Railway Health and Wellbeing Roadmap The High Level View Version 1 February 2014 ‘GB railway is an industry where everyone takes responsibility for HEALTH and WELLBEING and benefits from it’ The roadmap identifies a collaborative intention for better employee health and wellbeing within the railway industry. A roadmap has been developed through a detailed industry conversation as to how health and wellbeing can be improved This document represents ‘The High Level View’ of the roadmap. If you would like a more comprehensive understanding of the roadmap and the process used to develop it then please refer to ‘The In-depth View’. The roadmap can be seen in two layers: • A graphical interpretation of the main information for general discussion • Detailed plans that elaborate on the 5 key strategic themes of the roadmap The roadmap was developed in collaboration with a number railway professionals and health and wellbeing experts who are thanked for their input. The companies represented at the workshops were: Abellio Greater Anglia Bombardier East Midland Trains GB Rail Freight Marum Healthcare Ltd Southern Alstom (UK) Capita Health & Safety Executive Mersey Rail South West Trains Arthur D. Little UK Carillion Plc Health Management Ltd Network Rail Transport for London Arriva Trains Wales Chiltern Railways Ergonomics Design Safety Consultancy Training Research Health@Work Northern Rail TSSA ASLEF Costain Rail Heathrow Express ORR Unipart Rail Atkins Cross Country Hesketh Work & Health Ltd PACTS UNITE ATOC Department of Health IPA RSSB Work and Well-Being Ltd Balfour Beatty Rail Ltd Department for Transport London Travel Watch RMT Bam Nuttall East Coast Passenger Focus Southeastern Eversholt Rail First Great Western First Group Freightliner First Trans Pennine Express Endorsements – ORR, RSSB Board, RDG??? The timing is right for a more collaborative way of working to improve railway employee health and wellbeing Through a variety of cross-industry and sector initiatives many industry professionals with an involvement in managing health have shown an openness and desire to come together to improve the health and wellbeing of railway employees. They also recognise that this work should increase employee productivity and reduce the cost of health impairment within the industry. This willingness to act comes at a time when health is of increased focus for rail companies because: • The regulator has formally drawn attention to regulatory failings within organisational management. • The railway value for money study recognised the high industry cost in this area. • Franchising and the Network Rail Final Determination now include health and wellbeing requirements. The Government itself has recognised that employee health and wellbeing will affect the continuing competitiveness of UK industry because: • An ageing workforce and changes in its composition will increase costs of employee management. • Rising costs of chronic disease and ill-health shall alter current arrangements for health management. • Low engagement rates of UK employees within their workplaces creates a productivity deficit. Through collaboration GB rail companies can collectively gain control of some important health and wellbeing figures 1. Most importantly, HLOS figures put the number of people working on behalf of GB railway at approximately 120,000 people. The collaborative vision for the roadmap is: ‘GB railway is an industry where everyone takes responsibility for health and wellbeing and benefits from it’. If the key figures below can be controlled and at the same time the vision be met then the lives of many railway people can be positively affected. 2. The estimated cost to the rail industry of direct and indirect sickness absence is thought to be £316m per annum. We wish to understand this figure more fully and to improve it for industry stakeholders. 3. The estimated costs of presenteeism is thought to be £474m per annum. This figure would be a significant cost to industry in addition to sickness absence. We wish to fully understand the usefulness of this figure, as it is open to question, and if appropriate how to manipulate it to create improvements for industry. 4. Total spend on Occupational Health (OH) and wellness programmes is evaluated to average out at £201 per person per annum. As with the other figures there may be a wide range between industry organisations for this figure but we are aware that the majority of the spending is on reactive activities. With better understanding we wish to know how well the money is spent and where possible create initiatives to spend it better. 5. Lost Time Rate (LTR) across the rail sector is approximately 3.9%. This figure varies markedly amongst different types of role within an organisation. We wish to improve the reliability of this figure and given a better understanding of absence and presenteeism understand by how much it could be improved. 6. An LTR reduction of just 0.4% would deliver savings in sickness absence costs alone of £32m per annum. Collaborative action can be facilitated by the railway health and wellbeing roadmap Following agreement from the RSSB board and the arrangement of industry oversight, the following will be delivered through the roadmap: • A Health and Wellbeing policy group with senior cross-industry representation will be set up to oversee and promote the work recognised within the roadmap. • RSSB will take on day to day support of the roadmap and associated groups. • Project tasks will be picked up by the RSSB Health and Wellbeing project and through the R&D health research topic. • Other railway sector groups and rail companies will take on tasks as appropriate to assist their membership and organisational strategies • Trade unions and representatives of railway people will be fully involved. • Industry professionals will be asked supply experience and knowledge through involvement in steering groups, conferences and identification of good practices. • Key priority tasks have been identified and have a budget for development. • The business case for health and wellbeing activities will be continuously maintained, developed and reviewed to guide project development and ensure industry commitment. What can railway companies do to become involved? The roadmap will involve a collaborative effort between a number of companies with a mix of effort and reward. Rail companies and their leaders can become involved by: 1. Acting as a champion for health and wellbeing whilst operating and improving their business in a way that minimises the negative impacts and maximises the benefits of working in the railway environment. 2. Setting up health and wellbeing programmes and policy where required; looking to meet basic legal requirements, to be an employer of choice and where practical to align to roadmap initiatives to increase impact and reduce cost. 3. Recognising the cross-industry Health and Wellbeing Policy Group and providing support and cooperation as needed. 4. Seeking to drive improvement in the management of health as well as safety risks within the company and across the industry. 5. Supporting RSSB’s involvement in facilitating actions from the roadmap. 6. Allowing company staff to participate on steering groups, seminars, R&D projects and conferences. 7. Being willing to share good company practices and improve the reliability of health data internally and across the industry. Railway Health and Wellbeing Roadmap Strategic Theme Industry Leadership Rail leaders promote that rail is a good place to work and invest Clinical Knowledge 2014/2015 Set up policy group Industry can demonstrate control over health Employee Engagement Employees believe the industry is a place where they can thrive Behavioural Change Alongside societal aims we contribute to the healthier lives of people CP6 2018 Develop a cross industry health and wellbeing charter Engage board level champions Infuence Policy Ongoing communication and engagement agenda Review and agree a set of voluntary medical stds ess case y and busin g e t ra st on i Rehabilitat where everyone takes responsibility for Health and Wellbeing and benefits from it Risk based guidance for rail organisations rket s of health ma Stimulate and reduce cost rategy Develop wellbeing st We understand how to keep more people in work Reporting and Monitoring CP5 2016/2017 Our Vision GB railway is an industry ecifcation Cross industry health data system sp tem ustry sys Set up ind ce telligen In d n a s Analysi gs Findin n o t c A ent gem a g n ee ploye m e t r Suppo ss) stre t tem s n . y l s e il c a m r n n (i anage im within desig presentees ealth m d n h b a n m o s i i j e e y t n r a e in tte Evaluate effects of abs ployee s ent rch be onments cha m Increase em y e l Resea r i g p v a up ail en man es g mon r h t m n i o c e h in alth in ellb ealt dw view he e r h n to a t ts lis por alth Use specia sup al he erials o n t t a o s m s tive aining n per nitia ks to tr role i i n i l s / f e e o e k ly y rta via supp emplo Unde omote alth training r e h P of n io s i v o r p Increase Short term data solution Principles of Working ent anagem m h lt a e h ctive active to proa Shift focus from re • Acollaborativeapproach • Sharebestpractice • Keepitsimple • Evidencebaseddecisionmaking • Onesizedoesnotfitall • Costeffective Ownership - Through stakeholder ownership and input the roadmap should continually evolve toward industry needs. Industry Leadership Roadmap Detail CP5 Industry Leadership 2014/2015 CP6 2016/17 2018 Key Bold and underlined words are top priorities CBA – Cost Benefit Analysis CP – Control Period NSARE – National Skills Academy for Railway Engineering To create health change within the rail industry those operating at the highest levels of the railway system hierarchy need to: • Show leadership direction toward a shared vision for health management • Raise the profile and priority placed on health and wellbeing management • Engage with those that can create change within industry Set up policy group Engage board level champions • Policy group has remit to drive collaborative industry action • Support organisational use of proactive health policies and strategies • Hold health and wellbeing conference • Develop a voluntary organisational health and wellbeing charter / standards and consult with industry • Provide oversight for implementation & monitoring • Help to foster health links to other industries • Re-evaluate health and wellbeing roadmap for next CP The conference facilitates and promotes action Working alongside other programmes targets action • Support industry response to franchising • Influence next control period planning Contractual requirements and programmes drive future activities • Promote cross industry collaboration and support for organisational policies and programmes • Work alongside organisational health and wellbeing programmes (NR, TOCs, ORR, RSSB …Others) Influence policy • Assist RTS whole system approach to the rail way by influencing the people section. Incl assisting NSARE Success measures and indicators • • • • Board level champions facilitate speed and quality of actions CBA justifies ongoing work • Develop CBA for health and wellbeing Develop a cross industry health and wellbeing charter Ongoing communication and engagement agenda A policy group is needed to carry out tasks in this section and provide oversight to all other sections • Establish a Health policy group with governance • Identify and engage industry board level champions &develop an executive health and wellbeing information pack Important links Survey of employer’s attitudes towards health and wellbeing at work Increases in perception of rail industry as a good place to work – get independent review from business community Positive movement in the cost of impaired health within the rail industry – industry survey Evidence of health and wellbeing provision within rail industry strategies • NR OH programme ‘Everyone fit for the future’ CP6 Voluntary charter/ standards create a common level of working & drive other tasks identified therein • ORR Health Programme CP6 Outcome Rail leaders promote that rail is a good place to work and invest Clinical Knowledge Roadmap Detail CP5 Clinical Knowledge 2014/2015 2016/17 CP6 Key Bold and underlined words are top priorities OH – Occupational Health NICE – National Institute for Health & Care Excellence CBA – Cost Benefit Analysis 2018 To adequately understand how the health industry relates to and integrates with the railway industry there is a need for senior clinical leadership within rail. This clinical leadership should advise and provide direction for the clinical development of industry’s health capabilities but also be aware of the role of the organisation in the management of health. Clinical leadership can inform industry-wide as well as individual practice enhancing all aspects of health and wellbeing management. Review and agree set of voluntary medical standards • A clinical leadership sub group is developed from the Health and Wellbeing Leadership group • Strategy for clinical effectiveness considered • Develop a set of voluntary medical standards for effects of health on work and seek adoption within industry A Clinical Leadership group is needed to lead other tasks within this section and inform other groups Voluntary medical standards informs employee conditions and cost effectiveness • Promote effects of work on health stds/ guidance and inform rail organisations Voluntary standards based on effects of work on health informs risk activities and behavioural changes • Research approaches to medical standards Risk based guidance for rail organisations • Best practice review within and outside of industry • Develop voluntary guidance/ standards based upon effects of work on health Develop a wellbeing strategy Stimulate and reduce costs in the health market Important links • Plans developed for obesity management and the ageing workforce • Access for all to quality OH services • Develop indicators for individual health risks • Research cognitive decline within the workforce • Railway knowledge for practitioners • OH Guidance for knowledgeable customer • Identify key requirements for successfully engaging a third party health provider Rehabilitation strategy and business case Success measures and indicators • No. of incidents where OH clinical leadership leads to better industry management – cost savings identified • Increased support for OH eg. voluntary health standards, no of providers, no of professionals – No. of OH Provisions • Measures in place for the changing demographics of the workforce • Review introduction of a more uniform and/ or less complex range of medical standards which would cover the whole railway industry • Recognise NICE guidance and CBA’s for rehabilitation within rail Health risk indicators informs activities that drive individual behavioural changes • Opening up the accreditation scheme • Provision of clinics facilities available to rent in railway centres by landlords such as Network Rail, as occurs with other railway related services Uniform medical standards across mainline, underground and heritage increase the effectiveness of providers working in each sector • Look to stimulate market with relevant health professionals eg Physiotherapists Rehabilitation specialists cut costs of health issues and reduces absence issues • Increase use of new health technologies / tools in rail where there is a case to do so Outcome We understand how to keep more people in work Reporting And Monitoring Roadmap Detail Reporting and Monitoring CP5 2014/2015 2016/17 CP6 Key Bold and underlined words are top priorities CBA – Cost Benefit Analysis 2018 Health data collection is needed in order to create cases and make reasoned decisions to drive change within the industry. Data collection needs to be coordinated in order to compare information from many different sources. Whether for use in the clinical or managerial setting the desired outputs from any data collected should be understood during the planning stage for collection. Short term data solution Cross industry system specification • Industry agreement to bulk upload into SMIS Short term data collection speeds the capability to analyse data • RSSB begin analysis of key health risks • Rail company’s bulk upload of key (top 5/10) health risks (yearly) • Develop requirements from information collected by Initial investigatory work Good system specification enables better development of the system • Develop a roles and responsibility matrix The system and its arrangements enable the delivery of good data based information • Development of a data system Set up industry system Analysis and intelligence • Development of health data causal classification and data collection • Rail companies set up internal system to link to cross industry data • Development of suitable proactive metrics and benchmarking facilities • Analyse if employees are healthier for longer • Models are developed to analyse health data • Industry seeks possible uses of Health and wellbeing monitoring technology • Shift funding from reaction to prevention Act on findings Important links Analysis of data helps develop better CBAs and improves decision making for development of health risk controls • Industry can demonstrate control over health CBAs improve decision making for further resource investment • Publishing health data • Improved data used for better CBAs • Increased specialist resources in industry if justified by data Success measures and indicators • A cross industry data collection system is established within industry • Increased level of understanding of industry health risk management – Reasons for absence / work-related ill health / RIDDOR / individual health risk indicators • No. of railway organisations publicly publishing health data (e.g. to shareholders) Outcome Industry can demonstrate control over health Employee Engagement Roadmap Detail Employee Engagement CP5 2014/2015 2016/17 CP6 Key Bold and underlined words are top priorities 2018 Employee engagement is thought to be generally low within the UK and a potential barrier to growth in the economy. A motivated an employee is willing to give their best to their job. It shows how well motivated, energised and inspired they are to ‘go the extra mile’. Through active engagement industry productivity can be enhanced to improve successful outcomes for all. “This is about how we create the conditions in which employees offer more of their capability and potential.” – David Macleod – author of UK Government’s ‘Engage For Success’ report. Evaluate effects of absenteeism and presenteesim on rail Increase employee say in health management Use specialists to review common rail environments Important links • Seek to understand the causes of absenteeism • Seek to manage the causes of absenteeism • Seek to understand the causes of presenteeism • Seek to manage the causes of presenteeism • Unions/ Safety Reps and Organisations form a sub group with employees to increase employee say in health • Work/life balance issues are reviewed • Employ Hygienists, ergonomists & other specialists to review common rail environments for health hazards • Promote stress management within the workplace • Where possible seek to improve facilities used by railway employees Professional understanding of common risks can be spread widely and used for data matrix • Develop knowledge around job design • Review role of rest and recovery in health management Better job design in key to a healthier and more productive work environment Research better job design (incl. Stress) Support employee engagement initiatives • Seek to increase length of service levels and reduce/maintain death in service figures Understanding the causes of absenteeism and presenteeism can support the engagement of employees • Work to improve health surveillance response from employees Employee engagement can be a significant enabler to other projects • A survey shows employees recognise work is good for health • Improve job roles so they do not adversely affect health • Develop understanding of fatigue / shift patterns • Measure employee ‘burnout’ and fatigue related safety issues • Agree industry strategy for Engagement • Review employee resilience activities • Increase sophistication of Engagement surveys • Increases to productivity related to engagement scores Linking health and wellbeing to engagement activities makes them sustainable • Link to work of engage for success • Link engagement and health and wellbeing Success measures and indicators • Number of people losing work due to ill health / no of people in rehabilitation schemes / roles provided for those with mental health issues. • Employee engagement scores improve – organisational anecdote • Increases in productivity – organisational anecdote Outcome Employees believe the industry is a place where they can thrive Behavioural Change Roadmap Detail Behavioural Change CP5 2014/2015 2016/17 CP6 Key Bold and underlined words are top priorities RTS – Rail Technical Strategy 2018 Health data collection is needed in order to create cases and make reasoned decisions to drive change within the industry. Data collection needs to be coordinated in order to compare information from many different sources. Whether for use in the clinical or managerial setting the desired outputs from any data collected should be understood during the planning stage for collection. Increase provision of health training via supply of/links to training materials • Define and recognise line manager role in health. • Develop or recommend training materials • Industry educational and competence requirements are mapped • Promote widespread health training Important links Cross industry agreement on the educational and competence requirements will allow for a collaborative approach to improvement • Develop a competence framework • Promote use of proactive health management policies Shift focus from reactive to proactive health management • Promote use of individual health risk indicators • Improved management of individual health hazards through focus • Justify increased use of occupational Health and Wellbeing expertise Tools for health risk assessment and surveillance can make it easier to achieve to meet legal requirements in this area for effects of work on health issues groups • Tools developed to improve understanding of risk assessment and surveillance Promote employees role in personal health & wellbeing management Undertake initiatives to support health in the supply chain • Promotion of health activities to employees • Employees develop work / life plans • Nudging activities in key areas are developed Work relies on health risks indicators being developed Healthier workers should carry fewer health risks • Undertake work to understand the context of health up and down the Supply Chain and consider improvement incentives • Influence design of technology and roles with people in mind • Innovation of new equipment that can improve health Getting the supply chain right can prevent difficult health issues entering the railway system • Review management of health into equipment that enters into the rail system • Guidance developed recognising: Transient employees, health conditions and risks passed on to those lower down the supply chain. • Individual key health risk indicators are used by employees • Understand & influence the railway supply chain system Success measures and indicators • No. of health courses and trained employees within the industry • Survey use of health surveillance schemes within industry • Survey provision and context of health and wellbeing initiatives (what is available, reactive/proactive, active or passive role of org (e.g. contract out) – create specific category for the supply chain including RTS impact Outcome Alongside societal aims we contribute to the healthier lives of people Appendix: Definitions used to guide the development of the roadmap These definitions were used to help guide the workshop attendees on the interpretations used for this work. Occupational Health Contemporary thinking and the ORR recognise that health has three fundamental elements. • The effect of work on health (eg airborne contaminants, asbestos, musculoskeletal disorders, mental health) • Fitness for work (eg safety critical tasks, drugs and alcohol testing, health assessments) • General wellbeing (eg obesity, smoking, sickness absence management, rehabilitation) Industry consensus, including the Industry Safety Meeting (ISM), now supports rail employers actively embracing these three elements. Wellbeing The three components of employee wellbeing, taken from Wellbeing, Productivity and Happiness at Work (Ivan Robertson and Cary Cooper, 2011), are said to be: 1. Psychological wellbeing – for example, the ability to handle the stresses of everyday life and maintain a positive attitude and sense of purpose 2. Physical wellbeing – for example, the amount of exercise, sleeping habits, alcohol 3. Social wellbeing – for example, a positive and supportive social network Engagement Employee engagement is a measure of how motivated an employee is to give their best to their job. It shows how well motivated, energised and inspired they are to ‘go the extra mile’. Engagement is uniformly measured via staff surveys and typically asks questions about pride in their company, would they recommend as a great place to work, belief in company vision and goals, a willingness to go beyond their job requirements and whether they are considering leaving at the present time. Companies with high levels of employee engagement experience greater profitability, reduced absence and greater levels of employee wellbeing, amongst many other benefits. See http://www.engageforsuccess.org/ for more information. Employee engagement should not be confused with how we communicate and interact with our people. Presenteeism The term presenteeism is often interpreted in different ways. Robertson and Cooper (2011) suggest three attributes to the term: 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) The workshops identified an additional attribute: People who have a health risk factor that inhibits their ability to do their job (for example, obesity and manual work). The purpose of the roadmap is to encourage collaborative action in order to achieve a common vision for health and wellbeing improvement within the GB railway industry. The roadmap should be updated regularly in order to make it increasingly relevant to the common goals of those working with it. It is important that those with ideas for change and adaptation of the roadmap feedback comments so that they can be considered at the next update. Please provide comments about the railway health and wellbeing roadmap to: whwp@rssb.co.uk