Loughborough University has transformed its underutilised occupational health service into a fully in-house model that focuses on holistic care and overall wellbeing. Workplace wellbeing consultant Angela Steel speaks to the university’s occupational health and wellbeing manager Sarah Van-Zoelen.
Through my workplace wellbeing consultancy, SuperWellness, I work with some pioneering occupational health practitioners driving forward the wellbeing agenda for their organisations. Sarah Van-Zoelen has been leading the transformation of the OH service at Loughborough University, including building a wellbeing function.
The results achieved in just a few years reflect her vision for a holistic approach to OH and the hard work she and her team have invested in demonstrating the business case for wellbeing. Her achievements have led to her receiving the Vice Chancellor’s award for equity, diversity and inclusion in 2022 and the title of Queen’s Nurse for innovative practice and a high level of patient care in 2023.
In this interview, Van-Zoelen shares some insights into her background, career path in OH, and the approach she’s taken to developing the OH and wellbeing functions at Loughborough University.
How did you get started in OH?
I trained as a nurse at Cardiff University – I was one of the initial cohorts studying nursing at degree level. On qualifying, I worked in medicine enjoying the complexity of people that the specialty provided.
I joined OH by accident. I was struggling with the shift patterns on the wards and wanted to see what else was available. I started doing only vaccinations and pre-employment screening but, keen to develop, I achieved the scholarship to study the MSc in OH at Birmingham University.
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When I started in the specialism it was primarily doctor-led, but it soon became apparent that nurses could also take on management referrals and report writing. I worked in the NHS for almost 20 years and then stepped into the provider world. This is where I felt I learned my ‘trade’. Working on commercial contracts with differing levels of employee wellbeing support meant that I had to be more creative in empowering people in their health journey. It also meant I developed the drive to keep up to date with health and wellbeing on a wider scale. I’ve worked in a variety of settings: retail businesses, warehouses, emergency services and Formula One motor racing.
What is your remit and objectives for your role?
While working for a provider, I was allocated the Loughborough University contract. The service had undergone significant changes and needed to be rebuilt.
When I joined Loughborough, the service was hybrid: managed in-house, but delivered by an external company. Gradually we brought the service fully in-house. I now manage a team of two part-time OH nurses, a physician that visits once per month and an admin and wellbeing co-ordinator.
My key objectives were to stabilise the service and create policies, protocols and standards that enable us to measure the performance of the external provider and develop a quality, trusted service. Building relationships across campus was key to promoting OH and expand upon the services available to our staff. We re-tendered to a different employee assistance programme (EAP) that was more aligned to the values of the university and developed links with our in-house physiotherapy team to fast-track staff who were seen due to sickness absence for musculoskeletal reasons.
To develop the wellbeing function, I worked with public health bodies and the emergency services. I developed a wellbeing framework for the university, to benchmark and provide consistency across all schools and services. Alongside this, I developed training for wellbeing champions, a framework for safeguarding, and peer support of the champions. We work with SuperWellness, which provides us with monthly resources to our champions.
The service utilisation has grown significantly. Before I joined the university it was an under-used service, with fewer than 100 management referrals per year and no wellbeing interventions. In 2023 we delivered over 1,500 appointments for staff and hosted 11 wellbeing events. The service is now well regarded at the university and we are looking to expand further.
What have been the key challenges at Loughborough?
The key challenges have been proving the worth of the specialism; how to add value and make reports useful, so that we improve our relationship with managers. Providing evidence via datasets can help share our vision.
In a university I feel that in-house provision works better, as each school/department is treated like an employer in their own right, with differing needs and challenges. As with all employers, money is tight and we need to demonstrate worth to create investment in the service and its delivery.
What do you believe are the key health and wellbeing issues today?
The need for holistic patient care is greater than ever before. The pandemic led to increased waiting times and poorer health outcomes. As a service we now support staff who are preparing for and recovering from surgery, including employees unable to get any answers from the traditional medical model. We support more chronic conditions which cannot be easily resolved with medicines alone. Long Covid and auto-immune conditions all require a greater emphasis on overall wellbeing.
We need a more inventive approach to help people sustain their working patterns alongside their health conditions. This also allows for a much greater learning and development for practitioners.
How did you approach making a business case for wellbeing?
It’s my belief that by treating people holistically, you can start a ripple effect which may positively impact partners, families, and the wider community.” –Sarah Van-Zoelen, Loughborough University
With any business case, communicating the data is key. We have been able to provide information from multiple sources such as the utilisation of the OH service, types and reasons for referrals seen, trends, data from our EAP, effectiveness of the interventions, and physiotherapy data. We also include waiting time data for services in the local area to provide context.
My advice would be to build a story. One example was arranging a consultant dermatologist to talk to our grounds and gardens team on sun safety and skin health. This gave them a good understanding of how to protect themselves, and a signposting clinic afterwards led to three staff being fast-tracked to a skin cancer service by their GP.
Another example is our ‘MOT’ days, which have provided data on the number of employees with seriously high blood pressure who needed ongoing referral.
Getting testimonies and senior leadership sponsors also helps. The more you can evidence the benefit in line with the business needs, the greater the opportunity of achieving the outcomes you need.
What does wellbeing mean to you?
I have always been passionate about lifestyle medicine. There is a cartoon that shows two queues: the first one has numerous people in line waiting at a desk called ‘pills and potions’; the second desk is empty and states ‘lifestyle changes’.
I am a firm believer in the power of evidence-informed lifestyle medicine when delivered by experts. There is so much information in the public domain – wellbeing influencers are everywhere – yet information is complex, misleading and can be disempowering.
I know that personally if my sleep pattern is poor I over-eat or make poorer food choices the following day, my performance and concentration are affected, and my mood is lower, so I try where possible to safeguard my sleep patterns. I am still prone to slippage, the odd poor decision, the odd period of stress and anxiety, but I know that if I focus on the pillars of my health – diet, sleep, exercise, connection – that I can thrive.
I have always had an interest in healthcare and assumed that everyone knew the same information, but that’s not true. I chose my resources carefully and strongly recommend podcasts such as Live Better Feel More, Diary of a CEO and Zoe Science and Nutrition.
What is the role of OH when it comes to wellbeing?
I believe the role of an OH practitioner is to empower clients – help them make changes to their lifestyle that will have big impacts.
All our clinicians in my service have attended the prescribing lifestyle medicine course. Our service does not just focus on the specific reason for absence, but looks holistically at each person, assisting them to navigate their health and wellbeing journey.
I believe that by treating people holistically there can be a ripple effect which may positively impact partners, families, and the wider community. OH is not always considered a community nursing provision, but I believe our impact on the community can be huge, and supporting people in work has an impact on other health markers, such as mental health.
What advice would you give other OH practitioners considering their wellbeing offer?
The workplace doesn’t need ‘yoghurt and yoga’. Employees need a safe place to thrive and work – addressing the cultural and working concerns, along with a clear message. This may start as risk assessment-based, for example the sun safety session I mentioned earlier.
You should never assume that you have the answers; ask people first, then deliver their needs. Communicate all steps in the journey – employees get fed up completing surveys with no obvious outcomes.
Finally, be brave. If something doesn’t work, change it and communicate why.
What advice would you give for building a successful career in OH?
Find your passion and strive towards it, but be open to change. OH has so many interesting strands, and maintaining curiosity will keep your career interesting. My role in OH has changed significantly over the years.
You should keep up to date with reliable resources. Podcasts work for me on my commute, for example.
Never underestimate the need for a peer support network and mentoring/coaching, During my career I have been very grateful to have had access to many excellent practitioners who have shared, supported and guided me.
Where do you see OH heading in the future?
I hope that OH services will become more available to all businesses. To be effective it is important to provide evidence-based, up-to-date services, delivered in a timely manner.
The health and wellbeing of the OH team is essential. If every moment of their day is filled with complex cases, this will lead to burnout in the practitioners themselves. Variety in their roles helps the team stay engaged.
Making a business case for workplace wellbeing: 7 key steps
Whether you are looking to secure buy-in for a specific wellbeing intervention or longer-term strategy, the steps below should help ensure you cover all angles.
- Support the wider vision, mission and values
Align your wellbeing initiative with the organisation’s vision and mission, for example, ‘to be a leader in the industry’ or ‘to deliver a meaningful impact to the community’. Consider how your approach will align with, and reinforce, values such as respect, empowerment, innovation and responsibility.
- Define key objectives
Organisations with a wellbeing strategy are at least twice as likely to improve employee morale and retention, according to the CIPD. Typically, wellbeing interventions will help achieve performance, reputational, talent, duty-of-care and cost-saving objectives.
- Outline your dataset
How will you track the impact of the wellbeing initiative over time? There are different sources of data that may be already available or require setting up. You might draw upon internal records such as sickness absence, EAP data or utilisation of the OH service. If the data is not readily available, it could be collected via staff surveys or tools such as the HSE risk assessment. You could also turn to external benchmarking offered by standards such as ISO.
- Propose a plan
Keep in mind benefits of balancing three types of wellbeing intervention:
Primary interventions should be prioritised in order to address the root causes of stress and ill health at source. An example of this would be wellbeing training for line managers or adjusting shift patterns to allow for better rest and recuperation.
Secondary interventions such as mindfulness and resilience training help equip employees with the internal resources to deal with challenges and stress. Without addressing primary sources of stress however, they will most likely be ineffective.
Tertiary interventions such as the provision of an EAP are necessary remedial measures providing support to employees once issues have arisen. They have limited impact when it comes to preventing problems in the first place.
When outlining the steps to include in your plan, it’s helpful to prioritise those which are likely to deliver the greatest impact at the lowest cost, enabling you to secure buy-in further down the line.
- Plan for a pilot
Including a pilot within your plan will help achieve buy-in to your business case by offering multiple important advantages. It will demonstrate that you are looking to mitigate risks such as potential failure by starting on a smaller scale, and will provide a period of learning and evaluation leading to realistic expectations for the future. Gathering data and testimonials over this initial period will help you build the business case for a longer-term, larger initiative.
- Build relationships
It’s essential to nurture key relationships before presenting your business case. Gather input from decision makers – what would they value? Asking for feedback on your presentation before you present it provides the chance to clarify or adjust points to improve support once you are in the room.
- Present your business case
Present your business case in an easily understandable, engaging way. Data is key but if you can tell a story touching on the human element of your plan, your presentation will be even more powerful.
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