A question of responsibility

When it comes to deciding who takes responsibility for the health of employees, where does the buck stop? With the employer, the occupational health (OH) department, the HR manager, or even the NHS? Ultimately, it will be a combination of all of these. Here, we take a look at the people who help keep their workforce fit for work.

The role of HR

Employee health forms part of the responsibilities of the HR department at the West Yorkshire-based sites of insurance company Provident Insurance.

“We are supportive of employees with health issues and actively promote phased rehabilitation into the workplace after long-term illness, such as by reducing or changing hours or adapting duties,” says Sue Calvert, senior manager, HR.

Calvert has now adopted an even more proactive stance on health in the workplace by working directly with the local primary care trust (PCT).
She is taking advantage of a pilot project, known as Wellbeing@Work run by Calderdale PCT, which aims to promote best practice in healthy living. The scheme is one of nine national pilots in the British Heart Foundation’s Well@Work campaign, launched this month.

Calvert responded to an invitation from the PCT for one local employer to accommodate the PCT’s own workplace health specialist, Jan Spence, full-time for two years.

“She will have a desk within the HR department and will liaise on a regular basis with the HR manager, other business managers and members of the employee representative team,” says Calvert.

Spence’s role will include training other Wellbeing@Work champions about issues such as stress, weight management and healthy choices. These champions, drawn from Provident’s 444-strong workforce, will in turn report to HR.

“The project will assist in supporting a healthier workplace culture and will contribute to and support other initiatives to aid retention, reduce absenteeism, aid recruitment and improve morale,” Calvert says.

The role of occupational health

“You cannot impose good health on workers,” says Gail Cotton, head of OH Services at Leicestershire Fire and Rescue Services. “People have to make their choices but they have to be informed choices.”

Support for wellbeing has to come from the top, she says. “What message does it put across if [employees] see that bosses are fat, bloated, smoke and are drinking at lunchtime?”

Cotton, who is also past president of the Association of Occupational Health Nurse Practitioners, makes the link between health and productivity. She sees OH specialists as part of the senior management team and part of “any robust attendance policy”. OH professionals’ combined clinical expertise and knowledge of the company culture give them a rounded insight into issues such as sickness absence and the feasibility of restricted or modified duties, she says.

“For example, OH [specialists] can overcome the obstacles to recovery or tease out what the obstacles are,” she says. “They can challenge a sicknote and can advise on physiotherapy [services] rather than have someone sitting at home off sick waiting for a physio.”

Cotton is keen to overcome some of the myths surrounding sickness. “Common health problems are often cured by work or cured by treatment. Inactivity compounds poor health,” she says. “Bringing someone back into modified work can be better for them than immobility at home.”

The role of health and safety advisers

The term health and safety is increasingly focused on good health and productivity, particularly as companies move towards knowledge-based and sedentary occupations from heavy manual work.

This trend is reflected at utility company Severn Trent Water, where health and safety adviser Jane Carter is a ‘policy setter’ reporting to the HR director through the health and safety function.

“We speak with HR in formal monthly meetings and ad hoc discussions. We don’t separate health, safety and wellbeing in any of these meetings,” she says. “I measure the health of the business and put targeted interventions in place.”

Carter’s work has taken in stress, cancer awareness and the behaviour of staff outside work. “We’re trying to encourage people to behave responsibly at home,” she says, referring to awareness-raising campaigns for the 5,000 employees about alcohol consumption at home, the hidden fats in Christmas foods and how to keep their backs healthy.

But this is not nannying. Carter can find a correlation between good health and productivity thanks to an online health assessment programme from wellbeing consultancy Vielife.

“The programme gives a health and wellbeing score for departments, while the individual gets personalised, confidential data,” she says. “It also points out areas for improvement.”

Carter hopes that reduced absence rates encouraged by the online programme and other initiatives mean that Severn Trent Water is on target to save about £3m this year due to improved productivity.

The role of external providers

Employee assistance programmes are now very much a part of a support mechanism, working closely with OH departments. Amanda Dowson, OH nurse and director of Peritus Health, says: “You can’t isolate anyone’s responsibility from the manager to the OH department or HR.”
Dowson also points out that the biggest drivers are psychosocial – meaning an attitude to illness or rehabilitation. She predicts an increase in insurers’ use of cognitive behaviour therapy and behaviour change management to manage responses to illness.

Managing director of Axa PPP Healthcare’s OH services, Dr Mark Simpson, says: “Employers need to manage both physical and psychological factors effectively to get the most from their people.”

Referring to Whitehall studies of civil servants (first begun in the 1960s), which show the impact of social gradients on health and absence and that low job control and reward have a correlation with coronary heart disease, back pain and mental ill health, Simpson says that a sense of belonging is as important in determining workers’ morale as the physical conditions in which people work.

“To manage absence effectively, employers need to acknowledge the individual. The key question is: ‘What sort of patient has the disease, rather than what sort of disease does the patient have’,” he says.

Who manages health in A small business?

The question of who takes responsibility for the health of employees is simpler for small employers, says Mary Boughton, spokeswoman for health and safety at the Federation of Small Businesses. She points out that they are more likely to know exactly about the wellbeing of their employees and be in a position to implement changes quickly.

“The difference is the shorter reporting line, so bosses are more likely to be talking to their staff all the time,” she says.

Boughton’s family company, Dorwest Herbs, employs 15 people and produces herbal medicines for veterinary applications. It also packs goods for pharmaceutical companies.

“The way that you deal with the health of employees needs to be appropriate to the business,” says Boughton. “In a large company, because of the number of people involved, you would need to record this, but in a small company conversations are just as effective,” she says, referring to moves by the Department for Work and Pensions to formalise such dialogue.

Meanwhile, other small businesses are being encouraged to take a stance on employee health. For example, Business Link for Norfolk and Sport England East are heading a two-year pilot scheme called Working Well, launched at the end of September. The scheme will be taken into a dozen small firms across the region and aims to encourage exercise and healthy eating. Business Link for Norfolk will also practise what it preaches and has appointed its own Working Well champion.

How to get the health message across

Judy Cook is head of occupational health at British Airways and president of the Association of Occupational Health Nurse Practitioners. She says:

– Rarely ‘tell’ but frequently advise on health matters

– Use the specific expertise, skills and knowledge of the OH department to encourage people to take responsibility for health and safety from an individual to corporate level

– Try to make policies come alive – an organisation can rarely be considered ‘fit’ if there has been little dialogue or partnership approach at all levels

– Health awareness is high in the UK, so look for the reason why messages may be ignored


Calls for OH remit to extend outside the workplace

Certification should focus more on fitness to work

Message received and understood


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