02
Internal Health
Relationships
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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Internal Health Relationships
Contents
Acquire the competencies and awareness
needed to meet the challenge . . . . . . . . . 3
For more reliable outcomes, form teams
and develop health relationships . . . . . . . 5
Have respect for alternative views
on workplace activity . . . . . . . . . . . . . 7
On-going communications will
make proactive policies happen . . . . . . . . 9
Further information . . . . . . . . . . . . . . 11
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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 2 – Internal
Health Relationships
Within an organisation, several
departments may need to interact
to promote and safeguard the
health of employees. These internal
relationships between departments
exist, although in some cases, each
of the parties involved may show
indifference to the others and the
relationships are largely ineffective.
For a new proactive health policy
initiative to succeed, these internal
relationships need to be managed to
create the most successful outcomes.
This booklet suggests that the key to
successful internal relationships in an
organisation is founded on competent
teams that respect the views of
others and continually communicate
their intentions and activities.
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Internal Health Relationships
Acquire the competencies
and awareness needed to
meet the challenge
Good plans and ideas change nothing without enough
know-how and a readiness to be carried out.
Organisational expectations set
for employees through roles and
responsibilities should be accompanied
by adequate training for them to be able
to carry out their roles. For most railway
organisations there is a need to improve
the standard level of health knowledge
and training of those with health
responsibilities to meet this requirement.
Line managers are often expected
to manage health, but as a rule, they
receive little or no training in relation to
health management. Health and safety
managers can also be asked to act
beyond their competence when dealing
with certain health risks. This situation
creates obvious limitations of capability
within the organisation and can lead to
failings in the company’s duty of care to
the employee and control of risk to health.
NEBOSH (The National Examination
Board in Occupational Safety and
Health), offer training packages for
front-line managers and health and
safety managers. On occasion it may
also be necessary to purchase specialist
help from occupational hygienists or
ergonomists to assist health and safety
managers in risk assessment.
Organisations may also consider
developing structured programmes
to share knowledge across specialist
roles. Where there are existing ongoing local arrangements, these could
be used to promote the exchange of
information through presentations and
guidance information about their roles.
Activities such as case management
and group development of risk
assessment can lead to improved
management of health issues, by pooling
experience and knowledge. Joinedup health management strategies
will be encouraged if processes are
developed around these activities and
responsibilities, and are written into job
descriptions.
An example of this exchange of health
information may be that HR managers
create a presentation to inform health
and safety managers about the Equality
Act and in exchange, receive information
about health and safety legislation.
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Many rail organisations would also
benefit from increased support from
occupational health (OH) specialists. This
may be from directly employed personnel,
from improved contracts, or both. For
those organisations that are developing
proactive health policies, the increased
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spend on OH specialists is likely to create
good returns on investment through
absence savings. The business case
benefits of this have been identified in
booklet 1. Getting help early will help to
inform any plans and prevent rewrites by
those left out until much later.
The ORR is looking to help set up a rail-based NEBOSH certificate
in health and wellbeing for the rail industry.
Take a look at the web page and make it known if you have an
interest:
http://www.rail-reg.gov.uk/server/show/nav.2791
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Internal Health Relationships
For more reliable
outcomes, form teams
and develop health
relationships
It will take a team effort to embed changes and distribute
organisational workload effectively. Make teamwork a priority.
Teams encourage self-organisation
and participation, they also share the
workload and make solving problems
easier. Smaller organisations often find
that team or group activities form naturally
and the increase in participation and
feelings of involvement bring benefits.
This is because there is an optimal size
for teams or groups to be active; too
large, and any meaningful participation
becomes much more difficult.
Organisations should look at the best way
to form teams, whose purpose is to plan
and carry out a proactive health policy.
It may be beneficial for example, for
departments or a collective of specialist
roles to make health and wellbeing
plans for their own area, to which they
can respond and which can be audited.
Their plans can then inform the overall
organisational policy, and so contribute
toward its purpose and principles. The
teams can implement their individual
plans more effectively, since they are
able to self-organise in order to meet the
plans.
Team participation may also include:
• The granting of more power to those
managers operating closely with
employees, so that they can provide
effective leadership (more power may
be funding or a line of communication
to senior meetings).
• The creation of measures in
collaboration with the employees on
the ground: employees decide on a
measure and agree that is needed
and understand what it is intended to
achieve.
• A will to work on improving the overall
system and not attributing failure or
improvement to individual employees.
• The removal of rivalries that break up
the performance of the overall system.
A team approach can bring the right
combination of skills together to manage
health hazards that are beyond an
individual’s competence. For example,
health teams could open up the
ownership of health risk across a number
of roles:
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• The line manager understands the
workplace.
• The health and safety manager
understands risk.
• The occupational health specialist
understands the health of the person
• The HR manager understands the
organisational contract.
• The health and safety representative
can speak from an employee
perspective.
Bringing these skills together will be more
effective for the organisation than if they
work on their own.
Team behaviours:
• Stimulate the employee’s involvement
and competence.
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• Make employees feel that they are
treated fairly and will therefore
co-operate more freely.
• Increase the trust between members
of the workforce.
• Increase the understanding of the
needs of others and give a wider
viewpoint of how a situation affects
them.
• Increase the ability to recognise the
pressures and constraints of other
roles.
• Create a shared overall purpose when
dealing with contentious issues.
• Foster a management intention for
win – win opportunities instead of
managers looking after their own
corners.
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Internal Health Relationships
Have respect for
alternative views on
workplace activity
To show respect for alternative views on health and wellbeing
issues you need to be aware that legitimate views exist that
may seem alien to you.
The roots of the Equality Act highlight
how much our workplaces have been
dominated by a wealthy, white, male view
on life. This dominant view infiltrates so
much of our own view that many of us
are likely to see it as our own, even if we
do not fit into the category. The trouble
with a dominant view is that we feel that
everybody shares it, or that it is the one
‘right’ view, to the exclusion of all others.
Not knowing about the views and ideas
of others is a limitation in all human
beings, not a weakness in a manager.
However, as a manager implementing a
proactive health and wellbeing policy it is
important that you do respect alternative
views, and make yourself open to other
ideas you know little or nothing about.
Acknowledging alternative ideas may
involve accepting those of colleagues
from other roles within the company, and
it is especially important regarding the
views of the people who work for you.
Avoiding actions that create inequality
can be difficult and trade unions can
help to manage this. If there are
recognised trade union health and safety
representatives in the workplace then
they must be consulted on any health
and safety matter. However, health and
wellbeing is an issue that should also
involve union workplace representatives.
Stewards and equality representatives
may also have an important role. Some
union branches have even set up a health
and wellbeing committee.
Your union representatives
may find this union resource
a helpful guide to health and
wellbeing issues:
https://www.tuc.org.uk/
sites/default/files/tucfiles/
TUC_WORK_AND_WELLBEING.pdf
It may also help you to
understand where a union
opinion is coming from.
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Issues surrounding health such as
disability, rehabilitation, mental health and
workplace stress relating to gender or
colour are all related to the Equality Act.
Fortunately there is much freely available
guidance to keep you on the right track.
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There are also seven guides giving
advice on your company’s and your
own responsibilities (as someone
who has other people working for you
as employees) under equality law.
The guides look at the following work
situations:
This government equalities
office publication is an easyto-read introduction to the
Equality Act:
1. When you recruit someone to work for
you
https://www.gov.uk/
government/uploads/
system/uploads/
attachment_data/
file/85012/easy-read.pdf
4. Career development – training,
development, promotion and transfer
Further information and
guidance is available at:
7. Good practice: equality policies,
equality training and monitoring
2. Working hours and time off
3. Pay and benefits
5. Managing people
6. Dismissal, redundancy, retirement and
after someone’s left
https://www.gov.uk/
equality-act-2010guidance
The seven guides can be found at:
http://www.equalityhumanrights.com/advice-and-guidance/newequality-act-guidance/
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Internal Health Relationships
On-going communications
will make proactive
policies happen
Change that is guided by a proactive health policy will only
happen if organisational roles continue to communicate and
work together - even through difficult policy issues.
To make a policy happen there needs to
be on-going communications between
all parties involved. Employees need
to know what to expect, managers
need to understand their roles and
everyone needs to be clear about who is
responsible for what action. In order to
know and support the policy, those with
a role to play will need to understand
the details. It might be helpful if these
relationships are defined in a document
which is part of the health policy.
To be effective, communication needs to
be passed two-ways on every occasion.
So as well as expressing their own views,
managers need to actively listen to what
is being said to them – whether it is wellput, or not being communicated well at
all.
Plans and processes are statements of
the imagination, no matter how close they
are to reality. Communications need to be
on-going in order to continually adjust a
plan or process toward being effective in
helping the organisation reach its goals.
As managers we need to recognise that
our individual views or mental models
of how work is carried out are severely
limited. We therefore need to respect the
needs and views of others. Experience
from what is happening at the ground
level of an organisation can become
complex, as can the knowledge of how to
operate effectively.
Experience should not be undervalued
because it is difficult to show. It is
vitally important in the attainment of
organisational competence. This is not
to say experience is always right but it
should be listened to and moulded toward
the purpose of the proactive health policy.
This will allow those listening and learning
from it to work toward better plans and at
the same time engages those expressing
the views.
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To assist the development of good communications:
• Managers should encourage
and welcome dialogue with
employees by establishing two-way
communications and being prepared
to hear, accept and manage bad
news.
• Managers should be aware that
visible communications, ie their
actions, can be stronger than verbal
communications.
• Inappropriate employee actions
must be managed in such a way
that they are not perceived to be
reprisals related to poor health
practices.
• Managers should not allow
functional barriers to become a
natural dividing line where efforts to
communicate or co-operate can be
stopped.
• One to one discussion should be
regarded as pivotal for generating
understanding so the manager can
act in the most appropriate ways.
Written information in the form of
figures may give the manager an
impression of what is happening
but this should support face to face
discussions that really create the
picture of what is going on.
A manager may experience the following if communication
is poor:
• Some employees may be
aggressive in reporting problems or
expressing health concerns because
the activity makes them feel anxious.
• Some employees do not understand
or feel comfortable with certain types
of communication and therefore
communications should be targeted.
• The employee may feel undervalued
as a provider of information if
responses back to them are slow.
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Further Information
Unite Women’s Health, Safety and Wellbeing at Work Guide.
0
http://www.unitetheunion.org/uploaded/documents/
Women’s%20Health%2C%20Safety%20%26%20Well-being%20
at%20Work%20(Unite%20guide)11-5062.pdf
Health Champions within an organisation can make a significant
change in employee wellbeing. The Royal Society for Public
Health have developed a Level 2 Award Understanding Health
Improvement – it is training to become a health champion.
http://www.rsph.org.uk/en/qualifications/qualifications/
qualifications.cfm/Level-2-Award-in-Understanding-HealthImprovement
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