Should employers support employee health beyond simply managing absence? Welfare reform and the sickness absence review have placed employers right in the centre of managing absence. What impact can health benefits have on this, asks Emma Page?
According to the Chartered Institute of Personnel and Development (CIPD) Absence Management report 2011, the average number of days taken sick by staff in the UK was 7.7, costing an average of £6,783 per employee per year and UK employers a total of £12.2 billion. Loss of productivity is seen as the single most important cost of employee absence, more than the cost of the sick pay itself and the cost of hiring cover. As a result, a survey by the CBI last year showed that three-quarters (74%) of employers now consider improving employee wellbeing to be a priority for the next year.
Implementing and maintaining health benefits is less costly to businesses than trying to pay cash. In fact, the perception of the value of health benefits among staff commonly exceeds their actual cash value. Employers that are committed to improving staff health send a positive message about their work culture, enhancing their reputation and helping to attract good candidates, as well as helping to retain valued employees.
Chris Rofe, a senior consultant, health and productivity at Buck Consultants, says: "There's an absolute correlation between wellness and happiness of an employee and productivity and engagement."
Health and wellbeing benefits
Iain Laws, corporate sales director at Jelf, agrees: "Health and wellbeing benefits demonstrate to an individual that his or her employer is concerned about them. But messages around health and wellbeing need to be framed in a way that is welcoming and friendly; not hectoring or in any way attempting to police private choices.
Case study: City College Norwich
Facing significant funding cuts and unable to offer pay increases, City College Norwich experienced a high incidence of staff absence. But since introducing a wellbeing and resilience programme, days lost per employee have reduced by 2.81 since 2008, with long-term sickness halved, saving the College nearly £500,000 per year.
Hilary Bright, head of HR services, Norfolk Educational Services, which provides HR services to City College, says: "Our first initiative was to introduce flu vaccinations free of charge to staff.
"This was followed up a couple of months later with corporate membership of a cash plan, which enables staff to claim back dental, optical and physiotherapy costs and includes an EAP.
"We provide fully funded on-site health checks and more recently an on-site occupational health service including regular drop-in clinics."
The college has an on-site gym and holds yoga, Pilates and badminton clubs. Staff also enjoy discounts at health clubs and gyms in and around Norwich. "Over the years, this offer has increased as staff themselves request that particular activities are provided or offer to provide them to their colleagues themselves," explains Bright.
Initially, communication of the new benefits was through briefing sessions and wellbeing fairs. Now the intranet is more widely used, which has a designated wellbeing area, as well as emails to staff about specific events or initiatives.
Bright says that the cashback plan is the most popular staff benefit offered by the college. "It's viewed very positively by staff, who see this as part of the package on offer to them as an employee, and leavers express disappointment at no longer being able to access corporate membership."
Onsite health checks are also popular, and 20% of staff take up the flu vaccination - this figure increases each year.
She says the most valued benefits have been the most expensive, but when measured against the savings made and reduction in absence, the investment has been well worth it. "In a climate where we cannot give staff annual pay increases, it is important to find other ways of making them feel valued, and £50 per year per member of staff to improve wellbeing and morale, as well as reducing sickness absence is good value for us."
The health and wellbeing initiatives continue. Last year, the college invited staff, students and local celebrities to cycle from Land's End to John O'Groats on static bikes for Children in Need. The take-up was so high that the challenge was completed a lot sooner in the day than anticipated.
"Unless the wellbeing initiatives being introduced are put in a particular context or part of a bigger programme, they may well not be taken up in the same way," says Bright.
He advises companies to work closely with all stakeholders to make sure all collateral has the same pitch, with a neutral voice.
"It's a pull not a push sell. To be effective, it has to reflect the culture and setting of your workplace. For example a web portal may not be effective in a blue-collar environment."
Rofe believes that many well-intentioned organisations build a raft of wellness initiatives, with no appreciation of whether their employees will find them valuable or if they are of value to them as an employer.
"Before charging off on sickness absence management, learn why people are off, who the malingerers are and who needs to be disciplined," he says.
"Health benefits are only effective when they're deployed on the right populations to value them. Undertake surveys, hold work groups and consult staff, and also think about what benefits you as an employer.
"There's nothing wrong with using health benefits as a sickness management tool, or to reduce health insurance premiums, but make sure you deploy a suite of benefits that meet that objective."
Evolved health plans
Health plans have evolved from basic optical and dental benefits, or to cover a hospital stay, into sophisticated packages that reach into areas like nutrition, employee assistance programmes (EAPs) and smoking cessation.
Iain Laws says that a robust health and welfare programme is as much about supporting employee health than simply managing absence.
"Organisations that are well-managed and have a positive culture tend to have well-thought-out health and welfare programmes, which encompass both the prevention and cure of ill-health at work," he explains.
"Encouragement to take more exercise, a powerful intervention in the treatment of stress, should be backed up by subsidised gym membership."
Employers must get a detailed picture of their employees' health issues to ensure they choose a plan that provides the best return on investment. Health screening and online health risk assessments are an ideal starting point for understanding an employee's health profile and their needs.
Laws advises employers to think about the geography and demographic of their population: "Dental plans, for instance, tend to be valued more in the South-East, where access to NHS dentistry is limited.
Case study: Ipswich Building Society
Paul Winter, above, is chief executive of Ipswich Building Society, winner of the Business in the Community (BITC) Staying Healthy at Work Award 2012 says:
"Our health and wellness activities include group yoga classes and walking groups, and supporting national events such as Walk to Work Week as well as local events like the Midnight Walk in Ipswich. We also arrange free NHS health checks on-site, and run workshops on cancer awareness.
"We have a room dedicated to healthy activities with a Wii Fit for all staff to use and leaflets on health, nutrition and stopping smoking. One of the most simple but successful things we have done is providing a relaxing environment in our staff room where the team can play games and puzzles.
"We also have a garden area for staff to enjoy. Encouraging staff to get away from their desks for a break is a good way to reduce stress and to inject some fun into the working day.
"Some 80% of staff participated in a Fit for Work initiative in 2011, entitling them to take off time in lieu of exercise points collected. The amount of time isn't significant enough to create manning problems, but it does give employees a little flexibility over a slightly longer lunch break, or being able to leave work a bit earlier.
"We also had more than one-third of staff take part in NHS Checks to monitor cholesterol levels, blood pressure and receive advice on how to live a healthier life.
"Staff turnover has fallen to just 12% and sickness levels are at their lowest at just 1.54%. This reduction adds real value to the bottom line. In 2009, 553 days were lost due to staff sickness. This was reduced to 313 days in 2011, representing a saving of nearly £17,000 (based upon an average daily rate of £75 per day).
"Presenteeism is an important issue; staff shouldn't feel the need to drag themselves into work if they are feeling unwell, or work late to try and show their commitment to the organisation. Our staff should only be in work if they are well enough and workloads are managed so that they are not working late into the night.
"We have been developing our health and wellbeing activities over three years and we generate new ideas the time. I would like to provide more information to staff about how to cope with stress and depression as these are common problems that can affect anyone.
"As an employer, we will provide whatever help we can to our staff, whether it be for a physical or mental illness."
Make sure the content appeals to everyone. Offer people choices, and the potential to make different offers to different sectors. Make sure the offering is structured and offers schemes at different price points."
The best approach is a holistic one, he adds. "You can pat yourself on the back for putting lettuce on the menu but the best approach toward wellness is one that is holistic, with fresh and engaging communication, on-site events, backed up with line-manager training and a concerted effort at encouraging staff to undertake health assessments."
Make stress a priority
As the second largest cause of absence, employers should make it their priority to look at stress.
Rofe says: "Don't expect a suite of health and wellness initiatives to deliver on performance measures if fundamental issues with management and job design are ignored. Maybe middle management need training in recognising the early indicators of stress?"
"How easy is it for employees who think they have a stress-related problem to put their hands up in your organisation?" asks Laws.
"A detailed stress risk assessment will present carefully crafted questions that will indicate any adverse reaction to pressures at home or in the workplace. It's also important to emphasise and guarantee that access to any EAP programme is confidential."
Katharine Moxham, spokesperson for group risk industry body GriP, urges those looking into group income protection (GIP) schemes to consider how comprehensive the content is on any EAP that is offered.
"GIP providers use accredited Employee Assistance Professionals Association members and provide crucial elements such as face-to-face counselling, full reporting and online cognitive behavioural therapy (CBT)," she explains. "That said, it's important to look at what you're getting. One provider may exclude face-to-face counselling but include fast-track CBT. Don't approach EAP with a tick box of requirements."
Finding a solution that is holistic yet has the flexibility for you to add or subtract elements depending on your needs should be your goal. "Health benefits, especially those offered on a flexible platform, are complicated," says Laws. "The content must address the specific issues of the population involved based on available or recordable health data and will need to be able to adapt to a changing landscape. Successful plans not only address the immediate needs but also invest in the long-term management of employee health." Laws advises organisations to start out small and measure return on investment.
"Any enlightened employer will approach health and wellbeing as whole, but you have to be clear about what you are trying to achieve, whether it's a business tool for managing absence or a scheme that will attract high-calibre applicants," adds Moxham.
He concludes: "Look beyond the traditional components and incorporate healthy eating initiatives and stress management programmes. Some initiatives don't cost a fortune; team sports and exercise challenges for example, raising money for charity. Communicate in a way that engages with staff. Think outside the box; create incentives to make staff leave their desks. If you reward people, you'll see a greater response."