If organisations are committed to the idea of facilitating ‘good’ work that benefits people and business, occupational health practitioners must work with other professionals to create environments where employees can thrive, writes Dr Tarun Gupta.
No man is an island, as the saying goes. The same could arguably be said for occupational health.
Faced with ever-growing business and societal issues such as work-related stress, long-term sickness absence and health inequalities, should OH be collaborating more with other professionals?
OH undoubtedly has much to contribute in terms of risk assessment, management and adherence to UK legislation. But the world of mental health (the objective) has expanded to include mental wellbeing (the subjective). This is effectively a shift from being reactive and ‘intervention’ based, to proactive with the focus on creating the right conditions – or culture – in organisations to enable people to thrive. This is what we mean by ‘good work’.
With that in mind, can we really be sure that a traditional risk management approach is the right tool for all jobs? It might well help remove risks, but will it help people thrive?
This is not a new question. But it’s arguably a question that has yet to be fully debated.
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The limited constructive discussion on this topic might be evidenced by a recent report by the Society of Occupational Medicine (SOM) and the CIPD. The report provides a very useful examination of the evidence base for various interventions sold to employers. The goal is to help OH and HR professionals design more effective return-to-work programmes and interventions for their organisations, in line with existing health, safety and equality legislation. That all makes perfect sense.
However, it also suggests, in the following quote taken directly from the report, that the same programmes could, and should, be applied to mental wellbeing:
“It is beyond the scope of this report to describe how the legislation applies to mental wellbeing, which has a broader and more nebulous definition. Instead, given the overlap between mental health and wellbeing and the similarities in the factors predicting them, taking a preventive risk management approach as advocated by law would be conducive for good mental wellbeing as well.”
A different approach?
Over a decade ago, it was suggested that the traditional risk management approach could not simply be applied to factors that support mental wellbeing; the things that help people thrive or, to put it another way, ‘good work’ factors.
For example, an article on OHW+ in 2010 examined the concept of ‘flags’ in helping people return to work after sickness absence. It aimed to help clarify the place of one category – psychosocial flags – in the rehabilitation process.
The article describes the purpose of ‘unofficial’ pink flags, stating: “These were described by pain specialist physiotherapist Louis Gifford in 2005 to reflect his concern at the constant focus of medicine on the things that make people worse, rather than looking for factors that can help make people better… an accommodating workplace is a pink flag, and we know that the right sort of work is good for peoples’ health and wellbeing.”
In other words, pink flags are positive factors that should be identified and emphasised to help give people the chance of a better outcome. For example, an employee who gains satisfaction and self-esteem from being part of a team and wants to find a way to continue contributing even if they can’t be fully at work for other physical or psychological reasons.
Role of engagement in ‘good work’
Around the same time, the concept of positive OH psychology emerged. Unlike traditional psychology, this is dedicated to addressing mental wellness, as opposed to mental illness.
Positive OH psychology may be defined as “promoting those positive characteristics of the working environment that enhance human vitality, strengths and optimal functioning”, to quote the European Agency for Safety and Health at Work. It refers to those aspects of an individual’s job that may help reduce job demands and/or help in achieving work goals.
For example, one study found that aspects such as autonomy, social support and opportunities for career development were important in helping buffer the impact of patient harassment where homecare workers were concerned.
Positive OH psychology was born out of the concept of work engagement and well-evidenced findings over many years that employees who experience work engagement – feelings of positivity, fulfilment and motivation – perform better. In other words, a focus on work engagement may not only benefit the individual but also offer organisations a competitive advantage.
Positive OH psychology advocates things like shared values in recruitment, employee value propositions (EVPs), workshops and wellness audits. Such activity seems to be well-embedded in most organisations of a certain size these days. Still, the problem of work-related stress, long-term sickness absence and health inequalities remain.
More actors are needed
So, back to that question of collaboration. There’s currently an evolving narrative around the importance of good work – the culture of an organisation – to mental wellbeing. Again, this is nothing new. In fact, 40 years ago, academics were evidencing that work meets important psychosocial and health needs. Evidence shows that work is central to individual identity, social roles and social status. But that same evidence showed that the reverse might be true – that work can also pose a risk to health.
So we’re not just talking about work here, rather ‘good’ work; an environment where people can thrive. And it is here that an ‘objective only’ (risk management only) focus seems to fall down.
To my mind, no single discipline has the answer. Partnership working seems key; not only across multi-disciplinary specialists within the OH profession, but also other complementary clinical professionals to which an employer might have access – perhaps via existing employee benefits. For example, Group Income Protection includes access to vocational rehabilitation expertise, which centres on the provision of treatment to help individuals return to and thrive in the workplace.
OH resides in the world of the objective. And for good reason. But ‘good work’ is subjective. It needs to consider the whole person.”
That partnership working should ideally extend to joined-up thinking between clinical professionals and HR and senior executives too.
Considering ‘good work’ is ultimately about culture and whether the culture of an organisation supports employee engagement (positivity, fulfilment, motivation), clinical professionals should ideally be identifying and sharing the positive factors as well as the risk factors. In other words, the things that help people thrive, as well as the things that prevent them from thriving. For example, workload might be identified as a risk factor so the immediate thinking is that workload should be reduced. But with improved two-way management communication, maybe also the affording of a sense of autonomy, control and opportunities for reward and development, the workload might not be an issue after all.
This is information that should be of interest not only to HR, but also to the senior executive, considering the direct relevance to board-level goals. These include the workforce engagement aspect to environmental social governance (ESG) and diversity, equity and inclusion (DEI) as part of that.
The most important place for partnership working to start though, is with employees themselves. They are in the best place to describe what good work looks and feels like in their particular organisation.
OH resides in the world of the objective. And for good reason. But ‘good work’ is subjective. It needs to consider the whole person. So it stands to reason that ‘good work’ should be defined according to the individual (what is it that helps them thrive) not just according to medicine (removing the risk factors). This is a job for OH, health and safety, vocational rehabilitation and HR, with the individual and their needs at the heart.
Maybe there’s a case for OH to lead in building the business case for such a collaboration.
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