Ten years ago, while he was working in the construction sector, Karl Simons decided to concentrate his efforts for OSH improvement below the layers of minor incidents and near-misses in Heinrich's safety triangle where most OSH practitioners work.
"For every fatality there is a series of major injuries, lost-time injuries under that and first aid injuries under that," says Simons, rehearsing the standard model that posits widening numerical strata of lesser safety lapses for every severe one. "Under those you have a series of near-miss or close-call incidents. Below that we have the unsafe acts or conditions, that give us our last opportunity to observe or challenge. That's behavioural safety because it's external, we can see it."
That layer of unsafe behaviour is the base of the triangle of correlation in most models. "But underneath that you have the unsafe attitudes -- commonly referred to as the safety culture -- and that's internal."
Karl Simons career file
2012-present, Chief health, safety and security officer, Thames Water
2011-2012, Director, health, safety, environment and quality, Transfield Services
2009-2011, Director, environment, health, safety, quality and construction, Hyder Consulting
2008-2009, Environment, health, safety, quality and construction director, Carillion (Middle East)
2006-2008, Group national head of safety, quality and environment, Babcock Rail & Facilities Management
2003-2006, Health, safety and environmental senior manager, Carillion
1990-2003, Mechanical and electrical engineering manager, HM Forces
Those safe or unsafe attitudes will determine employees' behaviour when they are working unsupervised, he says.
He proposes adding another layer: leadership ("that's personal leadership, not chief executive leadership"), responses to others' actions which are guided, or not, by belief in and enthusiasm for safety.
Fostering that passion for safety, as he calls it, creating a "culture of care" in which the workforce is reminded daily how important their safety and health is to their employer, is the critical lever in reducing accidents to a minimum. The model is founded on a management framework that comprises resources, structures and standards that set expectations of employees.
It's a philosophy Simons has put most fully into practice over the past six years in the most senior OSH and security post at London's water utility, with a suite of initiatives intended to make clear to the company's 6,300 employees that Thames Water is concerned for their safety and welfare and that they should be concerned for each other's, helping them override the generators of unsafe behaviour such as lapses of concentration.
"You create a culture of care and the people will believe in what you are doing and they will challenge unsafe acts and conditions and therefore they will prevent illness and injuries occurring," he says.
The figures bear him out; Thames Water's lost-time injury rate (LTIR) has more than halved to 0.14 per 100,000 work hours on his watch, while reports of unsafe acts and conditions -- which provide the "last opportunity to predict and prevent" before a risk eventuates -- have jumped from 6,000 a year in 2012 to 50,000 in 2017.
The risks to our organisation swamp anything I've ever seen
But injury and illness rates are not the metrics that animate him. Instead, in line with his input-based approach, he points to the annual staff survey for the most explicit measure of whether employees believe in his culture of care: "For the past four years we've only asked one question on health and safety: Does Thames Water take health and safety seriously? There are 50 questions on other things and in those four years the health and safety question has come top. It was 91% last year and it's always been 90%-plus."
His other favoured measure is the number of "home safe days", when all employees go home safe and well.
Simons arrived at Thames Water as chief health, safety and security officer in 2012, straight from a global safety role in oil and gas. But Thames Water, which has the monopoly to supply clean water and treat waste water for London and parts of the home counties, presented bigger challenges, he says.
"This is a vital business. A quarter of the UK's population relies on us to provide safe clean drinking water every day. To make that happen you have to have a 24/7 business. We are also dealing with ageing infrastructure; pipes that are over 100 years old are not uncommon in the water industry.
"The risks to our organisation swamp anything I've ever seen before," he adds. "When I worked in oil and gas they had high-hazard sites in abundance. But our product, if we don't get the treatment and the storage and the supply correct we would kill people because everybody is drinking it. So my role is very different in terms of governance and assurance of the end product."
Thames Water's 6,300 employees commission and maintain equipment at around 7,000 sites in the capital and beyond, ranging from small booster stations that keep up water supply pressure far from the main pumping houses, through reservoirs, to the 250-acre Beckton sewage treatment works in East London, Europe's largest.
To maintain that supply the direct employees are bolstered by 10,000 workers for contractor companies "who break ground 10,000 times a month" laying and repairing supply and wastewater pipes, often under roads in urban areas.
Simons inherited a safety campaign with the tagline "Triple Zero", which committed the company and its employees to "zero accidents, zero ill health, zero compromise". (The last of these refers to not tolerating unnecessary risk. "It's a good word," he says.)
He toured the company's work sites from reservoirs to roadworks and asked the site managers if they had met the triple zero goal.
Inspection is a catalyst for all investment and maintenance and in many organisations budget ends up driving risk
"I was met with a laugh and, 'No Karl, that's something we are aiming to achieve'. There was a clear lack of belief in it and understanding."
"Some practitioners might have swapped an ailing campaign for something that carried their own stamp, but Simons set to work changing perceptions of the established one. He asked managers how many incidents, injuries, ill-health cases or compromises -- failures to meet safety standards -- there had been on their sites that day. When they said none, "I said right, days you achieved triple zero: one. With that the lightbulb came on. [They said] 'Well in that case, we have 69 days, 108 days, 250' or whatever."
Now, these home safe days or "perfect days" at site and company level are the main marker of OSH performance. "This isn't some corporate bullshit that sits on a wall or that [only] a senior executive says. It's something that happens on a daily basis in Thames. It's not something that you are trying to achieve that nobody believes in.
When the counter is reset, "emails go out, texts go out, everybody thinks, 'Oh, we've hurt somebody'".
In the scheme of things
As chief health, safety and security officer, Karl Simons reports directly to Thames Water's chief executive, a reporting line that was established with his appointment in 2012 and reflected an acknowledgement that OSH management had to be given a higher priority after a series of fatal incidents in the previous two years.
He provides the executive team and main boards with information and guidance on safety, health and security. "They are in no doubt that the chief executive and his executive team are responsible for health and safety in the company, not me. My job is to articulate the direction they need to channel their energies."
Simons has seven direct reports heading a group of 83 occupational health, safety and security staff, including field practitioners, policy, training and compliance and occupational health specialists.
When he started in the role he generated most of the OSH innovation in the company but says he is satisfied that his team has "now developed an appetite to come up with new things. Before people would have been worried about budgets or afraid of being shot down if they came up with an idea. People are now quite willing to say, 'Why don't we look at XYZ?'."
In the past two years Thames Water has seen a change in both its chief executive, chair and major shareholdings -- the Australian Macquarie Group sold its stake to Canadian pension fund OMERS and the Kuwait Investment Authority in 2017. How does Simons sell an OSH settlement that requires serious financial commitment to new incumbents at the top?
He says early face-to-face briefings are essential to explain to them the company's model for managing safety and health and security risks and its journey to this point, because that will help shape their decisions.
"So the chief executive, the chairman, the new investors, all the investors have had an induction from me that also goes into security -- their understanding needs to be no different from the new senior managers we are sending out on sites, it's the same presentation they receive."
He says holding these briefings in an informal setting away from the strictures of board meetings is important. "I want a healthy level of debate and challenge."
Is it difficult to book their time? "No", he says. "These are human beings. Just because they are board directors, they are no different. [I say] 'I need an hour of your time because I need to talk through the health and safety implications for the board you sit on'. They are not going to say no."
He says any high-severity incident or dangerous occurrence is followed by an investigation, an executive review and action to prevent a repeat. Asked for an example, he offers the recent failure of an ageing penstock water intake valve to a sewer.
"All the water companies saw these valves as environmental protection devices. But when you put people into a sewer, those devices holding back a head of water become safety critical. And that's something we and the rest of the industry have picked up on since one sheared, though fortunately nobody was injured."
This kind of insight is shared by the water industry heads quarterly at meetings of the Water UK Occupational Safety and Health Group.
One pillar in Thames Water's "culture of care" is its approach to employee health. In 2013 Simons introduced annual personal medical assessments for all staff -- at a cost to the company of about £50 a head -- provided by screening specialists Healthy Performance. The check-ups include blood and urine analysis, blood pressure tests and body fat measurement. The tests have led to early diagnoses of bowel cancer in five employees and produced more than 100 indicators of potential prostate cancer.
Simons believes Thames Water is almost unique in measuring lost-time illness rates alongside the LTIR. "In Thames, anybody off work as a result of injury or illness, work induced, I know about it and there's an investigation and an executive review."
There were 16 work-related ill health cases noted in 2017-18 in Thames Water's annual report. When I suggest this seems unfeasibly low, Simons says the figure is down around 80% over five years but stresses these are only work-related illnesses. For multifactorial conditions such as stress or musculoskeletal disorders, the company's occupational health staff triage the ill-health cases into predominantly home or work related. "For every one work-induced illness case my occupational health team see, they see a hundred non work-related ones," he notes. He emphasises that the classification is only to give the company clear data; employees receive the same support, regardless of category: "If you injure yourself on a football field we'll give you physio[therapy] free of charge, because it will keep you in work."
Physiotherapy referrals quadrupled when the extension to non-work conditions was introduced in 2016, but he says the savings in reduced sickness absence massively outweighed the extra cost.
A commitment to tackling mental ill health has resulted in one in ten employees training for two days as mental health first aiders and more than 1,000 attending the company's half-day Mind Fit mental health awareness sessions (see "Healthy immersion" box below).
Simons says there are now five mental health first aid interventions for every physical one.
"It's not because I've got lots of mental health first aiders," he says. "That's helped but it's because people are going to managers and saying, 'I need a bit of help'. Society is speaking more on psychological health, so people are speaking more about it in the world of work.
"We have created a culture of care that's flushing this to the surface and we will be a better organisation as a result of people feeling valued and getting support."
Another change he brought to Thames Water was closer integration of the contractor workforce whose work on the clean water and waste water pipes is the most publicly visible part of the utility's maintenance activity, and some of the most hazardous, day to day.
"We are at the bottom," he says, meaning that to reach the water or sewage conduits underground, the repair teams have to dig past the telecoms and electricity cables and gas mains, with an increased risk of service strikes. "And it means we are longer on site and we have to control traffic longer".
The firms undertaking these works include Clancy Docwra, Lanes Group, Morrison Utility Services and Murphy. Larger infrastructure projects such as water treatment plant upgrades are handled by two design-and-build joint ventures, one comprising Costain, Atkins and Black & Veatch, the other Skanska, MWH and Balfour Beatty, who collectively form the Eight2O alliance, with IBM as information technology partner.
"All our contractors wear Thames Water orange PPE," says Simons. "We gave them it three years ago. The standard of PPE wasn't where it should have been."
He says that an additional 10,000 workers wearing hi-vis suits with the Thames Water logo and driving branded vans raised the reputational risk if anything went wrong with their work, "but in terms of the family feel and community side, we gained.
"Our customers have a lifetime relationship with Thames Water; they don't have one with the contractors. Yet some of the contractors' [employees] have only ever worked for Thames. So why wouldn't we treat them like our employees and give them the best quality equipment and workwear? And when a member of the public sees somebody digging up the footpath I want them to see Thames Water, in the right gear, doing the right job in the right way."
He meets 20 operational directors of the company's major contractors monthly, in a session chaired by one of them, to discuss changes and improvements to the 29 essential OSH standards for Thames Water's suppliers, which range from the general (risk assessment) to the specific (safe use of telehandlers and drones). "They own the standards, not us," he says. "If a work at height standard needs to be adjusted, that group agrees it and we sign it off and everybody complies with it.
Virtual reality and 360-degree video training is gaining some ground to help workers practise work in environments such as confined spaces where close replication of the hazards is valuable to build competence, but Thames Water's use of 360-degree video to develop mental health awareness may be unique.
"I didn't want to see it happening to someone else," says Karl Simons of his reasoning for commissioning the immersive technology. "I wanted to be the person suffering the effects of mental stressors."
The half-day Mind Fit course allows groups of 12 to enter the world of "Dennis", a Thames Water employee suffering from severe stress. Trainees are put in the worker's place at home in front of a laptop with the phone ringing, children arguing in the background and his spouse complaining about him working so late. Other enervating scenes follow along with glimpses of colleagues noting Dennis's erratic behaviour and absences.
"We are creating a stressful environment, you really get frustrated when you are in it," says Simons.
The scenes build to a crisis, then trainees are shown the supportive behaviour on the part of managers and colleagues that could have helped Dennis avoid it, using materials based on the mental health charity Mind's mental health first aid light course.
About 1,000 of Thames Water's 6,300 employees have taken the voluntary course to date, and all the places on the three sessions a month are booked 12 months ahead. "The appetite for it suggests the content is right," says Simons.
"Never in five years has there been a discussion on cost in that group. Our discussion is whether it's the right thing to do. It's supply chain maturity at its best."
The national water industry rates published by the Health and Safety Executive are combined with the high ones of the waste industry and many of the UK's other water companies quote rates using different bases, making it hard to benchmark that rate. One available comparator is Wessex Water whose rate of 0.17 per 100,000 hours looks close to Thames Water's until you consider that the west country utility's figure covers direct employees only, while Thames's lower rate also comprises those 10,000 contractor employees.
To manage risk well, says Simons, a business must have the means to assess its current compliance level almost at a glance.
"Lots of organisations struggle with risk visualisation," he notes. "When I arrived ours wasn't what it should have been."
He asked the board: "How do you know your business is compliant at this moment across all its assets -- chemical tanks, pressure vessels, local exhaust ventilation systems, [systems harbouring] legionella risk?"
The answer was that they could not be sure.
"Now, if you ask that of one of my directors they are able to show them that health and safety compliance on a single page."
That page is a dashboard with no less than 34 graphs -- packed into two sides of an A3 sheet in printed form -- showing rolling 12 month rates for everything from reportable and lost-time injuries to underground service strikes and vehicle incidents, plus data on health surveillance and management action overdue, numbers of training courses delivered and inspections completed against target.
Though the graphs are clearly laid out their sheer quantity makes daunting reading, so they are summarised in a representation of the safety triangle with the lagging indicators for accidents and ill health beside the top strata and the leading metrics such as health surveillance, management site visits and corrective actions closed out mapped on to Simons' lower "internal" levels of attitude and leadership.
When red numbers appear in the dashboard, indicating a programme is falling behind, "then you have extraordinary risk meetings with MDs about why the programme isn't where it should be and what more we need to do".
Cart and horse
The dashboard is not just a helpful status check but also a critical lever in driving funding, he says. "Inspection is a catalyst for all investment and maintenance and in many organisations budget ends up driving risk.
"Let's say it's sewers crossing railway lines. What happened previously, five years ago, was that the programme owner would say, 'I can do 280 inspections on those'. Why? 'Because I only have £1m for that. And my stretch target from finance to manage my cost code is 10% [saving].'
"So they will only spend £900,000; that's budget driving your risk management." The following year, he says, the stretch target will be lower again.
"We turned that on its head at Thames. I said, 'I want to know how many inspections we need to do to keep us compliant and confident that we are doing what we need to do'. If they said 'we need to do 500' and it was going to cost us £1.6m, now risk is driving the discussion."
Setting the priority order so the level of risk and appropriate control is the starting point focuses the minds of the board, he says, because they can only argue over funding if they believe the planned inspection level is wrong.
And if budget constraints threaten to impinge during the year, the safety function has the board commitment to fall back on when defending the programme. "Who wants to be the director who says we are not going to inspect those assets?"
Performance against these fully-funded programmes then provides monthly measures on inspections, resulting actions specified and completed, which allow the risk committees -- one dealing with catastrophic risk such as that posed by reservoir breaches, toxic gas releases or the collapse of sewers crossing railway lines and one with general risk, such as fire, asbestos and legionella -- to monitor compliance.
From the start
Simons' career began in the British army as an apprentice mechanical and electrical engineer, in a 13-year stint that saw him stationed in Germany and Canada and complete three tours in Bosnia and one in Kosovo during the Balkans conflicts. He says the army's one priority there was the preservation of life, which set him on the course he has followed ever since.
The armed forces resettlement programme paid for him to gain the NEBOSH general certificate when he left in 2003, then he put himself through honours and master's degrees in OSH management.
Spells in construction and rail infrastructure in the UK were followed by his first director post, working for Carillion and based in Oman for two years.
"That taught me how to deal with large multicultural workforces. In the UK you might have 500 to 750 people on a large site. My largest site in Oman probably had 25,000 people on it. The number of people run over by buses alone moving the workforce from the camps to worksites was hugely challenging."
Then he moved to Dubai as construction director for consultants Hyder working on projects including the world's tallest building, the 829 m high Burj Khalifa.
His last job before Thames Water was in oil and gas with Transfield Services which operated and maintained many of Shell's offshore installations and refineries. "I had eight different countries and spent a week in each, then a week at home. The furthest was New Caledonia, three hours east of Australia, where we had a nickel refinery."
From that global role to a regional British one seems like a big shift in scope, but he comes back to his earlier point that Thames Water, however geographically contained -- "I'm happy to be able to go home and tuck my children into bed" -- provides the bigger job.
"We are the largest holder of critical national infrastructure," he says, alluding to the security responsibilities in his role. "The government is absolutely reliant on us. I have responsibilities to [environment department] Defra and [security agency] MI5."
At the end of my time with Simons we turn to his views on what makes a good OSH leader. Humility is "massively important", he says. "Credibility comes from honesty, trust, collaboration and mutual dependence."
Keeping your head is also critical. "When things are not going well people become very animated very quickly. Part of my role is to make sure my team always feel supported. The military teaches you there are a lot of things you can't do anything about but there are a lot of things you can sort out quickly. As a tank commander in a conflict you very quickly learn to keep your head."
That honesty, which he sees as a vital quality, extends to admitting what you don't know. He says the safety heads who report to him are always interested in boardroom dynamics, "because often there isn't the opportunity for the tier beneath the lead to go in and observe what happens there".
"I get asked, 'What happens if you get asked something you don't know?' I'd say, 'I don't know the answer'. That doesn't mean the board will think everything you have said before was rubbish. We are people, we don't know everything but we have teams of people who can find the answer."
Aside from his day job he serves as a non-executive director of the charity Water & Sanitation for the Urban Poor, which has given him insight into what those overseeing organisations expect of functional leaders.
"It's good to sit on the other side of the table," he says. "Most health and safety professionals don't take the jump to sit in non-executive director positions and understand the wider aspects of business management. Now I'm responsible for the finances of that organisation, the people, the procurement side, I'm on the risk committee; it makes you a rounded professional. Anyone who finds they can give a bit of time to sit on the board of a charity, I'd recommend it."
I ask if he has any unfulfilled ambitions. He struggles to name one. He says he is happy celebrating the achievements of those he manages and explaining to other businesses what Thames Water has achieved through its caring culture.
"I used to hear academics saying, 'Here's what you can do'. I wanted to get to a point where I was presenting a case study of an organisation that has achieved injury and illness reduction through waves of initiatives. That's where I am."