252 Chapter 8 The role of occupational health professionals in the complexity of systems The results of this thesis indicate that OHPs can play an important role in supporting workers in a vulnerable position to remain sustainably employed, by providing adequate guidance at the workplace. However, the extent to which they can exert their role largely depends on contextual factors in occupational health practice and beyond. To adequately address problems on multiple life domains, OHPs can play an important role in supporting workers in identifying and solving problems. However, the way occupational health care is organized in the Netherlands generates various barriers for OHPs being able to support workers in addressing problems on multiple life domains. OHPs can discuss problems on multiple life domains, as part of their normal way of working, but they do not always have the time to act on it, or do not even have the opportunity to preventively support workers in solving these problems. First, the extent to which OHPs have sufficient time or are able to preventively support workers depends on the type of contracts between an employer and occupational health service. However, as this thesis showed, preventive occupational health services are often not included in these contracts, and basic contracts mainly focus on the guidance of workers on long term sick leave. This is rather unfortunate, as the new Working Conditions Acts, which was launched in 2017, provided more attention to prevention (27). Second, collaboration with other health professionals in other domains is essential, but this is hindered by barriers on a system level. As was described earlier, workers with problems on multiple life domains may come in contact with (health) professionals that are employed in different kind of institutions, which are fragmented across different domains. For instance, occupational health care is by law strictly separated from curative health care, and policies regarding employment are regulated from a different ministry, compared to policies regarding health. As a result, professionals across services and domains hardly collaborate to align solutions or to discuss which solutions needs to be implemented (first). This was also one of the main obstacles in the implementation of the Grip on Health intervention. Considering the obstacles described above, the Dutch government may need policy reforms, wherein (health) professionals can more easily collaborate between domains and align solutions. Third, OHPs are, according to the privacy regulations, not allowed to share health related information with the employer. Health related information can only be shared with other health professionals in case the worker gives explicit permission for this (28). The privacy of the workers is highly valued among OHPs and may therefore hamper addressing problems on multiple life domains in collaboration with other health professionals and/or the employer. Moreover, according to the Dutch Gatekeeper Act, OHPs are legally obliged to give advice on return to work,
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