Health screening: Get the vital statistics

If you read nothing else, read this …

• Health screening can provide valuable information about workforce health.

• Over time, data can help to show a return on investment from health screening.

• However, an over-reliance on data can be counter-productive.

Proving return on investment in health initiatives can be difficult, and a careful approach is needed to produce data that will convince the board

Any organisation looking to introduce a health screening programme as part of a wellness campaign will need to secure boardroom backing. This is likely to involve demonstrating some form of tangible return on investment and making a case for the broader business benefits of having healthier and more productive staff.

Sometimes, benefits professionals may have to challenge and overcome misconceptions and scepticism. Chris Coyne, group head of reward at City and Guilds, recalls approaching a chief executive about a wellness programme. “It was the same time as Reggie Perrin was on television and there is one episode where he goes into a wellness clinic and it is all about whale music,” he says. “That was the chief executive’s perception of it and in a lot of places it will be seen as just another fluffy HR initiative. The challenge is to shift it to a far more commercial approach and look at the return on investment and the human capital angle in terms of what it can add to the business. It requires a big mindset shift.”

Having tangible evidence of the benefits of such programmes can help to overcome such prejudices. Dorian Dugmore, director of Wellness International, part of Adidas UK, says: “We need to get people who really commit to wellness in the company against the people who do not and actually look at the data it produces. Dame Carol Black’s report [Working for a healthier tomorrow] in 2008, said it was obvious we needed good corporate wellness, but we have not got really good data to show the power of it.”

Louise Aston, director, Workwell campaign at Business in the Community, says every business leader instinctively knows that a happy, healthy, engaged employee will be more productive than one who is not, but admits employers often have difficulty in proving this. “The metrics and the narrative reporting are so important,” she says. “People are under greater stress, but a lot of [organisations] do not even know the wellness status of their people. Some have got silo occupational health, silo HR, silo health and safety, but all these things are very interconnected and without having the right metrics or collating the right data, they will never be able to articulate the return on investment.”

Return on investment

Valerie Phillips, head of business at Randox Health Checks, says the company has carried out a number of benefits surveys, and she was surprised by how many organisations fail to calculate the return on investment from wellness strategies or healthcare benefits. “Part of it is because it is difficult to calculate what they are providing and what they are getting back,” she says. “But where you can see people engaging and managing their health over time, productivity increases and absence is reduced or avoided. Preventing disease happening can feed into the finance side of things and it becomes a more tangible, commercial issue.”

One way to show a return on investment is sickness absence levels. But this could be down to other factors that form part of an employer’s, or individual’s, approach to health. “A health programme could reduce sickness absence, but [employers] might just be lucky,” says Coyne. “It might help them to prove something to the board in some situations, but in other cases it might hang them out to dry because they have also done something else in that area.”

But over-reliance on data can be counterproductive, says Sara Turner, UK head of benefits and wellbeing at KPMG. “It is easy to get yourself into knots with a return on investment that can be challenged,” she says. “[Employers] can look at engagement reports and retention, but they can put those down to anything they do in their people space. They have to be careful about stacking their case up because it could be knocked down. Data can be dangerous from that perspective. A narrative and the context is sometimes more important than the numbers.”

The power of individual case stories in making the link between screening and cost savings should also not be overlooked, says Paul Ashcroft, a principal at Mercer. “You have only got to look at the health screening provider market. They all make claims that health screening helps to reduce absence, but there is rarely any hard data behind it.

“What they sell is the narrative: Joe Bloggs had a health screen, we discovered he had a major problem and we were able to act early to get it treated. Those stories are very compelling, but there is not much of a return-on-investment metric that you could hang your hat on.”

Research by Business in the Community into public reporting on wellness and engagement among FTSE 100 companies advocates a multi-faceted approach, including data and anecdotal evidence to demonstrate a return on investment, says Aston. “You rarely see the direct causation from a single occurrence, so a holistic, joined-up approach is so important in articulating the business benefits,” she says.

Yet while it may be hard to point to tangible returns for specific investments, there are measurements that can be screened for over a period of time that can demonstrate progress in creating a healthier workforce. These need not be too onerous an investment. “With health screening, [employers] can do quite a lot with very little,” says Coyne. “Key metrics such as blood pressure, body mass index and cholesterol are not going to cost a fortune and they can do a lot with that information. For a small investment, they can get quite a big return.”

Certain risks

The effective use of data can also help employers shape their programmes after screenings. “If health screenings show [employers] have certain risks, then their programmes should reflect that,” says Turner. “For example, there is no point doing a lot of work around anti-smoking if they do not have a problem with smokers.”

This information can then be benchmarked against the wider population or staff from equivalent organisations. Turner adds: “If their figure is slightly better than their competitors’, that does not mean [employers] do not need to do anything, but those trends are helpful in terms of where they put more investment because it puts it into context. Otherwise, they do not know just how bad having 30% of staff who are obese is in comparison to having 30% who smoke.”

Carrying out repeat assessments can also help engage staff, says Dugmore. “When you do tests again later and these show there has been an improvement, it is quite motivational.”

Read more from the health screening roundtable discussion