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Dr Zofia Bajorek

The Way Forward: Policy options for improving UK workforce health

Authors: Dr Zofia Bajorek

21 October 2014

The last two decades have seen a growing understanding among policy-makers, academics and practitioners that employee health and wellbeing is important - for the individual, the organisation and society - and it has become increasingly important that policy-makers and organisations understand their role in developing health and wellbeing initiatives.  The first paper from The Work Foundation’s Health at Work Policy Unit aims to stimulate discussion and debate about policy measures which could be adopted to increase the number of employers who are active and effective in developing and implementing workplace health and wellbeing programmes. 

But why is this important now?

The demographics of the workforce are changing, people are having to work longer, and there are more employees working with a long standing health problem (physical or mental), which presents an organisational productivity challenge and a major burden for society (increased healthcare costs and welfare payments).  Evidence suggests that organisations which have successfully implemented health and wellbeing programmes have indicated a reduction in sickness absence and improvements in staff turnover and employee satisfaction.

The issue here is that the benefits of health and wellbeing programmes accrue unevenly across a number of stakeholders, including businesses, individual employees, their families, the NHS, HM Treasury and the DWP.  You could then argue that it is rational for employers to under-invest in workforce health as they receive only a proportion of the returns. So, if the government wishes to see the wider societal benefits of improved workforce health and productivity, they too must be willing to invest more in well-targeted measures to improve the incentives for employers to act.

So what are the organisational barriers to investing in health and wellbeing?

A review of literature and employer-based interviews identified the barriers to organisational investment in health and wellbeing:

Planning: Organisations often fail to capture and articulate a business case, they fail to engage their employees, there is reduces senior management engagement, organisations may not have a ‘wellness’ culture, and resources (both staff wise and financial) create hurdles.
Implementation: There can be a lack of effective communication regarding programme benefits, and no co-ordinated or coherent structure for promoting workforce health and wellbeing.
Evaluation and continued management: Evaluation of health and wellbeing programmes can be difficult to undertake, making development or investments in future programmes difficult.

Is there a way forward?

The paper argues there can be if employers implement a number of steps to overcome the barriers, and if policy makers consider a broad range of measures to help promote employers to encourage workplace health and wellbeing. Employers need to develop a health and wellbeing strategy, invest and execute evidence-based interventions and measure and report outcomes. For policymakers a range of ideas have been presented, including: fiscal based incentives (such as tax incentives, matched funding, or levy systems); regulation (both in regulating the health and wellbeing measures that employers should provide and what health and wellbeing measures they should report); collaboration through local budget-pooling (stakeholders to be encouraged to overlap interests and collaborate more); responsible procurement (public sector to only procure the services of organisations with reputable health and wellbeing policies); investors perspectives (requiring investors to use organisational health and wellbeing data when deciding whether or not to invest in an organisation) benchmarking; kite-marking and organisational pledges (e.g. public health responsibility deal).

Our recommendations

After a decade of steady progress in the awareness of organisational health and wellbeing, we face another decade of challenges which requires increased momentum, boldness among policy-makers and some public investment.  Our recommendations to remove organisational barriers to the implementation of health and wellbeing include:

  • The government to do more to actively promote the issue of health at work, and including the policy options discussed into debate with a range of stakeholders.
  • The government should offer clearer, more up-to-date and proactive advice and guidance (e.g. reviewing the content and revising the HSE stress management standards, the active promotion of NICE guidelines and public health guidance from PHE etc.)
  • The business case for a healthy workforce should be made in a way which speaks to employers, tailored to organisations and encourages them to take voluntary action.
  • Employer-led voluntary options should be encouraged and expanded.  For example, organisational pledges, kite-marking/accreditation should be further developed and streamlined.
  • Feasibility testing on a range of options to understand how they could be implemented, including: fiscal incentive, levy systems and budget-pooling.  The government should also review the feasibility of targeted incentives.
  • The government should reform its procurement processes in order to include a consideration of workplace health and wellbeing when deciding on suppliers.
Let the discussion begin!  We look forward to an informed and lively discussion on these issues – please be part of it.