BITC model to improve employee wellness and engagement

A business model from corporate responsibility organisation BITC can improve employee wellness and engagement, says Louise Aston.

Sickness absence costs UK employers £8.4 billion each year; but the cost of presenteeism – employees working when they’re ill, or not fully engaged – is nearly twice as high at more than £15 billion per year (Sainsbury Centre, 2007).

Taking a proactive approach to wellness and engagement is not only an essential part of responsible business practice, it can have a major impact on the bottom line. And that means new opportunities for occupational health providers.

In the current economic climate, employers of all sizes and across all sectors are looking to maximise productivity and efficiency and ensure the long-term sustainability of their business. Evidence suggests that the best way to achieve this is to create a working environment where people can flourish: the key to a healthy business, it seems, is the wellness and engagement of its people.

Encouraging performance

Wellness – by which we mean physical, psychological and social health – directly affects the extent to which people are engaged in their work. Together, wellness and engagement support good performance over a sustained period. Without both, motivation and performance decline (Towers Watson, 2010). But while most business leaders know instinctively that a happy, healthy workforce is a productive workforce, many still treat employee wellness and engagement as an “optional extra” rather than as an integral part of the way they do business.

“Making wellness central to business strategy opens an important new avenue to increasing organisational effectiveness,” according to a report by talent and career management experts Right Management Consultancy for the World Economic Forum (Right Management, 2010). “As the post-recession world economy slowly takes shape, those organisations that choose to follow this path are more likely to boost workforce productivity, drive business performance and realise core strategic goals,” the report adds.

The role of Business in the Community (BITC) is to mobilise business for good – to inspire, engage, support and challenge businesses to perform better by working in a responsible and sustainable way – that means helping them put employee wellness and engagement at the heart of what they do.

In a report delivered to the World Economic Forum in January 2010, based on a survey of more than 28,000 employees in 15 countries, Right Management consultancy found that businesses that took a strategic approach to wellness and engagement were more innovative, more able to retain their staff, and more productive overall.

An Ipsos MORI survey shows that FTSE 100 companies with robust arrangements for reporting on employee health and wellbeing outperform the rest of the FTSE 100 by 10% (BITC/Ipsos MORI, 2010).

BITC believes that wellness and engagement should be treated like any other vital element of business effectiveness; that is, as a strategic boardroom issue.

Case study: Northern Foods’ Fit4Life campaign

The Fit4Life campaign was launched in early 2008. Part of Northern Foods’ ongoing staff engagement strategy, the campaign aimed to increase productivity, reduce absence and enhance retention rates among a predominantly manual workforce. The company also hoped that the scheme would provide a non-financial means of rewarding and motivating employees.

Specialist occupational health advisers were recruited at each site. All employees now get a personal assessment, with individually tailored health advice, plus access to on-site physio, massage and chiropody services. The first 100 employees to complete a lifestyle questionnaire received a pedometer, and NHS Choices trained a number of staff members as workplace health advisers. Staff are encouraged to walk or cycle to work.

The health checks act as an “early warning” system, giving employees the information and support they need to take responsibility for their own health and wellbeing. Since the campaign began, absence has fallen across all sites, resulting in significant savings.


The Workwell model

BITC works closely with its Business Action on Health leadership team, chaired by Alex Gourlay, chief executive Alliance Boots’ Health and Beauty Division, to develop an evidence-based model to support the employee wellness and engagement agenda: the BITC Workwell model.

The leadership team provides the direction and intellectual capital for the campaign, which aims to help UK plc realise the benefits of investing in a healthy workplace and encourage businesses to make wellness and engagement part of their reporting cycle.

“Employers should be encouraged to foster work environments that are conducive to good mental wellbeing and the enhancement of mental capital…analysis suggest [this could be] very cost-effective due to reductions in the costs of presenteeism, labour turnover, recruitment and absenteeism,” according to the Government’s Foresight report on mental capital and wellbeing (Foresight, 2008).

The Workwell model has evolved over three years, with input from BITC’s leadership team and expert steering groups. It draws on robust evidence linking wellness and engagement to business performance including the Foresight report, Mental Capital: Making the most of ourselves in the 21st century, and Coats and Lekhi’s Good Work (Coats and Lekhi, 2008).

Developed by business for business, the model provides a framework for articulating the business benefits of a strategic, integrated and holistic approach to wellness and engagement, plus practical toolkits to help businesses put the approach into action.

BITC aimed to create a biopsychosocial model that reflected the realities of the workplace and acknowledged the complexity and inter-relatedness of the factors that influence wellness and engagement. BITC recommends four approaches that employers should take to enable employees to flourish:

  • Better physical and psychological health calls on employers to create an environment where employees are encouraged to make healthy lifestyle choices.
  • Better work reflects the importance of a happy, engaging work environment that promotes “good work” – defined by Coats and Lekhi as work that is secure, varied and that puts employees in control.
  • Better specialist support acknowledges the role of early intervention and proactive management in supporting wellness and recovery.
  • Better relationships are about good communication, and developing social capital both at work and at home.

What the model demonstrates is that conventional health promotion activities – such as the Fruity Fridays and discounted gym memberships – are, by themselves, not enough. Alistair Dornan, head of wellness and productivity at Right Management explains: “You could be a triathlete, but if you’re not engaged, you won’t be performing as well as you could. Health interventions can be costly, and you may not see the benefits for years. By taking a holistic approach, you’ll start seeing measurable benefits in the short term as well as in years to come.”

The model takes a dual approach to wellness, encouraging employees to take responsibility for their own lifestyle choices. The five ways to wellbeing – keep learning, connect with others, give/volunteer, take notice and be active – were developed by the New Economic Foundation using evidence from the Foresight report and are designed to improve physical, psychological and social health inside and outside work.

“The model highlights the need for collaboration,” agrees Professor Cary Cooper, lead scientist on the Foresight report and a member of our leadership team. “It’s the employer’s job to create an environment where employees can make healthy lifestyle choices, but employees must take responsibility for their own health and wellbeing.”

This leads to opportunities for health providers.

National director for health and work Dame Carol Black says: “There is a new and exciting opportunity for the occupational health specialty in Britain today to seize the initiative and lead a development that unites all those engaged in improving, safeguarding or restoring the health of all working age people.

“It is a once-in-a-generation opportunity to build on the successes of the past to make a real difference in the future.”

The evidence linking wellness and engagement to productivity is robust. Business Action on Health is helping elevate the agenda to boardroom level; and the Workwell model provides a framework for action that has already been adopted by employers across a wide range of sectors.

But if organisations are to realise the full benefits of investing in employee wellness and engagement, occupational health providers, HR, health and safety and line managers must work closely together, pooling their knowledge and streamlining services.

BITC works closely with a number of leading occupational health providers, who agree that the wellness and engagement agenda is creating opportunities for them and their clients. Charlie Easmon of Number One Health believes that relatively small changes to working practices could have a big impact on performance and perception.

He says: “Providers should be meeting staff, getting to know the organisation, so they can develop proactive solutions rather than waiting for problems to arise.”

For Right Management’s Dornan, a member of the BITC leadership team, partnership working is key to releasing the potential of occupational health: “We can’t go on working in silos. If they position themselves right, this is an opportunity for occupational health professionals to be at the forefront of a revolution in the way services are delivered.”

The Workwell model highlights the benefits of this type of collaborative working. For example, BT has already put it into practice. A recent revamp of the company’s line manager competences and training demonstrates the point.

“We worked with a clinical psychologist to integrate the HSE’s management competencies for preventing and reducing stress at work into our general manager competencies,” says Paul Litchfield chief medical officer at BT, whose position in the company straddles occupational health and HR functions. “When you look at the framework now, you can’t see the joins. We’ve already done it with safety; now we’re taking the same approach to health and wellbeing. We see it as being equally critical to the business.”

The way ahead

“If absence [in the NHS] were to be reduced by one-third across the board, it would bring … a gain of 3.4 million working days a year … with an estimated annual direct cost saving of £555 million,” says Dr Steve Boorman, chief medical adviser to Royal Mail, in his NHS Health and Wellbeing Review Interim Report (DH, 2009).

Most companies still have some way to go in recognising the potential of wellness and engagement to improve their business. Right Management’s recent survey found that fewer than half of businesses are promoting wellness in the workplace, and that even fewer see it as a strategic tool for improving company performance.

At the same time, evidence for a link between individual and corporate wellness is building. In his recent review of employee health and wellbeing in the NHS, Boorman found “compelling and convincing evidence that investing in improving workplace health and wellbeing…can bring real and substantial benefits to the NHS and to patients”, and that the most effective organisations were those that had integrated wellness and engagement into all aspects of their everyday business from board level down.

Boorman’s review focused exclusively on the NHS. But the lessons learned apply to any organisation that wants to boost productivity and keep its people happy at the same time as controlling costs.

Good health is good business; occupational health providers who can enhance employee wellness and engagement are therefore “mission critical” to delivering the kind of sustainable success that we at BITC want all businesses to be able to achieve. Together, we can help shape businesses for the 21st century: businesses that are good for the economy, good for people and good for the wider community.

Louise Aston is national campaign director of Business Action on Health at Business in the Community.

Workwell in action: BT’s chief medical officer Dr Paul Litchfield on how the company is working fitter

“We put a lot of time and effort into wellness and engagement, which has meant improving communication across the company. Our old annual staff survey has morphed into a shorter quarterly survey, reducing the admin burden and helping us monitor staff attitudes and engagement levels closely so we can tackle any issues early on.

“Our health services also focus on early intervention and prevention. We’ve tried to move away from the old ‘command and control’ mindset to get people first to take responsibility for their own actions and then to a point where they’re looking out for each other. Our ethos is ‘Never let a colleague fail’, and that applies to business, to safety and to health and wellbeing.

“When I joined BT, the emphasis was still on traditional health screening programmes. They can make people feel better, but they won’t change behaviour in the long term. So we worked with the unions and third-sector partners to develop an online programme, Work Fit, with simple tools people can use to take control of their own health. Work Fit is driving home the message that improving health and wellbeing is very much a collaborative process.”

BT has incorporated the Workwell model into its new European guidance, which offers practical support to help business units enhance employee wellbeing.



Mental Health at Work: Developing the business case (Sainsbury Centre, 2007).

Towers Watson, Employee Wellbeing: Taking Engagement and Performance to the Next Level (2010).

Right Management, The Wellness Imperative: Creating More Effective Organisations, report to the World Economic Forum (2010).

BITC/Ipsos MORI, FTSE 100 Research: Public Reporting Trends (2010).

Foresight, Mental Capital and Wellbeing: Making the Most of Ourselves in the 21st Century (2008).

Coats and Lekhi, “Good Work”: Job Quality in a Changing Economy (2008).

New Economics Foundation Centre for Wellbeing, Five Ways to Wellbeing (2008).

Dame Carol Black, Working for a Healthier Tomorrow (TSO, 2008).

Dr Steve Boorman, NHS Health and Wellbeing Review Interim Report (DH, 2009).

Dr Steve Boorman, NHS Health and Wellbeing Final Report (DH, 2009).

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