Senior managers drive an organisation, but what if stress and healthcare issues undermine performance? Then learn to act on the early warning signs, says Kirstie Redford

Case study: Toshiba Information Systems

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Looking up from the lower ranks, senior executives seem to have it made. They have the power to take important decisions, do business over expensive lunches and take home a huge salary. However, the term 'executive stress' was coined for a reason. And working long hours in highly-pressured situations can medically take a heavy toll. Tony Urwin, clinical and business development manager at Bupa Psychological Services, says: "Successful executives tend to be competitive, driven and find it difficult to switch off.

While busy climbing the career ladder, years of stress could be accumulating and waiting to [be revealed] in a serious condition, such as a heart attack." Helping senior employees to take better care of their health makes business sense not only in terms of their own productivity, but also that of the workforce in general. Les Smith, chief medical adviser at provider firm FirstAssist, says: "Senior staff need to be resilient so they can bounce back if they are ill. They need to get better sleep, more time away from work and a healthier lifestyle. If they are seen to make these changes, it cascades down to the whole team. The more energetic staff are, the more productive they are and the more profitable they are to the organisation."

While senior management may encourage the taking of lunch breaks and flexible working in an attempt to reduce the stress levels of staff, when it comes to their own wellbeing, executives may turn a blind eye. Lesley Cooper, consultant at health advisers IHC, says: "When HR starts to talk about issues such as stress, they think: what do you know about running a business? But executives need to realise that they have to fire on all cylinders to perform well. If they are tired and over-burdened they will lose their edge and the ability to think clearly." For most organisations wanting to ensure the health of their senior executives is paramount, so regular health screenings are core benefits offerings. But these can be costly.

Peter Smythe, head of marketing at Bupa Wellness, says: "Our top-end product is Premier Health Assessment and costs between £540 and £585 per person. It tests stamina and strength with the aim of improving resilience to help executives cope with pressures at work." For an extra £400, Bupa can also provide a coronary risk assessment. This can detect a heart condition 10 years before it emerges. "One-third of people with heart disease know nothing of their condition until they drop down dead, so this is money well spent," says Smythe.

Apart from being prone to stress and heart-related illnesses, executives also tend to develop musculo-skeletal problems, according to Dr Sabine Donnai, managing director of Prestige Health. "We have advanced software that can do a postural check, assess resilience to stress and prescribe the best ways to avoid burnout. This may include recommending yoga and meditation to help balance the mind and body," she adds. Assessments from Prestige Health start at £60 per head to around £4,000 for its top-of-the-range six-hour assessment.

For those organisations looking for a cheaper alternative there are a number of online health assessment products. Bupa's Positive Health programme, which costs around £15 per head, gives staff regular advice via email on how to change their lifestyle to minimise health risks. Bupa claims that a recent study found this to prompt a 14% reduction in stress, 72% reduction in sleep problems and 52% reduction in excess alcohol consumption. Axa PPP Healthcare has partnered with Wellness Technology to provide an online health questionnaire for staff. Questions on issues such as diet and stress help the human resources department to benchmark wellness and identify whether certain groups are at risk of ill health. Dudley Lusted, head of corporate healthcare development at Axa PPP healthcare, says:"HR can then see if there are gaps in, for example, training, that are adding to pressure."

Other providers that give personalised health and wellbeing assessments, and improvement strategies include VieLife, Businesshealth and FirstAssist. Clive Pinder, managing director of Vielife, says: "Assessing factors such as sleep can be very important for senior staff. We also have lifestyle strategists that can give advice on, for example, jet lag if they are travelling a lot." To help senior staff perform better, Pinder recommends a quick break by taking 40 winks. "We have a nap room at Vielife, where staff can have a 20-minute nap before an important presentation. This has proved effective in other sectors too - Formula One drivers have a 40 minute nap before a race," he says. Other services can include counselling and mentoring to help staff with everything from giving up smoking to avoiding burnout.

FirstAssist, for example, provides access to a personal coach who gives advice via phone or email to help staff modify their behaviour. Prestige Health provides seminars on drug and alcohol abuse. "Drug and alcohol abuse can be a problem for senior staff as it is often a device used to cope with pressure. Seminars can provide valuable support without singling employees out and can reduce problems by 20%. The other 80% need one-to-one counselling which we can then arrange if employees choose this route," says Donnai. Nutrition is also important to wellbeing. Registered dietician Lyndel Costain says senior executives often complain of feeling tired and suffering from indigestion. "Our digestive system links with our nervous system and our bowels represent our emotional state. Employees should be encouraged not to eat on the run and take a full lunch break. Provide fruit instead of pastries in meetings and water instead of coffee," she says.

Practical help can also be offered to help executives cope with one of the key causes of stress - a heavy workload. Tim Cuthell, sales director at Employee Advisory Resource, says executives can be coached to prioritise their workloads: "Senior staff need time to be freed up so that they can improve the organisation. Coaching can help them identify the pressures they are under and sort out issues that are taking all their energy," he says. But there are more unusual methods of relieving stress such as T'ai Chi. John Ding, who runs a T'ai Chi Management programme, says: "The health benefits of T'ai Chi have been well documented as an antidote to stress and [the discipline] has even been proven to help improve performance."

Corporate cookery is another quirky way to help executives relieve stress. Italian Secrets in London offers classes for £115 per head and has clients including KMPG and Goldman Sachs. Anna Venturi, proprietor of Italian Secrets, says: "It's wonderful to see what a transformation is made from the tired executives once they've had a couple of hours of using their hands putting a dish together that they can enjoy." If senior executives can be motivated to take better care of their health, then it will be easier to foster a culture of wellbeing in the whole workforce. The investment will also ensure that tomorrow's high flyers are in the best condition to rise to the top

Case Study: Toshiba Information Systems

Toshiba Information Systems (TIS) has just 3.7 days' absence per employee each year, less than half the national average in the UK services sector. However, following a stress audit, which was conducted via questionnaires provided by Businesshealth, TIS has identified high stress levels for some senior executives among its 350-strong workforce. It is now putting together a plan through Businesshealth, to help reduce these stress levels. Susan Stevens, head of human resources, says: "We need to identify the pressures being faced by senior-level staff, so we're getting an external facilitator to come in so everyone can throw their thoughts on the table and work through possible solutions to reduce the risk of stress. We need this feedback to agree on what should be done with processes and procedures to reduce pressure. If senior staff are under pressure, this affects all the staff below." The company also provides health screenings for its senior staff. TIS pays £490 for a full assessment with ECG from Nuffield Hospitals. "When a report recommends a change in lifestyle or identifies problems, people take it seriously," says Stevens. Free golf membership is also offered to executives. "This may not be seen as a health initiative, but our view is that it gets senior managers out of the office doing some exercise, which has to be good for them," explains Stevens.

Healthcare choices

Health screening: although this can be pricey it can detect serious illness and give executives personalised advice on how to improve their health.

Self-assessment: online health and wellbeing questionnaires are quick to complete and alert employees to any health risks.

Seminars: providing information on issues such as stress and drug abuse can give staff informal advice that could motivate them to take action.

Coaching: One-to-one coaching can help employees prioritise workloads and make changes to their lifestyle and behaviour. Activities: giving senior executives the chance to let off steam through activities such as paint-balling, corporate cookery and t'ai chi can help to reduce stress.