Mandy Wardle Specialist in Public health

1. Health Work and Wellbeing Defining the priorities and engaging staff Mandy Wardle Specialist in Public health Health, Work and Wellbeing Co-ordinator

2. Workplace Health Needs Assessment Tool Work and health-background Why ‘Health needs assessment’ Overview of the tool- structure and content survey- rationale and examples of questions Analysis-illustrated with pilots' results Step by step guide

3. Some numbers.. • The cost of working days lost and worklessness is over 100 billion to the economy with 140 -150 million working days lost each year • The CIPD survey reports that the average cost of absence is £ 692 per employee a year. • 27.3 million people are in employment in the UK with 74% healthy, 26% with a health condition or disability and 650,00 off sick at any one time. Total cost of mental ill health at work to UK employers estimated at 26 billion per year (Centre for Mental Health) Prevention and early identification of mental health problems could  save employers 8 billion per year (NICE 2009) Estimates suggest inactivity costs the NHS across the UK £1.06 billion It is likely that by 2025 40% of adults will be obese and the number of people working with chronic conditions will rise steadily affecting morale, competitiveness and profitability

4. Work and health Research shows that good work is good for health and that better employee health is good for business. “Our conclusion from the evidence available … is that the correlation between engagement, wellbeing and performance is repeated too often for it to be a coincidence” (Macleod & Clarke)[1]. [1] Engaging for Success: enhancing performance through employee engagement. A report to Government by David Macleod and Nita Clarke

5. Identify problems/priority Engage stakeholders/team Identify effective action/intervention Implement action Evaluate impact outcomes inc economic Review and.. Assess the need-S/A, health check, self reported engage stakeholders Identify priorities implement evidence based intervention measure impact/outcome Repeat cycle HNA audit process

6. Turning that process into an accessible tool for employers Background why is health an issue for employers-Introductory summary Why are the topics included-rationale What can employers do –evidence What questions ..and why? Carrying out the survey-checklist Survey How to analyse the data –what does it tell you Step by step process Further help

7. Why and What • Only 6% of men and 4% of women meet the recommended levels of physical activity. • We spend 60% of our waking hours in work • Physical activity in the workplace can reduce sickness absence by up to20% • Public health Guidance13-business case • C4L

8. Carrying out the survey Why the information is being collected? What will be done with the information - how will it help to develop/prioritise workplace health initiatives? How will the results be publicised ? What are the timescales for completion of the questionnaire and when will the results and outcomes be circulated? Assurance of confidentiality – no names or other identifying information collected Participation is voluntary – choosing not to complete a questionnaire will not affect access to services/resources Details of any incentive or reward for completed questionnaires. Instructions for completion Details of how and to whom to return the questionnaire Other questions- from the longer version on EMPHO’s website

9. Validated Questions on key areas Demographic info-who are you asking? General health and wellbeing including mental health Smoking Alcohol Healthy eating ,healthy weight Physical activity Workplace health

10. Questions • Used in national surveys/research-so comparative and tested • Matching reported behaviour to actual • Good indicator for topic covered

11. Who are you asking? About you What is your age?  Under 25  35-44  55-64  25-34  45-54  65 and What is your sex?  Male  Female What is your occupational group? (in this section use the range of roles/groups which reflect your workforce spread)  Nursing/midwifery  Admin/clerical  Scientific/technical  Medical  Management  Ancillary/maintenance  Therapeutic staff  Ambulance  Other

12. Healthy eating A portion of vegetables approximately equals one handful or 3 serving spoons of vegetables or salad vegetables. A portion of fruit equals approximately a tablespoon of dried fruit, 1 medium sized piece of fruit (e.g. apples), 2 small pieces of fruit (e.g. kiwi fruit, apricot) or a 125ml glass of pure fruit juice. How many pieces of fruit, of any sort, do you eat on a typical day? _______ How many portions of vegetables, excluding potatoes, do you eat on a typical day? _________

13. Physical activity In the past week, on how many days have you done a total of 30 minutes or more of moderate or intensive physical activity? This includes any activities done to the point where you were slightly sweaty, breathing faster than usual and your heart was beating faster than usual. 0 1 2 3 4 5 6 7

14. Analysing the results Question by question guide What the data tells you Illustrated from the pilot

15. Who are you asking

16. Healthy eating

17. Physical activity

18. Pilot-HNA 15% no moderate intensity P/a 19% 5 days 41% 5 a day 22% limited daily activity 20% reported that they had had sickness or injury caused or made worse by work compared to 2%

19. Using the results • Implementing evidence based interventions on your priorities • Evaluating their impact & measuring outcomes

20. Steps to a healthy workplace • Identify priorities for health in the workplace • Guidance, tools and services for action based on evidence of what works best • Implementation • Evaluation, impact and outcome • Re-do survey, • Review plans

21. STAGE 1 STAGE 2 STAGE 3 Define problems and identify priorities Implementation/ review Action on priority areas identified Health Needs Assessment: > identify priorities > engage organization and workforce: health champion/top level support/staff involvement Tools/Services eg: Priority areas Guidance eg: Evaluate impact & outcomes/ next steps www.wellbeingcharter.org.uk ▪ Fit for Work Services: www.leicesterfit4work.org.uk www.nottsfitforwork.org.uk ▪ Derby CAB/GP ▪ Occupational Health Adviceline: 0800 077 8844 ▪ Think Fit: www.bhf.org.uk/HealthAtWork/getting-active-at-work.aspx www.promotingactivity.com ▪ Physical Activity Networks in all areas ▪ NHS/local smoking cessation services ▪ Mindful Employer www.mindfulemployer.net www.hse.gov.uk/alcoholdrugs ▪ Change 4 Life ▪ Commissioning Healthy Catering guide: www.regional platform.org.uk ▪ Sickness Absence policy/review ▪ Organisational development/leadership group ▪ Recruitment/ retention & rehab ▪ Occupational health services ▪ Keeping or getting more active → ▪ Help to Stop Smoking → ▪ Mental Health → ▪ Alcohol & substance use → ▪ Health & Safety → ▪ Food & Health → ▪ Workplace Wellbeing Charter ▪ NHS Health & Wellbeing Improvement Framework ▪ ACAS www.seqohs.org ▪ NICE guidance PH 13 NICE guidance: ▪ PH1, PH5 ▪ PH22 ▪ HSE Stress Management Standards ▪ HSE ▪ NICE CG43 ·Review action plan\strategy ↓ ·Reduced staff turnover ? ·increase in productivity ? ↓ ·Changes in sickness absence levels/trends ↓ · Staff surveys ↓ ·Evaluate the outcomes from all interventions eg increase in P/A reported, quitters, organisation change ↓ ·Regularly review progress & impact; continue to gather evidence to prove it works ↓ ·Cost/benefits analysis ↓ ·Re-run health assessments in Stage 1 to evaluate impact/success of actions ↓ ·Agree continuing activity/new activities/ sustain activity 1 SICKNESS ABSENCE Tools eg: www.businesslink.gov.uk/workingforhealth 2 HEALTH STATUS Self-assessed: ▪ Validated self-assessment questionnaire - DH/EMPHO HNA tool, focus groups Assessed: ▪ Health checks – individual health checks, eg: “How are you doing” NHS 40-70 yr olds ▪ NHS Choices – Health Check Steps to creating a healthy workplace

22. Improving OH provision to employers: Standards and Accreditation Enable services to identify the standards of practice to which they should aspire; Credit good work being done by high quality occupational health services, providing independent validation that they satisfy standards of quality Raise standards where they need to be raised Help purchasers differentiate occupational health services that attain the desired standards from those that do not. Standards were published in January 2010 and the accreditation scheme was launched in 2011. www.seqohs.org Produced by Faculty of Occupational Medicine

23. National charter standards England wide Consistent accreditation process Framework for health in the workplace Leadership, attendance matters, health and safety, physical activity, mental health, healthy eating, tobacco, alcohol and substance misuse

24. Leicester/Nottingham FFW • Have exceeded case mgt target at month 8 -278/250 • Rise in GP referrals/SME programme • 98% of sickness absence target at month 8 • Return to work 58% • Stayed at work 19% • Still off sick 11% • Unemployed 7% • Disengage from return to work plan 5%

25. Occupational Health Advice Helpline 0800 077 8844 Provides businesses and GPs with tailored occupational health advice, by advisers with special training in Mental Health. Employers calling the service are predominantly micro (0-9 employees) and small (10-49 employees) businesses – the target group Most callers are calling about an individual employee issue So far, few GPs have used the line 95% appreciate the contact and 92% would recommend to other employers 42% calls about sickness absence 24% calls are about the fit note 20% calls are about mental health (anxiety, depression, stress, and other mental health conditions) 19% calls are about health surveillance

26. Guidance and tools-issue is selection not supply National Health work and wellbeing self assessment tool/Charter Health work and wellbeing website HNA tool Case studies NICE Responsibility deal Sickness absence review

27. Further help Guidelines, tools and services NICE Guidance Health ,work and wellbeing Coordinators List of useful contacts/websites

28. Next steps • Nationally available used by as many different organisations as possible • HWWC - Platform Website-EMPHO-Hub/DWP • SME support project • ………

29. Positive Workplaces Key features common to those organisations which have achieved success in promoting physical and mental health and well-being: Senior visible leadership Accountable managers throughout the organisation Attention to both mental and physical health improvements Systems of monitoring and measurement to ensure continuous improvement Empowering employees to care for their own health Fairness Flexible work Health and well-being need to be embedded in every aspect of an organisation’s structure and work