Dame Carol Black Expert Adviser on Health and Work Department of Health, England

1. East Midlands Platform on food, physical activity and health Members’ Meeting Nottingham, 24 February 2012 The Responsibility Deal – and Work, Health and Well-being Dame Carol Black Expert Adviser on Health and Work Department of Health, England

2. The Fundamentals • Work and health are inextricably linked • Work is a determinant of health • People’s social and economic circumstances affect health throughout life, so health policy must be linked to the social and economic determinants of health • Work is generally good for health • Enabling people to be in productive work is a health issue • Good health is essential for a high-performing workforce • Worklessness is a greater risk to health than many ‘killer’ diseases • Improving working-age health is the business of us all.It is also a Public Health issue.

3. What we need in the UK Healthy, engaged workforces Well-managed organisations • A high-performing, resilient workforce • Enhanced productivity • Contributing to: • A well-functioning society • Better economic performance

4. UK Employment and Health Mental ill-health is the most common reason for claiming health-related benefits. Employed population 26% with a health condition or disability 2.4% off sick Inactive (about a third as many as are employed) 48% with a health condition or disability Source: Labour Force Survey of UK men and women aged 16-64 Unemployed (about a tenth as many as are employed) 29% with a health condition or disability Beneath these figures lie diminished lives, little aspiration, and disrupted families.

5. To achieve our goals we need to: Create employment and workplaces which both protect and promote health, mental and physical Enable people with disabilities and long-term conditions, especially mental health conditions, to stay close to the labour market Reduce sickness absence, job loss, and flow onto benefits Support people to work to a later age, and Above all, enable a change in culture, attitudes and behaviour in connection with work Ensure that work is ‘good work’.

6. Election May 2010: new UK landscape Major reform of the NHS Public Health re-organisation Local Councils’ enhanced responsibilities Public Health Responsibility Deal Major reform of welfare system Independent review of sickness absence “ We simply have to get to grips with the sick-note culture that means a short spell of sickness absence can far too easily become a gradual slide to a life of long-term benefit dependency.”

7. Sickness Absence Review - the ongoing journey • The current system lacks coherence and wastes human and material resources. 39 weeks 28 weeks ESA benefit and support Week 4 20 Work Sickness absence Work Capability Assessment Claim to Employment Support Allowance (ESA) Work Capability Assessment Claim to Employment Support Allowance (ESA) JSA benefit and support Work Inactivity • We made recommendations to: • - support employees at work to stay in work • - improve the benefits system to offer better advice and support, towards work • - tackle sickness absence through various interventions, throughout process. • Our recommendations could also save £400 million a year for employers, £300 million a year for the State, and boost economic output by over £1 billion per year.

8. The Power of the Workplace for Health and Productivity Improvement The potentialfor large-scale health impact: 27.5 million employees in the UK families of employees extend impact further Advantages of the workplace: a microcosm of society, as to age, gender, income, ethnicity powerful communication and education structures a culture of health at work can reinforce positive health behaviours (Public Health in the workplace) employer/employee relationships can sustain healthy behaviour infrastructure for measurement of health outcomes is often in place. Also, we do not usually attend GPs’ surgeries for well-being advice.

9. Percentage of employers citing each Adjustments employers make for employees to stay in work Measures used in the last 12 months to help keep employees with health problems in work or facilitate their return to work: No measures provided ---- Source: Employer Survey, DWP

10. Positive Workplaces Key features common to those organisations which have achieved success in promoting 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

11. The Responsibility Deal “Public health is everyone’s responsibility and there is a role for all of us, working in partnership, to tackle these challenges.” - Andrew Lansley, March 2011 We want to create an environment that supports people to make informed, balanced choices & to lead healthier lives. Businesses and other organisations can lead the way in positively shaping & creating this environment to improve public health. They can make a difference through their influence over the workplace, physical activity, food, and alcohol. They can do this an employers, and through their commercial and community activities. Over 330 organisations have already signed up.

12. Working together The plenary group oversees development of the Deal. It includes senior representatives from business, NGOs, public health and local government. The alcohol, food, health at work and physical activity networks are responsible for the Deal’s work programme in each of these areas. The behaviour change network provides advice across the Deal as a whole. The chairs, and Ministers supporting, each network are set out in the diagram above.

13. Signing up as a Responsibility Deal partner To become a Responsibility Deal partner an organisation: signs up to all the core commitments & supporting pledges signs up to a minimum of one collective pledge[this can be an alcohol, food, health at work or physical activity one] registers with the Department of Health online at http://responsibilitydeal.dh.gsi.gov.uk All partners, and the pledges they have committed to take action upon, are listed on the Responsibility Deal website. Any organisation – public sector, commercial, voluntary – which can make a firm commitment to take action on at least one collective pledge can sign up to the Responsibility Deal.

14. Responsibility Deal : Health at Work network The aim of the Health at Work Network – one of five networks - is to find ways to help employers use the workplace to improve the health of their employees. Current work includes: • Developing pledges for action to help people at work lead healthier lifestyles. The Network has agreed six initial pledges. Now we are publicising them and encouraging uptake. • Local Business Partnerships: Unilever, Mars UK, Novo Nordisk, mentoring SMEs • What works for SMEs • Providing generic guides on managing chronic conditions in the workplace • Developing ways to make Occupational Health more proactive and preventative

15. Health at Work pledges • Launched in March 2011: • - H1. Chronic conditions guide • - H2. Occupational health standards • - H3. Reporting on health and well-being • - H4. Healthier staff restaurants • Launched in September 2011: • H5. Smoking cessation/Respiratory • health • - H6. Staff Healthchecks

16. Health at Work pledges Occupational health standards – we will use only occupational health services which meet the new occupational health standards and aim to be accredited by 2012/13 Health and well-being reporting – we will include a section on the health and well-being of employees within annual reports and on websites Chronic conditions guide – we will embed the principles of the chronic conditions guides within our HR procedures Healthier staff restaurants – we will implement some basic measures for encouraging healthier staff restaurants / vending outlets / buffets. Smoking cessation - we will facilitate on-site stop-smoking support services and/or encourage staff to attend local stop-smoking services during working time without loss of pay. Health checks – we will offer staff health checks, and/or encourage use of the NHS Lifecheck, and participation in the NHS Health Check for vascular disease, and other NHS screening programmes. To date 170 companies have signed up to one or more pledges.

17. H1. Chronic Conditions Guidance Pledge “We will embed the principles of the chronic conditions guides (developed through the Responsibility Deal’s Health at Work Network) within Human Resources procedures to ensure that those with chronic conditions at work are managed in the best way possible with reasonable flexibilities and workplace adjustments.” Context There are many long term conditions, some of which are increasing, such as diabetes and heart disease. So more employers need to manage employees with these conditions. Employers will benefit from good management of chronic conditions through improved productivity and attendance. Employees will benefit from improved health and make them feel valued within the organisation.

18. The Guidance Two guides published to help employees and employers in the management of chronic conditions in the workplace. Also linked to a number of health websites, which offer appropriate guidance on specific long-term conditions. Available on NHS Choices at http://www.nhs.uk/LiveWell/Workplacehealth/Pages/workplacehome.aspx

19. H1. Mars Case Study – Winning with Wellness Have a positive attendance management policy which is committed to making reasonable workplace adjustments and aims to be as flexible as possible to support staff and to ensure that those with acute and chronic health conditions are managed in the best way possible at work. Committed to making reasonable adjustments and to creating modified return to work plans and capability processes to support staff with acute or chronic health problems in the workplace.

20. H3. Reporting on Health and Well-being Case Study - GSK Health Work and Wellbeing included in annual Corporate Responsibility Report Review of all uncertified and certified sickness absence data undertaken. Actions agreed to improve reporting and support for managers New reports have highlighted trends and costs not previously known.

21. Showing results After signing up, partners produce a brief delivery plan for each pledge, to be published on the Responsibility Deal’s website. By April each year, partners submit updates on their progress. To guide partners in completing delivery plans and annual updates, templates have been developed for all collective pledges. These are available on the website. Partners’ pledge delivery plans and annual updates will be published on the Responsibility Deal website. By Spring 2012 online submission of delivery plans and annual updates should be available. Contact us at responsibilitydealhealthatwork@dh.gsi.gov.uk

22. Why sign up? A fitter, healthier workforce is more engaged and more productive, performing more efficiently. A commitment to the Responsibility Deal sends out a positive message about work culture, reputation and attitude to employees and the workplace. It sends positive messages to those who use your services –customers or clients - and the wider community. Being part of the Responsibility Deal network ensures you can both contribute to and share the latest developments in the field of health and work. RD events provide networking opportunities.

23. Further information Further information about the Deal, including a full list of all the pledges and of partners can be found at http://responsibilitydeal.dh.gov.uk/. The website is currently being improved and expanded for partners and other interested organisations. In the meantime more detailed information on the Deal can found at http://www.dh.gov.uk/en/Publichealth/Publichealthresponsibilitydeal/index.htm We publish regular e-Bulletins to keep partner & other interested organisations updated on the work of the Deal and to highlight interesting developments. These can be viewed at http://www.dh.gov.uk/en/Publicationsandstatistics/Bulletins/ResponsibilityDealbulletin/index.htm Email us at responsibilitydeal@dh.gsi.gov.uk Call us on 020 7972 4549 or 020 7972 4858

24. “ Health is created in places where we live, love, work and play. * ” World Health Organisation Final thoughts