It is unclear who and which system ensures that first aiders have sufficient competence. That is which role has the final responsibility, and which formal system is used, to ensure that all first aiders have sufficient competence at all times.
Request clarification on which role is responsible for ensuring that first aiders who are on the job meet the requirements for competence, as well as which system is used for this management.

Aramak to provide information about how the competence of first aiders is checked before sending personnel offshore and who does this.

Provide example of sheet used to check that first aiders have required competence when offshore.
From Aramark (se also email)

OCS HR blir brukt til å registrere førstehjelpstreningen, etter innsending fra både medic og forpleiningssjef.
I tillegg har vi eget xls skjema for dobbel kontroll.
Skjema for Invincible ligger vedlagt. Noen få har færre moduler enn kravet, men vi har pr i dag 10 stk på jobb til enhver tid, og det er 6 stk som er med i førstehjelpslaget ved behov. Alle får trening hver offshoretur.
Vedlagt er også rapport hentet ut fra OCS HR. I denne står utløpsdato, altså 1 år frem i tid i forhold til treningen.
Til slutt er rapporten Hvem er hvor, hentet ut fra OCS HR. Her har jeg manuelt sjekket hvor mange moduler hver enkelt har, fra xls skjema og OCS HR, og ført på med tall slik at dere har oversikten for de som er offshore nå.

From medic: Punkt 1: Alle førstehjelpere har et 40 timers førstehjelpskurs fra land. Når de begynner i jobb offshore bliver de fulgt opp av sykepleier med undervisning 1 gang per tur. Her følges NOC sine forskrifter og moduler. 9 Moduler totalt. Om noen jobber 50 % stilling og ikke får fulgt alle moduler vil medic kunne tilby ekstra undervisning. Det vil si at de får undervisinig i den eller de moduler de mangler. De må ha minimum 6 moduler for å være godkjent førstehjelper. De er først og fremst Aramark som er ansvarlig for at førstehjelpere får dekket inn all sin førstehjelp. Aramark har et kompetansekrav til førstehjelperne, Offshore Norge’s krav er retningsgivende.

There is a personal delegation to nurses for dispensing medicine. This is not dated, and with no specified duration. There is furthermore no reference to the management system and no documentet audit.
14/5: “The medicine delegation for present Medic contains a duration for delegation, for medic as of now this is valid until February 2026.
9/6: “According to the legislation, a delegation must be given at company level, not at individual level. If all nurses have the same valid delegation, this is accepted.

Confirm that the delegation is to each individual medic.

Confirmed via email from company doctor that personal delegation.

Fra Morten Hellang, FAL:
Delegering skal være personlig, ikke på virksomhetsnivå.
Helsedirektoratets Rundskriv IS-8/2012 sier om helse helsepersonelloven § 5: «Videre skal oppgavetildeling med hjemmel i helsepersonelloven § 5 være personlig. Et helsepersonell kan altså ikke overlate sine oppgaver til en generell gruppe av helsepersonell.»

The drinking water manual does not describe responsibilities in the event of any deviations. That is which role has responsibility for handling deviations and how this should be done. The flow chart in the drinking water manual on responsibilities does not provide an answer to this either. As usual, nurses have to send e-mails or communicate verbally to TSL in the event of any deviations. It is unclear whether nonconforming samples are followed up in the company’s nonconformance system. The nurse is not familiar with the company’s deviation system.

Recommendation: Clarification of responsibility/role and system. Use the deviation system for deviations in drinking water.
Provide training in the deviation system.

Drinking water manual is being updated.

Training to medics in use of RCAL system – where deviations against requirements in the drinking water manual shall be registered will be started end of August. Will also be addressed during yearly medic seminar.

Health monitoring was last carried out several years ago according to the nurse, most likely in 2017. It is unclear how 0 examinations are practically carried out, i.e. health examination of new employees.

Recommendation: Carry out health monitoring at regular intervals. Create a routine to ensure that all new employees receive an offer of zero examination.

Fra Noble HSE

Arbeid med å starte en ny runde med helseovervåkning for relevante personer pågår. Statusmøte med BHT der de har fått aksjon om å legge frem en plan for hvordan dette skal gjøres. Aksjon på Noble angående oppdatering av prosedyrer i etterkant, blant annet for nullundersøkesler

The health manual does not state a routine for handling any proven work-related illness. This applies both to regular consultations and as part of health monitoring. It does not appear how any findings are summarized and deviations are handled at individual level and at group level (barrier control and continuous HSE work).

Recommendation: Create a routine for handling ARS, including non-conformance handling.

Det skal ikke være egen (separat) rutine for sykepleiers håndtering av påvist arbeidsrelatert sykdom fordi legen har ikke delegert denne oppgaven til sykepleier. Meldeplikten i Aml § 5 gjelder bare for leger. Sykdommer eller mistanke om sykdommer relatert til arbeidet rapporteres rutinemessig til FAL på samme måte som annen sykdom. FAL står for den videre vurdering, oppfølgning, viderehenvisning og melding til tilsynsmyndigheten, etter interne rutiner i BHT på land.

“KRM” – Cf. points 6.03.01 and 6.18.4. in the health manual. It is stated that “the employer is responsible”, and lists of compulsory registration are written in the health manual. However, it is unknown which role is responsible for this and carries it out, as well as the entry point to the process, i.e. how the need for registration is initiated. The terms Risk-exposed groups and KRM appear to be mixed up in chapter 6.

14/5: “Responsibility for the obligation to register lies with the employer, this appears from the Health Manual ch. 6.18. Medic conveys health-related information to FAL, through the web-based record system Extensor.”

The health manual has references regarding competence in chapter 8, as well as equipment in chapter 9, but links in chapter 11 that are referred to no longer work. The Sharepoint page referred to in chapter 11 of the Health Manual also no longer exists.

Recommendation: Repair links, and re-establish Sharepoint page.

Barbara to work with Sunniva to have links repaired.

Morten Hellang to discuss updates to the health manual – chapter 11 reference to be removed. (Marianne Bertelsen can assist with this).

Training at AHLR no longer takes place externally, and the company no longer holds licenses in the NRR. Only personal training is carried out.

14/5: “Annual training for the first aider at DHLR takes place offshore (cf. Module 3 in Offshore Norway recommendations).
Annual recertification in AHLR for medic takes place at Safeguard Medical. This has been followed up by FAL.”

It is planned to use personnel from drilling teams after they have gone off duty. This can result in the loss of valuable competence that has been built up by today’s first aiders, a doubling of the number of first aiders and the need for training, as well as that available first aiders have not had sufficient rest in the event of an effort.

14/4: “The challenge is assessed and solutions are highlighted for the employer.”

Disposable equipment is mostly used for suturing. There are no disposable eye skewers present. There is still some equipment that requires sterilization present, i.e. older metal surgical equipment. There is no dishwasher or sterilizer. Hand washing and surface disinfection are not optimal.

14/5: “Metal surgical equipment is not in use, it is only stored. It is not appropriate to acquire a sterilization machine.”

Audiometer was calibrated when purchased in 2015, as well as in 2018. There is no documentation of calibration after this date.

Recommendation: Calibrate the audiometer.

Medic: “Vårt Oscilla Audiometer blir gjevnlig sendt inn til service for kalibrering. Sist kalibrert 01.12.22. Se vedlegg. Neste kalibrering vil skje ved årsskiftet.

Har nå lagd en egen mappe under Medic – Confidenital- BHT- Audiometer, hvor alle servicerapporter ligger.”

See email with documentation. Saved on Falstaff SP.

It is not clear how the routine of medical-technical control works.

14/5: “Maintenance and inspection of Medical technical equipment is handled and controlled through IFS, Noble’s maintenance programme. Which means that the Medic receives a notification with daily tasks with periodic checks and maintenance. Maintenance tasks are led by MSL.”

It is unclear who and which system ensures that first aiders have sufficient competence. That is which role has the final responsibility, and which formal system is used, to ensure that all first aiders have sufficient competence at all times.
Request clarification on which role is responsible for ensuring that first aiders who are on the job meet the requirements for competence, as well as which system is used for this management.

Aramak to provide information about how the competence of first aiders is checked before sending personnel offshore and who does this.

Provide example of sheet used to check that first aiders have required competence when offshore.
From Aramark (se also email)

OCS HR blir brukt til å registrere førstehjelpstreningen, etter innsending fra både medic og forpleiningssjef.
I tillegg har vi eget xls skjema for dobbel kontroll.
Skjema for Invincible ligger vedlagt. Noen få har færre moduler enn kravet, men vi har pr i dag 10 stk på jobb til enhver tid, og det er 6 stk som er med i førstehjelpslaget ved behov. Alle får trening hver offshoretur.
Vedlagt er også rapport hentet ut fra OCS HR. I denne står utløpsdato, altså 1 år frem i tid i forhold til treningen.
Til slutt er rapporten Hvem er hvor, hentet ut fra OCS HR. Her har jeg manuelt sjekket hvor mange moduler hver enkelt har, fra xls skjema og OCS HR, og ført på med tall slik at dere har oversikten for de som er offshore nå.

From medic: Punkt 1: Alle førstehjelpere har et 40 timers førstehjelpskurs fra land. Når de begynner i jobb offshore bliver de fulgt opp av sykepleier med undervisning 1 gang per tur. Her følges NOC sine forskrifter og moduler. 9 Moduler totalt. Om noen jobber 50 % stilling og ikke får fulgt alle moduler vil medic kunne tilby ekstra undervisning. Det vil si at de får undervisinig i den eller de moduler de mangler. De må ha minimum 6 moduler for å være godkjent førstehjelper. De er først og fremst Aramark som er ansvarlig for at førstehjelpere får dekket inn all sin førstehjelp. Aramark har et kompetansekrav til førstehjelperne, Offshore Norge’s krav er retningsgivende.

There is a personal delegation to nurses for dispensing medicine. This is not dated, and with no specified duration. There is furthermore no reference to the management system and no documentet audit.
14/5: “The medicine delegation for present Medic contains a duration for delegation, for medic as of now this is valid until February 2026.
9/6: “According to the legislation, a delegation must be given at company level, not at individual level. If all nurses have the same valid delegation, this is accepted.

Confirm that the delegation is to each individual medic.

Confirmed via email from company doctor that personal delegation.

Fra Morten Hellang, FAL:
Delegering skal være personlig, ikke på virksomhetsnivå.
Helsedirektoratets Rundskriv IS-8/2012 sier om helse helsepersonelloven § 5: «Videre skal oppgavetildeling med hjemmel i helsepersonelloven § 5 være personlig. Et helsepersonell kan altså ikke overlate sine oppgaver til en generell gruppe av helsepersonell.»

The drinking water manual does not describe responsibilities in the event of any deviations. That is which role has responsibility for handling deviations and how this should be done. The flow chart in the drinking water manual on responsibilities does not provide an answer to this either. As usual, nurses have to send e-mails or communicate verbally to TSL in the event of any deviations. It is unclear whether nonconforming samples are followed up in the company’s nonconformance system. The nurse is not familiar with the company’s deviation system.

Recommendation: Clarification of responsibility/role and system. Use the deviation system for deviations in drinking water.
Provide training in the deviation system.

Drinking water manual is being updated.

Training to medics in use of RCAL system – where deviations against requirements in the drinking water manual shall be registered will be started end of August. Will also be addressed during yearly medic seminar.

Health monitoring was last carried out several years ago according to the nurse, most likely in 2017. It is unclear how 0 examinations are practically carried out, i.e. health examination of new employees.

Recommendation: Carry out health monitoring at regular intervals. Create a routine to ensure that all new employees receive an offer of zero examination.

Fra Noble HSE

Arbeid med å starte en ny runde med helseovervåkning for relevante personer pågår. Statusmøte med BHT der de har fått aksjon om å legge frem en plan for hvordan dette skal gjøres. Aksjon på Noble angående oppdatering av prosedyrer i etterkant, blant annet for nullundersøkesler

The health manual does not state a routine for handling any proven work-related illness. This applies both to regular consultations and as part of health monitoring. It does not appear how any findings are summarized and deviations are handled at individual level and at group level (barrier control and continuous HSE work).

Recommendation: Create a routine for handling ARS, including non-conformance handling.

Det skal ikke være egen (separat) rutine for sykepleiers håndtering av påvist arbeidsrelatert sykdom fordi legen har ikke delegert denne oppgaven til sykepleier. Meldeplikten i Aml § 5 gjelder bare for leger. Sykdommer eller mistanke om sykdommer relatert til arbeidet rapporteres rutinemessig til FAL på samme måte som annen sykdom. FAL står for den videre vurdering, oppfølgning, viderehenvisning og melding til tilsynsmyndigheten, etter interne rutiner i BHT på land.

“KRM” – Cf. points 6.03.01 and 6.18.4. in the health manual. It is stated that “the employer is responsible”, and lists of compulsory registration are written in the health manual. However, it is unknown which role is responsible for this and carries it out, as well as the entry point to the process, i.e. how the need for registration is initiated. The terms Risk-exposed groups and KRM appear to be mixed up in chapter 6.

14/5: “Responsibility for the obligation to register lies with the employer, this appears from the Health Manual ch. 6.18. Medic conveys health-related information to FAL, through the web-based record system Extensor.”

The health manual has references regarding competence in chapter 8, as well as equipment in chapter 9, but links in chapter 11 that are referred to no longer work. The Sharepoint page referred to in chapter 11 of the Health Manual also no longer exists.

Recommendation: Repair links, and re-establish Sharepoint page.

Barbara to work with Sunniva to have links repaired.

Morten Hellang to discuss updates to the health manual – chapter 11 reference to be removed. (Marianne Bertelsen can assist with this).

Training at AHLR no longer takes place externally, and the company no longer holds licenses in the NRR. Only personal training is carried out.

14/5: “Annual training for the first aider at DHLR takes place offshore (cf. Module 3 in Offshore Norway recommendations).
Annual recertification in AHLR for medic takes place at Safeguard Medical. This has been followed up by FAL.”

It is planned to use personnel from drilling teams after they have gone off duty. This can result in the loss of valuable competence that has been built up by today’s first aiders, a doubling of the number of first aiders and the need for training, as well as that available first aiders have not had sufficient rest in the event of an effort.

14/4: “The challenge is assessed and solutions are highlighted for the employer.”

Disposable equipment is mostly used for suturing. There are no disposable eye skewers present. There is still some equipment that requires sterilization present, i.e. older metal surgical equipment. There is no dishwasher or sterilizer. Hand washing and surface disinfection are not optimal.

14/5: “Metal surgical equipment is not in use, it is only stored. It is not appropriate to acquire a sterilization machine.”

Audiometer was calibrated when purchased in 2015, as well as in 2018. There is no documentation of calibration after this date.

Recommendation: Calibrate the audiometer.

Medic: “Vårt Oscilla Audiometer blir gjevnlig sendt inn til service for kalibrering. Sist kalibrert 01.12.22. Se vedlegg. Neste kalibrering vil skje ved årsskiftet.

Har nå lagd en egen mappe under Medic – Confidenital- BHT- Audiometer, hvor alle servicerapporter ligger.”

See email with documentation. Saved on Falstaff SP.

It is not clear how the routine of medical-technical control works.

14/5: “Maintenance and inspection of Medical technical equipment is handled and controlled through IFS, Noble’s maintenance programme. Which means that the Medic receives a notification with daily tasks with periodic checks and maintenance. Maintenance tasks are led by MSL.”