1. This is the best way forward for all the employees

2. Committed to Health PDO Chief Medical Officer
Dr. Sulaiman Al Rawahi, MD, MSc(OH), MSc(DM),FFOM(I)
PDO Chief Medical Officer

3. We can provide better employee Welfare
Remain a challenge in PDO concession area, mostly in contracting workforce population which has increased significantly to over 55,000.
Of many of employees with known chronic medical
conditions, no appropriate follow up.
Health risk factors, Life style issues, employees denial of
medical problems and ignorance of medical advice.
Issues with return to work following significant illnesses.
Inappropriate medical facilities in some locations or rigs e.g.
MER issues including competence of Contractors’ doctors
and nurses, shortage of drugs and MER equipments.
Recent observed incidents of suicides.
Investigations often not conclusive with difficulties in
conducting autopsy in many cases.

4. Non Accidental Death - Challenges

5. The main factors to NADs
Challenge
Causes 1
Pre-existing conditions
HTN, Diabetes, High cholesterol level 2
Individual behaviors and life style issues
Lack of exercise, Heavy smoking, Over eating, obesity, etc. 3
Attitude, culture and beliefs issues
Bad beliefs, Fears, Ignorance of medical advice and denial. 4
Non-compliance with FTW Standards and medical surveillance
Issue of appropriate exams. 5
Issues with return to work medicals
Ignorance v/s fear of losing job 6
Occasional no follow up of cases with chronic medical problems.
Inappropriate follow up and care of chronic medical conditions

6. Rate of NADs expressed against Man-hours
Total manhours (mln.)
rate/mln hours
1998 15
59.31
0.253
1999 13
52.81
0.256
2000 10
51.62
0.194
2001 8
48.47
0.165
2002
53.39
0.150
2003 11
60.87
0.181
2004
67.21
0.119
2005
64.26
0.171
2006 18
78.84
0.228
2007
99.62
0.151
2008 21
127.06
2009 17
147.07
0.116
2010 16
147.93
0.108
2011
141.24
0.092
2012 7
149.15
0.047
2013 9
158.49
0.057

7. Background
Following external and internal medical services review, and the investigation of several NADs and other medical emergency responses, the decision was made to centralized contractor provision of medical services in each hub to better serve the workforce and deliver a coordinated Medical emergency response.
This means that all contractors’ clinics, run single hand by nurses in locations where PAC is available will be required to close down their facilities and relocate their healthcare services to the nearest PAC.
This decision will neither affect mobile rig clinics, whose services are handled by competent paramedics, nor temporary clinics in remote areas, which will exist only under strict criteria and which will be supported by PDO/PAC doctors (and later by centralized clinic) by some form of telemedicine.

8. Centralization of Medical Services
The phasing out of small clinics manned by single nurse and provide centralized
facilities manned by doctors who will be able to follow up chronic medical conditions
which increased risk of heart attack and other causes of sudden death.
No more sub standards medical services.

9. Background

10. Contractor medical centralization
It is envisaged that in this harmonization of health provision we will have better management of chronic medical conditions such as diabetes, hypertension and other heart ailments by a qualified physician.
Furthermore, fitness to work medical check of employees, which hitherto, were defaulted, will now be easily monitored and reinforced, as are the skills and competency of the doctors performing the checkup due to their exposure and clear knowledge of the PDO working environment.
A string of meetings and communications on the issue were held with all the concerned parties - CHs, CEOs, Area Coordinators etc., involving the Managing Directors, Mr. Raoul Restucci, as well as members of the PDO medical team in the interior.
The restructuring (i.e. centralisation) of the contractors’ Primary Healthcare Services (PHC) has been driven by the unacceptable living conditions of the workforce resulting in a number of social behaviours, poor health and even NAD’s as established and reported by the Occupational and Public Health teams, in several inspections.

11. Benefits of medical centralization
Better organizational design with a unified PDO health vision for both PDO and contractors. This will in turn align health services with business goals directly and easily under a single umbrella of care.
Both service and quality are managed in parallel with defined responsibilities of different parties (PDO staff for quality and supervision, contracted staff for service). This will in turn facilitate improvement of quality of service among contracting community as there will be direct supervision and monitoring.
Better management and control of chronic medical conditions, such diabetes, hypertension and heart ailments, which have connected to past cases of NADs.
Enhance the effectiveness of MER system through integrated service and unified team. This provides coordination and team management during MER with full fledged team available at one site for management of incidents.
Better management and control of OH services which include elements such as improved and controlled fitness to work (FTW) and health surveillance system where all employees are managed at single point of service and access available for all workers, OH reporting and investigation, etc.

12. Benefits of medical centralization
Better communication and facilitation of consultations through the virtual organization approach that will reduce the need for travelling to a doctor-manned clinic, improve safety and enhance patient satisfaction.
This will also facilitate harmonization of health services within contractor employees as a basic requirement.
Improved integrated health service where full collaborative/supportive team (including doctors with more extended capability) will be available in most of the clinics. This in turn will reduce stress and other organizational /working factors for medical staff operating clinics single handed.
Removing the burden of direct provision of medical services to allows the contractors to focus on their core business and safety issues and hence improve performance.
PDO Medical Services could become a role model in the business with such an integrative, well-organized health services with broader coverage of all employees and contractors. This will add to positive reputation of the company.