RSSB
Health and Wellbeing Conference
London, 3 November 2015
Creating Health
and Wellbeing
Dame Carol Black
Expert Adviser on Health and Work
Department of Health and Public Health England
Principal, Newnham College Cambridge
Employee Health and Wellbeing
• Mental Health
• Musculo-skeletal Health
• Long-term conditions, often with co-morbidities
• Obesity
• The older worker and maintaining capability for work
• Good work and good workplaces
All influence employee wellbeing, engagement and productivity.
What we need to do ....
“In the UK, we need to compete on the quality of
what we do – and that makes staff performance
and productivity vital. And workplace health is
essential to both of those key factors. ”
Neil Carberry
CBI director of employment & skills
“If like me you believe in a tax-funded NHS you’ll
want the Health Service to play its part in growing
our nation’s economy, … ”
“To do this, NHS employees will need to be
healthy, both mentally and physically, have good
well-being, and be fully engaged in their work
towards improved outcomes for patients.” Simon Stevens Apr 2014
Our State of Health :
Britain’s Healthiest Company
•
Running for 3 years: in 2015 111 organisations (inc. 2 hospitals),
32,500 employees
•
Objective:
- Make society healthier by generating a credible evidence base
on links between employee health and wellbeing and
company productivity,
- thus increasing the number of companies taking
responsibility for employees’ health.
•
Approach :
- Understand the prevalence of modifiable risks in the workplace
- Add to the evidence base on the effect of clinical and
non-clinical risks to productivity
- Determine the effectiveness of workplace interventions in
promoting employee health.
Employees’ health is important
Challenges
from Britain’s Healthiest Company survey 2015
– 20.7% of employees report being obese
– 28% not exercising enough
– at least 25% reporting high blood pressure
– nearly 30% having some health risks (present or
past) related to smoking
– 33% having health risks related to alcohol
– around 50% have suboptimal nutrition.
Workplace health
• Over 15% of employees reported
being bullied at times.
BHC 2015
• Less than 70% feel that their manager cares
about their health and wellbeing.
• A majority of employees feel that they face
unrealistic time pressures.
Courtesy C van Stolk, Rand Europe
• A minority of employees feel that their
line manager has received training to
support their health and wellbeing.
Commitment to
staff well-being aids productivity
• Best companies had 24% lower cost of lost productivity (absence and
presenteeism) than the worst-performing companies.
• “Vitality Age” (on clinical and lifestyle health risks): averaged 43 years
compared with 39 on passports (gap 9 months worse for men than
women, and for lower-paid employees)
• Many companies now provide stress-management info., bicycling
schemes, healthy canteen food, and nutritionist services.
• This fits well with staff desires: 57% want to improve their BMI,
52% hope for more physical activity, 26% for improved nutrition.
Physical fitness supports Mental Health - research shows.
Top 5 health-related business risks
Top 5 health conditions as identified by RSSB project T832
Obesity-related?
RSSB
In UK, what prevents us from working or from working well and feeling good ?
• Common mental health problems
• Musculo-skeletal problems
• The quality of work and the workplace
- organisation of work
- managerial behaviour and leadership
- absence of ‘good work’
• Other important reasons
- long-term conditions – mental and physical
- psychosocial/ home-related problems
- lack of education and/or skills.
Mental ill-health and UK plc
• Accounts for nearly a half of all
absenteeism
• 70 million lost working days /year
• Accounts for nearly half of all
people on health-related benefits
• 1 in 6 experiencing depression,
anxiety or stress
• Costs £1,035 per employee
• Reduces GDP by £52 billion a year
Courtesy Dr Catherine Kilfedder
Mental Health and the Workplace
Organisations and companies need to recognise that :
• Mental health is a business issue
• The economic cost of failure is high
• The human cost can be far higher
• Managers need help to understand it
• Most interventions are low key
• Poor leadership or management may
contribute to mental ill-health
Managers’ Mental Health training, BT
Aims:
• Preserve life when in danger
• Provide help to prevent
deterioration
• Promote recovery of good
mental health
• Provide comfort to the
distressed
Skills:
• Recognition of mental health
symptoms
• Provision of initial help
• Guidance towards
appropriate professional help
Outcome:
– 97% increased awareness
and understanding
– 91% increased confidence
– 94% provided additional
skills
– 90% helpful or very helpful
in their managerial role
– 36% applied in 6 months
after attendance
Courtesy Dr Catherine Kilfedder
Organisational commitment :
NICE Guideline 2015
• Make H&WB a core priority for top management
• Value the strategic importance/benefits of healthy workplaces
• Encourage consistent, positive approach to H&WB for all.
All with remit for workplace health should address issues of :
• physical work environment
• mental wellbeing at work
• fairness, justice, participation, and trust
• senior leadership
• line managers’ role, leadership style, and training
• job design.
National Institute for
Health and Care Excellence
Engagement and Disengagement
Lack of motivation and sub-optimal health cause UK workers to work
below peak productivity, holding back potential growth. Study of 5000 workers
• About half of people do not go above and beyond at work because they
think it won’t be acknowledged or rewarded.
• Over a third of teams are experiencing extra stress
and pressure due to staff ill health and absences
• One in four staff admit they don’t want to win new
business as it will only mean more work for them.
BUPA/Centre for Economics
and Business Research,
December 2013
• Failure to unlock employees’ ‘discretionary effort’ costs businesses
dearly, cutting a potential £6 billion – equivalent to 0.4 per cent of
GDP – from the UK economy in 2012.
Musculoskeletal Disorders
in the Workforce
• Across the EU 44m workers have MSDs caused by work
• The cost each year in sickness absence and lost
productivity is 240 bn Euros (2% of EU GDP)
• MSDs account for half of all absence from work..
• …. and for 60% of permanent work incapacity.
UK Up to 80% of the adult population will suffer
significant back pain at some stage
Cost of MSDs per year estimated at £7 bn.
MSDs: Action needed
Five principles which healthcare professionals,
employers, employees and governments should focus
upon to improve working lives of those with a MSD:
•
•
•
•
Focus on capacity not incapacity
Early intervention is essential
Imaginative job design is key to rehabilitation
Think beyond the physical symptoms of MSDs (they
are often associated with depression)
• Assess the direct and indirect costs of MSDs
Musculoskeletal Disorders and Labour Market Participation,
The Work Foundation 2009
Obesity : the costs for businesses
• McKinsey Global Institute (Nov.2014) : obesity generates a UK
economic loss of £47 bn per year. Total economic impact on UK
employers is around £5 bn annually, much due to decreased productivity.
• IHPM : “Employers used to see obesity as just
a personal problem, but that is changing.
Prevention is always better than cure, and
employers should continue to focus on that.”
• NICE states: “On average obese people take
four extra sick days per year.”
• Health and Safety Executive (2013): Employers might be expected to
take responsibility for encouraging or assisting staff to reduce or
avoid obesity, and may need to take special account of obese
workers in job design and risk assessments.
London Underground: data on
Body Mass index and sickness absence
• Study by Kings College and Kings College Hospital
• Lead researcher Dr Samuel Harvey
• Published in 2010 Occupational Medicine August 2010
Volume 60 Issue 5: pp362-368. S.B. Harvey et al. Obesity and
sickness absence: results from the CHAP study.
• Data on more than 9000 operational staff (all operational
staff employed between 1st April 2005 and 31st March 2007) was
analysed, matching Body Mass Index information against
sickness absence
• Information about individuals’ medical diagnoses was
also available.
Courtesy Dr Olivia Carlton
BMI from data collected
• BMI available in 2706 people (29.1% of sample)
• Average BMI was 29.3 (UK average is 27)
• Slightly higher BMIs in female staff
BMI and sickness absence
• Positive linear trend
(p<0.001)
• No evidence of gender
interaction (p=0.23)
• Overweight employees
have more short- and
long-term sickness
absence
Workers typically had per annum :
- 6 days sick leave if of healthy weight,
- 9 days if obese, and 11 days if very obese.
Increased long-term sickness absence in obese employees
appears to be due to obesity-related medical disorders.
Integration : Total Worker Health
•
Traditionally, workplace Health and Safety has been separated from
Health Promotion.
•
Growing evidence supports the effectiveness of combining these
efforts through workplace interventions that integrate health
protection and health promotion.
• NIOSH (National Institute for Occupational Safety and Health, USA)
is now emphasising Total Worker Health :
“ Integrating health protection and promotion will create synergy,
enhance overall health and wellbeing of the workforce, and
decrease the likelihood of workplace injury and illnesses.”
“ Having a psychologically-healthy workplace and having a profitable
and sustainable business are linked.”
Integration : Total Worker Health
Gains in health
wellbeing,
fitness for duty
Organisational Health and
Safety
Strategic, integrated
Cost
minimisation
Absence of
illness or injury
incidents
Harm Minimisation
Compliance, systems,
culture
Illness/injury
incidents
Gains in
company
performance
Expanded value
chain goes
beyond absence
of injury
Loss
Control
Slide courtesy of Anne-Marie Feyer and Niki Ellis
Good Employment :
Essential characteristics
Good work
• Stable and safe
• Individual control
• Fair work demands
Good workplaces
• Visible senior leadership
• Appropriately trained
managers
• Flexible arrangements
• Opportunities training,promotion
• Promotes Health and
Wellbeing
• Integration of OHS with
health promotion and
illness prevention
• Prevents isolation, discrimination
• Shares information
• Reintegrates sick /disabled if
possible
• Empowering employees to
care for their own health
• Monitoring & measurement
• Enabling staff engagement
Office of Rail and Road :
Occupational Health Programme 2014-19
What we expect from the rail industry:
• Excellence in health risk management, implementing strategies
e.g. exposure monitoring, health surveillance
• Greater engagement with employees, e.g. signing PHRD pledges
• Better efficiency and reduced costs due to work-related ill-health
• Enabling improvements in competency, information, co-ordination.
Also:
• Senior-level commitment to the above, driving
improvements in health and wellbeing
• Better use of specialist resources, ergonomists, physiotherapists etc
‘Health’ is to be understood to cover three things:
• Effect of work – adverse dust, noise, vibration, stress, MS risk
• Fitness for work – safety-critical tasks, drug/alcohol, capability
• General well-being – lifestyle, absence management, rehabilitation.
The Roadmap