Dina Themistocleous: How to future-proof a workplace health strategy

This article is supplied by the University of Bath.

Since Dame Carol Black’s call for a reorientation of occupational health from a treatment focus to promoting and maintaining good health, in her Review of the Health of Britain’s Working Age Population report, published in March 2008, we have seen an increase in public policy endorsing employee health and wellbeing. 

Key points

  • The focus of workplace health initiatives is shifting from being treatment-focused to promoting and maintaining good health.
  • Contemporary prevention practice in occupational health tends to be limited to addressing lifestyle issues, which are unlikely to affect the headline causes of work-related ill-health.
  • Most workplace strategies are assessed in the form of outcome data, which tends to be insensitive to capturing improvements in health and wellbeing. 
Dina Themistocleous

Both the government and the NHS have targeted early intervention and prevention as a core priority for 21st century public health. In particular, Public Health England and the NHS’s Five-Year Forward View, which was published in October and sets out a five-year vision for the NHS, identify the workplace as a game-changer in terms of improving people’s mental and physical health.

Therefore, we might expect to see an even greater focus on health as these bodies attempt to put their health agendas into practice.

The enhancement of employee wellbeing has the potential to deliver worthwhile benefits to both the private and public sectors, which explains why a number of employers have engaged with health and wellbeing initiatives. But contemporary prevention practice in occupational health tends to be limited to addressing lifestyle issues, such as obesity, smoking and physical activity.

Such health-promotion initiatives are aligned with public health behavioural change models, but are unlikely to affect the headline causes of work-related ill-health, such as workplace stress, mental health problems and musculoskeletal disorders, which require employers to adopt health and wellbeing strategies with a more comprehensive and holistic approach that extends beyond healthy lifestyle elements.

Consider organisational and environmental factors 

Employers need to evolve their prevention agendas in health and wellbeing to address the defining influences on employee health and wellbeing that extend beyond lifestyle health issues, such as the organisational and environmental changes generated by the financial crisis, which are forcing staff to work in a more austere climate.

Organisations also need to consider the effects of workforce factors on staff, such as the rising age demographic and increasingly distributed workforces, spread across multiple geographical locations. 

To achieve a holistic approach, employers need to focus on more fundamental influences on employee wellbeing, which are rooted in the design and configuration of work. But there is a lack of evidence from case studies to show the value of outcomes from interventions aimed at influencing these elements, particularly a return on investment, which finance directors and procurement teams increasingly want to see.

Consequently, encountering employer-led intervention activity that addresses these potentially higher-impact influences on employee health and wellbeing remains the exception rather than the norm among employers. And even when psychosocial aspects are considered, employer interventions tend to be based on an expectation that affected employees should change, for example through education initiatives designed to help them cope with stress, rather than being focused on the deeper-rooted influences. 

Reconsider how to evaluate strategy implementation success 

Finally, employers need to reconsider how they evaluate the success of their health and wellbeing strategy implementation.

Most employers assess their strategies in the form of outcome data, which may show, for example, a reduction in sickness absence or an increase in quality performance data. But these, and similar, trail indicators tend to be insensitive to capturing improvements in health and wellbeing, which is why it can be a challenge for employers to demonstrate cause and effect in this area.

There is significant scope for employers to develop a robust set of indicators that will act as barometers to show how well they are managing risks to workforce wellbeing. This will be a crucial development to help them see whether investment in specific initiatives is making a difference to their business. 

Some sort of employer benchmarking tool depicting health and wellbeing best practice could also help drive comprehensive health and wellbeing strategies of the future. 

Dina Themistocleous is a researcher at the University of Bath