The Power of the Workplace for Health & Productivity Improvement

2. Keynote speaker Dame Carol Black, DBE Senior Government Advisor on Workplace Health

3. One-day Conference Healthy Workplace 2016 Northampton, 15 September 2016 Importance of Workplace Health Dame Carol Black Expert Adviser on Health and Work Department of Health and Public Health England Principal, Newnham College Cambridge

4. Work and Life span Society needs the maximum number of productive years from as many people as possible. Those not working depend on others. We need the ratio of earners and wealth-generators to dependants (children, pensioners, unemployed) to be as high as possible. Childhood Working life Retirement Being sufficiently healthy is a condition for work, and maximising healthy life as a proportion of total life is therefore a desirable goal for individuals and society. This needs to be a shared enterprise.

5. The Power of the Workplace for Health and Productivity Improvement The potentialfor large-scale health impact: • 31 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, examples of good practice • “Public Health” in the workplace • a culture of health at work can reinforce positive health behaviours • employer/employee relationships can promote positive mental health • measurement of health outcomes can be possible.

6. Work : its value Galen (129-200) “Employment is nature’s physician and is essential to human happiness.” • Work is generally good for your health • Work needs to be ‘good work’, and workplaces health-giving • Enabling people to be in productive work can be a health issue • Work provides income, material well-being and participation in today’s society • Work meets psychosocial needs • Employment and socio-economic status are the main drivers of gradients in health

7. What prevents us from working - or from working well and feeling good ? Common mental health problems - nearly half of all absence Musculo-skeletal problems - back pain most common condition Long-term conditions - many obesity-related The quality of work/workplace - managerial behaviour and leadership Home-related problems :debt, addictions Lack of education and/or skills.

8. UK - The evolving picture Acceptance of the primary importance of • leadership, managerial behaviour and workplace culture to individuals’ health, wellbeing, engagement and productivity ; To embed Health and Wellbeing into workplaces you must start with leaders, boards and managers, and then provide the fruit and bicycle schemes. • Concept given a major boost by NICE Guideline 2015 • Now all workplaces need to act on this.

9. NICE Guideline 2015 : Organisational commitment • Make H&WB a core priority for top management • Value the strategic importance/benefits of healthy workplaces • Encourage consistent, positive approach to H&WB for all. • All with remit for workplace health should address issues of : • physical work environment • mental wellbeing at work • fairness, justice, participation, and trust • senior leadership • line managers’ role, leadership style, and training • job design.

10. BiTC : Leading on Mental Wellbeing • Recommendations on line managers : • Recruit and promote those with strong interpersonal skills to promote wellbeing and recognise stress, anxiety, and depression. • Fully induct them on organisation’s approach and facilities • Incentivise them to act as role models for the organisation’s wellbeing approaches, and encourage open culture around mental health. • Include interpersonal skills as key component of their training. • Include in appraisal wellbeing of people in their team. • Equip them with skills, e.g. resilience and mindfulness, to look after their own mental wellbeing. • Develop clear, simple referral pathways to internal and external specialist support, including self-referral options. 2016

11. BT ManagingMental Health training Aims: • Preserve life when in danger • Provide help to prevent deterioration • Promote recovery of good mental health • Provide comfort to the distressed Skills: • Recognition of mental health symptoms • Provision of initial help • Guidance towards appropriate professional help Outcome: • 97% increased awareness and understanding • 91% increased confidence • 94% provided additional skills • 90% helpful or very helpful in their managerial role • 36% applied in 6 months after attendance Courtesy Dr Catherine Kilfedder

12. Mental Health and the Workplace Businesses and institutions need to recognise that : • Mental health is a business issue • The economic cost of failure is high • The human cost can be far higher • Managers need help to understand it, and be appropriately trained • Most useful interventions are low key • Poor leadership or management may contribute to ill-health.

13. Employers and Mental Health • Examples of positive activity for and by employers: • Continued growth of Mindful Employer • Mental Health First Aid – more aiders, more instructors • Workplace Wellbeing Charter – MH component. • Advice from PHE, NICE etc • City Mental Health Alliance – London-based initiative • NHS – new H&WB programme for staff • BiTC’sLeading on Mental Wellbeing • MIND’s new Workplace Wellbeing Index

14. Workplace Health and Engagement PRESSURES BEARING DOWN ON WORKPLACES Too often: analytic management, command, control intensification of work The Outcome for the Employee : - low wellbeing - low trust - mental health issues - low engagement leading to : - low confidence - low ‘ownership’ - less innovation - less efficiency - low agility People want to be respected, valued, heard. A CULTURE COLLISION Engage for success. Macleod and Clarke POOR PRODUCTIVITY AND WELLBEING

15. Promoting Health at Work • Consult staff – then design. • Leaders and managers must be creating Good Work and Good Workplaces • Mental Health : Prevention 1st, 2nd and 3rd ! - stress management, resilience training, counselling, mediation, yoga, etc • Physical Health : (also benefits mental resilience) - health assessments, running clubs, discount on gym membership, fit bug, smoking cessation, dietary changes in canteens, cycling schemes, physiotherapy, pilates, reflexology, etc. • Lifestyle : physical activity, less drinking, flexible working, signposting to debt counselling, better sleep, etc.

16. Creating Good Workplaces Key features common to those organisations which have improved health , well-being, resilience and engagement : • Visible senior leadership • Board-level or equivalent engagement • Accountable trained managers • Empowering staff • Enabling engagement • Attention to both mental and physical health improvements • Evaluation to ensure continuous improvement

17. Mental Health and Wellbeing : – happier@work King’s Health Partners : 36,000 staff in London NHS Issue : Survey found staff felt effects of increasing demands, larger complex workloads, less control less recognition/appreciation, undermining morale. Action taken : ‘managing for wellbeing’ and ‘practical skills for peace of mind’; courses on stress awareness and mindfulness. Impact : 15% increase in employees who would recommend KHP as workplace. Some improvement in wellbeing indicators, decrease in indicators for poor mental health. (External evaluation by LSBU). Success of the pilot secured further funding.

18. Physical inactivity at work • British Heart Foundation research 2015: • “sedentary work is killing people by discouraging exercise” • they correspond by email even when sitting at next desk • 52% regularly eat lunch at their desk • 31% sit so long they even put off going to the toilet • 78% of office workers feel they sit too long at work • 62% fear that this could impact health negatively • 66% say less active at work than at home • Should we not build in need for more mobility around the building, rather than ever greater densification ?

19. Good Work for All • Stable and safe work - that is not precarious • Individual control– part of decision making • Work demands– quality and quantity • Fair employment– earnings, security • Flexible arrangements – where possible • Reintegrates sick or disabled wherever possible. • Promotes Health and WellBeing– mental/physical • Prevents social isolation, discrimination & violence • Opportunities – training, promotion, “growth” • Shares information - participation in change (mixture of Marmot and The Work Foundation)

20. Control at Work : 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.

21. The difficult to discuss • Obesity • Bullying • Harassment • Domestic Violence – effect on work • Sexual harassment and violence • among staff at all grades.

22. Obesity : the costs for businesses • McKinsey Global Institute (Nov.2014) : obesity generates a UK economic loss of £47 bn per year. Total economic impact on UK employers is around £5 bn annually, much due to decreased productivity. • IHPM : “Employers used to see obesity as just a personal problem, but that is changing. Prevention is always better than cure, and employers should continue to focus on that.” • NICE states: “On average obese people take four extra sick days per year.” • Health and Safety Executive (2013): Employers might be expected to take responsibility for encouraging or assisting staff to reduce or avoid obesity, and may need to take special account of obese workers in job design and risk assessments.

23. Employment rate decreases with no. of LTCs Health Survey England analysis

24. A road map:Workplace Wellbeing Charter • A set of workplace standards to promote good, safe and healthy work, evidence-based, in eight activity areas, SME focussed, locally derived. • Standards are set for Leadership, Attendance Management, Health and Safety Requirements, Mental Health and Wellbeing, Smoking and Tobacco-related ill-health, Physical Activity, Healthy Eating and Alcohol and Substance Misuse. • An Award is given to organisations that achieve the Charter standards. • All completely voluntary. Employers can use the Charter to assess their approach to workplace wellbeing in whichever way suits their business best - only obliged to share self-assessments if going for an Award.

25. Newnham College – a journey • 89 staff – initial staff survey May 2013 • Staff Focus Groups May/June 2013 • Initial base-line Assessment 2013 • Newnham started from a low base, and found the Charter helpful. Workplace Wellbeing Charter

26. Newnham’s journey Leadership Team: Principal, Bursar, Domestic Bursar (89 staff) BEFORE (June 2013) AFTER (Mar 15) Leadership   Commitment Commitment Attendance Management    Achievement Commitment Health and Safety    Excellence Excellence Mental Health   No level Commitment Smoking      Achievement Excellence Physical activity    No level Commitment Healthy eating     No level Achievement Alcohol & substance misuse   No level Commitment

27. Ongoing activity on MH in Newnham • Leadership Days (first time this had been done) • Training for Heads of Department • Two Focus Groups on consistent behaviour across departments. • Staff Link Day with multiple objectives: • - break down barriers between departments. • - approach to welcoming students for 2015-16, • - ideas on further wellbeing initiatives for staff, • Next project : training for line managers, inc.MH First Aid. • Considering MIND’s new Workplace Wellbeing Index • 2nd Staff Survey completed January 2016

28. Britain’s Healthiest Workplace Results from the 2016 survey In BHW, we look at annual productivity loss (working days lost) due to suboptimal health across employers annual productivity loss + = absenteeism presenteeism

29. Lack of sleep • Financial concerns • Stress • Depression • Poor physical health What is mainly driving the number of working days lost?

30. Interesting trends from 2016 BHW data • Depression linked to low income and the younger generation • Lack of sleep for higher earners • Inadequate physical activity, obesity and high blood pressure arelinked to number of working days lost • Problems in the public sector. Workers most likely to: • Lose work time due to absence and presenteeism • Have two or more dimensions of work related stress • Suffer from depression

31. Workers in the public sector are most likely to lose work time (14%). • Time lost due to absence and presenteeism is more likely to go down with age: 18-20 lost 14% of work time, but 61-65 lost 8% of work time. • Workers earning between £10k and £20k are most likely to lose work time (13%). This is a problem income range, with workers most likely to : • Lose work time due to absence and presenteeism • Have financial concerns • Have two or more dimensions of work related stress 11% of working days are lost due to suboptimal health and wellbeing

32. On average, 30% sleep less than 7 hours per night. • Men are more likely than women to sleep less than 7 hours per night than women (33% to 26%). • 51-55 years is age group most likely to sleep less than 7 hours per night (38%). • Workers earning between £80k and £90k and between £120k and £150k are most likely to sleep less than 7 hours per night (33%). Lack of sleep is linked to lower productivity and increased risk of obesity

33. On average, 40% of workers had two or more dimensions of work-related stress. • Workers in the public sector are most likely to have two or more dimensions of work-related stress (50%). • Workers earning less than £10k and between £10k and £20k are most likely to have two or more dimensions of work related stress (42% and 43%). Stress seems high in the public sector and among low earners

34. On average, 5% of workers suffer from depression. • Workers in the public sector are most likely to suffer from depression (7%). • Workers in the 18-20 age group are most likely suffer from depression (13%). • Workers earning less than £10k and between £10k and £20k are most likely to suffer from depression (9% and 10%). Depression is common in the young and among low earners

35. Employees who : • exercise more • are at lower risk of being obese • and have lower blood pressure also tend to have slightly fewer working days lost. • Overall 31% of workers are physically active – over 150 minutes of exercise per week  • 26-35 year olds are most physically active (35%) • London is most physically active region (35%) Physical health matters too

36. Having a good health and wellbeing offer with high participation (including groups at risk) • Line manager training • Creating an environment that looks after mental health issues • Flexible working • Managing those working irregular hours, shifts and offsite • Job security and decent wages • Senior executives taking an active interest in, and monitoring, health and wellbeing outcomes What can be done?

37. Thank you! Any questions?