Bill Gunnyeon, IOSH

"I've always been more of a world-changer than a care-and-maintenance person," observes Dr Bill Gunnyeon, "so helping to try and make things better, helping to try and change things is what has motivated me."

Gunnyeon is explaining what attracted him to the post of chairing IOSH's trustee board. He has held senior governance posts before, including the presidency of the UK's Faculty of Occupational Medicine, but he says IOSH is on a different scale. "It is a huge organisation from a professional body point of view, with over 46,000 members and it is not insignificant in terms of turnover as well."

He says the post attracted him partly because the institution was going through a period of major change and would benefit from direction and strong leadership.

The first tasks on his appointment in early 2016 were recruiting new trustees to fill vacancies and overseeing the search for a new chief executive. "And most importantly of course we also had to get work underway to have a new strategy ready for April of this year. So those were my three immediate priorities and they were challenging."

The strategy, launched on 27 April and designed to set the course for IOSH until 2022, is one of the reasons for interviewing Gunnyeon now. But he is as well qualified as anyone to talk about OSH leadership after a career in senior occupational health roles -- including nearly ten years as chief medical adviser to the Department for Work and Pensions (DWP) during which he oversaw the government's work and health initiative.

Fine tuning

Work on the strategy over the past year has been in tandem with a review of IOSH's procedures more generally.

"We had identified the need to review our board committee structure," he says, "and we needed to look more closely at how we dealt with equality and diversity in the organisation. I know there's a huge amount of work under way across the organisation. Of course that's going to be important because to deliver the new strategy IOSH will need to change and develop."

I ask what changes members are likely to see in their dealings with the institution. "I hope that they will see an improvement in the support and the services they get," he says, "that they will start to see an organisation that is a bit slicker, a bit quicker at doing things, a bit more customer focused. It's not a term I necessarily like but at the end of the day that is what it's about: people's experience when they interact with the organisation."

He says there will be an acceleration of projects already in progress -- "IOSH Blueprint, for example, we need to get on and roll that out more quickly" -- and the launch of new training products.

Before drawing up the new strategy the trustees researched members' needs and perceptions through last year's membership survey and a series of focus groups.

They also sought the views of other bodies inside and outside the OSH world.

"I think one of the challenges for IOSH is that its brand is quite well known within the safety and health field," he observes, "but if you go beyond that people don't know about or don't understand what it does or indeed what occupational safety and health professionals do. One of the biggest challenges for us is to change that."

Responding to that challenge by enhancing the OSH profession is one of the strategy's three central priorities.

"A key element of the strategy is looking at how to develop the profession so it can be seen as having equal standing with other professions in the occupational health and wellbeing space," he says.

The strategy document notes there is an opportunity to capitalise on a growing appetite in business to protect workers against safety and health threats, not just for compliance purposes but to boost loyalty and productivity and reputation.

Work to support the goal of strengthening the profession's standing will include extending free access to the Blueprint competency framework beyond the membership to the rest of the world and revamping the continuing professional development structure. IOSH also plans a "future leaders" programme; a pathway to help young practitioners prepare for senior roles.

At the time of our interview in late March, there is little detail available about another strand of the strategy: IOSH's plan to offer an entry-level qualification for OSH practice. I ask Gunnyeon what the institution wants to add to a market that already has a choice of qualifications.

"I think we will have a qualification that is a little more business focused rather than technically focused. That's the difference. So it is about meeting our commitments to support business and organisations."

Will it be more closely mapped on to the Blueprint competency framework, which has a strong emphasis on business skills? "Yes, that would be the hope."

Global stage

Codependent with the aim of raising the OSH profession's status and profile are the other two strategy goals: increasing IOSH's own influence and impact around the world, and partnering with other organisations to achieve its mission and charitable aims.

On the issue of influence, Gunnyeon says: "Some of that is about moving the perception of IOSH to that of a professional body representing the occupational safety and health profession, not just a membership organisation providing some services to members.

What would the shift involve? "I think it is about what IOSH sets as its direction and how it works with others," he says. "We'd like IOSH to be seen as the go-to body for anything that happens on a safety and health related issue; that everybody, including the media, would immediately think, 'Let's get a view from IOSH'. And that governments, not just in the UK but elsewhere, would look to IOSH to provide input into policy. I think we've got a lot of work to do to get to that point but I'm confident we can do it."

The strategy is looking at how to develop the profession so it can be seen as having equal standing with other professions in the occupational health and wellbeing space

The institution must also identify what it can best do on its own and where it should work with and through other organisations.

"I think there's been a tendency to try and be all things to all people," he says. "It is about looking at what IOSH's unique selling point is. What is it that the occupational safety and health professional does better than anybody else?

"We shouldn't necessarily be seeking to do things ourselves, but to work in partnership with others to bring our expertise along with the expertise of others to have a greater impact overall on our vision. We've got to choose the right partnerships. But then we've got to work well together with other organisations with a shared vision to try and help have a really long-lasting impact on work-related illness and injury."

On this latter point he observes that of the 2.3 million work-related fatalities annually, around two million are attributable to occupational disease: "We get a lot of focus globally on things like malaria, for example, and yet the number of deaths globally annually now from malaria are less than from occupational cancer. So there's a huge challenge and I think we need to be able to show that we are starting to have some influence on those figures."

Does he expect that to involve IOSH funding research or sharing expertise?

"I think some of it will be about sharing expertise; IOSH has a huge amount of knowledge. But we also need to look at our research portfolio. We're very good at funding research but not so good at communicating the results. We will be looking at how we can fund

more research, but perhaps in different parts of the world. There's been a tendency to focus on research in the UK."

Baseline generator

The shape of IOSH's global partnerships is still to be decided, "But we are clear that one size won't fit all. And certainly you can't do things just the way you might do them in the UK; cultures are different, the way business is done is different, the challenges are different, so we have to look at different models.

"In the current strategy there's been a tendency for the focus to be on growing membership and branches in different parts of the world and I'm not convinced that in order to influence what happens in other countries we need to have feet on the ground. We don't necessarily need to have offices and infrastructure but we need to work out how we can use all our combined knowledge and research to influence organisations in each country; to find local partners who we can help, support and work with."

The strategy runs for five years and its first 12 months is described in the document as the "baseline year" for gathering information on the ways to achieve the broad aims.

"More of the year one work is about enhancing the profession so there will be things that members will start to see then, things like [the new] qualification and CPD [continuing professional development]," he says.

"In the other two areas: collaborating through building strategic partnerships will take a bit more time. It will be about identifying not just who we want to partner with but how we do that in a way that will be mutually beneficial. And then on influencing globally, some of that will be about doing the research to determine the best models to use to work in other parts of the world, to be in a position to develop that in the subsequent four years. The other thing is that we want to get some baselines so that we can set some clear KPIs [key performance indicators] and milestones for years two to five. It's going to be important for the board to be able to track progress on the strategy; the strategy has got to help change things and move things forward."

Take-off point

Gunnyeon has spent almost his entire career in occupational health, starting as a Royal Air Force (RAF) medical officer, moving to the private sector to run increasingly large medical services providers to business and then back to the public services as chief medical adviser to the UK DWP.

"I don't know whether this was something subconscious because I had never really thought about wanting to be a pilot," he says. "But my father was an RAF pilot and was killed in a flying accident just before I was born."In his first year at medical school in Dundee in the 1970s he did the rounds of the student societies all vying for members and lighted on the university air squadron.

The squadron taught him to fly -- "I think it would be fair to say that I didn't demonstrate my father's natural flying ability" -- and awoke an interest in the RAF. He secured an air force medical cadetship which supported him through the last three years of his degree.

A short spell of post-degree training in the National Health Service was followed by a five-year commission as a RAF medical officer.

"When I graduated I didn't have any thought that I wanted to be a heart surgeon or a brain surgeon and I think I knew that in the long term I didn't want to be a GP. But I was committed to the air force. I found it fascinating and that's where my interest in occupational health developed."

You won't always be universally popular if you are going to change the world a little bit

Short tours on helicopter and jet stations were followed in 1982 by an 18 month posting as senior RAF medical officer in Northern Ireland, at the height of the conflict there. His duties involved caring not just for air force personnel and but also an army regiment, the 1st Battalion Royal Green Jackets. On 22 July 1982 an Irish Republican Army bomb was detonated during a concert by the Green Jackets' regimental band in London's Regent's Park, killing seven members and injuring the remaining 24.

Gunnyeon helped rehabilitate the injured bandsmen and by the time his posting came to an end, the band was reformed and ready to start another tour.

"I was suddenly summoned to the door of the medical centre one day," he recalls, "and there was the Green Jackets band lined up and playing for me. It was an incredibly emotional moment but I also learned something about people's ability to pick themselves up and move forward. It's very humbling to work with people like that."

Health-work nexus

Fast forward 20 years and Gunnyeon was appointed to the most senior OH post in the UK government: chief medical adviser at the DWP. His titles in the post also included chief scientist but he says the most important, added after his arrival, was director for health and wellbeing.

"I arrived in June 2005 just after the election," he says. "There was a new secretary of state for work and pensions, David Blunkett, and he had a particular interest in occupational health. At the same time there was also a focus on the huge burden of ill health-related benefits. And it was an ideal opportunity to bring it all together. Because if we could stop people falling out of work, then falling on to benefits, it would be infinitely easier than trying to get them back in again [after]."

In a matter of months Gunnyeon and his fellow civil servants developed a health, work and wellbeing strategy. The strategy brought together with the DWP for the first time the Department of Health and the Health and Safety Executive and health departments in the devolved administrations in Scotland and Wales.

Gunnyeon says that critical to setting the early momentum for the programme to stop long-term sick employees leaving the workforce altogether was the research review he commissioned from Gordon Waddell and Kim Burton, published in September 2006, just after Dame Carol Black was appointed as the first national director for health and work, fulfilling another strategy commitment. Waddell and Burton's research (bit.ly/2oEQreG) provided the first comprehensive evidence associating good work with good health.

In early 2008, Black published her own review, which recommended, among other things, a new "fitnote" allowing GPs signing patients off from work to say they might be fit for some duties.

"We were lucky," he says modestly. "We had a vision of where we wanted to get to but a lot of things just happened at the right time."

Gunnyeon is proud that he managed to sustain political support for the strategy and programme through frequent departmental changes; between 2005 and 2010 he had to brief and resecure commitment from five secretaries of state. "Some of it's about having a clear long-term view but finding things that would fit with the shorter-term agendas the different ministers have, but would also help progress the strategy in the longer term."

Still going

"It was challenging at times," he says of his time overseeing the strategy, "but it was also infinitely stimulating and satisfying. You always look back and ask yourself, 'Did we really make a difference?' I think when I reflect upon it that we set in motion a focus on all the links between work and health that hadn't previously existed in government and even in business."

He notes that the green paper Work, health and disability: improving working lives (bit.ly/2f5hXLb), published by his old department at the end of last year, still refers to the Waddell and Burton study as the evidence base for continuing to try to keep people with long-term conditions in work.

I note that the green paper signaled a review of the fitnote, in the light of criticisms by employers' bodies in the seven years since it was introduced that the option to declare employees fit for some duties has not been embraced widely by GPs and their patients.

He says the change was a radical step after 50 years of GPs using the old sicknote with its binary choice of fit or unfit for work.

"It was always going to be difficult with 40,000-odd GPs who already have challenging lives and are under lots of pressure from people to get them to do things differently." He sees it as still work in progress: "It hasn't perhaps had the degree of impact we might have hoped but it has had an impact."

With hindsight, he says, though a lot of effort was spent trying to prepare businesses, trade unions, public bodies and GPs for the fitnote, there were never the funds to educate the public that "the idea that work must be bad for you and that you should stay away from it for as long as possible, is clearly not right. So if somebody had given me a large budget, I would probably have spent it on a public education campaign."

I note that his fellow occupational health physician Dr Sayeed Khan, chief medical adviser at the EEF manufacturers' body suggested in a previous leader interview with this magazine (bit.ly/2oo2Cv1) that safety and health professionals would be competent to carry out non-clinical assessments of whether employees with long-term medical conditions could carry out specific duties.

He says that at DWP he worked with IOSH to examine what part OSH practitioners could do in supporting return to work for long-term sick employees.

"For me it was more about [OSH professionals] being able to help employers if they had somebody who was coming back and needed workplace adjustments. I think that certainly is a role. People who are coming back are going to have limitations on what they can do, so you want to know that they're going to be able to do it safely.

"Quite often employers say we can't take somebody back unless they can do everything because it's a health and safety risk. I think getting away from that would be helpful, being able to say, 'I've got some advice and actually that's fine, there is no risk'. Or if there is a slight risk, 'Here's how we're going to mitigate it'."

Clear steer

Asked what a career spent mostly in senior management posts has taught him about leadership, he says he has found setting a clear direction is critical.

"Far too often people don't know where the organisation is going. If you are going to lead people up a hill and you have a choice of three hills, then it's fine to have a discussion about which hill with people. But sooner or later there has to be a decision. And if you can't agree, you have got to say, 'Right, this is the hill we are going up, now follow me'."

Gaining colleagues' confidence so they will follow where you lead depends on trust in and credibility of a leader, he says. "Reputation is hard won and very easily lost and I think professional integrity is critical."

Even-handed treatment of others is an important way to maintain credibility. "That's about praising people when they do something well and not being afraid to make clear to them when they haven't. We often devalue praise by feeling that we have to praise everybody and underplay poor performance. Managing poor performance is really important; it is important to the individuals to try to help them improve their performance and it's only fair to those people who do strive to perform well."

He has worked on developing patience: "I'm by nature a fairly driven and passionate person. So I like to make things happen. And of course one has to temper that because you can very easily become impatient and risk being seen as intolerant. I've had to learn to temper my passion, so it's directed in the right way. But when I have been successful, part of the reason was having that drive.

"You won't always be universally popular if you are going to change the world a little bit. We all want to be loved and wanted but you also want to make a difference sometimes."

Find out more about IOSH's strategy at www.ioshwork2022.com