The ‘Whole Person Approach’ to Health & Safety

Published: Wednesday, November 11, 2020 - 07:19

This week, we have been talking about the "Whole Person" approach to health and safety, and individually looking at the components that form the concept. However, to appreciate the impact this theory has on our methodology here at PSS, we first need to examine where this approach came from and how the different factors fit in. Port Skills and Safety Operations Manager Rean Da Costa leads us through the principles and explains why it is important to consider the "Whole Person" when looking at health and safety.


Rean Da Costa
Rean Da Costa

We know ports have become safer through our annual data collection, in fact as has been mentioned before, reportable accidents have reduced by 67% since the turn of the century. This progress is commendable, but as we celebrate this waypoint, there is a realisation that we have arrived at a safety plateau because the rate of progress has slowed down. From here there is a need to think proactively and embrace new ways of thinking and new tools to navigate this untraversed territory. We know the foundations of this complex puzzle are core safety and Skills because they have got us to this waypoint over the last few decades but how do the relatively new puzzle pieces of culture, health and mental health fit into this journey?

Lets first take a step back and shed light on Skills and Core Safety that have got us to this waypoint.

Skills –Through PSS the UK port industry has been building safety competence into the job description. This has been achieved because PSS is custodian and developer of various National Occupational Standards (NOS) and Trailblazer Apprenticeships. These standards of performance layout what individuals must achieve when carrying out functions in the workplace, together with specifications of the underpinning knowledge and understanding that bring full competence in a particular occupation. PSS ensures that through NOS, Trailblazer apprenticeships that employees possess the necessary toolkit to tackle all the challenges in the port right from day one. Safety is part of everyone’s job and they are provided with the skills behaviour and knowledge ahead of the task commencing.

Core Safety – Any and all work in the UK is governed by risk assessment, which mitigates any potential risks through efficient risk management in line with the risk control hierarchy. Those organisations/ employers who create the risk to have a duty of care to ensure no one gets hurt from those undertakings. PSS’ key initiative in this risk management arena is the tripartite badged Safety in Ports (SiP) guidance document suite. This may be the only exiting suite of guidance documents in the world collaboratively created by people from the sharp end, including employers, union representatives and badged by the UK regulator The Health and Safety Executive. Another key initiative here is the Annual Accident Data collection and recent Bi-Monthly Accident Data collection that allows members to glean key insights from accident trends and leading indicators across UK ports. This allows employers to construct targeted accident prevention initiatives specific to their unique port environment across the UK. These initiatives are core and are the foundation upon which culture can then be addressed. It is very hard to gain trust from employees that an organisation cares about the safety culture of its employee when the day to day risks and accident root causes are not eliminated or managed effectively. There is an old Dutch proverb which goes ‘trust comes on foot but it leaves on horseback’. The efficient management of risk in the workplace forms the bedrock upon which trust and culture must be built upon.


Now that we have looked at Skills and Core Safety let us take a look at the new pieces of the puzzle, namely Culture, Health & Mental Health in a slightly different light.


Millers Law & Whole Person Approach - In 1956 George Miller published a highly cited study which argued that the number of objects an average human can hold in short-term memory is 7 ± 2. This number is often referred to as Millers’ law. If the human mind can only focus on 7 ± 2 objects in working memory, then it brings an interesting insight into designing intrinsically safer workplaces for our workforce through the Whole Person Approach. One can infer that an individual’s ability to concentrate on the job and stay safe depends on keeping the employees' cognitive load in between the 7 ± 2 range. When it comes to core safety and risk management, sound risk management calls for top-level deployment of the hierarchy in the first instance namely; risk elimination. This is followed by substitution, engineering controls, admin control and finally PPE & signboards. Therefore through the understanding of Millers Law, it can be inferred that organisations who deploy controls at bottom of the hierarchy thus allow the hazard to exist in the workplace and for potentially innumerable combinations and permutations of interactions with the employee. Arguably, the efficient elimination of risk from the workplace allows the individual to use their cognitive load to focus on the task at hand.

Health and Mental Health - Firstly when it comes to mental health we have to understand that we all possess a state of mental health and secondly our mental health exists on along a continuum. We all fluctuate between thriving, struggling and potentially being ill. This fluctuation is normal. There is ample evidence that stress can cause this fluctuation and lead to cognitive impairment that includes issues with attention and the 7 ± 2working memory. With regards to work-related sources of stress, the HSE has specifically identified and developed management standards. According to this standard, the six key areas of work design that organisations must properly manage are; work demands, work control, support, relationships, role and organisational change. With regards to occupational health conditions, the Stevenson and Farmer review notes that those individuals with long term health conditions like musculoskeletal conditions, heart problems and chest or breathing problems are two to three times more likely to experience the ill effects of poor mental health.

There are other sources of ill mental health that can be perceived to originate from outside of work but can impair cognitive load such as bereavement, divorce or separation, finance/money etc. This brings us to the argument about whether organisations can only tackle mental health issues raised from work-related outcomes or adopt a holistic approach. This is up for debate but what we do know that mental health is a complex interconnected web, and we bring our whole selves to work. It is not possible for us to leave a part of us at the company entrance and simply bring a selective version of us into the workplace. The Stevenson and Farmer review appears to support this viewpoint through its recommendation that guidance should provide a more holistic approach that helps support employers to protect and enhance the mental health of their workforce. This is further reinforced through their Mental Health Core Standards, which speaks of encouraging open conversations when employees are struggling and the importance of a healthy work-life balance.

Culture – This brings us to organisational safety culture. Putting together the previous puzzle pieces of Skills and Core safety, Health and Mental health, we now have a complex question of trying to understand what common vision of organisational culture are we aiming for?. The HSE can provide us with clues to this through their safety culture maturity model. The HSE safety culture model for maturity proposes that organisations progress sequentially through five levels namely: emerging, managing, involving, cooperating, and continually improving. Some of the features associated with higher maturity include “ The majority of staff in the organisation are convinced that health and safety is important from both a moral and economic point of view” and “The importance of all employees feeling valued and treated fairly is recognised”. The HSE safety culture maturity model provides a good frame of reference to aim for. But the important question for the industry is how piece these pieces of the puzzle together for each port’s unique context? How to start practically creating workplaces that actively demonstrate leadership, engagement, empowerment and thus enable a positive health and safety culture to emerge?


In 2019 PSS helped industry take a huge leap towards this goal and officially launched the sector plan for UK ports. This has been modelled upon the HSE’s own approach which is high level and sector-wide. While we are still standing on this safety plateau and starting what will be our marathon exodus off this plateau, this SMART sector plan is the first step in implementing this whole person approach to Health and Safety. It strengths the Skills and Core Safety achievements of the sector but set the sector on a new journey out of the accident plateau, incorporating Culture, Physical and Mental Health or as we now call it at PSS ‘The Whole Person Approach’