Legal issues, HSE and government guidance
Health and Wellbeing Research

Improving the health and well-being of UK citizens is currently a major government concern. So much so, that they have funded a great deal of research aimed at trying to determine how best to do this. As UK citizens spend much of their time at work, all the reports state that the workplace should be more involved in promoting information on health and well being.

Many organisations are therefore starting to recognise a corporate responsibility to provide information and advice on health and well being in the workplace. However, there are also good economic reasons for tackling health and well being at work. Poor employee health and well -being can result in reduced performance and increased absenteeism.

As a result of this a number of research projects have also been carried out to try to determine good practice for tackling health and well being at work and to try to evaluate different approaches.

Below are outlined

  1. some of the major points that have been made in the reports on the role of the workplace in promoting health and well being
  2. some of the most useful research on how best to do this.


Research and recommendations for the role of the workplace in improving health and well being in the UK

1. “Working for a healthier tomorrow”
In 2007 the National Director for Work and Health, Dame Carol Black conducted a comprehensive investigation of health and well being in Britain. In March 2008 she released a report “Working for a healthier tomorrow.” In this report Dame Black commented on the results of the investigation and current state of health and well being in the UK, and made recommendations for improvements.

Although many factors were considered in the report not least the role of primary care, the introduction of a fit for work note rather than a sick note and a fit for work service, there was a great deal on the role of organisations in improving the health of the nation.

In the report Dame Black suggests that “the workplace can be a key setting for improving people's health and well being” and in Chapter 3 “Good Health is Good Business” she outlines the components of a good organisational well being programme. These are as follows:

  • Needs to address employees needs in a specific organisation
  • Requires true senior management buy in - not lip service
  • Needs to be aligned with the business’ aims and goals and not an after thought
  • Employees views should consulted about programmes and informed and updated of initiatives
  • The organisation should measure the outcomes of the programmes and share the business case with directors share holders and other organisations

It was very reassuring to see that these recommendations totally reflect the ApP approach to health and well being.

In making these recommendations Dame Black recognises that there is a good business case for tackling health and well being at work but recognises that one of the biggest obstacles to this happening is the fact that the evidence base to support the business case is poorly understood by employers. She also recognises that there is a lack of appropriate information and advice. She therefore suggests that

  • A robust model should be developed for reporting on the benefits of employer investment in health and well being and this should be used to report on health and well being in the board room and company accounts
  • There should be a business led health and well being consultancy service offering tailored advice and support at a market rate.
  • There should be a major drive to promote understanding of the positive relationship between health and work among employers, healthcare professionals and the general public.
  • Finally, Dame Black states that all organisations must ensure compliance with H&S and other employment law, through good H&S management prevention and exposure to risk. The following information will therefore be useful for helping organisations do that for stress and common mental health problems. The HSE has produced guidance for this.

The HSE guidance is outlined on this web site under Legal issues and health and safety guidelines on this web site. Click HERE to see these.

ApP provides help with all aspects of H&S guidance for stress

 

2. The Foresight Project on Mental Capital and well being (Oct 2008)

This stated that:

  • employers should play a part in reducing the stigma of mental ill-health
  • fulfilling work can be beneficial for mental health
  • poor conditions in the workplace can cause stress and exacerbate mental health problems
  • employers should be encouraged to foster work environments that are conducive to good mental well being and the enhancement of mental capital
  • collection of wellbeing data against key performance indicators
  • employers in both the public and private sector should be encouraged to carry out an annual stress and wellbeing audit and act on its findings
  • better training for managers so they understand the impact they can have on mental capital and wellbeing
  • raising the profile of the importance of mental health and well being at work
  • encourage companies to include wellbeing indicators in their annual reports, thereby benchmarking their performance for shareholders and showcasing any improvements

 

3. The Boorman report NHS staff health and Well-being Review 23rd November 2009

This stated that:

  • All NHS leaders and managers are developed and equipped to recognise the link between staff health and well- being and organisational performance and their actions are judged in terms of whether they contribute to or undermine staff health and well- being
  • All NHS trusts develop and implement strategies for actively improving the health and well-being of their workforce – this should be developed with a full involvement of staff
  • All NHS staff should implement the NICE guidance on promoting mental health an dwell being at work
  • Training in health and well being should be an integral part of management training and leadership development … and should be built into annual performance assessment and personal development planning processes
  • Ensuring managers have the skills and tools to support staff with mental health problems
  • When drawing up a health and well being strategy a proper assessment is taken of key health priorities and risk factors. These should fully reflect legal requirements in this area
  • Consistent access to early interventions
  • In addition to core services there Should provide a range of specific health and well being services targeted at the needs of the organisation
  • Staff engagement critical in determining what services are required
  • Staff health and wellbeing services should be regularly assessed and reviewed

4. NICEGuidance for employers on promoting mental wellbeing through productive and healthy working conditions

These guidelines from the National Institute for Health and Clinical Excellence (NICE) set out clear recommendations, based on the best available evidence. The guidance is for those who have a direct or indirect role in, and responsibility for, promoting mental wellbeing at work. This includes all employers and their representatives, irrespective of the size of the business or organisation. There are 5 recommendations and all can be seen at http://www.nice.org.uk/nicemedia/live/12331/45895/45895.pdf

Below are recommendations 1 and 4 around which the e learning was based

Recommendation 1: strategic and coordinated approach to promoting employees’ mental wellbeing

Adopt an organisation-wide approach to promoting the mental wellbeing of all employees, working in partnership with them. This approach should integrate the promotion of mental wellbeing into all policies and practices concerned with managing people, including those related to employment rights and working conditions.
  • Ensure that the approach takes account of the nature of the work, the workforce and the characteristics of the organisation. Promote a culture of participation, equality and fairness that is based on open communication and inclusion.
  • Create an awareness and understanding of mental wellbeing and reduce the potential for discrimination and stigma related to mental health problems.
  • Ensure processes for job design, selection, recruitment, training, development and appraisal promote mental wellbeing and reduce the potential for stigma and discrimination. Employees should have the necessary skills and support to meet the demands of a job that is worthwhile and offers opportunities for development and progression. Employees should be fully supported throughout organisational change and situations of uncertainty.
  • Ensure that groups of employees who might be exposed to stress but might be less likely to be included in the various approaches for promoting mental wellbeing have the equity of opportunity to participate. These groups include part-time workers, shift workers and migrant workers.

Recommendation 4: the role of line managers

Strengthen the role of line managers in promoting the mental wellbeing of employees through supportive leadership style and management practices. This will involve:
  • promoting a management style that encourages participation, delegation, constructive feedback, mentoring and coaching
  • ensuring that policies for the recruitment, selection, training and development of managers recognise and promote these skills
  • ensuring that managers are able to motivate employees and provide them with the training and support they need to develop their performance and job satisfaction
  • increasing understanding of how management style and practices can help to promote the mental wellbeing of employees and keep their stress to a minimum 7


Research and guidance on best practice for tackling health and wellbeing at work

 

1. Health and Safety Executive

Following a landmark legal case for stress at work The HSE stated that it is necessary to carry out regular risk assessments for stress. Based a great deal of research they have produced a set of comprehensive guidelines. These are available in the HSE publication managing the Cause of Work Related Stress – ISBN 978-0-7176-6273-9 alternatively they can be can be accessed from the HSE web site www.hse.gov.uk/stress . A shortened version is available on the ApP web site.

Major research on which the guidance is based was published in Work and Stress (2004) 18 No 2 Special Issue – “Risk Management: Work and Organisational Factors” This journal contains a number of research papers all related to work related stress and mental health. In particular is the research paper entitled “management standards and work related stress in the UK: policy background and science by Mackay et al (2004). This outlines how the HSE guidance was developed and discusses much of the theory on which it was based. Of particular interest are the following points.

  • The more control employees have the better they perform, the fewer days they take off sick and the less likely they are to leave
  • The clearer employees are of their role the more productive they are, the more they are at work and the more likely they are to stay
  • The better an organisation manages change, the more likely they are to retain staff and decrease absence
  • Higher levels of support and better relationships at work improve business performance
  • Even simple interventions to improve job control and change management can reduce sickness absence up to 28%.

2. RR133 - Beacons of excellence in stress prevention.

At the same time as the HSE were developing their guidance for stress the Beacons of Excellence Research was being carried out. This dscribes the authors' work to identify good practice in stress prevention. It summarises and draws conclusions from many academic studies on stress prevention, and uses this information, as well as advice from a panel of international experts, to develop a comprehensive stress prevention model. This model is then used to describe examples of stress prevention practices within a wide range of UK organizations. Of particular importance is their finding that ssuccessful stress management interventions all tend to have the following components:

  • top management commitment
  • risk analysis
  • stress prevention strategy
  • a participative approach
  • interventions concentrating on individuals teams and organisations
The report can be found on the HSE web site at www.hse.gov.uk/research/rrhtm/rr133.htm

 

 

3. HSE obstacles RR389 ISMAUK stress workshops 04: Attitudes, opinions

This report summarises the results of telephone research undertaken on behalf of the Health & Safety Executive between 10 June and 24 June 2005, it can be accessed from www.hse.gov.uk/research/rrhtm/rr389.htm

Of most interest here is that it cites the obstacles that organisations need to overcome to produce effect stress programmes. These are:

61% lack of time
55% lack of understanding about stress in general
48% lack of manager commitment
46% stigma of stress
34% lack of senior management buy in

Some of these obstacles are addressed in the Beacons of Excellence Research.

 

4. Building the Case for Wellness by PricewaterhouseCoopers (PwC).

This report considers the wider business case and specifically the economic case for employers to invest in wellness programmes for their staff. In this review, PwC found evidence in over 50 UK case studies that health and well being programs have a positive impact on intermediate and bottom line benefits.

 

5. Mental health and work by The Royal College of Psychiatrists.

This report looks at the evidence for addressing mental health and work.
And finally a very recent piece of research is

 

6. RR633 Management competencies for preventing and reducing stress - Phase Two

This research identifies the management behaviours necessary to implement the HSE Management Standards. These are basically good people management skills and apply to all aspects of managing employee health and well being. This research can also be accessed from www.hse.gov.uk/research/rrhtm/rr633.htm


From these reports and guidelines there are a number of common themes that have been recommended for successfully addressing to health and well being at work.

These are as follows:

  • Organisations should take a strategic approach to health and well-being. Senior managers need to be involved and take responsibility (e.g. NICE, Boorman Report Black HSE).
  • Regular assessments of employee psychological well-being should be
  • Made. Such as using a survey tool (e.g. (Foresight, NICE HSE).
  • Managers should have health and well-being key performance indicators
  • (E.g. Foresight, Boorman).
  • Leaders and managers should be trained and developed to deal with health
  • And well-being issues (all reports).
  • Employees should be trained to improve health and well being at work (Carol Black. HSE)

The e learning packages help managers deal with all these recommendations

 
© Copyright Dr Rosemary Anderson 2008
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