Employers should try to look after employees' health, but must not seem like Big Brother, says Katrina McKeever

From lunchtime weight-loss clinics to smoking cessation sessions and blood-pressure monitors linked to computers, some employers have expanded their health and wellbeing benefits far beyond the traditional approach of providing private medical insurance (PMI) to selected senior staff. Some employers now encourage employees to walk to work, exercise at their desks, eat five portions of fruit and vegetables a day, and even measure their body fat at work.

Improving employees' health can have business benefits, for example, by reducing the cost of PMI premiums, increasing productivity, boosting staff motivation and cutting absence levels. But employers should take care not to overstep the mark, because there can be a fine line between showing concern for the health and wellbeing of their workforce and nagging them to shape up. If employers try to dictate to employees how to live their lives, they could end up alienating staff, rather then encouraging them to stay.

But with the ever-increasing cost of PMI and sickness absence hitting the bottom line, organisations are increasingly interested in keeping tabs on the state of their employees' health. In the US, employers are encouraged by their insurers to monitor staff health in order to pick up potential problems early, so as to minimise claims. As employers recognise the importance of data on employee wellbeing, some in the US are going so far as to incentivise staff to fill in health assessments. But in the future, they may not need to rely on employees filling in forms to monitor staff heath.

In January this year, Microsoft was reported to have filed a patent application for a computer system that links people to their computers using wireless sensors that measure their metabolism and factors such as heart rate, body temperature and blood pressure. Microsoft has already launched a system that enables computer users to measure their blood pressure while working at their desktops.

Such technological developments have raised fears that employers could adopt a Big Brother-approach to staff health by using the systems to monitor employees' physiological state for performance purposes.

But, realistically, there would be many hurdles to clear before UK employers can go down this route, including opposition from unions.

Paul Maloney, senior organiser at the union GMB, says monitoring must be consensual. "GMB frequently finds that monitoring of employees by their employers results in bullying and harassment and in the long term can cause stress illnesses," he adds.

Kristina Herrera, senior vice-president, reinsurance and US benefits at UnitedHealth International, says in the US, health risk assessments are common and consist of questions about employees' height, weight, type of food consumed in a typical day, the amount of exercise they do, tobacco use, whether they wear a seat belt when driving, and the number of doctor or hospital visits they make in a given year. "If we can identify those people with health risks early and work to modify their behaviour, we can prevent disease and help people live healthier lives," she says.

Employers who put the health and wellbeing of their staff as a top priority may be considered too paternalistic by some people, but David Priestley, sales director at PruHealth, says businesses will only do what makes commercial sense for them. Some employers recognise that having a healthy workforce helps to maximise productivity, but those that do not may be forced to put a greater emphasis on staff health and wellbeing in the future as legislation is moving towards encouraging employers to take greater responsibility for staff, says Priestley.

In some cases, employees have come to expect their employer to take a paternalistic approach to their health and wellbeing, especially where benefits such as PMI are provided. Paul Ashcroft, unit head of health and wellbeing benefits at Mercer, says: "Once you have moved down the road to providing these benefits, it is very difficult to take them away. They become highly valued."

Even so, employers may find some health and wellbeing initiatives are not being utilised fully by staff. For example, staff may be reluctant to use an employee assistance programme (EAPs) to help them deal with the sensitive issue of stress or may not want to take part in office weight loss and fitness programmes for fear of embarrassment. Employers may find they have to motivate staff to take advantage of what is on offer, but should ensure they are not perceived to be nagging them to do so because this could be counter-productive.

"Employees need motivation and incentives," says Priestley. "Employers need to dangle that carrot to encourage them to take part, remove barriers that exist to making healthy choices. For example, people might not get a health screen because it is expensive, so provide a discount. Smoking cessation, health screening, accessing a gym — there is a whole array of activities, so make it cheaper and easier for staff to access these things, and reward them for doing so."

The key for employers is to incentivise employees, not punish them. Even subtle moves, such as reducing car parking spaces to encourage more staff to walk to work, will have a negative impact if it is not handled correctly. Instead, employers could look at rewarding their workforce for choosing healthier ways of travelling to work, such as cycling or walking.

Another subtle way is to offer wellbeing perks through flexible or voluntary benefits schemes, says Andrew Grigg, strategic healthcare director at Jelf Group. Staff then feel they have made their own decision to take action, rather than being forced to do so.

Health and wellbeing perks that fit into flex and voluntary benefit schemes include discounted gym membership, cycle-to-work schemes and EAPs. These can be offered alongside further initiatives such as weight loss and smoking advice clinics, health assessments, and even free fruit at work. Providing such benefits as options can also help to mitigate any suggestions that an employer is taking too much of a Big Brother-approach to employee health.

But communication must be handled with sensitivity. In the US, employers are tackling the issue of obesity by offering staff the chance to join the Biggest Loser League, a weight-loss programme run through a social networking site, set up by Willis HRH Employee Benefits and Partners, and the television network NBC.

In the UK, Water (for Work and Home) offers a range of wellbeing initiatives that staff can use confidentially, such as its smoking-cessation group and a wellness point at its head office where staff can check their blood pressure, weight, body mass index, fat content and hydration levels in five minutes.

Managing director Ben McGannan says no one feels the company is taking a dictatorial approach and, because the initiatives are anonymous and voluntary, staff have engaged with them. Absence has halved to three days per employee per year since 2005 and turnover has improved, he says. "It is all in the context and spirit of things. Never isolate people and say 'why aren't you doing this?'. Make people aware, but don't judge them."

So communication is key to encouraging staff to take up healthy benefits without being seen as taking too hard a line. Charles Cotton, reward and recognition adviser at the Chartered Institute of Personnel and Development, says the most effective method is to treat staff as adults and "explain what you are doing, why and how, rather than taking a more paternalistic approach, such as whipping puddings off the staff canteen menu" EB For more pm wellbeing, visit: case studyTowry Law enhances wellbeing Wealth management company Towry Law introduced a wellbeing strategy two years ago following a remodelling of the business.

Its aim was to change the workplace culture and enhance the wellbeing of its 650 employees.

As part of the change, the firm gave free gym membership to all staff and provided a purpose-built gym at its head office in Bracknell, where two personal trainers are based permanently. Staff can ask the qualified trainers questions on diet, health and wellbeing, either in person or via a button on the web page.

There is also a superstars day, which is a grown-up sports day for staff to take part in various activities.

The health package is supported with free access to smoking cessation sessions with Allen Carr Easyway, health and nutrition advice, and workshops on demand.

Alex Rickard, head of human resources, says: "We believe staff should enjoy work and feel healthy. That is why we look out for their emotional and physical health. People feel happy, comfortable and looked after. It has also had an effect on our bottom line."