Local authorities: Cultivating health

Local authorities have a lot to gain from persuading staff to lead healthier lives. They have soaring absence rates, an ageing workforce and an image problem among younger people, so a wellbeing programme will improve employee morale and job satisfaction.

And with absence rates reported at 11 days per employee per year in the Chartered Institute of Personnel and Development (CIPD)’s latest Absence Management survey, and pressure mounting to increase productivity in the face of staff cuts and budget constraints, there is growing interest in promoting wellbeing within this sector.

What’s more, this issue has become a higher priority for councils since the government published its strategy document Health, Work and Wellbeing – Caring for our future. The report was produced by the Department for Work and Pensions, the Department of Health and the Health and Safety Executive. It sets out a detailed strategy for everyone of working age, seeking to increase employment levels, boost attendance and performance, encourage staff and employers to promote their own health, reduce health inequalities and social exclusion, and to allow people with health problems or disabilities to optimise their work opportunities. These are all areas in which local authorities have a dual role – as employers and as service providers to people at every point on the health spectrum.

However, both private and public sector employers still have a long way to go before government targets are met, a recent survey from Business in the Community, in collaboration with disability insurer Unum Provident, has found.

It found that millions of British workers are denied access to the basic components of a healthy workplace: healthy food, exercise facilities, regular health checks and even access to independent colleagues or OH staff who can discuss stress and work-related issues with them.

And while healthy food was identified as one of the most important components of a healthy lifestyle by a majority of employees, the research showed that 42% (or nearly 12 million workers) don’t have access to healthy food during the working day – unless they bring it in themselves. Meanwhile, 67% had no exercise facilities, and 70% were never offered medical check ups.

So the growing interest in wellbeing is a welcome development, says Ben Willmott, employee relations adviser at the CIPD. “Anything which local government employers can do to promote wellbeing has to be a positive move,” he says.

“The public sector is starting to look at employee wellbeing, and the attitude of senior management is likely to be more supportive than in the private sector. They are focused on wellbeing, but they do have a long way to go.”

The CIPD’s survey shows that public sector organisations are more likely to have employee wellbeing schemes in place than private sector employers – 42% compared to 22% in the private services sector, and 25% in manufacturing and production organisations. Within that group, 87% have counselling services for staff, 57% give advice on stopping smoking, 44% offer stress assessment, 42% subsidise gym membership, 40% give advice on healthy eating and 27% have an in-house gym.

One council in the vanguard of promoting and supporting wellbeing among staff is Kent County Council, which launched its Wellbeing Initiative in 2002, with the backing of chief executive Peter Gilroy. The scheme now includes funded initiatives providing personal health checks, private health schemes, gym membership, policies on smoking and obesity, a suggestion box for staff and a range of measures to reduce the frequency and duration of sick leave. The council also uses a case management approach, with links to personnel, health and safety, counselling services and rehabilitation and redeployment.

Health promotion

Kent employs 46,000 staff and is facing the issue of an ageing workforce, in line with the national demographic. Even so, staff care manager Elaine Mason says the council needs to promote the health of staff at all stages of life.

“We do need to recruit and retain younger staff, and take a lifecycle approach,” she says. “Our priority is to recognise the needs of individuals and organisations, linked to the national agenda of sickness absence, stress, mental health and so on, and to try to minimise absenteeism and keep people well at work.”

The key to Kent’s approach is to link wellbeing to overall performance, and to base its scheme on feedback and information from staff. “The statistical information we have helps us set our priorities,” says Mason. “We get feedback from unions, personnel colleagues, managers and staff as a whole.”

Kent may be in the vanguard, but the rearguard is some way behind. According to Pauline Crawford, director of workplace consultancy Corporate Heart, Kent is fortunate in having a strong commitment to wellbeing at the most senior level. She has seen HR and OH staff in other authorities struggle with an indifference or lack of understanding of the importance of such initiatives.

“There can be a lack of will,” she says. “One person I came across was fired up with enthusiasm and tried to push a similar idea through with her authority but got nowhere – she just can’t get the buy-in.

“What you need is a tipping point, and this hasn’t happened yet with local authorities. It needs management from the top, and charismatic people to push it through,” Crawford adds.

Another issue is defining what ‘wellbeing’ means, Crawford points out. “The problem is explaining what it is,” she says. “It covers everything from pedometers to emotional intelligence – the remit is so wide.

“Everyone knows they need wellbeing in their organisations: they can see the evidence in their sickness rates and productivity. But the more difficult it becomes, the more difficult it is to talk about. Making fundamental change is hard – it’s easier to go back to re-arranging the furniture.”

Make the link

One way of overcoming this is to link wellbeing with performance, and therefore with productivity and the
bottom line. For Michelle Smart, head of employment practice at Hampshire County Council, this is a key priority.

“We want to set up a system which compares the costs of absence to the cost of putting preventive strategies in place,” says Smart.

“If someone has a back injury or a frozen shoulder, there is a big difference in how quickly they come back to work if OH makes appropriate interventions, compared to how long it would take if they were left alone. And that saves a lot of money.”

The council is in the process of launching an initiative to promote wellbeing among its 36,600 staff. “We are developing a wellbeing strategy as opposed to a scheme,” says Smart.

“One of the council’s external corporate objectives is ‘wellbeing’ in terms of the services we provide to the community. We aim to look at the preventative aspects as opposed to dealing with the acute – when someone actually goes off sick.”

Hampshire has just appointed Denize Bainbridge as occupational health manager to work on this initiative. Bainbridge, who has previously had senior OH roles at Royal Mail and Peterborough District Council, says there are particular challenges for local authorities.

“Private companies are more likely to offer benefits like funded gyms and private health care,” she says. “But local authorities employ staff who do heavy, physical work – like care staff who carry out labour-intensive roles. And when they are off sick, it is harder to get them back into work. Musculoskeletal disorders do tend to re-occur if you go back into heavy work.”

Partnership

For both Smart and Bainbridge, the way forward is for HR and OH to work in partnership. “We are setting up a model where we work together,” says Bainbridge. “This is more important for us because we have a range of different jobs and functions to cover, and we need to check that we are doing the right thing.

“The plan is to develop a toolkit, so that HR staff can manage short-term sickness absence, sit staff down and say: How can I help you? How can I support you?”

An integrated approach is also needed if another issue is to be addressed: communicating the wellbeing message to employees. Mason has found this to be a continual challenge, in spite of making considerable efforts to make sure that staff know what is going on.

“We are a large geographical spread – with 800 business sites – so this is a problem,” she says. “We are exploring the use of technology, developing wellbeing days for learning development teams, and communicating via the intranet, leaflets, pay slips and so on.

“But people still say they don’t know anything about it. So we are taking health promotion events around the county – to fire stations, police stations and schools, for instance.”

Communication

Communication with individual staff is also vital. Both authorities stress the importance of using a case management system to ensure that individual cases are followed through. “We can give people strategies for coping with stress, for example,” says Bainbridge. “We can recommend exercise and diet, and monitor their progress. Clinical depression is more serious, and needs regular follow-ups and referrals to the GP, but GPs don’t necessarily have the time to follow this up.

“People are very appreciative when OH does this. We set them simple and achievable goals. It’s about moving people forward.”
Another way of making the case for wellbeing is to be clear about the starting point, and to measure the stress levels, job satisfaction and general fitness of staff before such a programme is launched.

Health and performance management consultancy Vielife is working with a number of local authorities. Before launching any wellbeing initiative, Vielife assesses the current levels of health and motivation among staff, so that it can then measure any difference made by its programme.

Diane Nye, European commercial director at Vielife, says this is especially important if local authorities are to show they are meeting the requirements of best value performance indicators. These are national standards laid down for the public sector, which set out a whole range of efficiency and performance targets. Two of these relate directly to wellbeing: benchmarking against days lost to sickness, and benchmarking against early retirement due to ill health.

“This is a big issue – there are more and more targets for customer-facing staff, who are also stressed due to dealing with the general public, and for senior staff, who are stressed by their heavy workload,” says Nye. “There is also the pressure to downsize, not replace people who retire, and to increase productivity.

“But they do need to measure the effectiveness of wellbeing programmes. For example, they might actually find that poor nutrition is the problem. Something as straightforward as this can make a huge impact. People don’t necessarily realise a Healthy Eating Day can boost productivity.”

Once a wellbeing programme is in place, Nye says the key requirement is for both HR and OH staff to take a different attitude towards the health of staff. “Traditionally, HR is about risk mitigation – and so is OH,” she says. “The aim is to make sure that people don’t get repetitive strain injury, have ergonomic chairs, don’t injure their backs if they are waste collectors and so on. It’s more reactive, and less proactive.

“And it’s also about trying to get people with a couple of risk factors to take this seriously, and make changes before it gets chronic. This could save so much heartache later on. Research from Mercer and Unilever shows that 15% of staff in organisations account for 76% of health costs.”

Growing trend

Willmott says this is a growing trend. “Of the authorities which have programmes in place, 10% are starting to evaluate what they are doing,” he says. This is the only way to make a convincing business case for wellbeing, he believes.

“In the US, organisations have looked at the benefits of wellbeing programmes much more closely, because employers have to pay health insurance premiums for staff, and if they cut the risk, their premiums fall. About two-thirds of US organisations have wellbeing schemes in place.”

But measuring effectiveness is just one piece of the wellbeing jigsaw, says Willmott. Cash-strapped local authorities should pilot wellbeing within certain areas of their work, to test the water and use other parts of the organisations as control experiments – and wellbeing initiatives should be a strand in a coherent management strategy.

“No wellbeing strategy can work unless employers take a holistic approach,” he says. “The way people are managed can create an environment in which they want to work – it’s no good giving healthy eating advice if managers are shouting at staff.
“And finally, you should get the message across to staff that this is something extra they are being offered, rather than taking a punitive approach.”

Getting wellbeing right

Do



  • Test the water in specific departments
  • Build wellbeing into management strategy
  • Assess the health and morale of staff before you start
  • Network with other authorities to see what they recommend
  • Get the backing of the chief executive.

Don’t



  • Expect wellbeing programmes to be a ‘quick fix’
  • Work in isolation without consulting colleagues
  • Take up trendy new ideas without thinking
    them through
  • Ignore basic areas such as nutrition and hydration
  • Take the punitive approach.

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