How employers are embracing a preventative approach to health and wellbeing

Having healthy workers is clearly a good thing for businesses. Not only are such individuals much less likely to take time off work, they are also likely to be more motivated and productive when they are in work, and to stick around for longer. Yet while many organisations have put in place measures designed to ensure those who are sick return to work as quickly as possible, it is only relatively recently that attention has focused on preventing people becoming ill in the first place, and proactively improving the health and fitness of employees.

Attitudes towards this are starting to change, however, largely as a result of the growing realisation of the impact that both physical and mental health can have on employees, and ultimately business performance. There is now a growing belief that employers have not just a moral duty to ensure staff are healthy - a 2015 survey by Aon Employee Benefits found 75% of employers now believe they have a responsibility to try and change employee behaviours around health and wellbeing - but also that such a strategy makes commercial sense.

"The fact that employers recognise that good employee health is important, and that they have a central role in positively influencing employee lifestyle and behaviour risks, is encouraging," says Matthew Lawrence, head of broking and proposition for health and risk at Aon Employee Benefits. "Employers can help facilitate the right environment for this through their culture; a focus on informing, educating, nudging and providing targeted benefits, services and programmes; and finally effective communication."

Making a start

The problem is that many businesses don't know quite where to start. Research by Axa in April 2016 found 77% of senior managers in medium and large businesses said their organisation had a health and wellbeing strategy, but a fifth said they hadn't seen any benefit as a result. "This signifies a lack of connection between purporting to have a strategy and it making a perceptible difference," suggests Nick Jeal, head of corporate marketing at AXA PPP healthcare. "A better understanding of the drivers of employee health and wellbeing can help align interventions to address the particular requirements of your business more effectively."

Xerox HR Services senior consultant Chris Evans says a good starting point is to carry out a health assessment of the business to identify its own specific needs and any areas of concern. "Using health assessments is an excellent method of establishing baseline data from which to navigate," he says. "Typically we would define wellbeing in three categories - physical, mental and financial - and interestingly they are all interrelated, which means that whatever programmes are deployed they can impact all three areas."

Alongside this, however, there needs to be a broader culture which understands and promotes the importance of workplace health. "Businesses need to make this part of the organisational culture and embed it from the top down, to demonstrate to employees how committed the business is to their wellbeing," says Nicki Cresswell, wellbeing co-ordinator at the Chartered Accountants' Benevolent Association (CABA), which often deals with both physical and mental health issues. "This can be done from directors leaving on time twice a week, through to wellbeing days when massages or health MOT checks are available to all employees. Even small measures, such as water dispensers near to desks, will encourage healthy habits."
Getting physical

On the physical side, there are a number of simple steps which employers can take, says George Anderson, a health and fitness coach who provides advice and guidance to businesses. "It's possible to start making a difference with something as simple as introducing healthier options at the staff canteen, or replacing chocolate and fizzy drink vending machines with fruit, packs of nuts and smoothies," he says. Other options include discounted gym memberships, on-site workout classes, educational workshops or team challenges like the Three Peaks or London Marathon, he adds.

Team Activ specialises in running team-based challenges for employers including Rolls-Royce, PwC and Plusnet, designed to improve health and wellbeing as well as encourage closer team bonds. These range from business sports days based around themes such as James Bond or the Olympics to more regular five-a-side football tournaments. "We've found it increases people's productivity and creativity," says founder Darren Padgett. "They work better as a team and it increases their self-belief and confidence, leading to increased motivation."

Introducing a cycle-to-work scheme can also have a positive impact, by encouraging employees to cycle to work rather than drive. A survey by the Cycle to Work Alliance suggests 89% of employers see health improvements among staff after introducing a scheme, including increased fitness levels, lung capacity and reduced stress levels.

"Cycling to work five times a week can burn 4,000 calories, based on an average seven-mile commute," says Steve Edgell, managing director of Cycle Solutions. "Studies have also shown cycling to work can reduce the risk of diabetes, low blood pressure and the chance of a heart attack or stroke by up to 50%. This type of exercise can improve mental health and wellbeing too; riding a bike can trigger an endorphin rush, reducing stress levels and making employees feel generally happier."

Where there are concerns around health conditions, employers can also take action to prevent these becoming more serious or identify any existing conditions early on. Hosting workshops providing advice on particular issues is becoming more common, says Annie Parsons, founder of Wisteria Wellbeing, and these have the added advantage that staff can support each other when making lifestyle changes. "Major risk factors for poor mental health include unhealthy eating and obesity, lack of exercise, smoking and alcohol abuse," she says. Follow-up sessions after three months can track how people are doing and record any improvements to health and wellbeing, she adds.

Health screening

Individual health screenings are also becoming more of an option for employers, particularly as costs have come down recently with new providers entering the market. At an individual level, this can take the form of ‘know your numbers' assessments, suggests AXA PPP's Jeal. "This can give employees valuable information on key health indicators such as blood pressure and body mass index (BMI), as well provide guidance on the small lifestyle changes that can make a big difference to an individual's health and wellbeing," he says.

Such tests can also help employers identify more general workplace issues, using anonymous employee data provided by health screening suppliers, around areas such as blood pressure, BMI, liver health and the number of smokers an organisation has. In some cases this can identify particular areas which require attention; Bluecrest Wellness managing director Pete Blencowe gives the example of multinational food business Danone, which found it had an issue with a lack of vitamin D in staff during the winter months, prompting it to provide sprays to employees.

For some organisations, the area of concern will be mental, rather than physical, health. This can also form part of health screening programmes, says Carol Porter, head of commercial and communications at The Health Insurance Group, and where any issues are identified people can be directed towards an employee assistance programme. "These are intended to help employees deal with personal problems that might adversely impact their job performance, health and wellbeing, and can include short-term counselling and referral services for mental health issues," she says. Employees often receive free access to such services as part of group income protection policies.

Work-life balance

Here, too, though, it's vital that there is a culture where people can maintain a healthy work-life balance, without coming under so much work-related pressure that they end up becoming unwell. The reality is that most organisations do not pay enough attention to this. "We work in cultures where longer hours and ‘presenteeism' are often encouraged," says Sarah Rudder, a consultant at Thales Learning and Development.

"We're now seeing reports of ‘leavism' where people are using annual leave instead of sick leave, and using days off to catch up on work. Emails are responded to 24/7 and this is deemed to be the norm. We eat ‘al-desko' and don't take breaks. We've lost our boundaries as individuals, and employers aren't encouraging people to put those back in place." Organisations need to have a culture where it is acceptable to talk about issues, and where staff can take regular breaks and work flexibly when required, she adds.

Line managers also have an important role to play here by identifying any potential issues or signs of stress in their employees, says CABA's Cresswell. "A manager who recognises the problem and puts a solution in place quickly will help alleviate stress before it becomes a major issue," she says. "For example, if an employee finds lots of meetings or disruption stressful, it may be beneficial for them to work from home twice a week to get their work done." But line managers need training in this, she adds, including initiating discussions around how people are feeling at one-to-one meetings and in spotting changes in behaviour.

Demonstrating a return on investment

One of the challenges for any business in tackling health issues before they become more problematic is to prove the return on any investment and the impact that having healthier staff has on wider business aim.

There are a number of ways in which this can be done, however, including staff wellbeing surveys which can help pick up on the overall mood of a workforce. "Sending these out every six months and monitoring them against a benchmark can provide a snapshot of employee sentiment," says Cresswell.

"This enables businesses to identify issues, implement solutions and then ask again, hopefully highlighting an improvement. It also enables target setting and new areas to improve."

Data from health screening programmes can also demonstrate the impact of health initiatives, both physical and mental, says The Health Insurance Group's Porter. "This can track improvements in BMI, blood pressure and cholesterol levels, as well as increased exercise and reductions in anxiety, depression and substance abuse," she says.

Ultimately, a successful preventative health policy should filter through into more engaged staff, which can be measured in employee engagement surveys. There is a clear link here, suggests Aon's Lawrence; an engagement study by the consultant suggests employees with strong wellbeing are nearly six times as likely to be engaged as those with poor health. In turn, this should lead to other benefits, including higher productivity, better retention rates and reduced recruitment costs.

Perhaps the most convincing evidence, though, will come in the form of reduced absence costs; something the CIPD estimates costs every employer £554 per year for each employee, even before the impact of presenteeism is taken into account. "Whatever the cause, the consequences of ill-health can be calamitous for a business," points out AXA PPP's Jeal. "Why wouldn't businesses want to address this?"