been selected to be tested, ID checks need to be conducted to verify the individual. The facility where the specimen is to be collected needs to be secure and meets the requirements set out within the Network Rail standards.”
The standards that need to be followed are of course to ensure the specimen isn’t contaminated, it’s a real human specimen, and is from the individual required to be tested.
As we know, an instant POC test can instantly tell if the urine specimen is negative or not. If it is non-negative, then they must inform obviously somebody in charge who will then probably step that individual down. But it’s important to note that doesn't class as a positive unless it has been confirmed by a laboratory.
If the specimen does need to go to the laboratory for further testing, then there is an entire custody process that collection officers undertake to ensure the individual sample is contained and secure, which indeed also form part of a RISQS audit.
Once the specimen arrives at the laboratory the specimen needs to be managed in a secure manner to avoid contamination.
“What we, as auditors, are looking for is to examine the entire process from ID checks and testing processes right through to analysis and reporting. It’s a complex and lengthy chain that needs to be upheld to the required standards otherwise of course, the results could be challenged.”
In 2022, the RISQS auditing team delivered 3,578 audit days, an annual increase for the third year in a row. We continue to work with the entire supply chain to reduce unnecessary risk and uphold best practice within operational and non-operational working environments.
If you have any questions, please contact the RISQS team via email email@example.com