Dr Bridget Juniper and Mike Tyler explain how occupational health teams can help to add value to wellbeing initiatives.
Concluding our series on employee wellbeing, this article looks at the shape and role of an occupational health service.
To date, this column has considered staff wellbeing in organisational terms so it makes sense to narrow down the focus to the one function in a company that has an obvious link to workforce wellness.
Other than some multinationals that employ tens of thousands of people, most companies will opt for an outsourced OH arrangement. Unlike insurance cover, companies often fail to review their OH provision regularly enough and risk missing out on new innovations, service improvements and potentially significant cost savings. The choice of possible providers can be daunting and selecting a provider that can deliver to exact specifications, which reflect cultural and commercial needs, is vital.
Although every case is different, employers should bear the following five steps in mind.
1. What kind of OH service do you want?
The broad term “OH”, like “wellbeing” and “case management”, can mean many things to many people, so first you need to know what you want and what your objectives are. There are many layers to these questions and the answers should all flow from your overall health and wellbeing strategy (assuming that you have one). Do you require heavy-duty health surveillance in a high-risk industry or lighter-touch monitoring in a white-collar environment? Are you only considering case management of long-term absences or something more preventative such as training and education programmes or sickness absence management referrals? Do you prefer on- or off-site provision? Do you want to use occupational health nurses or physicians? How do you want the service to be supported – paper, telephone or online? Could, and should, your needs be serviced by more than one provider? What size of service are you looking for? What experience in your sector has the potential provider got? Speak to past and present users of the service and find out about their experiences first-hand. How do they find them? If they are no longer using them, why not? Finally, are the service delivery standards consistent across all of the clients?
2. Costs – the devil is in the detail
Depending on the shape of OH provision coming out of the exercise above, fees will vary widely. Price differences of up to 40% can be seen, but be aware of the small print and the number of ways providers will construct their pricing, from an all-inclusive package to multiple discrete pricing elements. Find out what is included in pre-employment health screening, for example. Get breakdowns on as many categories as possible and make sure you’re happy with the way the provider proposes to invoice you and the supporting documentation they intend to submit. It is essential to run the alternative proposed pricing frameworks through a series of scenarios of expected usage to look at the range of total costs. All this should be bound up in the service level agreement, which will summarise all elements of the agreement and be the baseline against which evaluations can be made.
3. Measurement and metrics
Appropriate measures need to be confirmed and put in place so that OH professionals are able to obtain metrics on the programme provision that are transparent and understandable.
Although not always readily available, a wealth of data can be found if you know what you are looking for within the existing arrangements. Importantly, these will establish clearer links between the business and the service. Categories such as open versus closed cases, duration of case management and complexity mix can be insightful and help to reshape the strategy and delivery of the service.
4. Try to link to other healthcare providers
It is true to say that all OH providers profess to offer a service that links “seamlessly” with other health programmes offered, for example private medical insurance, employee assistance programmes and group income protection.
In our experience, this rarely happens. All the research denotes that early intervention OH services play a vital role in returning people to work appropriately so that they do not fall between the cracks that may ultimately progress to worklessness. To encourage early intervention there need to be mechanisms in place to enable cases to be passed from one healthcare touch point to another, in a way that is effective, efficient and traceable while adhering to medical confidentiality and data protection. Collaboration of providers usually benefits from an independent overview that can challenge and guide discussions, help shape process flows and protocols, as well as facilitate true collaboration.
5. Regular reviews
Client organisations must conduct regular reviews of their OH provision. No one would disagree with this but it is surprising how few actually follow through on a meaningful evaluation. The authors suggest six-month reviews as a minimum. Their recommendation is quarterly reviews, supplemented by key performance data dashboards where possible.
Putting the tender out to market every two years is also regarded as a good discipline. By regularly looking at the data and discussing it with your OH team, you will be better placed to spot trends, capture any cost savings and refine the service that is offered.
Where possible, benchmarking data against other similar players in your industry can be helpful. It is also worth considering spot checks and staff feedback.
There are real benefits to be gained from a well-designed OH programme. By following these five steps, organisations can capitalise on the potential value offered that will support not just the workforce but the business itself.
Dr Bridget Juniper is head of Work and Well-Being Ltd, which specialises in the measurement of employee wellbeing. Mike Tyler is managing director of Buck Consultants (Health and Productivity), which helps clients to design comprehensive wellness programmes.
