European Health and Safety Week
RSSB Conference
Railway Health and Wellbeing
RCP, London, 20 October 2014
Work – its benefits,
to health and beyond
Dame Carol Black
Expert Adviser on Health and Work
Department of Health and Public Health England
Principal, Newnham College Cambridge
Why am I here?
• To encourage and champion the drive to
improve the health and wellbeing
of all who work in the railway sector.
• To support the introduction of the
RSSB’s Road Map and vision.
“ GB railway is an industry where everyone takes
responsibility for Health and Wellbeing, and
benefits from it.”
RSSB Roadmap
Workers in the Rail Sector
• Employees in a safety-critical sector (on a par
with aviation, oil industry, healthcare etc)
• The product of the sector is infrastructure and
movement, for human benefit.
• Other sectors have their various workforces
and products, food, manufacturing, retail etc
• All employees, in whatever sector, respond in
fairly similar ways to how they are treated, in
the presence or absence of ‘good work’ and
‘good workplaces’.
Good Work
• Stable and safe work - that is not precarious
• Individual control – part of decision making
• Work demands – quality and quantity
• Fair employment – earnings and security from
employer
• Flexible arrangements – where possible
• Opportunities – training, promotion, “growth”
• Promotes Health and WellBeing – mental and
physical
• Prevents social isolation, discrimination & violence
• Shares information - participation in decision making,
collective bargaining, justice in conflicts
• Reintegrates sick or disabled wherever possible.
(mixture of Marmot and
The Work Foundation)
Good Workplaces
Key features common to those organisations which have achieved
success in promoting physical and mental health and well-being:
• Senior visible leadership
• Accountable appropriately-trained managers throughout the
organisation
• Integration of traditional Health and Safety with promotion of
Health and Wellbeing
• Monitoring and measurement to ensure continuous improvement
• Empowering and facilitating employees to care for
their own health
• Enabling staff engagement
My train driver
•
•
•
Baker Street station, London
Early shift
Bakerloo line
Good things for the driver:
• This is my train – I’m in charge
• Shift work suits my life
• I know the Bakerloo line – I’m competent
• I don’t need extra variety, this work
gives me enough.
• Good mates, good OH, reasonable pay.
Leadership - necessary
for Health and Wellbeing
Predictors of back pain :
After adjustment for age, sex, skill level, severity and
other potential confounders, the most consistent were:
• decision control
(lowest OR 0.68;
99% confidence interval (CI): 0.49 -0.95),
• empowering leadership
(lowest OR 0.59; 99% CI: 0.38-0.91)
• fair leadership
(lowest OR 0.54; 99% CI: 0.34-0.87)
Christensen JO, Knardahl S. 2012
Managers : a critical influence
• Good line management is key to good workplace health.
•
Managers should focus on:
– effective communication with the
employee and other members of staff
– awareness of the issues and the
ability to empathise
– developing open culture with employees feeling
able to discuss their problems.
• Learning about mental health enables managers to judge when
they need to refer employees to outside help.
• There are many sources of advice and good training courses.
Integration
•
Traditionally, workplace Health and Safety has been separated from
Health Promotion.
•
NIOSH (National Institute for Occupational Safety and Health, USA)
is now emphasising Total Worker Health :
“ Growing evidence supports the effectiveness of combining these
efforts through workplace interventions that integrate health
protection and health promotion. ”
“ Integrating health protection and promotion will create synergy and
enhanced overall health and wellbeing of the workforce, while
decreasing the likelihood of workplace injury and illnesses.”
“ Having a psychologically-healthy workplace and having a profitable
and sustainable business are linked.”
Traditional OHS : Injury prevention
HEALTH
GAINS
ORGANISATIONAL
GAINS
HEALTH
PROMOTION
Promote health
and well-being
Improvements
to productivity
Health promotion
in the workplace
OHS
-
-
HEALTH
PROTECTION
Prevent harm
-
-
-
-
Reduce
losses
physical
environment
individual
Psycho-social
environment
Work-related conditions
Non work-related conditions
Courtesy Professor Niki Ellis
Integrated approach to OHS
ORGANISATIONAL
GAINS
HEALTH
GAINS
SOCIAL
CAPITAL
GAINS
+
HEALTH
PROMOTION:
Organisational
and
+
Health and Safety
-
- -
IMPROVEMENTS
TO PRODUCTIVITY
individuals
+
Management
+
HEALTH
PROTECTION:
+physical
environment
-
Organisation social
environment
REDUCED
LOSSES
REDUCED SOCIAL
ISOLATION
family and community
Courtesy Professor Niki Ellis
Occupational Health in the 21st century
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
Absence of injury – added value
• The Olympic construction site had an Accident
Frequency Rate of 0.17 per 100,000 hours
worked, less than half the average for the
construction industry – attributed to strategies
known to improve employee health, wellbeing
and engagement.
• There were no deaths in building the 2012
London Olympic Village – a first in modern
Olympic history.
• Exemplary services were provided for those
who built the facilities.
Engagement at Serco
“Conducted over the years with scientific rigour, our analysis confirms that the
links at Serco are genuine and statistically significant. Higher levels of
engagement drive higher levels of performance, again and again, across
diverse Key Performance Indicators.”
Study of 133 UK
Serco contracts,
follow-up of 81 a
year later.
International public
services company
with over 100,000
employees in 30
countries
•
•
Contracts divided into 4 groups on Employee Engagement Range.
For each group, Customer Net Promoter Score (NPS) is % of
customer promoters minus % of customer detractors on staff.
Engagement at Serco
Staff turnover pa
Contracts with higher levels of
engagement lose fewer staff members
to attrition, so carry less of this cost.
(Evidenced across 47 matched contracts
suitable for analysis, in three Divisions).
Contracts with lower engagement
levels have more Lost Time Incidents,
reducing productivity and raising
operating costs.
Rate-of-change of engagement is also
important, increase lowering LTI rates.
Lost Time Incidents
(per year, per 100,000 staff)
Engagement at RBS Group
RBS (formerly Royal Bank of Scotland) : Nailing the evidence
– the link between Engagement, leadership and
Business Performance.
Studied over 370 anonymised business units (headcount >10) for any
correlation between staff engagement, business results, leadership
capability and customer service,)
Do Workplace Wellness
Programs Work?
Johns Hopkins study, JOEM, September 2014
- considering programmes in the US system.
Best and promising practice:
• Health education
• Supportive social and physical environments
• Integration with HR, infrastructure and
environmental health and safety
• Links between HP and related programmes
e.g. EAP
Journal of Occupational and
Works if:
Environmental Medicine
• Goals aligned to business
• Programme design is evidence-based
• Evidence-based implementation
Modified from
• Ongoing evaluation
Niki Ellis
If only goal is to save money, maybe not worth it
Effectiveness of Wellness Programmes
Report 2014
Surveys of 255 US-based executives, and 630 full-time US
employees in firms with wellness programmes, in firms of a
similar range of sizes, conducted May 2014.
• Cost effectiveness no longer the primary measure
employers use to assess programmes.
• Top objective is improving health as indirect driver
of productivity, morale and engagement.
Executive views :
Benefit employer even without business
case, because of intangible benefits
Can be cost effective, but only if
supported by data collection
Help company be employer of choice,
forming part of progressive HR strategy
% of
respondents
Empowering Staff
• Long-term improvements in H&WB need
individuals to act on their personal health issues
• Employers can support this.
Example: The Walton Centre NHS FT :
‘Work well’
• Implemented HWWB plan that staff helped to design
• Focused on key health issues where staff said help needed
• Considerable ewmphasis on physical activities
• Almost halved sickness absence rates from >7% to <4% in 18 months.
Total Worker Health
Creating a culture of Health and Wellbeing
“My employer cares about my wellbeing” is
central to employee engagement …
… and employee engagement affects key
business outcomes.
Wendy Lynch and Bruce Sherman,
First International Conference on Total Worker Health,
Washington, 6-9 October 2014
Railway Health and Wellbeing Roadmap
RSSB Rail Safety
and Standards Board