Workplace health: All in it together

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Employers should encourage staff to take more responsibility for their health and wellbeing to ensure they are fit to enjoy retirement, and able to work for as long as they like, writes AXA PPP's Nick Jeal.

In recent years employers in the UK have undergone a significant shift in the way they think about employee health and wellness.

Driven by an ageing workforce (due in part to the abolition of the default retirement age), the increasing prevalence of chronic conditions and increasing complexity and cost of treatment, employers' thinking has changed from depending on the state as the main provider of healthcare towards a more collaborative approach, with individuals and employers taking more responsibility for employee health.

Recognition is growing that the state's resources are finite and inadequate to meet potentially infinite demand. To address this conundrum there is growing acceptance for a greater need for a preventive approach, using tools such as occupational health, to safeguard employee health and wellbeing more effectively.

Businesses can help employees with mental health issues by ensuring that they train and support their line managers to identify and deal with employees in these circumstances

Occupational health services and health insurance do not only support individual employees when they are off work sick. They can also be used to identify health risk factors and enable employers to devise and introduce strategies to minimise the impact of sickness absence.

Occupational health programmes can also help employers to tackle the stigma associated with ill health at work (especially mental ill health) by raising awareness and understanding of the issues, as well as highlighting and encouraging employees to use the support available to them, whether for physical or psychological problems.

Occupational health is good for employees, and good for business. It enables ill or injured employees to get the treatment they need for an early recovery and successful return to work.

AXA PPP healthcare is not alone in placing importance on workplace health. Dame Carol Black, in her 2008 review of the health of the working age population, Working for a healthier tomorrow, made the case for the positive impact of work on employee health and wellbeing, and that healthy and well-motivated employees will positively affect workforce productivity.

Fit for Work service

The government's newly introduced Fit for Work assessment and advisory service, which is intended chiefly for smaller-sized firms without access to occupational health support, allows employers to refer absent employees to an occupational health specialist to assess their situation, identify possible obstacles to their returning to work and devise a care plan to facilitate their recovery and return to work. 

Larger-sized businesses, on the other hand, with their own occupational health support will tend to receive bespoke advice, tailored to their workplace, operations and culture that enables them to make well informed, nuanced decisions to manage the recovery of ill or injured employees.

Fit for Work is unlikely to offer this level of in-depth knowledge and businesses are likely to find it more effective to follow the recommendations of their own occupational health team.

Indeed, the Department for Work and Pensions has noted that Fit for Work "will complement, and not replace, existing occupational health services provided by employers".

To manage employee health and wellness effectively, businesses also need to think more flexibly about how they support their employees to stay healthy. Employees' healthcare needs are diverse and vary with age, gender and individuals' personal circumstances.

We know, for example, from the Office for national Statistics' Labour Force Survey that working days lost to stress, anxiety and depression have been increasing over the past decade. And our own recent survey of UK workers showed that one in four have personally experienced mental ill health at some time.

To help to address this, businesses that create a positive, supportive culture where it is acceptable to speak openly about mental health will create an environment where mental health issues can be addressed successfully. 

Older workers

Similarly, older workers, typically seen as having greater healthcare needs, want employers to be flexible and allow them to continue to contribute their expertise once they have reached the state pension age.

When AXA PPP healthcare surveyed senior managers in small to mid-sized enterprises (SMEs) last September, one-quarter said they planned to continue working full time after reaching retirement, while 60 per cent indicated that they planned to continue working part time or as a consultant.

Only one-quarter said they would stop working altogether. This 'can do' attitude is a key feature of the changing healthcare landscape and, if employees wish to continue working into their later sixties and seventies, businesses would be wise to encourage and support them to take care of themselves.

The cost of ill health

For SMEs, the consequences of ill health can be catastrophic. A business without an absence management strategy faces potential costs for finding cover for a skilled employee and losses from reduced productivity during absence or sickness.

In SME research conducted by AXA PPP healthcare in 2014, 20 per cent of senior managers said they'd lost revenue from back pain related absence, while 28 per cent said sickness absence had contributed to missed deadlines.

According to the Centre for Mental Health, the UK loses more than 140 million working days each year because of mental ill health-related sickness absence at a cost of £8.4bn each year.

Presenteeism, where individuals continue to go into work even though they are unable to function at full capacity, is estimated to cost about £15.1bn each year. 

Indeed, 39 per cent of the SMEs we surveyed said they had experienced reduced productivity due to illness. Presenteeism persists in part because of the stigma attached to acknowledging illness: especially mental ill health.

Employees with common mental health problems will often continue coming into work when they are unwell because they fear discrimination or even losing their job if they disclose the nature of their illness to their employer.

In the end, many long-term sick employees do not return to work. The Centre for Mental Health further estimates the annual cost to UK businesses of recruiting and training new staff to replace those that do not return at about £2.4bn.

Businesses with good occupational health programmes and plans for managing long term absence will be better able to avoid this cost as they can provide the right kinds of support to employees to enable them to return to work after a period of illness.

Individual responsibility

The preventive approach to health and wellness depends to a considerable degree on individuals taking more personal responsibility for looking after themselves. From a business perspective, a healthy worker reduces the cost a business has to bear through lost productivity.

However, the UK is facing a considerable burden due to lifestyle-related conditions such as obesity, diabetes and heart disease among the workforce. This problem is further compounded by comorbidity of many of these conditions which, in turn, makes them more complicated and costly to manage.

Cancer Research UK has recently highlighted the need for greater individual responsibility by showing that the proportion of people in the country likely to be diagnosed with cancer has been steadily increasing over the past 40 years so that now half of us can expect to receive a cancer diagnosis at some point in our lives.

The charity also observed that a large number of these cancers are potentially avoidable through positive behaviour change such as stopping smoking.

Addressing mental ill health

Individuals generally have a fairly good sense of their own physical wellbeing: for example, if they are coming down with a cold. But they can struggle to acknowledge, even to themselves, when their mental health is compromised. 

Businesses can help employees with mental health issues by ensuring that they train and support their line managers to identify and deal with employees in these circumstances. Research shows that many employees in UK businesses are risking burnout.

We would like to see SMEs especially recognising these risks and taking positive steps to avoid them. For example, research we conducted among SMEs last year showed that 40 per cent of employees were regularly working extra hours to try to cope with excessive workloads and two-thirds saying they had gone into work when unwell in the past three months. 

These findings are concerning and businesses should be prepared to address them. Businesses that have access to occupational health professionals will be able to benefit from expert advice – for example, on positive behaviour change to improve employees' health.

And, to promote workplace wellbeing effectively, it is important for employers to ensure they communicate and encourage employees to make the most their available programmes. 

In a changing healthcare landscape, businesses that take advantage of occupational health expertise will be better able to manage workforce wellbeing by tailoring provision to meet their employees' healthcare needs, ensuring that they stay fit and healthy, both for today and for tomorrow. 

Nick Jeal is head of corporate marketing at AXA PPP healthcare 

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