A new health and wellbeing index is helping the rail industry to better understand and manage the often-complex health and wellbeing needs of its workers, with its innovative approach making it a winner in this year’s Occupational Health & Wellbeing Awards. Dr Michelle O’Sullivan explains how it came about and how it works.
For the past five years, the rail industry has been quietly but determinedly building its know-how around managing the health and wellbeing of the quarter of million people who work in the sector.
With the support of the Rail Safety and Standards Board (RSSB), the industry has now launched the Health and Wellbeing Index (HWI), a composite indicator that captures the impact of different health conditions into a single number to help drive better performance.
Developed by health economists but also as a cross-industry collaboration, the HWI is believed to be the first of its kind anywhere in the world. Its innovative approach was recognised in this year’s Occupational Health & Wellbeing Awards, winning in the Best multidisciplinary initiative category.
It has been designed to behave in a similar way to the FWI (Fatalities and Weighted Injuries) measure used in rail safety analysis and decision-making.
Different health conditions, such as musculoskeletal problems or mental health issues, have been weighted in line with the seriousness of their effect. These weighted values are then combined to provide a headline metric that rail companies use to inform business cases and decisions around health management.
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The HWI has been constructed to be broadly equivalent to the FWI. This means that, for the first time, companies can better understand how health compares to other safety considerations and make a stronger case in the competing calls on budget.
Historically, spend on safety within the rail industry has been far greater than spend on workforce health. This looks unlikely to change any time soon but this initiative allows companies to start to have conversations that compare the HWI with the FWI.
For example, Network Rail, with a workforce of 42,000, has been routinely using the HWI since its launch earlier this year. As Martin Frobisher, Network Rail’s group director for safety, technical and engineering, explains: “The HWI has really helped us to understand and prioritise health and wellbeing issues. We have been using it for our executive safety reviews, and it is helping us prioritise improvements in a more effective and targeted way.”
Different health conditions viewed
During the pilot testing of the HWI, most participants prioritised health areas for investment based on raw case numbers and sickness absence records.
The Health and Wellbeing Index has really helped us to understand and prioritise health and wellbeing issues.” – Martin Frobisher, Network Rail group director for safety, technical and engineering
While this may identify the most common health complaints experienced by the workforce, it does not consider the varying impact of different health issues. One benefit of using HWI values over raw numbers is that the HWI transforms health conditions into comparable units, enabling the impact of less severe conditions that happen more frequently to be compared with more severe health conditions that happen less often, on a like-for-like basis.
This allows a more evidence-based approach to employee health strategies and investment decisions. Impact is calculated using ‘Willingness to Pay’ (WTP) and ‘Quality-Adjusted Life Year’ (QALY) health economic methods and considers costs suffered by the individual in terms of their reduced quality of life, impact on society, and costs to the business.
Currently, there are seven different health conditions listed in the HWI. These are set out, with their fatality ratio weightings, in table 1 below. As the take-up of HWI matures, it is envisaged other conditions may be added.
Tracking and benchmarking
Provided the data is available, HWI values can be calculated systematically and regularly to allow for consistent tracking of health and wellbeing in the rail sector over time. HWI values can also be normalised across companies to allow for meaningful benchmarking between companies of different sizes.
This is a ground-breaking piece of work which will really tackle the issues of reporting, measuring and benchmarking health and wellbeing metrics and determine ‘what good looks like’ in the rail sector.” – Stuart Webster-Spriggs, health, safety, quality, environment, and sustainability director at VolkerRail Group
It can also be calculated across different categories of employee to explore trends in health and wellbeing. This provides the opportunity to explore specific risks faced by workers in different age groups, roles and working environments.
Stuart Webster-Spriggs, HSQES (health, safety, quality, environment and sustainability) director at VolkerRail Group says of the index: “This is a ground-breaking piece of work which will really tackle the issues of reporting, measuring and benchmarking health and wellbeing metrics and determine ‘what good looks like’ in the rail sector.”
Through allowing performance monitoring over time across different companies as well as specific groups of workers, the HWI is expected to raise the profile of occupational health and wellbeing in the sector.
It also has the potential to help companies meet their legal requirements to protect and improve the health and wellbeing of employees.
Indeed, while the HWI has been developed in consideration of health conditions relevant to rail, the overall approach could be adapted by other sectors to fit their own particular health challenges.
Rail’s future plans for health
The HWI is one of a number of new initiatives underway within the sector to support the systemic health management of rail workers. A project to design, build and populate a cross-industry health data system is currently underway, for example.
For the first time, organisations will be able to access a shared, health data system to build health data dashboards and benchmark against others.
Another initiative is a new development and education programme for rail OH professionals. This is taking shape and is looking at how best to tackle fatigue and alertness management is high on the agenda. Additionally, there are specialist teams considering how best to respond to the challenges of musculoskeletal disorders and occupational hygiene which are inherent in an industry such as rail.
Summing up rail’s approach, RSSB’s director of systems safety and health, Ali Chegini says: “This is a first. With the HWI, the rail industry is leading the way with this kind of approach. There has been no known other successful attempt to build a composite metric to measure organisational performance in health and wellbeing, least of all one that has the potential be used to directly compare health and safety,” he says.
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“It could offer a double win of improved quality of life, a healthier and happier workforce, and all the while reducing unnecessary costs,” Chegini adds.
Additional contributors to this article were Liz Davies (professional lead data and modelling at RSSB), Kevin Thompson (lead SMS specialist at RSSB), Lisa Regan (risk and safety intelligence analyst at RSSB) and Dr Bridget Juniper (Work and Well-Being Ltd).
