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Report Assignment Sample -HEALTH NEEDS ASSESSMENT IN PRACTICE

HEALTH NEEDS ASSESSMENT IN PRACTICE 

Table of Contents

1. Introduction 3

2. Social and Health Care Data in Essex 4

2.1 Social Data 4

2.2 Health Data of Essex 11

3. Determinants Inequalities and Barriers to Health in Essex 13

4 Critique of the Health Care Services Available for Dementia 15

4.1 Health Care Services Available for Dementia 15

4.2 The Nurses’ Role 17

5 Conclusion 18

References 20

1. Introduction

This paper focuses on the rising health risk in the Essex region. From the surveyed data in the area, there is a clear indication of the increasing need for public health services in dementia therapy.

Before delving into the critical component of this report, this research first presents an introduction to Essex, which covers the county’s demographics along with the specific local health and social services in Essex to determine why Dementia, which has been classified as the most urgent concern for the area, is on the increase.

The report will move forward to offer more details regarding the locality of Essex in the second section.

This includes all the many medical services in the region to clarify the frequency of Dementia in Essex and its epidemiology. This information is supported by graphs, tables, and real-time data to provide a comprehensive picture of the public health issue the region faces.

The information and figures in this report section were gathered from the National Health Service (NHS) and the official local authorities in Essex. The factors responsible for inequalities, marginalisation, and barriers to health in Essex are extensively analysed in the third section of the research. It is crucial to note that this analysis is, however, restricted to Essex’s current dementia epidemic.

Thus, this section will compare the factors affecting health in Essex and the rest of the United Kingdom using empirical data. The fourth section presents an analysis of the current service provision in Essex.

This section specifically focuses on the policies that affect service delivery and discusses nurses’ roles in Essex’s health screening and promotion. It is followed by the Conclusion, which summarises the most significant findings from the study and offers recommendations for future practices.

2. Social and Health Care Data in Essex

2.1 Social Data

Essex, a County in the United Kingdom, is situated northeast of London and southeast of England.

According to data acquired during 2015–2017, it is noteworthy that the life expectancy at birth is around 83.3% for girls and 80.2% for males [Public Health Intelligence Research and Insight Essex County Council (PHIR Essex County), 2019]. This is based on the observation that females have a greater life expectancy at birth than males.

The county has a higher life expectancy than England, whose birth expectancy is 79.6 years for men and 83.1 years for women (City Population, 2020). In the Essex region, cancer kills 131 people per 100,000, cardiovascular disease kills 62.6 people per 100,000, and respiratory illnesses kill 30.8 people per 100,000 (PHIR Essex County, 2019).

Table 1. The growth of the population of Essex

word image 84530 1

Not all districts in Essex have the same population density, which stands as a crucial consideration. Between 2011 and 2018, each district significantly expanded, as shown in the bottom right corner of Image 1 below.

According to PHIR Essex County (2019), Colchester and Basildon are the places in Essex with the largest populations and the fastest population growth rates, while Maldon is the region with the fewest inhabitants. More details on the local demographic changes are provided in the following sections.

Figure 1 shows the population growth rate over an average year.

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source: PHIR Essex County (2019)

According to the area’s demographic figures for 2019, Essex has a total female population of 760,839. In contrast, the number of males is projected to reach 728,350 in 2020 (City Population, 2020). This suggests that there is no wide disparity among the population’s members.

Figure 2 makes it abundantly evident that persons between the ages of 18 and 64 make up the majority of the population in the area (City Population, 2020). This shows that Essex’s population’s average age is relatively high and low. Another significant component of this number’s relevance is that it illustrates that a sizable portion of people in Essex are at risk for having Dementia (Mapes & Hine, 2011).

The demographic structure of Essex is further broken down in Figure 3 compared to the population structures of other regions in the United Kingdom. The towns of Castle Point, Maldon, Rochford, and Tendring have the greatest senior populations overall in terms of the percentage of the total population comprised of individuals over 65.

According to statistics from the City Population (2020), the regions of Basildon and Harlow have a lower percentage of older citizens. However, the age distribution in Essex is examined in further detail in Figure 4. From the graph, it is evident that a significant portion of the population in Essex is older than sixty.

Figure 2: Population Structure in Essex

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Source: City Population, 2020

 

Figure 3: The Population’s Age Distribution in Essex

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source: PHIR Essex County (2019)

Figure 4: Essex’s Age Distribution

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Source: City Population, 2020

The information in the accompanying graph makes it abundantly evident that the great majority of people who now live in Essex were born in the United Kingdom (Figure 5).

Moreover, 1.2 million people in Essex were born in the United Kingdom, 9,278 people were born in the Republic of Ireland, and around 30,000 people were born outside of Europe, according to the City Population from the 2020 projection. In comparison, around 61,000 city inhabitants (City Population, 2020) were born on a continent other than Europe.

This trend supports the Essex population’s ethnic breakdown, which shows that the city has a mostly white population (City Population, 2020). The information in Figure 6 indicates that in 2011, around 1.3 million white people were living in Essex. Contrarily, the region had 34,000 individuals of Asian heritage and over 18,000 people of Black descent, compared to only 2,000 people of Arab descent. Only around three thousand people are in the region when all other populations are considered.

Figure 5: The Country of Origin of a Person

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Figure 6: A group of ethnic people from 2011

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Source: Alihu (2011)

Religious practices are one of the most significant factors that shape a place’s sociocultural composition (City Population, 2020). Religion is important because it significantly affects the cultures that people accept, including what they consider morally suitable and wrong.

It also affects how individuals manage health-related issues, such as deciding who or what needs to go to the doctor and who or what may be treated in the privacy of their own homes. The religious makeup of the region is presented in Figure 7 below.

Figure 7 of Essex’s Population’s Religious Makeup

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Source: City Population, 2020

2.2 Health Data of Essex

Dementia is one of the illnesses with noticeably higher rates of illness and admissions in Essex, with a predicted increase of more than 1% above the average for England (City Population, 2020). As a result, it is one of the diseases with a high prevalence rate. According to the trends, eight of the twelve Districts have higher rates than England, while only four have lower rates than England (Figure 8).

The overall diagnosis rate for Dementia in Essex rose from 60% to 64.5% between 2017 and 2019. Despite this, the prevalence of dementia diagnoses is still low, indicating that there may be more people in this region who have Dementia but have not yet been diagnosed with it.

Figure 9, however, shows that the issue of Dementia is anticipated to become considerably more common within a relatively short period. The Projecting Older Persons’ Population Information (POPPI) also predicts that by 2019, there will be around 21,972 people in Essex who are over 65 and have Dementia.

The estimates indicate that if everything remains the same, this figure might increase by 33% by 2030, demonstrating why it is such a significant public health concern for Essex.

Figure 8: QOF Prevalence (% of GP Registered Patients)

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Source: Older People’s Population Information (POPPI

Figure 9 Projected number of people aged 65+ with Dementia

word image 84530 10 Source: Older People’s Population Information (POPPI)

3. Determinants of Inequalities and Barriers to Health in Essex

According to findings from Davies et al. (2018), people in the UK who earn below-average salaries often have worse health and shorter life spans than those who are financially successful. Data from several earlier studies also showed that socioeconomic inequalities cause an increase in morbidity and a decrease in life expectancy in the country.

The study by Moldovan (2018) predicts that inequality would directly cause the loss of an average of 1.3 to 2.5 million years of life each year in the United Kingdom.

Additionally, the Siddiqui et al. (2020) study showed that the population vulnerable to marginalisation is often characterised based on age, gender, disability, marital status, pregnancy, race, ethnicity, belief, religion, or sexual orientation. For instance, only a relatively small percentage of the region’s workforce comprises people of Asian, Black, and Arab descent.

Furthermore, this group faces considerable discrimination when accessing medical treatment and educational services (Living Well Essex, 2020). This information highlights the magnitude of the problem confronting ethnic minorities in the region. This also suggests that there is a good chance that there will be noticeable ethnic inequalities in Essex.

Another notable trend, according to Galama and Kippersluis (2012), is that White males have access to more employment opportunities than persons of any other gender or ethnicity. The key causes of ethnic minorities’ underrepresentation in formal work, according to Galama and Kippersluis (2012), are differences in their countries of origin, ethnicities, and languages, which are connected to the first two criteria.

However, the fact that fewer than 92,000 residents of Essex, as seen in Figure 5, were born in nations or territories that are not a part of the UK invalidates this argument. Instead, Essex experiences systemic prejudice against racial and ethnic minorities, similar to those in other parts of the United Kingdom (Galama and Kippersluis 2012).

It is crucial to note that women from racial and ethnic minorities are exposed to the most marginalisation. This results from the fact that women face greater economic disadvantages than men do, even among the ethnic groupings that make up the majority (Moldovan, 2018).

Furthermore, the problem of Dementia has also affected this population. According to Alzheimer’s Research UK (2020), Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease are a few further prevalent causes of Dementia, while age, genetics, diabetes, depression, smoking, eating poorly, drinking excessively, not exercising, and abusing drugs are a few physical and lifestyle variables that may contribute to the development of the illness.

Linking this Conclusion to the findings of Galama and Kippersluis (2012), which suggest that the marginalised groups in Essex have more health risk behaviours such as drinking excessively, not exercising, and drug abuse, it follows that the marginalised group in the region is more at risk of having Dementia.

The same is true of Essex’s dementia statistics, which show that compared to White populations, who make up the majority, persons of racial or ethnic minorities and members of economically disadvantaged groups are disproportionately affected by Dementia. Around 22,000 Essex residents had Dementia in 2012, according to the Essex County Council.

This population is projected to be about 30,000 by the year 2020 and 35,000 by the year 2035, according to projections from Essex County Council et al. (2012). Creed (2019) predicted that by the year 2050, there would be about 73,000 people living with Dementia, a 156% rise over the statistics for the previous year.

4 Critique of the Health Care Services Available for Dementia

4.1 Health Care Services Available for Dementia

Unfortunately, the services offered to dementia patients in Essex are not as successful as they may be. According to a 2017 NHS report titled “Southend, Essex, and Thurrock Dementia Strategy 2017-2021,” the quality of care offered to dementia patients is poor, inconsistent, and fragmented. Additionally, the number of people with Dementia has generally increased, increasing the demand for caregiving services.

The NHS (2017) report on the quality of services currently available highlights the fact that the majority of services are only intended for those who have been diagnosed with Dementia, even though the UK’s proper strategy is to target and support entire families to meet the needs of caregiving.

Another big issue in Essex is that Dementia is often overlooked in its early stages, which lowers the effectiveness of illness treatment. Essex has a widespread lack of high-quality information and help, both of which are required for the successful planning and treatment of Dementia, according to the NHS (2018).

The 2017 NHS report on racial and ethnic composition also highlighted that Dementia is underdiagnosed among racial and ethnic minorities in Essex, especially Black and Asian Minority Ethnic (BAME). This claim is supported by the figures provided by Darwent (2017), which are summarised in Figure 10.

Despite this, this group has considerably greater rates of Dementia than the general population. Additionally, even members of this group with a dementia diagnosis are less likely to utilise the current dementia services. According to Darwent (2017), Essex has a substantially less general understanding of Dementia and less access to support for those with the disease than the UK.

Additionally, there is a lack of culturally competent providers and an issue with delayed diagnosis in the region. This directly improves the quality of services provided to the White majority population relative to the ethnic minorities that make up the population’s minority (Darwent, 2017).

Figure 10: Recorded Cases versus Unrecorded Dementia Diagnosis

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Source: Adapted from Darwent (2017)

According to Essex Dementia Care (2021), the adult social services department in several locations is responsible for overseeing the daily personal care activities of dementia patients. The social services group offers speciality services, including access to day centres, help and modifications, washing and dressing, laundry services, and meals delivered to clients’ homes. (North East Essex Health and Social Care, 2020).

They provide information on local and national services, including charities, to people with Dementia and their families (The Good Care Group, 2020). This is another important feature of their services (The Good Care Group, 2020).

Additionally, they are beneficial in supporting the requirements assessment process. A diagnosis of Alzheimer’s does not automatically make a person eligible for financial assistance for Alzheimer’s services, even if there is no fee for the required assessments. The NHS offers inclusive treatment in hospitals and general practitioners’ offices. For example, physiotherapy, hearing care (also known as audiology), eye testing (also known as optometry), foot care (also known as podiatry), speech and language therapy, and support from the Older People’s Mental Health team are all included in this assistance (NHS Right Care, 2018).

It is crucial to be informed that the National Health Service (NHS) collaborates with the non-profit group Dementia UK to supply Admiral Nurses in certain regions (The Good Care Group, 2020). This kind of treatment entails knowledgeable dementia nurses from the NHS visiting dementia patients in their homes.

4.2 The Nurses’ Role

When it comes to the treatment of Dementia, nurses’ advocacy obligations are crucial, especially in the context of Essex, which is replete with issues with the delivery of care services. Nurses may focus on ensuring that people with Dementia can effectively manage their illnesses despite their conditions and provide professional care services (Wittenberg et al., 2019).

Since they are the ones who give the most care in social settings, particularly in the homes of persons living with Dementia, these services must also include support for relatives of people with Dementia. Moldovan (2018) contends that in these circumstances, families need aid in figuring out the best ways to help their loved ones with Dementia.

Depending on the requirements of the family and the dementia patient, they also need information on where they may get treatment services or other sorts of care, including financial support from charities (Moldovan, 2018). This assistance could take the shape of knowledge.

Nurses must spread more awareness about the value of an early diagnosis and the places where one may be made. Additionally, they must encourage those from low socioeconomic areas and racial/ethnic groups to ask for help when they need dementia care (Moldovan, 2018).

The activities of the nurses are primarily limited to advocating for dementia patients and spreading knowledge of the condition, since, as was previously said, there is little that can be done to ameliorate the symptoms of Dementia once they have begun.

Figure 11: The Nurse’s Role in Managing Dementia

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source Living Well Essex, 2020

5 Conclusion

The results of this investigation show that White people make up most of Essex’s population. There have been reports that the region is experiencing significant health problems, but Dementia remains one of the most important health challenges confronting the area.

Dementia patients may not get adequate care from current providers, according to some reports. Despite making up only 5.7% of the total population, research has found that ethnic minorities in Essex suffer from Dementia at a rate that is disproportionately greater than that of the general population.

The results of this investigation show that people of colour are more likely to have several of the major physical and lifestyle variables that cause Dementia. Despite this, the majority of ethnic minorities get preliminary diagnoses.

Additionally, most people with diagnoses do not get treatment or have access to it. This might be partially ascribed to the care services’ need for cultural awareness. It is necessary to improve the accessibility and quality of care services offered to the residents of Essex, especially the populations made up of racial and ethnic minorities and those economically underprivileged.

The best chance for this development is if nurses take on the role of advocates and educate patients and the general public about dementia-related concerns.

References

Alzheimer’s Research UK. (2020, June 25). Diagnoses in the UK. Retrieved from www.dementiastatistics.org: https://www.dementiastatistics.org/statistics/diagnosesin-the-uk/

Byrne, B., Alexander, C., & Shankley, W. (2019). ETHNICITY, RACE AND INEQUALITY IN THE UK: State of the nation. Place of publication not identified: POLICY Press.

City Population. (2020). ESSEX County in the United Kingdom. Retrieved from www.citypopulation.de: http://www.citypopulation.de/en/uk/admin/E10000012__essex/

Creed, R. (2019, October 31). The number of people in Essex diagnosed with Dementia is to reach 73,000 by 2050. Retrieved from www.gazette-news.co.uk: https://www.gazettenews.co.uk/news/18003440.number-people-essex-diagnosed-dementia-reach-73-000-2050/

Darwent, Melissa. (2017). DEMENTIA IN THE EAST OF ENGLAND. London: NHS East of England Clinical Networks. Retrieved from file:///C:/Users/User/Desktop/East%20of%20England%20Dementia%20Infographics%20Final%20Version%20Nov%202017.pdf

Davies, N., Manthorpe, J., Sampson, E. L., Lamahewa, K., Wilcock, J., Mathew, R., & Iliffe, S. (2018). Guiding practitioners through the end-of-life care for people with Dementia: The use of heuristics. PLoS One, 13(11), e0206422.

Essex County Council. (2019). Essex Local Economic Assessment. Essex: Essex County Council.Essex County Council; Southend-on-Sea Borough Council; Thurrock Council; NHS North

Essex Dementia Care. (2021). Essex Dementia Care is here to help. Retrieved from www.essexdementiacare.org.uk: https://www.essexdementiacare.org.uk/

Essex; NHS South Essex; NHS Foundation Trust. (2012). Living well with Dementia: A dementia strategy for Essex, Southend and Thurrock. Retrieved from Southend CCG.nhs.uk: https://southendccg.nhs.uk/about-us/key-documents/128-essexdementia-strategy/file#:~:text=Within%20the%20geographical%20area %20of,increase%20to%2035%2C000%20by%202025.

Galama, T., & Kippersluis, H. v. (2012). A Theory of Socioeconomic Disparities in Health Over the Life Cycle. Rand Working Paper, DOI: https://doi.org/10.7249/WR773.

Living Well Essex. (2020). Living Well Essex ESSEX JOINT HEALTH AND WELLBEING STRATEGY 2018-2022. Retrieved from www.livingwellessex.org: https://www.livingwellessex.org/media/621973/jhws-2018-cabinet-aug-2018.pdf

Mapes, N., & Hine, R. (2011). Research Project: Living with Dementia and Connecting with Nature–looking back and Stepping Forward. Dementia Adventure, Essex.

Moldovan, A.-L. (2018). Socioeconomic disparities in science knowledge, biomedical self-efficacy, and public participation in medical decision-making. PhD thesis, University of Essex, http://repository.essex.ac.uk/id/eprint/21632.

NHS North East Essex. (2020). DEMENTIA. Retrieved from www.neessexccg.nhs.uk: https://www.neessexccg.nhs.uk/dementia-1

NHS Right Care. (2018, December). Equality and Health Inequalities Pack: NHS North East Essex CCG. Retrieved from www.england.nhs.uk: https://www.england.nhs.uk/wpcontent/uploads/2018/12/ehircp-e-north_east_essex-ccg-dec18.pdf

NHS (2017). Southend, Essex and Thurrock Dementia Strategy 2017–2021. London. https://www.livingwellessex.org/media/523329/Dementia-Strategy.pdf: NHS.

NHS. (2018, July 24 ). Dementia, social services and the NHS. Retrieved from www.nhs.uk: https://www.nhs.uk/conditions/dementia/social-services-and-the-nhs/

NHS. (2018, September 18). Dementia and care homes: Dementia guide. Retrieved from www.nhs.uk: https://www.nhs.uk/conditions/dementia/care-homes/

Public Health Intelligence Research and Insight, Essex County Council. (2019, September). Joint strategic needs assessments: Essex Countywide Report. Retrieved from cmis.essex.gov.uk: https://cmis.essex.gov.uk/essexcmis5/Document.ashx?czJKcaeAi5tUFL1DTL2UE4zNRBcoShgo=0j2Cl10xBy8FeoppSl8d6Q4T5vm1Km0AJWzeXTmK%2BjuopxlGt4NY2Q%3D%3D&rUzwRPf%2BZ3zd4E7Ikn8Lyw%3D%3D=pwRE6AGJFLDNlh225F5QMaQWCtPHwdhUfCZ%2FLUQzgA2uL5jNRG4jdQ%3D%3D&mCTIbCubSFfXsD

Siddiqui, T. G., Whitfield, T., Praharaju, S. J., Sadiq, D., Kazmi, H., Ben-Joseph, A., & Walker, Z. (2020). Magnetic resonance imaging in stable mild cognitive impairment, prodromal Alzheimer’s disease, and prodromal Dementia with Lewy bodies. Dementia and Geriatric Cognitive Disorders, 49(6), 583-588.

The Good Care Group. (2020). Dementia charities in the UK. Retrieved from www.thegoodcaregroup.com: https://www.thegoodcaregroup.com/live-incare/dementia-care/dementia-charities-uk/

Wittenberg, R., Hu, B., Barraza-Araiza, L., & Rehill, A. (2019, December). Projections of older people living with Dementia and costs of dementia care in the United Kingdom, 2019–2040. Retrieved from www.lse.ac.uk: https://www.lse.ac.uk/cpec/assets/documents/cpec-working-paper-5.pdf

 

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Report Assignment Sample -HEALTH AND SAFETY LEADERSHIP REPORT FOR ELECTRICITY COMPANY OF GHANA (ECG)

Report Assignment Sample -HEALTH AND SAFETY LEADERSHIP REPORT FOR ELECTRICITY COMPANY OF GHANA (ECG)

EXECUTIVE SUMMARY

The ECG is a state-owned organization that enjoys monopolistic power in the sense that, it is the only power distribution company that distributes power throughout southern Ghana. Although the Northern part of Ghana is geographically larger than the Southern part, the southern part happens to the industrial hub of the country. This report presents an overview of the health and safety-related problems in the electricity company of Ghana while discussing the appropriate leadership response for these problems.

Though the overall goal of the report was to conduct an appraisal of the leadership actions for mitigating the health and safety-related problems, the paper also highlighted relevant literature on leadership styles and models that further provided credence to the recommendations in the paper. Pertaining leadership style most appropriate for managing health and safety practice in ECG, the report, recommended the transformational leadership style noting that employees who work under transformational leaders are more inclined to exert extra effort to ensure safety standards are met when discharging their duties, and consequently perform above and beyond perceived expectations or job requirements.

The reports, also recommend a Leader-Member Exchange model, as its fusion with transformational leadership style can make employee safety concerns at work is increase, which causes an improvement in safety commitment and communication.

.

Introduction:

The Electricity Company of Ghana is a national corporate body that was established in 1947. Like several companies in Ghana, it has evolved. It was previously known as the electricity department, then became Electricity Division, it was again changed to the Electricity Corporation of Ghana and currently is known as the Electricity Company of Ghana. It has been legally mandated by the government of Ghana to distribute safe and reliable electricity to industrial and domestic consumers within southern Ghana on a sound commercial basis.

The company’s vision is to be counted among the leading electricity distribution companies in Africa. And its mission is to provide quality reliable and safe electricity services to support the economic growth and development of Ghana. The ECG has 12 directorates namely engineering, operations, finance, legal, audit, human resource, customer service, procurement, materials and transport, estate and premises, network projects, and ICT. It is however broken down to ten operational regions namely Accra East, Accra West, Tema, Eastern, Central, Volta, Western, Ashanti East, Ashanti West, and Sub Transmission.

In the Electricity Company of Ghana, Engineers and Technical workers work with live wires and are exposed to step/voltage, some also stay at the control rooms and substations that are full of electro-magnetic x-ray machines for long hours. Additionally, most cables are located in bushes which exposes them to harmful reptiles. It has been further observed that most transformers these workers work on are very old, which exposes them to poly chloride biphenyl (PCB), and other carcinogens. Again, the nature of the power distribution industry requires that workers of the Electricity Company of Ghana come into direct contact with customers from time to time in order to successfully execute their duties.

Recommended: Term Paper Sample on CONGENITAL ABNORMALITY

However, more often than not these workers stand the chance of being physically, verbally, and emotionally abused by enraged customers, especially in conducting disconnection exercises (Kumi, 2017). These and many other health and safety issues can affect employees’ health and for that matter may retard the growth of the company if they are not well managed.

Safety is a leading concern in high-risk industries of which energy is no exception. Most industrial accidents and injuries occur on the job and have been highly associated with employee’s unsafe acts (Addai, et al., 2016). Studies have also pointed to the fact that organisational, managerial and human factors rather than purely technical failures are prime causes of accidents in high-reliability industries (Addai, et al., 2016).

One would therefore expect organizations to place a premium on selecting the right leaders to place in safety sites. In practice, however, the opposite is demonstrated. Much emphasis is placed on technical factors; having well-constructed buildings, and ensuring machinery and plants meet safety requirements. These appear to be prioritised to the neglect of the sort of leaders or employees who are to ultimately ensure that safety is carried out to the last detail.

Investigations into the leadership and safety relationship have progressed substantially over the last 30 years, however, a greater number of these studies have focused on the influence and importance of overall effective leadership or general leadership styles on a variety of safety outcomes (von Thiele Schwarz et al., 2016). Nonetheless, research into leadership and safety has established that transformational and transactional leaders are the best leadership choices for safety sites (Çalış and Büyükakıncı, 2019). However, the underlying mechanisms by which leadership may influence safety are not yet well understood. As leadership is often conceptualized as a multidimensional construct. In light of this von Thiele Schwarz et al. (2016) made a call for researchers to put in more concerted efforts to understand both the moderating and mediating mechanisms that link transformational leadership to follower outcomes and commented that, only a few preliminary studies had simultaneously examined mediated moderation or moderated mediation.

Hoffmeister et al. (2014) also made a similar call for the study of the influence some moderating factors could have on the leader-employee safety relationship. Although employers are legally mandated to ensure the safety of their employees, in Ghana there are no sound laws enforcing safety issues with greater emphasis being laid on increasing productivity and profitability, whiles compromising health and safety standards, procedures and policies.

It is necessary for organizations to focus on factors that enhance health and safety standards at work specifically with respect to workers health and safety and focus on ways of enforcing and encouraging these health and safety standards among employees. This report is a response to this call, as from review of studies conducted, there is the need to investigate the leadership actions for directors, board members, business owners and organisations to lead health and safety at work in the Ghanaian context and to determine the interrelationship between leadership styles and employee health and safety at Electricity Company of Ghana.

LITERATURE REVIEW

Leading health and safety at work

Several studies have reported varying findings on the relationship between transformational and transactional leadership styles and health and safety practices. In view of this results are inconclusive (Çalış, and Büyükakıncı, 2019; Griffin & Hu, 2013). For instance, Çalış, and Büyükakıncı (2019) in examining the effects of leader influence tactics on employee safety in the UK, used structural equations modelling to assess a broad group of general leadership tactics on a variety of safety outcomes. Interestingly safety p\articipation emerged as the safety outcome in the model.

This demonstrates the significant influence leaders may exert not only in ensuring that employees comply with rules and procedures but also in encouraging the extra effort required by employees to engage in safety participation. The findings also highlighted the role of rational persuasion, a leader influence tactic more aligned with transactional than transformational leadership, in enhancing safety participation. Interestingly earlier researchers’ von Thiele Schwarz et al (2016) linked rational persuasion which is a cost-benefit exchange relationship to an element of commitment called target commitment.

Explanations they gave to this concept connote commitment to a task job or work. That is to say, the use of rational persuasion encourages employee commitment to a task. This is an attestation to Zacharatos, Barling, and Iverson (2005) assertion that the use of commitment-oriented leadership which is currently a leading practice, could be associated with improved safety provided safety is embedded within the job, task, or is made an organizational target.

Furthermore, Griffin and Hu (2013) also conducted a study to examine the impact of specific leader behaviours on employee’s safety performance among Australians from various occupations and work roles. Path analysis revealed that safety inspiring, similar to inspirational motivation of transformational leadership promotes safety participation. On the other hand, safety monitoring similar to management by exception (transactional leadership) showed inconclusive results with safety participation. Griffin and Hu (2013) also looked at two dimensions of transactional leadership; management by exception active (MBEA) and management by exception passive (MBEP). He reported consistent positive significant relationships between (MBEA) and a variety of safety behaviours. Still reporting on transactional leadership, he observed consistent significant negative relationships between (MBEP) and safety participation.

Liu et al (2019) also termed transactional leadership as compliance motivation and similarly reported a negative relationship with safety participation Griffin and Hu (2013) on the other hand however reported an indirect positive relationship between transactional leadership and safety participation. Griffin and Hu (2013), however, raised an argument that there could have been some moderating or mediating factors responsible for the inconsistent findings between transactional leadership and safety participation; and by introducing a variable known as safety learning there finally appeared to be some relationship between transactional leadership and SCB. Although results on the transformational, and transactional leadership-safety relationship appear to be inconclusive, the majority of studies reveal a more positive relationship between transformational leadership and SCB (Hofmann et al, 2014).

Although not specifically addressing the relationship between leadership styles and health and safety practice, Hofmann et al. (2014) in using participants from the US army in examining leader-member exchanges with SCB, obtained results that confirmed that employees chose to perform health and safety practices when they enjoyed high-quality exchange relationships, more likely to be transformational than transactional with their superiors.

Also, theoretical conceptualizations of transformational leadership point to the fact that it has direct significant effects on the motivation and commitment behaviours of employees which drives them into putting in extra efforts known as acts of citizenship on the job or work. For instance, Conger and Kanungo (1998) have opined that by creating a positive vision of the future of the organization, transformational leaders motivate employees to work and go beyond job descriptions to engage in extra roles in anticipation of that glorious organizational future.

Impact of Globalization on health and safety Practices

Globalisation in a firm or an enterprise has some effects on its stakeholders, including management, employees, competitors, customers and investors (Kumi, 2017). While globalisation sometimes introduces business changes that are unsuccessful, others are successful and tend to be advantageous to the company or organization (Molnar et al., 2019). It is thus, fundamental for managers of firms to properly plan changes to restore better performance and competitiveness of an organisation). For HSE, Leadership responsibility during organisational change or globalisations centres around managing the health and safety effects on employees including their stress management (Molnar et al., 2019; Hoffmeister et al 2014).

In view of this, von Thiele Schwarz (2016) argued to be able to deal with future change implementations, managers embarking on globalisation must be abreast with the previous ways in which their organisation facilitated change and its sensitivity to the workforce. This is because most change management process is accompanied by health and safety standard issues and the process itself is a stressor. For instance, Honyenuga, and Dogbeda, (2017) in a study of the energy sector in Ghana, the researcher observed that employees’ involvement in the change process is mostly limited to the provision of enough information on improvement in the equipment used.

The study further indicated that change generally heightens occupational stress which has a negative effect on employees’ health. Thus, it is suggested that managers should be able to deal with change and also assist their subordinates and all employees in doing the same to update the health and safety practices in the organisation (Honyenuga, and Dogbeda, 2017).

In ECG specifically, the changes in the electricity sector that have occurred in the past decades brought about new demands to the workers and has also increased precarious working conditions. Social transformations coupled with newer energy models have aggravated the problem by escalating the worker’s activities (Griffin and Hu, 2013). Growing responsibilities and demands on Engineers, from the industrial sector, the service sector has certainly exposed them to work-related stress and on the job injuries. This has consequently resulted in health problems among them: illness, skin irritation, or breathing problems to name a few.

Medical and social costs due to these problems have grown increasingly in the past few years, with figures reaching billions of shillings or dollars in various countries. Thus Griffin and Hu (2014) recommended that the ever-increasing population coupled with the growing demand for electricity calls for electricity distribution companies to explore diverse ways of managing business processes to effectively deliver on their mandate while protecting its employee’s health and safety standards.

APPLICATION OF THEORY TO PRACTICE

Leadership Styles for improved HSE in ECG

With regards to the leadership style in the ECG, Kumi (2017) have emphasized that, transformational and transactional leadership appear to be dominating leadership in the company. This is mainly because, they are seen to be of relevance to the organizations and further contribute immensely to the success of the organizations (Honyenuga, and Dogbeda, 2017). Transformational leaders stimulate, inspire and transform the values, aspirations, needs, and priorities of followers, transactional leadership style on the other hand is basically a cost benefit exchange relationship between a superior and a subordinate, or leader and follower in which both the leader and the follower influence each other to gain something of value. However, the policy document for safety health and environment unit indicates that “both employees and employer shall respect the rights of each other in the discharge of their respective obligation as specified in the policy documents”. It also harmonises the steps and procedures employees and employers ought to follow in emergency situations, compliance, and reporting issues relating to safety suggesting that the front-line leaders’ employees directly reports to must be transformational leaders.

The policy documents also encouraged safety participation which it referred to as “a broad group of behaviours that support workplace safety, such as helping co-workers with safety-related issues, seeking to promote safety programs demonstrating initiative, making suggestions for change, voluntarily attending safety meetings and improving safety”. According to Çalış and Büyükakıncı (2019) this safety participation is best practiced under the transformational leadership style. As such, employees who work under transformational leaders are more inclined to exert extra effort to ensure safety standards are met when discharging their duties, and consequently perform above and beyond perceived expectations or job requirements. This is usually because, they feel motivated by the actions of their leaders to do so. This assertion has been supported by other renowned scholars (Griffinand Hu 2013: Akomaning-Adofo, (2010). This implies that for engineers and technicians in ECG to engage in safety health and safety practices, front line leaders and supervisors must adopt transformational leadership tendencies.

Though Liu et al (2019) concluded that, transactional leaders are also ideal choices in meeting employee health and safety needs which encompasses physical safety, the passive nature of this leadership style can make leaders fail to interfere in safety issues until problems become severe. Griffinand Hu (2013), who reported consistent significant negative relationship between transactional leadership (management by exception passive (MBEP), and safety participation also suggest that in cases where employees look up to their leaders, it is likely that such subordinates take up a relaxed and unconcerned attitude waiting for safety issues to become problematic before reacting. Hoffmeister et al. (2014) in testing the individual facets of both transformational and transactional leadership style on a variety of safety outcomes pointed to the fact that, transformational leadership consistently, positively predicted a variety of safety behaviours including safety participation; perhaps by virtue of the nature of that leadership style.

Leadership Model for improved HSE in ECG

The numerous theories propounded on the concept of leadership can be broadly categorized into two. The first category focuses on the characteristics of effective leaders and attempts to explain individual, group, and organizational performance outcomes by identifying and examining specific leader behaviours directly related to them. The second category, on the other hand, is a relationship-based approach that directly concentrates on how one-on-one social exchanges between leader and follower evolve, nurture, and are sustained. This relationship is best conceptualized by the leader-member-exchange theory (LMX) (Graen & Uhl-Bien, 1995).

Leader-Member Exchange (LMX), refers to the quality of the working relationship between an employee and his or her immediate supervisor (von Thiele Schwarz, 2016). It was originally referred to as the vertical dyad linkage theory. It conceptualizes leadership as a process, that is centred on the interaction or quality of working relationship between leaders and followers, or an employee and his immediate supervisor. LMX is the most researched and stands tall amongst other leadership theories and this is because it assesses the leader-follower relationship from a two-way perspective.

Leader-Member Exchange theorists have argued that time pressures, energy constraints, and work demands of leaders, make it practically impossible for them to give equal attention to all followers. Consequently, key subordinates usually become beneficiaries of close leader-follower relationships as and when they do develop. Nonetheless, the nature and quality of these leader-follower relationships are more dependent on Personality factors, implicit theories and self-schemas; than on demographic characteristics like age gender and ethnicity.

Studies and assertions by other scholars have also demonstrated that LMX is an important element that explains the effect of leader behaviours on subordinate outcomes. For instance according to Hofmann and Morgeson (1999) when transformational leadership style is fused with a high-quality LMX, employee safety concerns at work is bound to increase, which causes an improvement in safety commitment and communication. LMX relationships also suggest that employees are likely to engage in extra role behaviours in relation to safety when they have high-quality exchange relationships with their leaders, more likely a transformational than transactional leader (Hofmann & Morgeson, 1999; Hofmann et al., 2003). This is because LMX is based on transforming relationships and exchanges when trust mutual respect is established.

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Conclusion

It is an established truth that organizations cannot possibly predict and eliminate all forms of hazards in the workplace. It is also generally accepted that it is an arduous task for organizations to clearly spell out a broad group of behaviours needed to meet organizational goals and targets, more especially in safety prone settings. In line with these assertions, leaders have a role to play in ensuring their safety as well as the safety of other colleagues. This can be achieved by taking proactive steps in the workplace.

Findings from this study confirmed that leadership plays a salient role in the enhancement of safety behaviours at work. Although existing literature posits that both transformational and transactional leadership styles can enhance safety at work, findings from this study suggested that transformational leaders are more effective. In consonance with this finding, management must pay particular attention to the kind and sort of leaders they assign to safety sites. In addition to this, personality tests should be conducted on leaders before they are assigned to safety sites. Finally, leadership training seminars should be held as often as possible to train leaders to be more transformational. Additional findings revealed that employees are bound to exhibit some citizenship behaviours when they are professionally committed.

REFERENCE

Aboagye, B., Gyamfi, S., Antwi, E.O. and Djordjevic, S., 2020. Status of renewable energy resources for electricity supply in Ghana. Scientific African, p.e00660.

Addai, E.K., Tulashie, S.K., Annan, J.S. and Yeboah, I., 2016. Trend of fire outbreaks in Ghana and ways to prevent these incidents. Safety and health at work, 7(4), pp.284-292.

Akomaning-Adofo, E., 2010. Assessment of public and occupational exposure to extremely low frequency fields within the vicinity of electricity transmission substations in the Greater Accra Region of Ghana.

Çalış, Ç. and Büyükakıncı, B.Y., 2019. Leadership Approach in Occupational Safety: Taiwan Sample. Procedia Computer Science, 158, pp.1052-1057.

Donkor, D., 2012. Evaluation of health and safety practices and policies at Electricity Company of Ghana, the Case of the Ashanti East Region (Doctoral dissertation).

Duryan, M., Smyth, H., Roberts, A., Rowlinson, S. and Sherratt, F., 2020. Knowledge transfer for occupational health and safety: Cultivating health and safety learning culture in construction firms. Accident Analysis & Prevention, 139, p.105496.

Griffin, M.A. and Hu, X., 2013. How leaders differentially motivate safety compliance and safety participation: The role of monitoring, inspiring, and learning. Safety science, 60, pp.196-202.

Hoffmeister, K., Gibbons, A.M., Johnson, S.K., Cigularov, K.P., Chen, P.Y. and Rosecrance, J.C., 2014. The differential effects of transformational leadership facets on employee safety. Safety science, 62, pp.68-78.

Honyenuga, B.Q. and Dogbeda, C.K., 2017. Occupational Health and Safety Practices: An Assessment of the Electricity Company of Ghana, Ho Division. African Journal of Technical Education and Management, 1(1), pp.71-71.

Kumi, E.N., 2017. The electricity situation in Ghana: Challenges and opportunities (p. 30). Washington, DC: Center for Global Development.

Liu, S., Gyabeng, E., Joshua Atteh Sewu, G., Nkrumah, N.K. and Dartey, B., 2019. Occupational Health and Safety and Turnover Intention in the Ghanaian Power Industry: The Mediating Effect of Organizational Commitment. BioMed research international, 2019.

Molnar, M.M., Schwarz, U.V.T., Hellgren, J., Hasson, H. and Tafvelin, S., 2019. Leading for safety: A question of leadership focus. Safety and health at work, 10(2), pp.180-187.

von Thiele Schwarz, U., Hasson, H. and Tafvelin, S., 2016. Leadership training as an occupational health intervention: Improved safety and sustained productivity. Safety science, 81, pp.35-45.

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