Health, work and wellbeing in wales

1. Health, work and wellbeing in wales Dr Steve Coppell, HSE ... and, for the purposes of today, WAG

2. First ....... a little history Ill health and absence costs businesses, people, and society a great deal of money HSE’s “Good health is good business” campaign 2000 - Securing Health Together 10 year occupational health strategy Stopping people being made ill by work Helping people who are ill back into work Improving work opportunities for the unwell and those with disabilities Based on using the workplace as a setting to promote the health of workers and the public alike

3. Securing health together Five key programmes Compliance Continuous improvement (beyond compliance) Knowledge (better intelligence) Skills – professionals, managers, workers, young people Support mechanisms – improving access to OH support Progress to date – variable!

4. And then along came dame carol black “Working for a healthier tomorrow” – a review of the health of Britain’s working age population The health of the working age population The role of the workplace in health and wellbeing Changing perceptions of fitness for work Developing a model for early intervention Helping workless people Developing professional expertise for working age health The next generation Taking the agenda forward

5. DCB – the health of the working age population We’re living longer – but not in better health 175 million days lost to illness in 2006 Cost to the taxpayer – more than £60Bn Total cost to society – more than £100Bn At any one time 10% of the working age population are either on incapacity benefit (7%) or off work sick (3%) Equates to around 6 to 8 days absence per worker per year Absences over 4 weeks - 6% of the total absences, 43% of days lost MSD’s and common mental health problems the main causes of sickness absence And while we might not always agree - good work is good for people and their families

6. The role of the workplace in health and wellbeing – in wales First – the health warning – I have only spoken to the volunteers!!! In summary ...... Lots of good people doing good things, and making a positive difference Generally better joined up in the private sector – driven by the bottom line! Some very good practice in the public sector – but a lot of people keeping their heads down! Some evidence of effective leadership ..... but Sometimes about achieving compliance rather than best practice Not enough nurses and doctors .... but good OH is not just a medical issue! SME’s generally have little or no OH support – and often struggle to achieve basic compliance

7. HWWB in Wales – some examples of good practice – NHS Trusts Variable standards across Trusts in Wales Nurse led services - with physician support Some good links to H&S Role in managing sickness absence (target 4%) – proactive, early phone advice, support for managers People working to their skills – role for technicians Public and private sector external contracts Using (ring fenced) income to fund a better service for staff All the usual OH and WB stuff- compliance, helplines, access to counselling, lunchtime roadshows, health checks, website, drug and alcohol policy, health promotion, healthy eating, subsidised chiropody, complementary therapy etc Only public sector clients interested in WB, private sector interested in compliance, pre-employment checks, MSA, SME’s decide what they can afford

8. HWWB IN WALES – SOME EXAMPLES OF GOOD PRACTICE – PUBLIC SECTOR 1 £1.4 M pa cost of sickness absence Mixed workforce – many locations Highly effective sales pitch from HR/H&S for better OH service - to include proactive approach to WB Secured senior manager support and Board champion High profile launch – “selling the service” – ads, letters with pay, briefings, newsletter, website External OH provider – case management approach - help from MIND Events for manual staff (older, higher risk, poorer lifestyle), plus annual MOT’s Enabling access for office staff - softer approach EAP, counselling (piloting online “chat room”) etc plus support for managers, the usual stuff Evaluation planned – anecdotally it seems to be working – culture is changing

9. HWWB IN WALES – SOME EXAMPLES OF GOOD PRACTICE – PUBLIC SECTOR 2 Widespread use of contractors - clear contractual standards for contractors in place All the usual OH and WB stuff – “lunch ‘n’ learn”, subsidised sports and social Detailed annual MOT’s for senior managers Accidents down 21%, absence down 13% - despite more employees Drug and alcohol policy – random and due cause testing – help and intolerance offered Looking to agree common OH standards across contractors, benefits already spreading to other parts of the contracting businesses

10. HWWB in Wales – some examples of good practice – manufacturing 1 Large manufacturer – another cathartic moment, and another strong sales pitch to senior management 21% of absence due to mental health – salary cost £360K pa - average absence 48 days In house OH service – added specialist external provider – comprehensive service – various referral routes (incl self referral) to case manager who designs outcome focused, time limited, support package Training for OH, HR, managers, TU - served to remove stigma of mental health Savings - £142K in Year 1, another £44K in Year 2 – average absence down to 28 days Some limited success with GP engagement

11. HWWB in Wales – some examples of good practice – Manufacturing 2 Large employer – lots of contractors Well resourced in-house OH service plus – Doctor led Very little work-related ill-health – mostly lifestyle issues – proactive health promotion approach Health objectives set by Board – reduce exposure (top 5 risks), reduce absence (down from 10% to 4% in 2 years) - “Roadmap” – strong leadership Health in the business goals – reflected in all performance agreements Case management approach to MSA, managers involved Offering OH services to contractors – labour only contractors treated as employees Exploring a “Passport to Health” for contractors - seen by OH, initial screening, statutory health surveillance Drug and alcohol policy – funding for community D&A advisers – help and intolerance offered

12. HWWB IN WALES – SOME EXAMPLES OF GOOD PRACTICE – MANUFACTURING 3 “Fit for life” programme started 2004 – initially without corporate funding On site OH nurse On site activity co-ordinator funded by Sports Council and business Pre employment visits to OH nurse Annual assessments – showing decline in indicators of ill health 4/5 themed weeks each year 5 fun health days each year Free staff access to local fitness centres - 14% uptake Salary sacrifice to buy additional benefits – holidays, BUPA Physio on site 1 day each week Weekly management meetings to review sickness absence – case managed by nurse 2-3 % absence – despite generous sick pay scheme

13. HWWB IN WALES – SOME EXAMPLES OF GOOD PRACTICE – MANUFACTURING 4 Residential 3 day course for managers – eventually for all staff – aimed at improving work-life balance Cheque books, free LA gym membership WB strategy – with targets and champions Programme of events – “The games” Contractors involved in the events Wellbeing icon on desktops

14. HWWB IN WALES – SOME EXAMPLES OF GOOD PRACTICE – MANUFACTURING 5 Multi site business Board support and approval 5-year strategy – “Fit for 2010” – two strands – “compliance and vitality” 2007 – “Wellness strategy” – OH strand devoted to prevention – health fairs (3152 (46%) of employees tested in 9 months) Site specific action plans – nutrition, physical activity, resilience (targeted at stress “hotspots”) 32% of employees using on site gyms Health awareness modules delivered by managers Absence 2-7% - average 4%

15. HWWB in Wales – some examples of good practice – higher education 1 In house, nurse led OH service, use of specialist external providers OH and H&S both within HR HWWB strategy launched (as part of wider HR strategy) with senior management and TU support Using Corporate Health Standard as vehicle to support HWWB Website - “live long and prosper”, events, health checks, the usual HWWB stuff etc June 2008 was HWWB month – wide range of activities – positive outcome to evaluation Sickness absence KPI (currently 3.4%) – considering monitoring full attendance

16. HWWB in Wales – some examples of good practice – higher education 2 2 year initiative to improve working environment – “excellent employers attract excellent staff” – support from senior management Representative HWWB group – TU etc In house, nurse led traditional OH service Supported by specialist counsellor Stress management training - personal and for managers - ”mindfulness “ courses – days lost before and after being monitored

17. HWWB in Wales – some examples of good practice – higher education 3 In house OH nurse with specialist support – OH and H&S combined Corporate approach to HWWB – Director led – co-ordinated across departments Strong brand for HWWB – newsletter, leaflet, campaigns Quality of working life survey identified people in their late 50’s and early 60’s as having lowest quality – Departments required to produce action plans Mandatory stress training for managers Physical activity policy – 30 minutes free time each week – free healthy breakfasts for cyclists – subsidised gym membership Absence down from 9% to 4% Price increases for unhealthy food – more healthy options – 40% increase in footfall in canteens

18. HWWB in Wales – some examples of good practice – further education 1 Quest for Corporate Health Standard led to HWWB group - directs event and activity programme Pre employment checks – questionnaire with line manager’s risk assessment for activity to OH nurse Activity programme – free use of gyms, looking to improve facilities – events, campaigns Twice yearly lifestyle checks for all staff – no longer just the worried well Absence rates falling

19. HWWB in Wales – some examples of good practice – Further education 2 External OH provider - access to nurses, Doctors, counsellors Wide use of “Access to Work”, Shaw Trust Not all have EAP/helpline access – students do, staff don’t Use of INSET days for physical activities etc Workload assessments for new staff – buddying Small budget for urgent private medical referrals Absences phoned into HR – early involvement of managers Voucher scheme – staff, retirees, contractors -1/2 price for family members

20. HWWB in Wales – some examples of good practice – local authority 1 Strategic HWWB steering group with senior manager and Member/Leader support HWWB plan aimed at delivering CHS gold In house nurse led service – saving £8K per month compared to private provider Good links to H&S Income generated recycled to OH In house counsellor, planning to recruit in-house physio Referrals (incl self) to OH nurse who identifies support package – funds available to fast track to NHS consultants Wide range of themed and targeted events, campaigns, “back school”, depot visits by nurse Targeted lifestyle screening

21. HWWB in Wales – some examples of good practice – local authority 2 Moved away from external OH provider In house OH nurse recruited to reduce absence Revised policies and procedures More proactive contact with those of work and unwell Part of local health alliance set up by HWWB coordinator – LHB support for events, health checks for manual workers LA improvement plans include HWWB targets – subject to scrutiny Looking to build better links across the LA, incl regulatory services

22. HWWB in Wales – some examples of good practice – local authority 3 Strategic Director and Member support HWWB one of three key themes – seeking population level impact, and reductions in sickness absence Corporate Health Standard as driver Service Improvement Plans include H&WB to support organisational development H&WB an agenda item at management meetings Partnership with Police, LHB, Trust OH, H&S, Regulatory Services and others actively involved in corporate health working group External funding to pump prime – part linked to commitment to partnership - plus LA monies

23. HWWB in Wales – some examples of good practice – local authority 4 Supported by the usual range of activities – plus Pool bikes scheme 12 week lifestyle support package for employees Involvement of Community Activity Teams in workplace visits Developing links to GP’s Men’s health week events taken to industrial estates – incl health checks by OH nurse (250) Absence down from 13+ to 10 days Reduced trigger points for absence – and looking to reduce further Moving to shared service with another public body

24. Emerging findings ...... Lots of good people doing good things, and making a positive difference Proactive approach to managing sickness absence works! Bigger private sector employers do some excellent OH things – the business case is made Some very good practice in the public sector – but also very variable standards, not generally joined up, not evaluated Effective leadership critical for success Sometimes about achieving compliance rather than best practice – role of Corporate Health Standard?? Not enough nurses and doctors .... but tasks need to be done at the right grade SME’s generally have little or no OH support – and often struggle to achieve basic compliance – Workboost Wales

25. THE SECRETS OF SUCCESS? Healthy people = healthy profits (or more people at work to deliver public services) www.workingforhealth.gov.uk/Employers/Tool/ Business case to secure that essential senior management support – Corporate Health Standard? Health and wellbeing in the business goals – and performance agreements You have to speculate to accumulate - but it need not cost a fortune Involve the workforce – you are seeking massive cultural change! Works best if H&S, HR and OH joined up

26. MORE SECRETS OF SUCCESS? Provide access to a “fit for purpose” occupational health service – if you use an external OH provider, make sure you get what you need Give priority to keeping people in work – plenty of help (and ideas) out there Cherish your employees ….. make them feel loved and wanted – lots of good things you can do! Be very proactive in managing absence – training and support for managers essential Remember – improving health and wellbeing requires a long term commitment And a final one for public sector employers – you have a wider responsibility for improving public health – so be creative!!

27. Any questions???