The Way Forward: Policy options for improving workforce health in the UK

Transcription

1 Octber 2014 The Way Frward: Plicy ptins fr imprving wrkfrce health in the UK Executive Summary Zfia Bajrek Victria Shreeve Stephen Bevan Tyna Taskila 1

2 Abut the Health at Wrk Plicy Unit The Health at Wrk Plicy Unit (HWPU) prvides evidence-based plicy recmmendatins and cmmentary n cntemprary issues arund health, wellbeing and wrk. Based at The Wrk Fundatin, it draws n The Wrk Fundatin s substantial expertise in wrkfrce health, its reputatin in the health and wellbeing arena and its relatinships with plicy influencers. The HWPU aims t prvide an independent, authritative, evidence-based vice capable f articulating the views f all stakehlders. The Wrk Fundatin transfrms peple s experience f wrk and the labur market thrugh high quality applied research that empwers individuals and influences public plicies and rganisatinal practices. Fr further details, please visit 2

3 The Way Frward This first paper frm The Wrk Fundatin s Health at Wrk Plicy Unit aims t stimulate discussin and debate abut plicy measures which culd be adpted t increase the number f emplyers wh are active and effective in develping and implementing wrkplace health and wellbeing prgrammes. Althugh Dame Carl Black s 2008 reprt, Wrking fr a healthier tmrrw encuraged plicy makers and practitiners t develp and implement initiatives t imprve wrkfrce health and wellbeing, and ur awareness f the issues has increased ver the last decade, a number f barriers t innvate, implement and evaluate such initiatives have been recgnised. The demgraphics f the UK wrkfrce are changing: the wrkfrce is ageing and having t wrk lnger. In additin there is an increasing number f emplyees with a lng standing health prblem r disability (bth physical and mental cnditins). This presents bth an rganisatinal prductivity challenge and a majr burden fr sciety due t increased healthcare csts, increased welfare payments, reductins in incme tax receipts and increased sickness absence. A number f plicy dcuments and practical initiatives frm gvernment (such as the Fit Nte) have emphasised the imprtance f tackling emplyee illhealth, and the evidence suggests that rganisatins which have successfully implemented health and wellbeing interventins have reprted a reductin in sickness absence and imprvements in staff turnver, emplyee satisfactin and a decrease in accidents and injuries reprted. Therefre the questin remains: If the business case has been made in such a cmpelling way, why then are a large number f rganisatins still nt investing in health and wellbeing? And what rle, if any, des the gvernment have in imprving the situatin? T explre the barriers that emplyers face when carrying ut health and wellbeing prgrammes bth a review f the literature and emplyer based interviews were used. Barriers were identified at three stages (planning; implementatin; and, evaluatin and cntinued management): Barriers at the planning stage: Making a business case: there is ften a failure t capture and articulate the ecnmic benefits f health and wellbeing in a way that resnates with business and is integrated in and tailred t individual business needs. Withut this there is little hpe in engaging business leaders t invest in wrkplace health and wellbeing. Emplyee engagement and assessment: if there is a lack f emplyee interest and reduced participatin n the part f high-risk emplyees, health prmtin prgrammes may nt be successful. Cnsultatin withut actin can lead t limited emplyee engagement with health and wellbeing prgrammes. 3

4 Senir management engagement: there is currently limited senir management engagement with wrkplace health and wellbeing, and withut this initial buy-in, it is difficult t sustain health and wellbeing prgrammes. Culture: rganisatins must invest in building a culture f wellness t achieve ptimal results frm health and wellbeing prgrammes. Resurces: budgetary cnstraints fllwed by having sufficient physical resurces are hurdles when carrying ut health and wellbeing prgrammes, especially in SMEs. Barriers faced at the implementatin stage: Cmmunicatin: lack f effective cmmunicatin abut features and benefits f health and wellbeing prgrammes limits emplyee and management engagement and mtivatin twards these initiatives and prevents an rganisatinal shift twards participatin. Resurces: health and wellbeing prgrammes shuld be implemented thrugh crdinated and cherent actin and clear accuntability, with jined up thinking between the range f stakehlders wh have a respnsibility fr prmting wrkfrce health and wellbeing. Barriers faced at the evaluatin and cntinued management stage: Management f the evaluatin: evaluatins f health and wellbeing prgrammes can be difficult, especially withut gd baseline data, hwever if rganisatins fail t capture all the benefits f their prgrammes then making a business case fr further interventins r develpment f prgrammes becmes difficult. Cnsequently, there is a need t further develp initiatives that can encurage r incentivise mre emplyers t imprve the health and wellbeing f their emplyees. It seems bvius that the gvernment wuld be in favur f encuraging mre emplyers t invest in mre wrkplace health interventins. Hwever, this is prblematic as the benefits f health and wellbeing prgrammes accrue unevenly acrss a number f stakehlders, including: businesses, individual emplyees, their families, the NHS, HM Treasury and the DWP. It culd be argued, therefre, that it is ratinal fr emplyers t under-invest in wrkfrce health if they receive nly a prprtin f the returns. Thus if the gvernment wishes t see the wider scietal benefits f imprved wrkfrce health and prductivity, they t must be willing t invest mre in well-targeted measures t imprve the incentives fr emplyers t act. Fr rganisatinal health and wellbeing prgrammes t be adpted and implemented successfully there are a number f steps that emplyers must take t vercme sme f these barriers: 4

5 Develp a health and wellbeing strategy which demnstrates hw ptimal emplyee health and wellbeing can supprt the delivery f peratinal bjectives, high-value custmer service, higher prductivity r ther drivers f cmpetitive advantage. Invest in evidence-based interventins and execute them. Measure and reprt utcmes. Hwever, this paper argues that given the public health benefits which culd be realised by a step-change in the number f emplyers becming active investrs in wrkfrce health it is in the gvernment s interests t cnsider ding mre t incentivise and c-prduce better health utcmes fr wrking age peple. After a decade f steady prgress, during which awareness, evidence and the number f gvernment initiatives have increased, we nw face anther decade f challenges which, in ur view, require mre mmentum, sme bldness amng plicy makers and sme public investment. Having reviewed a range f ptins frm within the UK and frm verseas, we have identified a brad range f measures which plicy makers shuld cnsider when attempting t encurage emplyers t d mre t prmte health and wellbeing in their wrkfrces. These include: Fiscal incentives: intrducing tax incentives fr health and wellbeing prgrammes as at present many emplyer spnsred health interventins are taxed as benefits in kind. Other fiscal incentives can include matched funding, where a gvernment grant is equally matched by emplyer investment, tax credits (in the frm f tax relief n emplyer Natinal Insurance cntributins), r t develp a structure f authrised prviders wh prvide a menu f pre-apprved and evidence-based prgrammes. Levy systems: A small levy is paid by eligible rganisatins, and thse wh implement rganisatinal health and wellbeing prgrammes can claim grants that are paid fr by the levy. Incentivising cllabratin thrugh lcal budget-pling : encuraging stakehlders with verlapping interests t cllabrate mre, enabling legislatin and budgetpling at a lcal level. Respnsible Prcurement: public sectr rganisatins culd prcure the services f rganisatins that have reputable plicies with regard t rganisatinal health and wellbeing. Regulatin: this invlves regulating the health and wellbeing measures that emplyers shuld prvide. The prvisin f certain interventins culd becme cmpulsry r require emplyers t reprt n hw they have used them. Regulatin fr reprting: There may be a case fr increased regulatin in what rganisatins shuld disclse and reprt regarding health and wellbeing measures 5

6 and practices they undertake. Benchmarking: a lighter apprach t data reprting, allwing rganisatins t enhance self-assessments f health and wellbeing practices thrugh clsely mnitring what is being dne in their and ther rganisatins. Investr s Perspective: requiring investrs t use rganisatinal health and wellbeing data t gain insights int hw rganisatins treat and value their staff and the verall health and wellbeing f their staff when deciding whether r nt t invest in an rganisatin. Kite-Marking: quality standards develped t raise the attentin and quality f emplyee health and wellbeing utcmes amngst thse wh sign up t accreditatin awards. Organisatinal pledges: rganisatins can make pledges that encurage them t develp a cmmitment t wrkplace health and wellbeing (e.g. Wrkplace Health Charter, Public Health Respnsibility Deal, Time t Change). Our recmmendatins as t hw t remve rganisatinal barriers t the implementatin f health and wellbeing prgrammes include: Debate amngst all stakehlders in this arena needs t mve n frm narrw discussins abut making the business case, t brader discussins abut the range f plicy ptins set ut in this paper. The apprach taken shuld require actin frm the range f stakehlders wh benefit frm health and wellbeing interventins at wrk (emplyers, the NHS and DWP, individuals, and their families) and nt weigh t heavily n any ne. The gvernment shuld d mre t actively prmte the issue f health at wrk, bringing these ptins int mainstream plicy debate. The gvernment shuld ffer clearer, mre up t date and practive advice and guidance, fr example thrugh reviewing the cntent and use f the HSE stress management standards, and the active prmtin f NICE guidance and public health guidance frm PHE and thers. The business case fr a healthy wrkfrce shuld be made in a way which speaks t emplyers and is tailred t their rganisatin in rder t encurage them t take mre vluntary actin; regulatin in mst cases is a secnd rate ptin. A number f emplyer-led vluntary ptins already exist, and these shuld be encuraged and expanded upn. The frm f measurement used shuld be further develped and streamlined as far as pssible: 6

7 Benchmarking Investrs Perspective Organisatinal Pledges Kite-marking/accreditatin. At the same time, the gvernment shuld review the feasibility f using targeted incentives (e.g. thrugh tax relief n Natinal Insurance Cntributins) in rder t redress market failures and t encurage mre emplyers t act and invest in wrkplace interventins. A number f ptins fr this shuld underg feasibility testing t understand exactly hw they culd be implemented: Fiscal incentives Levy system Budget-pling. Gvernment shuld refrm its prcurement prcesses in rder t include a cnsideratin f wrkfrce safety, health and wellbeing when deciding n suppliers. A number f ptins fr hw this is implemented shuld be explred (e.g. thrugh an accreditatin system, thrugh a mre detailed set f labur standards criteria, etc.). 7

8 Acknwledgements The authrs wuld like t thank the emplyers wh kindly ffered their time t take part in the expert interviews and clleagues at The Wrk Fundatin fr their supprt with this paper. In particular, the authrs wuld like t thank Jenny Gullifrd fr her cntributin t the initial scping and develpment f the HWPU. The Wrk Fundatin transfrms peple s experience f wrk and the labur market thrugh high quality applied research that empwers individuals and influences public plicies and rganisatinal practices. Thrugh its rigrus research prgrammes targeting rganisatins, cities, regins and ecnmies, The Wrk Fundatin is a leading prvider f research-based analysis, knwledge exchange and plicy advice in the UK and beynd. The Wrk Fundatin is part f Lancaster University an alliance that enables bth rganisatins t further enhance their impact. This paper has been supprted financially by grants frm Napp Pharmaceuticals Limited and Bupa Investments Limited wh have had n editrial input. 8

9 Cntact details The Wrk Fundatin 21 Palmer Street Lndn SW1H 0AD All rights reserved The Wrk Fundatin (Lancaster University). N part f this publicatin may be reprduced, stred in a retrieval system r transmitted, in any frm withut prir written permissin f the publishers. Fr mre infrmatin cntact [email protected]. The Wrk Fundatin Alliance Limited, 21 Palmer Street, Lndn, SW1H 0AD, UK. Registered Charity N Registered as a cmpany limited by guarantee N Registered address: Lancaster University, Bailrigg, Lancaster LA1 4YW, UK. 9

10 10