01
Proactive
Health Policy
HEALTH POLICIES
01. Proactive Health Policy
02. Internal Health Relationships
03. Health Surveillance and Screening
04. Mental Health and Stress
05. Getting People Back to Productive Work
06. Employee Wellness and Engagement
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Proactive Health Policy
Contents
Proactive health management can
bring savings to your organisation . . . . . . . 3
Proactive health and wellbeing
management can increase productivity . . . . 5
A good leadership structure is needed
for proactive health management . . . . . . . 7
To create change, create a clear
purpose for the proactive policy . . . . . . . . 9
Document the proactive policy so that it
can be communicated to the organisation . . 11
Notes . . . . . . . . . . . . . . . . . . . . . 13
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About the Proactive
Health Policies booklet
series
Management of employee health and
wellbeing is an important challenge
for all organisations. Becoming
proactive in health management can
assist corporate responsibility, reduce
company costs, increase productivity
and, most importantly, improve
people’s lives.
involved engage with a similar set of
ideas. These ideas will enable a flow
of information and understanding that
can push the health agenda forward.
They highlight:
This nest of six health policy booklets
is designed to support organisations
in becoming proactive in health
management. They are a starting
point to help the different disciplines
• Good practice
• Key focus areas
• Important concepts
• Useful tools and links
Booklet 1 - Proactive
Health Policy
This booklet identifies some of
the high level arguments and
arrangements for creating a proactive
health policy.
It sets out:
• The financial issues
• Productivity issues
• How to enable leadership
• A considered purpose for
achievement
• Documenting the policy
Booklet 2 will set out some important
managerial considerations. Booklets
3 to 6 then draws the reader to a
range of practical ideas and tools that
are readily available for discussion
and use.
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Proactive Health Policy
Proactive health
management can
bring savings to your
organisation
A number of sources of research identify the savings to be
gained through an organisation’s health management activity.
The CBI/Pfizer Absence and Workplace
Health Survey 20101 estimated that
employee absence cost the UK economy
£16.8 billion in 2009, with long-term
sickness absence accounting for 22%
of all working time lost, at a cost of £3.7
billion. In 2006, RSSB research estimated
the direct payroll costs of ill health to be
about £100m per year. This figure was
thought to be around ten times that of the
total expenditure on occupational health
provision at that time.
Health and wellbeing costs are even
higher when absence losses are looked
at in a wider context. For mental health
alone, the National Institute for Health
and Clinical Excellence (NICE) estimated
the annual cost in the UK to be £25.9
billion in 2006 (£23.8 billion in 2009 pay
levels)2.
This cost was broken down into:
• £8.4 billion a year for sickness
• £15.1 billion a year in reduced
productivity at work
• £2.4 billion a year in replacing staff
who have left due to mental health
problems
Indeed, when the total costs of ill health
to the rail sector were considered by
RSSB research, it was estimated to be up
to £327m per year.
The monetary and reputational benefit to
the employer from a more co-ordinated
and consistent approach to health and
wellbeing can be brought about by
reducing the harmful effects of:
• Absenteeism
• Presenteeism
• Loosing valued staff
• Unnecessary recruitment and training
costs
• Statutory Sick Pay (SSP) and overall
sickness absence costs
• High compensation liabilities
• Equality discrimination against
employees
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It has been noted that the cost to prevent
these losses is likely to be many times
less than the cost of failure. Therefore
a case can be made to invest more.
However, as well as preventing losses
to the organisation, proactive health
management can also create significant
gains in productivity through enhancing
the benefits of:
Absenteeism
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• Safeguards to the livelihood of
employees
• Improved workplace relations
• Increased organisational engagement
/efficiency/productivity
• Raising the organisation’s reputation
Presenteeism
Turnover
Source: The Sainsbury Centre for Mental Health (2007)
Figure 1: Estimated costs of mental ill health to UK employers
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Proactive Health Policy
Proactive health and
wellbeing management
can increase productivity
Leading organisations are now using proactive health and
wellbeing policies to help their organisation deliver demanding
business strategies at the same time as creating cost savings.
Mowbray in The Wellbeing and
Performance Agenda (20093) suggests
that, ‘the costs associated with lack of
wellbeing are high. The national headline
costs are so high they fail to make an
impression on individual organisations
that would be expected, as the figures
seem unreal’. He goes on to note that
the costs associated with health and
wellbeing are often attributed to absent
staff but that 58% of the costs are actually
found within presenteeism.
Some health professionals find the term
presenteeism unhelpful, especially if
applied to people attending work when ill.
Booklet five in this series: Getting people
back to productive work’ recognises that
rehabilitation and work can be good for
you rather than have a negative effect.
However, there may be good use of
the term when referring to employee
engagement (as in points 2 and 3 in the
list above) if used to help unlock potential
in this area.
The term presenteeism is often
interpreted in different ways. Robertson
and Cooper (2011) suggest three
attributes to the term:
In their report ‘Engaging for Success’
Macleod and Clarke cite evidence to
support the need for stronger employee
engagement within UK organisations. The
evidence includes:
1. Attending work when unwell
2. Putting in long hours but not working
all of the time (often known as ‘face
time’)
3. Working at a reduced level because
of distractions (for example, going
online)
• Gallup found that engagement
levels can be predictors of sickness
absence, with more-highly-engaged4
employees taking an average of
2.7 days per year, compared with
disengaged employees taking an
average of 6.2 days per year5.
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• The Corporate Leadership Council
reported that engaged organisations
grew profits as much as three times
faster than their competitors.
• The IES/Work Foundation report,
‘People and the Bottom Line’ found
that if organisations increased
investment in a range of good
workplace practices which relate to
engagement by just 10 per cent, they
would increase profits by £1,500 per
employee per year.6
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The benefits of increased employee
engagement have not been lost within
the top UK companies, as in its report
on ‘Building the Case for Wellness’,
PwC notes that success and company
excellence are not just being measured
in financial terms but also business
performance. And wellness is being seen
as part of an organisation’s Corporate
Social Responsibility and is publicly
reported7.
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Proactive Health Policy
A good leadership
structure is needed
for proactive health
management
For organisations that want to enhance their health and
wellbeing capabilities it is important to create the conditions
for leadership in this area.
A conscious decision needs to be taken
by the company board to become
proactive in health leadership. This
should include input into the development
of a proactive health policy and related
plans. It is important that the people at
company board level understand the
actions that will be taken to develop
the proactive health policy and how
it assists the organisation. There
should be clear accountabilities for the
proactive health policy at board level
and all senior managers should be
aware of the basic health and wellbeing
arguments. However, one individual
could have specific accountability for
health and wellbeing in the business, and
have a higher level of knowledge and
competence.
Informed and experienced health advice
should be arranged to report into the
company’s board. This may be achieved
through renegotiated contracts with
occupational health providers to include
strategic health input. It may also be
achieved through the development of
internal health knowledge, for example,
through a chief medical officer or the
managerial advancement of health
specialists.
The company board should not be above
reviews on their own ability to perform in
relation to the health and wellbeing policy.
For example, it is good practice to employ
one or more non-executive directors with
appropriate knowledge and experience
to challenge a board’s thinking and
engagement on health and wellbeing.
Following commitment from the board,
the proactive health policy will need
further leadership to help integrate plans
into organisational activity. Organisations
should have a clear understanding of
what effective health and wellbeing
leadership looks like for them.
Within the workplace a supportive
environment for leadership should be
provided, so that leadership behaviours
have a chance to be embedded and
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adopted by other employees that may
become leaders one day. A supportive
environment includes:
• Long-term commitment
• Mentoring
• Appropriate competencies
• Provision of responsibility alongside
authority and resources
Leadership is not the same as
management. It should not be assumed
that managers are automatically leaders
just because they have experience of a
role or have been on a training course.
Take the time to choose a network of
leaders that are committed and share the
vision of change.
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Leaders consider the initiation of the
change, and highlight the more strategic
aspects to the employees around them.
They:
• Establish starting points for change
• Design and manage the journey
• Communicate any guiding principles
within the organisation
• Create individual, team, and
organisational capacities for change
• Communicate and make informal
connections (how is it going to work
for us?) to create a path for change
A network of health and wellbeing champions should be considered
to assist change within the organisation. Check out the Royal
Society for Public Health Level 2 Award ‘Understanding Health
Improvement’ and consider using this low cost course to train your
champions.
Find out more at:
http://www.rsph.org.uk/en/qualifications/qualifications/
qualifications.cfm/Level-2-Award-in-Understanding-HealthImprovement
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Proactive Health Policy
To create change, create
a clear purpose for the
proactive policy
If a health and wellbeing initiative is ever to be fit-for-purpose,
to deliver change, and create savings, it needs a clear purpose
to begin with.
An organisation needs to put concerted
effort into stating a clear purpose for
a proactive health policy to determine
how it needs to be built and share
understanding as to how it should be
shaped. The purpose sets out what
managers and employees aim towards, it
allows them to understand what they are
contributing to and clearly asks them to
invest in the idea. It allows management
to show leadership and direction, and
should generate co-operation between
functional interfaces to meet the overall
purpose.
To work out a purpose, all relevant
roles should participate in a workshop.
Relevant roles include:
Each attendee should read the six
Proactive Health Policy booklets and
develop opinions on what may or may not
work. The booklets should be a starting
point for content, and to guide how ideas
may be carried out.
While developing a purpose, the
organisation should make a conscious
effort to understand:
• Why a proactive policy is needed
within the organisation
• What the policy is about
• What content is delivered
• What the principles are for
achievement
• Senior management representative
• What achievement looks like
• HR managers
• How the policy is delivered
• Health and safety managers
A time limit to act out the proactive policy
will provide more focus and urgency in
what is being achieved. Try directing your
purpose towards a time limit that your
organisation can achieve – is it two years,
• Occupational Health specialists
• Line managers
• H&S representatives
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five years or longer? After the time limit
has expired the organisation may find
a new, and by this time more relevant,
purpose to follow, based upon previous
achievements.
When delivering change, good principles
should govern process. When the
process does not work for an element of
the organisation good principles should
help the team to understand the changes
needed to embed the work. Good
principles may include:
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• Understand the basics of the Equality
Act
• Talk to employees rather than hide
things away
• Know the specialists that can help and
make use of them
• Work in teams rather than as
individuals
• Be aware of the contents of the policy
booklets
Credit to Simon Vine Photography
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Proactive Health Policy
Document the proactive
policy so that it can be
communicated to the
organisation
Look to communicate widely within the organisation in order to
develop the policy and make it happen.
As already identified, while planning and
developing the policy you need to get
support from employees, your senior
managers, health and safety managers,
occupational and human resource
professionals, line managers, trade union
and other employee representatives.
Build the plan with them and look to
integrate their ideas. It is also important
that the overall approach is fair,
consistent, and disability-aware.
Enough information surrounding the
purpose of the policy needs to be
gathered to make the company position
clear. It may be that the policy is an
A4 sheet with additional supporting
information behind it. Write the policy
using simple words and concepts. Speak
directly to the people who will be reading,
enforcing, and living by the policy. After
each paragraph, ask yourself ‘what if’
questions, to make certain the policy
is covering the basics and the normal
exceptions and questions.
Develop the policy by:
1. Establishing a team of professionals
who are coming from the same place:
• Use the booklets to create a
common language (this does not
mean that all have to agree exactly
with each other or with the guides
provided in the booklets)
2. Gaining a mandate from the board:
• Use this booklet to help with the
financial case
3. Gathering organisational information
on what is happening now:
• This could include what works, any
gaps, and what could be improved
4. Develop and write the policy with the
assistance provided in booklets:
• Booklet 2: Health Relationships
• Booklet 3: Health Surveillance
and Screening
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• Booklet 4: Mental Health and Stress
5. Test the policy with a pilot group.
• Booklet 5: Getting People Back to
Productive Work
6. Review the policy with:
• Booklet 6: Employee Wellness
and Engagement
Do not try to take on too much. Start
small and build upon successes. Aim
for targeted work with clear goals and
outcomes.
• The board
• Trade unions
• Consideration of the legal team
7. Implement the policy:
• With consideration of Booklet 2:
Health Relationships
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Proactive Health Policy
Notes
1
The CBI/Pfizer Absence and Workplace Health Survey 2010
Promoting wellbeing at work – Business Case – Implementing NICE guidance, NICE,
2009 (using information from Sainsbury Centre for Mental Health 2007)
2
Mowbray, D. 2009. ‘The Wellbeing and Performance Agenda’ available at:
http://www.the-stress-clinic.net
3
Engaging for success: Enhancing performance through employee engagement, A report
for Government by David Macleod and Nita Clarke, 2009
4
Harter, J. K., Schmidt, F. L., Kilham, E.A.,Asplund, J.W. (2006) Q12 Meta-Analysis,The
Gallup Organisation
5
6
People and the bottom line, Penny Tamkin, Marc Cowling, Will Hunt, Report 448, 2008
7
Building the case for wellness, PWC, 2008
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