The Aviva UK Health Health of the Workplace Report Issue 4. October aviva.co.uk/health 1

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1 The Aviva UK Heath Heath of the Workpace Report Issue 4 October 2010 aviva.co.uk/heath 1

2 Foreword Now in its fourth year, Heath of the Workpace is Aviva s annua study that canvases GP, empoyer and empoyee opinions on topica issues in order to uncover and raise awareness of important matters reating to heath. This information is then used to suggest soutions that wi hep both empoyers and empoyees. To achieve this we work with a speciaist research agency to survey 200 GPs, 200 empoyers and more than a thousand empoyees. The Heath of the Workpace 4 research took pace in Apri This year, we have divided the report into two sections: Section 1 - The GP s view This section presents the findings from our research with UK GPs and expores how their roe has changed in recent years. It highights the chaenges doctors face and shows the increasing roe web-based information pays in both their own, and their patients ives. The coaition Government s recent announcements about the changing roes of GPs in the new NHS structures mean that the views of GPs are now more infuentia than ever. The sometimes worrying findings from our research provide an insightfu view into the chaenges faced by GPs and hep to highight the factors the Government shoud consider when tacking these issues. We aso ook at how peope can pay a roe in maintaining their own heath and webeing, which heps GPs to focus on those that reay need their support. Section 2 The empoyee and business eaders view This years business eader and empoyee study expores whether work reationships have repaced the traditiona famiy support network. It focuses on the roe eadership, effective communication and socia networks pay in morae, motivation and webeing in the workpace. We are committed to heping to deveop as broad an understanding as possibe of the key heath-reated issues faced by empoyers, empoyees and GPs and we are peased to present our fourth Heath of the Workpace report. 2 Heath of the Workpace 4 Report

3 Section 1 GP findings Key trends identified in this report: GPs are under increased pressure with neary haf of otherwise we patients visiting them more than five times a year They have ess time to spend with their patients than five years ago Current arrangements mean that GPs have ess time than they fee they need to propery assess their patients Onine toos are increasingy being used to aid diagnosis GPs sti see themseves as roe modes but reationships are no onger as strong between them and their patients There s sti imited awareness about Fit Notes and a ack of beief in the abiity of the new Fit Note system to meet its objectives. aviva.co.uk/heath 3

4 GPs are under increased pressure Athough evidence shows that doctors are working 17% ess hours than they were six years ago when the new GP contract was introduced 1, our research shows that neary haf (45%) of otherwise we patients visit their GP five times or more a year. We are therefore not surprised to earn that over haf (57%) of the GPs we questioned say that they have ess time to see their patients than five years ago. Despite it being current practice to schedue doctors appointments for 10 minutes each GPs fee they need more time with their patients. Neary a of the GPs we questioned (97%) say that they woud ike to spend 11 minutes or more with each patient. Moreover, neary seven in ten (69%) GPs woud ike up to 15 minutes to see each patient and a quarter want 16 minutes or more. In an idea word, how much time woud you ike to set aside to see each patient? 70% 68.63% 60% 50% 40% 30% 20% 20.10% 10% 7.35% 3.92% 0% 10 mins or ess mins mins Over 20 mins Source: Heath of the Workpace 4, GP research, Apri Ony 7% of GPs say that ack of time with their patients has no effect on their abiity to do their job propery. Source: Heath of the Workpace 4, GP research, Apri Genera Eection 2010: Conservatives pedge better access to GPs, The Teegraph, Laura Donney, 10th Apri Heath of the Workpace 4 Report

5 Worryingy, this situation is eading to a fa in the perception of the service given. Over haf of GPs (51%) admit that the ack of time definitey affects their abiity to do their job. Moreover, 43% say that the imited time they have with their patients affects their abiity to provide a detaied diagnosis and offer wider heathier ifestye advice. This is a concern as there is a strong connection between ifestye and future iness. Does having ess time with your patients affect your abiity to do your job propery? 55% 50% 50.43% 45% 42.74% 40% 35% 30% 25% 20% 15% 10% 5% 0% 6.84% No it does not Yes it does It doesn t affect my judgement but it has affected my abiity to provide a detaied diagnosis and offer ifestye advice. Source: Heath of the Workpace 4, GP research, Apri % of patients fee that NHS appointments are aways rushed. Source: Aviva UK Heath s Deayed Diagnosis consumer research, Apri aviva.co.uk/heath 5

6 The impact of technoogy and the media Doctors are increasingy using onine toos to hep them in their roe, with neary every GP we spoke to (96%) saying that they use search engines in their daiy working ife and over haf (65%) using other onine services and net forums. Onine support is used for a number of reasons incuding networking with coeagues (29%), earning about new techniques and finding best practice advice (49%). The majority of GPs (83%) use the internet as a resource to aid diagnosis. The days of doctors reying on their memory aone are ong gone. They are ceary embracing technoogy to hep them keep up to date with deveopments and to support the service they provide to their patients. Which of the foowing best represents why you use Googe, net forums etc in your work? 90% 80% 83.33% 70% 60% 50% 49.02% 40% 30% 28.92% 20% 10% 5.39% 0% As a resource to support diagnosis To network / communicate with coeagues To earn about new techniques / best practice I don t have time to read up / consut coeagues Source: Heath of the Workpace 4, GP research, Apri % of peope say that their number one priority is knowing what s wrong with them when they are unwe. Source: Aviva UK Heath s Deayed Diagnosis consumer research, Apri Heath of the Workpace 4 Report

7 Technoogy and the worried we Interestingy, it s not just doctors who are using onine toos in reation to heath. Our Deayed Diagnosis research conducted in Apri 2010 shows that individuas are aso increasingy turning to the internet for immediate heath-reated advice and support. Over haf of the individuas we questioned (54%) have worried themseves by sef-diagnosing on the internet, eading neary haf (49%) to worry that there might be something seriousy wrong with them. Indeed, recent research in the Journa of Bone and Joint Surgery highights that visiting Dr Googe can provide peope with vasty differing eves of quaity and can ead patients to misinterpret the information resuting in a wrong or inaccurate diagnosis 2 Whie media coverage and resources such as the internet can undoubtedy pay an invauabe roe in heath and webeing education, the combination of sef-diagnosis and heightened awareness of heath issues may be fueing additiona visits to the GP. Our Deayed Diagnosis research shows that the majority of GPs are trying to tacke these behaviours, with ony a quarter (26%) saying that they woudn t raise the issue of constant visits from a patient foowing sef-diagnosis on the internet. However, a simiar number (24%) said that they woudn t raise the issue if they suspected that anxiety was eading to hypochondria. 31% of peope have gone to their GP after seeing a TV character with symptoms simiar to their own. Source: Aviva UK Heath s Deayed Diagnosis consumer research, Apri Web based technoogy has revoutionised the way we a work and fast access to high quaity information can be an invauabe support for patients and professionas. Utimatey, however, there is no substitute for a thorough assessment by a quaified GP. This requires adequate time; something that the GPs in our survey don t fee they have. Dr Doug Wright, Principa cinica consutant, Aviva UK Heath 2. Quaity and Content of Internet-Based Information for Ten Common Orthopaedic Sports Medicine Diagnoses, James S. Starman, F. Keith Gettys, Jason A. Capo, James E. Feischi, H. James Norton, and Madhav A. Karunakar. Appeared in Journa of Bone and Joint Surgery, Juy aviva.co.uk/heath 7

8 Reationships between doctors and their patients Despite the trend to arger group practices and targets set by the Department of Heath, peope beieve that their reationship with their GP is generay good, athough they fee that they don t reay know their doctor. Given the high incidence of peope visiting their GP more than 5 times a year, there appears to have been a decine in the traditionay strong reationship many peope have with their famiy doctor. This coud be attributed to the ack of time doctors now have with their patients. Worryingy, a quarter of peope we spoke to don t fee that their GP takes them seriousy. This increases to 41% for the age group. The continuing trend for the greater use of technoogy during a consutation may aso be paying a roe in the breakdown of this reationship. It is aready known that patients and doctors can find the computer a distraction and when combined with the apparent time pressures, the situation can be worsened. 60% of peope said they d turn to their partner if they had a probem with their heath, compared to just 33% who woud turn to their GP. Source: Heath of the Workpace 4, empoyee research, Apri Neary a the doctors we spoke to (95%) fee that it is important to ead by exampe when it comes to iving a heathy ifestye. In genera, GPs say they personay do this we, with just over a quarter (27%) feeing that they practice what they preach. Whie over a third of doctors (38%) admit that they are overstretched, this increased pressure does not appear to be affecting their own heath, unike the empoyees surveyed in our Heath of the Workpace 3 study. How heathy woud you consider yoursef to be? 40% 38.24% 35% 30% 25% 25.49% 27.45% 20% 15% 16.67% 16.18% 10% 5% 0% We I work hard and pay hard We I practice what I preach regarding heath and webeing We I ve got a great ife, car, famiy Good I m OK, but I am in great shape overstretched for my age 2.45% Poor - I drink a ot 0.49% Poor I take recreationa/ prescription drugs 5.39% Poor I m stressed a the time 3.92% Poor I often find it hard to seep Source: Heath of the Workpace 4, GP research, Apri Heath of the Workpace 4 Report

9 The impact of Government initiatives Fit Notes Apri 2010 saw the introduction of a new Fit Note (medica statement) to repace the traditiona sick note that has been used by GPs for the past 60 years. Introduced in 1948 to protect the vunerabe, the sick note system gave GPs the authority to sign peope off work for the first six months of incapacity before they move into the state incapacity benefits system. 48% of GPs admit that they ve been asked to fasify a sick note in the past Source: Heath of the Workpace 4, GP research, Apri The introduction of the Fit Note aims to change the sick-note cuture to one that encourages GPs and empoyers to work together to hep peope with a medica condition to return to work faster. Under the new Fit Note initiative, ine managers and HR professionas wi have an increased responsibiity in the decisions taken to support an empoyee s rehabiitation back into the workpace. Whist they aren t obigated to take the GPs recommendations, they can use them to hep bring the empoyee back into the business faster, which benefits both parties. The initiative aims to hep reduce the impact ong-term sick eave has on UK businesses, which is estimated to cost the UK economy neary 17 biion a year 3. When it comes to making Fit Notes work in practice, the Government is missing an important trick by ignoring the important roe group income protection and occupationa heath services that aid rehabiitation can pay in their success. Currenty occupationa heath practitioners are the missing piece of the jigsaw but can perform a potentiay crucia support roe in bridging the knowedge gap between empoyers, HR, managers, GPs and workers. Without this engagement, the introduction of Fit Notes may cause more probems than it soves. Dr Doug Wright, Principa cinica consutant, Aviva UK Heath 3. Source: CIPD/Pfizer Absence and Workpace Heath Survey aviva.co.uk/heath 9

10 GPs are unconvinced of the benefits of Fit Notes Worryingy, more than haf of GPs (65%) taking part in our Heath of the Workpace 4 study say they fee i-equipped to provide Fit Notes to the UK workforce. Despite the initiative now being ive, this is ony a 1% increase from the 2009 Heath of the Workpace study. When asked about the effectiveness of Fit Notes, 68% of GPs say they fee that Fit Notes won t cut absence eves. This compares to 54% ast year prior to their introduction. 40% 35% 30% 25% How far do you agree with the foowing statement? I fee Fit Notes wi hep contro sickness absence % 31.37% 36.76% 20% 15% 10% 5% 0% 3.92% Strongy agree Sighty agree Sighty disagree Strongy disagree Source: Heath of the Workpace 4, GP research, Apri Empoyers and empoyees are unconvinced too Aviva UK Heath s Eary Intervention Prevention research conducted in January 2010 demonstrates that empoyers and empoyees are equay sceptica about the effectiveness of Fit Notes. Of the 500 empoyers we questioned, just 5% say they think Fit Notes woud reduce absence rates. One in ten thinks that Fit Notes wi be hard to administer and 68% have itte or no knowedge of the change and how it wi work for them. On the empoyee side, the majority of the 1,000 respondents (57%) do not think that their doctor is in a position to say if they are fit enough to work. 10 Heath of the Workpace 4 Report

11 Future Government poicy At the time of writing this report it s cear that the new coaition Government s primary focus is on the recovery of the economy and their future heath poicy is yet to be fuy defined. Earier this year, the coaition announced its programme for Government (The Coaition: our programme for Government, 20 May 2010) which promises that heath spending wi increase in rea terms. Poicies that directy affect GPs focused on a number of key themes; improving accessibiity, increasing choice and quaity of care, prevention and weness management: NHS Heath Secretary Andrew Lansey, has caed a hat to NHS reconfiguration in London meaning the NHS in London wi need to find an aternative means of saving the 5.1bn funding gap it estimates its Primary Care Trusts wi face by The Heathcare for London (Darzi) pan invoved shifting care out of hospitas and into GP-ed centres or poycinics. In June, the Government subsequenty announced its high eve pans to review the existing NHS operating framework and GP budget hoding, signifying its intentions to make prompt changes to the NHS. Principes of GP Budget Hoding (as described by Andrew Lansey on the 24th June) incude: Deveop 24-hour urgent care across Engand, incuding GP out-of-hours services Patients to register with any GP they want, regardess of where they ive GPs to hod a budget to enabe them to have contro of commissioning decisions GPs to be supported in their decision making by an autonomous NHS commissioning board Pubic heath Give GPs greater incentives to tacke pubic heath probems Improve access to preventative care in deprived areas The NHS commissioning board wi have a focus on quaity standards that are integra to effective commissioning. This quaity measure wi be aigned to standards used by the CQC. The NHS is exporing the possibiity of using financia incentives to encourage peope to ead a heathier ifestye. aviva.co.uk/heath 11

12 In addition to this, the revised operating framework aims to scrap the 18-week target for hospita waiting times, the 4-hour A&E target and the 48-hour target for GP access. Instead the Government is recommending a series of new evidence-based quaity measures to hep the NHS in Engand improve patient care. Andrew Lansey recenty unveied the standards for the first three areas - stroke, dementia and bood cots - that were put together by NICE in consutation with doctors and patients. It is anticipated that the Government is ikey to pubish a set of quaity measures for over 150 different areas of care over the next five years. It is proposed that the new quaity guideines wi be used when services are commissioned by managers and GPs when they take on responsibiity for managing oca budgets. Patients wi be abe to use the standards to ensure they receive the best quaity of care. To hep faciitate this, those services that do not meet the standards wi strugge to attract funding. Unike Labour s targets, there wi be no requirement for hospitas and other services to report to the Government that they have met them, or expain themseves when they do not. Commenting on the changes, Andrew Lansey said: These are standards not diktats. It is not poiticians estabishing these I am not picking them out. If I started doing that I woud be distorting cinica standards. 4 In Juy 2010, the coaition Government reeased the white paper, Equity and Exceence: Liberating the NHS. They identify three key themes that are integra to their vision for the NHS: Patients at the heart of a new poicy - the pans are to give patients more contro over their care and increase access through aowing more choice no decision about me, without me Increased focus on cinica outcomes - this underines the coaitions desire to move away from targets and with the introduction of more evidence-based outcome measures, there are pans to remove any targets with no cinica justification Empowerment of heath professionas - announcements in this area have created passionate debate, particuary around commissioning, with the primary theme on doctors and nurses using their professiona judgement to make decisions for their patients Source: New goas to repace NHS targets, Nick Trigge, BBC News Onine Juy Source: Equity and Exceence: Liberating the NHS, Department of Heath (2010) 12 Heath of the Workpace 4 Report

13 Athough there is more detai to be pubished on the proposas, the white paper has aready sparked much debate. The responses have been both positive and negative. Anna Dixon from the Kings Fund states the reforms wi create a heathcare system, unique internationay, that gives groups of genera practitioners unprecedented contro over pubic funding 6 whist Dr David Price of Edinburgh University argues that it wi remove the Government s duty to provide a universa heathcare service 7 and senior cinicians are critica about the ack of incusion of the acute sector in the commissioning review 8. Aviva s response We wecome the proposas to put patients and carers at the centre of the pans for the NHS. The intention to aow patients more say in their care and promote understanding of their heath status coud be an important step in addressing some of the heath chaenges faced by the nation. Furthermore, the aim to achieve word-cass cinica outcomes in the NHS is a positive deveopment that can ony benefit patients. The scae of the reforms has surprised many commentators in the media and ed to considerabe debate, especiay around the pans for GP commissioning. Whist this debate is important, we hope that the focus on patients and heath outcomes wi not be ost and continue to drive the reform process. We woud wecome the scrapping of this target, as it wi give GPs greater fexibiity to organise their appointment booking system in a way that best suits their oca patient popuation. Dr Laurence Buckman, of the British Medica Association 9 Whie the coaition Government has outined its heath poicies focusing on improving access to GPs and offering a wider choice of doctors, both patients and GPs are ceary demanding a better GP experience, and access times and choice are just one piece of this jigsaw. Dr Doug Wright, Principa cinica consutant, Aviva UK Heath 6. NHS Reform? Great, Thanks for warning us, David Aaronovitch, The Times 15/7/ We cannot aow the end of the NHS in a but name, Seumas Mine, Guardian, 14 Juy Consutants criticise white paper s ack of acute focus, Caire Lomas, HSJ Onine, Juy Source: GP waiting time target scrapped, Nick Trigge, BBC Onine. 21st June aviva.co.uk/heath 13

14 Focusing on heath outcomes - Back-Up from Aviva Evidence now shows that taioring treatment pans to the individua s persona needs, has a far better outcome for a parties. Back-Up, which is just one of a number of new speciaist case management initiatives introduced by Aviva UK Heath, refects the need to move away from a traditiona one size fits a approach to private heath insurance caims management to offering customers an expert-ed service taiored to their exact needs. Deveoped with the UK s eading professiona rehabiitation provider HCML, Back-Up, which utiises evidence based medica guideines for managing back and neck pain, has proven to significanty improve the speed of recovery and return to work rate for customers. In addition, the number of physiotherapy sessions required has been greaty reduced with far fewer peope needing to be referred to a speciaist. Rather than having to wait to see their GP, customers are referred to the Back-Up service to speak to a dedicated case manager who conducts an in-depth assessment and offers practica and cinica advice and support. A personaised rehabiitation pan is then taiored to their individua needs. Where the customer is part of a group scheme, the case manager can aso work with their ine manager to advise how they can be heped safey and effectivey at work. Key resuts from Aviva s customers incude: 50% of empoyees say the service prevented them going absent or restricting their duties Of the 25% who were absent prior to using the service, 100% successfuy returned to work through Back-Up Physiotherapy sessions have been reduced by 37.5% At east a 15% saving on treatment costs 98% rated their treatment as exceent or very good* * Percentage of customers giving a rating of between 7 and 10 out of Heath of the Workpace 4 Report

15 Summary Our research shows that GPs are over stretched and this can affect the quaity of support they are abe to offer their patients. Web based technoogy has revoutionised the way we a work and fast access to high quaity information can be an invauabe support for patients and professionas. Utimatey there is no substitute for a thorough assessment by a quaified GP. From our research this is ceary not happening in a cases. We urge the new coaition Government to support and work with key stakehoders to ensure deivery of the right care for patients, whether it is via GPs or a wider network of medica professionas. This network coud incude pharmacists, nurse practitioners and third party providers, such as speciaist rehabiitation companies and occupationa heath providers. The move to put GPs at the heart of decision making in the NHS wi hep to drive this agenda forward. Whie improved access times and increased choice are one part of the soution, there are many other chaenges that need to be overcome. These incude tacking the current heath probems driven by the aging popuation, ifestye, behavioura and environmenta issues. We beieve that improved education and heath promotion can pay a key roe in this. The roe of education Our Deayed Diagnosis research ceary shows that an individua s number one priority is to find out what s wrong with them when they are unwe. Technoogica advances have ed peope to expect quick responses and if they can t access the information prompty from their GP, they are instead turning to the internet for soutions. Whie sef-diagnosis on the internet is no substitution for a thorough assessment by a GP, the internet and media coud provide a usefu source of information to enabe individuas to sef-manage simpe conditions once their GP or another medica professiona (such as NHS Direct or a GP Hepine provided by their medica insurer) has ascertained what is wrong with them. Peope therefore need to be educated to choose the right support services for their own persona circumstances. This in turn wi hep to enabe GPs (and indeed our A&E departments) to focus on providing the appropriate advice and support to the patients who need it most. aviva.co.uk/heath 15

16 The heath of the nation is a crucia issue to address. As the argest insurance services provider in the UK we are more than aware of the impact of ifestye choices and ack of awareness on peope s ongterm heath. We are committed to raising awareness of the benefits of eading a heathier ifestye to hep improve the nation s heath and webeing. Dr Doug Wright, Principa cinica consutant, Aviva UK Heath Weness Management In its simpest form, heath promotion is about adopting a more pro-active approach to heath that focuses on positivey managing the heathy so that they are ess ikey to fa i, rather than treating symptoms once they have occurred. Such an approach shoud focus on an individua s menta and physica webeing. Weness management shoud not just be associated with someone who doesn t have an iness, but rather a positive state of good physica and menta heath and webeing. A person with diabetes, for exampe, can effectivey manage their condition and ead a heathy ifestye with the right education, menta attitude and support. Heath promotion is by no means a new concept, and one which the previous Government took steps towards through its Change4Life programme. However, whie the NHS is exporing the use of financia incentives to encourage peope to ead a heathier ifestye, the Government s focus on the economy s recovery means it is unikey that the previous investment we ve seen for mass marketing campaigns wi continue. Indeed, recent announcements on the Change4Life programme which wi see centra investment being scaed back and more invovement from the private sector confirm this view. It s therefore important that other stakehoders continue to engage and encourage individuas to take more contro of their own heath by promoting the benefits of eading a heathy ifestye and communicating the message that prevention is better than cure. This can be achieved through a number of means, incuding education and advice deivered through primary care faciities such as GP surgeries, industry sponsored activity days and promotions, a continued focus on more responsibe food abeing and heathier content, and new product and service deveopment. For an empoyer, there is the opportunity to provide weness initiatives in the workpace that aso contribute to this wider pubic heath imperative. 16 Heath of the Workpace 4 Report

17 How is Aviva heping? Aviva has been proud to be the No 1 sponsor of UK Athetics since 1999 and is committed to deveoping the sport at every eve from the payground to the podium. Each year we put on six word-cass athetics events on home soi and hep the Aviva GB & NI junior, senior and paraympic teams as they prepare for a major events and championships. Through the Aviva UKA Academy it is our aim that by 2012, we have given every chid in the UK the opportunity to get invoved in athetics. Aviva s ambition is to not ony provide products to support customers heath, but to positivey change peopes, behaviours and attitudes to heath. We are encouraging our customers to ead a heathier ifestye, through reguar customer communications and MyHeathCounts. Designed by medica experts, MyHeathCounts contains a weath of invauabe information incuding a heath assessment too and an onine coach offering personaised advice on the simpe steps individuas can take to improve their heath. Since Juy 2009, Aviva has aso promoted Change4Life through our UK Athetics grassroots programmes, which has incuded information sent to a schoos in the UK and at the indoor season athetics events. Aviva is in support of Change4Life through our sponsorship of UK Athetics and by promoting Change4Life messages that aign with MyHeathCounts. The roe of business eaders in managing heath As we have seen, the Government has aready taken steps to encourage empoyees and indeed GPs, to hep peope return to work foowing i-heath through its introduction of the Fit Note. However, to have the biggest impact, we fee that they shoud take this one step further and pro-activey encourage empoyers to hep their empoyees to ead a heathier ifestye - preventing them going off sick in the first pace. We discuss this further in the summary of our research with business eaders ater in this report. aviva.co.uk/heath 17

18 Potentia benefits for a stakehoders Whist managing weness is never going to competey eradicate absence or visits to the GP, companies who ook after their staff by promoting heath and webeing effectivey and consistenty coud see a positive impact on their organisation. Staff turnover, absenteeism, accidents and stress eves coud fa as fast as morae, oyaty and productivity rise. Evidence aso indicates that there wi be significant benefits to other key stakehoders - ong-term sickness wi fa generating potentia savings on incapacity benefit and reducing the direct heath costs borne by the NHS Source: Buiding the case for weness, PriceWaterhouseCoopers, 4th February Heath of the Workpace 4 Report

19 Section 2 - Business eader and empoyee findings Key trends identified in this report: Productivity and profit continues to be prioritised above empoyee heath and webeing, yet the two are intrinsicay inked Business eaders are generay happy with the atmosphere at work athough pressures are sti evident Business eaders are sti rewarding staff but the majority focus on the short-term gains from staff socia events, rather than investing in their empoyees ong-term heath and webeing Business eaders recognise the important roe work/ife baance and teamspirit can pay in their empoyees heath and webeing Over haf of socia events incude acoho, but neary as many business eaders say they woud worry they were having a damaging effect on their empoyee s heath if they caed in sick the next day Over haf of empoyees and around the same amount of business eaders don t reay enjoy these events but attend them because they fee they shoud Business eaders beieve they have an open reationship with their empoyees. However, there s a distinct ack of communication between empoyees and empoyers when it comes to persona probems or heath issues. aviva.co.uk/heath 19

20 Introduction When we conducted our third Heath of the Workpace report a year ago, the outook ooked ess than positive with both GPs and business eaders predicting stress eves woud soar in the year ahead. Worryingy, empoyee behaviours were aready beginning to demonstrate that their predictions coud be correct. Neary six in ten workers said that their work environment was making them fee stressed and under pressure. Empoyees were working onger hours, taking fewer unch breaks and spending ess time on eisure activity. Moreover, instead of turning to their empoyers for hep, they were smoking, induging in a poor diet and drinking acoho to hep them dea with the stress. The situation was aready having an adverse effect on empoyees heath and webeing, with neary haf of workers strugging to seep due to work reated-stress and a third suffering from neck and backache. As expected, the nations stress eves continued to be a much-covered topic throughout Findings from the CBI/Pfizer 2010 absence and workpace heath survey show that menta iness continues to be a eading cause of sickness absence for UK industry. In fact, anaysis from the empoyee assistance programme Aviva offers its customers has shown that the number of work stress cases assessed has increased by 64% between 2008/9 and 2009/10. The number of fact sheets accessed on topics reating to redundancy and changes at work have trebed in the same period and the number of cas directy reating to the credit crunch doubed. The outook for the insurance industry aso ooked chaenging. Whist few companies had cut spending on private medica insurance (12%), group income protection (8%), group ife (7%) and counseing services (9%), there were few signs of new investment, with just 1% of businesses panning to introduce new heath and rehabiitation benefits in Heath of the Workpace 4 Report

21 New era, new opportunities A year on from our Heath of the Workpace 3 report, we re officiay out of the recession and embarking on a new poitica era. Whist there s some cause for optimism, our Heath of the Workpace 4 research shows that business eaders are sti facing the same diemma that they were a year ago - the need to baance the cost of investment in empoyee heath and webeing with the financia priorities for the businesses. Whist business eaders recognise the importance of a heathy happy workforce, they are sti prioritising productivity and profit over staff motivation and work/ife baance. Neary a third (31%) want maximum profitabiity for headcount Two in five (39%) demand a highy productive team who are fexibe and can respond to change. That said, it s good to see that there is evidence of paternaism in some companies, with over a quarter (27%) saying that their main priority is to create a motivated team who enjoy working together and a quarter (25%) saying that their number one priority is achieving a friendy company with a good work/ife baance. Whie empoyers are making some very positive moves towards fostering a heathier workpace environment, the overwheming priority is sti on chasing profitabiity. In the short-term, this strategy can sustain a business through a difficut trading period, but it wi undermine business performance in the onger term by damaging staff morae and aowing conditions ike stress to fourish. Dr Doug Wright, Principa cinica consutant, Aviva UK Heath aviva.co.uk/heath 21

22 Bigger isn t aways better Consistent with the findings from our Heath of the Workpace 3 report, our research shows that company size pays a key roe in business priorities. Smaer companies appear to pace a stronger emphasis on paternaism and nurturing strong inter-persona reationships in the workpace. The smaer the company, the more important work/ife baance appears to be, with haf of companies with ess than nine empoyees citing this as their number one priority for their business. This fas to just 12% for companies with over 100 empoyees. This paternaistic approach appears to be reaping rewards. Our empoyee research shows that focusing on creating a heathy, happy working environment has a knock-on effect to empoyees morae, with neary a third (29%) working for companies with up to 249 empoyees saying that they work in a friendy company with a great socia ife. What do you consider to be the main priorities for your workpace to achieve? 40% 39.22% 35% 30% 25% 30.88% 22.55% 27.94% 25.00% 20% 18.63% 15% 12.25% 10% 5% 0% Maximum profitabiit for head count Award winning service offering Creating a motivated team who enjoy woking together A highy productive team who are fexibe and can respond we to change Creating a vibrant office ife, where staff wiingy give 110% A friendy company with a good work / ife baance. A fexibe / creative environment ready to respond to new chaenges Source: Heath of the Workpace 4, business eader research, Apri Heath of the Workpace 4 Report

23 How do empoyees fee about their workpace? When asked about the atmosphere in their office the responses are generay positive with ony 2% of empoyees stating that they don t find peope at work friendy. A quarter (24.8%) of empoyees are generay happy saying that they work in a friendy company with a great socia ife. This was particuary true for those aged years. Interestingy, this was aso the most popuar answer for those aged 65 years or more, with around a third (32%) saying that they work in a friendy company with a great socia ife. In fact, our research reveaed that neary a quarter (23%) of this age group considers their work to be their ony socia ife, suggesting that peope may continue to work post retirement for reasons other than financia. In comparison, there is another group of peope focused ess on atmosphere at work and more on the task in hand with one in five (21%) saying that they get the job done and go home. The proportion of peope giving this answer was fairy we baanced across the age groups, with the year ods (24%) and 65 and over (27%) showing a sighty higher preference to the answer. A quarter (24.5%) say that the workpace is friendy enough but admit that they don t have much socia ife. This answer was favoured most by peope aged between 25-64, with the highest proportion of those in agreement in the year age group (31%). Ony 13% of those aged and 65 or oder agreed with the statement. Our research re-confirms that there are two distinct types of peope those who see their work ife as an integra part of their socia ife and those who see it purey as a vocation. These findings refect the ong-hed view from behavioura psychoogists that peope fa within one of two categories; those that are tasked focused putting emphasis on getting the job done as the highest priority and those more concerned with emotion and webeing. There is a genera beief that if peope are happy they wi be motivated and oya. In addition, it is aso thought that they wi take ownership for their work and wi pan, monitor and improve much of what they are doing. Understanding the significance of work in a person s ife can ead to more successfu eadership. It can aso improve staff motivation, morae, productivity and webeing. Moreover, by understanding what motivates their empoyees, empoyers can adapt their management stye and rewards strategy accordingy. aviva.co.uk/heath 23

24 Which of the foowing best refects the atmosphere in your job? 25% 24.80% 24.50% 20% 21.12% 22.31% 15% 10% 5% 4.88% 2.39% 0% It s a friendy company, with a great socia ife We get the job done and go home I have a core of good friends at work but don t sociaise as a team I don t find peope very friendy at work We work hard, pay hard It s friendy enough but we don t have much socia ife Source: Heath of the Workpace 4, empoyee research, Apri How are empoyers contributing to the atmosphere? When asked if their manager does a good job at maintaining heath and happiness in the workpace, a high proportion of empoyees say that their boss is having a positive effect on the atmosphere: Neary a third (30%) agree that their boss ensures that they have a good work/ife baance Neary one in five (19%) say that their boss takes a persona interest in how each person is performing and makes sure they are not overoaded. However, as with most things, there s aso another side to the story with neary one in five (19%) empoyees saying that their boss creates a stressfu atmosphere and one in five saying that their boss makes sure that everyone pus their weight. Perhaps more worrying, neary a quarter (22%) of empoyees say that they don t think that their boss has any contro over the atmosphere suggesting that they too are under pressure. 45% of business eaders say they are more stressed at work than at home. Source: Heath of the Workpace 4, business eader research, Apri Heath of the Workpace 4 Report

25 Reationships in the workpace Friend versus coeague When asked about reationships with coeagues, findings from the business eaders and empoyees research are very simiar. Not surprisingy, our research shows that the workpace sti pays a key roe in nurturing persona reationships for the majority of business eaders and their staff: Neary three quarters (73%) of business eaders say that they woud consider a few of their work coeagues to be persona friends A third (33%) of empoyees say they have two to three work friends who they ove to sociaise with Neary three quarters (72%) of empoyees say that they have cose friends either at work, or that they d met at work Conversey: One in five (20%) business eaders ike to keep their home ife and work ife competey separate A quarter of empoyees say that they keep their work and home friends competey separate. Woud you consider any of your coeagues to be persona friends? 50% 45% 47.11% 40% 35% 30% 25% 24.70% 23.01% 20% 15% 10% 5% 2.39% 2.79% 0% Yes, I have a coupe of friends I have a number of friends who I met at work No, I have ony just joined the company so I haven t made any friends yet No, I don t ike where I m working and woudn t consider any of my coeagues a friend No, I ike to keep my work and persona ife seperate Source: Heath of the Workpace 4, empoyee research, Apri aviva.co.uk/heath 25

26 How often do empoyees sociaise together? The genera trend across the whoe sampe shows that it is commonpace for empoyees to sociaise with their work coeagues every few months (23%). This increases in the oder and younger segments, with one in four (20%) year ods, and neary a quarter of those aged 65 or over, saying that they sociaise with their coeagues every week. Of the one in six (15%) who say they never sociaise with their work coeagues, men are more ikey to keep their home and work ife separate, with one in four (19%) saying they never sociaise with their coeagues compared to one in ten (12%) women. Roe modes Despite the high profie of many of today s business eaders and the increased time many empoyees are spending in the workpace, it is apparent that home ife sti pays a greater roe in defining peope s behaviours and beiefs. Interestingy, 44% of business eaders say that they don t have a roe mode in their ife and ess than 4% mention another we-known business eader. Of those who cited a roe mode: Fewer empoyees have a roe mode (39%) and it s evident that home ife pays an even greater roe in defining empoyee behaviours: Neary a third (32%) say their mum 27% say their dad 14% say their partner. Worryingy, ony 4% say their current or a former boss is their roe mode, despite 47% of business eaders feeing that they are good roe modes. This demonstrates a contradiction between how business eaders perceive themseves and how empoyees perceive them. 47% of business eaders think that they are good roe modes yet ony 4% of empoyees cite a current or previous boss as their roe mode. Source: Heath of the Workpace 4 business eader research, Apri A quarter (25%) say their mum One in five (19%) say their current or a former boss 15% say their partner. 26 Heath of the Workpace 4 Report

27 Roe modes in the workpace When asked specificay about roe modes in the workpace: One in five (20%) business eaders say it is their boss or ine manager 18% say a senior coeague 16% say their coeagues / peers. When asked if they are a good roe mode 43% say that they don t know, which is concerning considering the importance of good eadership in the workpace. In addition: Neary a third (29%) fee that they are good roe modes because they ve sacrificed a ot to get to where they are Neary one in five (18%) say they are good roe modes because they ve buit their company up from nothing. Despite specificay asking about roe modes in the workpace, neary haf (45%) of empoyees say they don t have a roe mode at work. Of those that say they do have one, the coser the empoyee is to the person in seniority, the greater the infuence: Roe modes pay an important roe in an individua s behaviour, particuary when it comes to heath. If parents ead an unheathy ifestye, it s ikey that their chidren wi too, meaning that they are ikey to suffer from simiar heath issues. The workpace can aso pay a key roe in empoyee behaviours. Worryingy 45% of business eaders admit that they are more stressed at work than at home, and it s evident that this is affecting their empoyees. Empoyers recognise what they have to do and they now need to ead by exampe. Dr Doug Wright, Principa cinica consutant, Aviva UK Heath Neary a quarter (24%) say a coeague/ peer Neary one in five (17%) say their boss/ ine manager Just 2% say their company CEO sighty ess than motivationa books. aviva.co.uk/heath 27

28 Behaviours and eadership When asked if they behaved differenty at home than at work, over a third of business eaders (37%) say that they are more dominant at work than at home. 61% of empoyees fee that they were equay dominant at work and at home. Interestingy, when this is spit by gender, both mae and femae business eaders fee that they are more dominant in the workpace. However, when we asked empoyees the same question, stereotypes came into pay with women tending to say they are more dominant at home (27%) and men feeing that they are more dominant at work (21%). When asked specificay about their stress eves, we saw simiar resuts for both business eaders and empoyees: 45% of business eaders say they are more stressed at work than home, compared to just under haf (47%) of empoyees Ony one in ten (10%) business eaders and empoyees say that they are more stressed at home. 28 Heath of the Workpace 4 Report

29 Staff motivation and reward Empoyee benefits Despite the chaenging economic environment, just over haf of business eaders (51%) offer one or more of the key heath and group risk benefits. With neary a third offering private heath insurance, it continues to be the most popuar empoyee benefit, foowed by group ife (29%) and group income protection (14%). Interestingy, ess that one in five (18%) offer an empoyee assistance programme, despite rocketing stress eves in % 45% 40% Do you have any of the foowing in your empoyee benefits package? 49.02% 35% 30% 25% 29.41% 30.88% 20% 17.65% 15% 10% 14.22% 11.76% 5% 0% Group Life Assurance Group Income Protection/Permanent Heath Insurance Group Critica Iness Empoyee Assistance Programme Group Private Medica Insurance None of these Source: Heath of the Workpace 4, business eader research, Apri aviva.co.uk/heath 29

30 Wider initiatives to motivate and reward empoyees When considering the wider motivationa initiatives and rewards package, empoyee communications and engagement featured highy, with around a third of those we spoke to saying that they run an empoyee newsetter (31%), operate an intranet site (37%) and recognise the importance of giving staff a voice through an empoyee counci (28%). Monetary reward appears to be ess widey offered with just over a quarter of business eaders saying that their company operates a bonus scheme (28%) or runs an empoyee of the month or simiar reward scheme. Overa, socia events prove to be the most common means to motivate staff, with over haf of the business eaders we spoke to saying that their company organises reguar get togethers to hep buid team spirit. Interestingy, our research shows that despite business eaders funding socias, the responsibiity for arranging the events is given to their empoyees. Over a third (37%) of empoyees say that they and their coeagues arrange things informay between themseves. Just one in ten (12%) say that their boss arranges their socia events. Given this, you d expect empoyees to vaue and enjoy these events but our research suggests otherwise, prompting the question whether the motivationa budget aocated to these events coud be better spent esewhere. We expore this more in the vaue of socia events section of the report. 31% of business eaders arrange socia events every few months 20% rarey, or never have socias Source: Heath of the Workpace 4 business eader research, Apri % 45% 45.59% Thinking about buiding team spirit, do you offer any of the foowing? 40% 35% 30% 30.88% 36.76% 27.94% 28.43% 25% 22.06% 20% 18.14% 18.14% 15% 10% 5% 0% Organise reguar Run an empoyee socias newsetter Operate an intranet Operate (PRP)/ Awards / Teambuiding bonus empoyee of games the month Empoyee counci / representation None of these Source: Heath of the Workpace 4, business eader research, Apri Heath of the Workpace 4 Report

31 The most popuar socia activities When we asked business eaders what form their socia events take, going to the pub for drinks (57%) or out for a team unch (60%) are by far the most common ways of sociaising. In comparison, ony one in five (23%) run teambuiding days and just one in ten (13%) participate in sporting pursuits. As expected, the findings from the empoyee research refect those from the business eaders with: Over haf (52%) of empoyees saying that they go to the pub for a drink Over a third go out to restaurants (37%) Less then one in ten (7%) participate in sporting activities. The roe of acoho Athough many socia events are hed in pubs, ony 45% of business eaders say that there s no obigation to drink acoho at these events. In fact, over a quarter (26%) admit that they don t mind their staff having a few drinks, as ong as they don t get out of hand. Our research shows that acoho is seen as a way to encourage empoyees to reax with just over one in ten (13%) saying that a few drinks heps peope come out of their she. A simiar amount (12%) of business eaders even admit they get the inside track on the workpace once their empoyees have had a drink. Which of the foowing do you reguary do on work socias? 70% 60% 57.35% 60.29% 50% 40% 30% 20% 10% 13.24% 18.63% 22.55% 10.78% 14.71% 4.41% 9.80% 0% Go to the pub / bar for drink Gym / sporting pursuits Cinema / theatre Team buiding days Restaurant / team unch Watching sporting fixtures Quizzes / games and competitions Other, pease state I do not take part in work socias Source: Heath of the Workpace 4, business eader research, Apri aviva.co.uk/heath 31

32 Despite doing itte to discourage their empoyees from drinking acoho, it is cear that business eaders don t see excessive acoho consumption as an excuse for absence. If this happened, over a quarter (27%) of business eaders woud be unsympathetic, saying that empoyees shoud be abe to hande their drink. The same amount woud worry that empoyees may think it is acceptabe to take sickies foowing a work night out. 40% of business eaders say they woud worry that they were having a damaging effect on their empoyees heath if their empoyee caed in sick the next day. 50% 45% If most of your socia events invove drinking, which one of the foowing best refects how you fee about it? 45.10% 40% 35% 30% 25% 26.47% 20% 15% 10% 13.24% 10.78% 5% 0% A drink heps bring peope out of their she I am a for a few drinks, but don t ike things to get out of hand 2.94% I woud ike to vary what we do but the team enjoys going to the pub We work very hard, and are due a chance to et off steam 1.47% Peope shoud be abe to take drink if they want to fit in here There s no obigation to drink acoho on our socias Source: Heath of the Workpace 4, business eader research, Apri % 40% Which of the foowing best refects how you d fee if an empoyee caed in sick after a work night out? 40.20% 35% 30% 25% 26.96% 26.47% 20% 15% 16.67% 17.16% 10% 5% 0% I d find it amusing - as ong as it didn t happen too often. I ve got no sympathythey shoud be abe to hande their drink. I d be concerned that work organised events coud be having such a negative impact on their heath. I d wonder if it was a sign of a bigger probem for the empoyee. I d worry that other empoyees might get the idea that it was OK to take sickies! Source: Heath of the Workpace 4, business eader research, Apri Heath of the Workpace 4 Report

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