Business performance and employee well-being go hand in hand Chris Thomas highlights the challenges of tackling health in the workplace and outlines how businesses can rise to them.

Employers are realising that the health of their staff is integral to the health and success of their business. Many companies have implemented a variety of staff benefits, such as private medical insurance, occupational health and health screening. But the provision of such services in isolation is not enough to reap the maximum benefits to the business. With pressures coming from increased legislation and the financial burden of staff ill-health, employers need an integrated solution to ensure that all elements of their healthcare and well-being policies work together.

Understand the challenges

In order to tackle healthcare in the workforce, employers need to understand the challenges they face. Pressure is coming from a number of different sources; they include the threat of financial penalties for non-compliance, health and safety provisions and the new disability regulations. The wealth of new employment legislation that has been introduced over the last seven years, as well as rising numbers of claims for injury at, or caused by, work, also add to the burden employers face.

More significant - and often the hidden cost - are the loss of productivity and lost orders through poor service, as a result of employee non-attendance or lack of employee motivation.

In many organisations, the impact of employee absence on productivity may be invisible, but it is very serious. Recent figures have borne this out, with 168m working days recorded as lost by UK plc last year. According to the British Occupational Health Research Foundation, 17m days absence were attributed to work-related stress in 2004, more than twice as many as were caused by workplace injury. The direct cost of lost working days is estimated at around £12.2bn, but one risk management company believes that the indirect costs could add up to as much as £33bn.

A 21st century plague

The focus on reducing levels of absenteeism has unfortunately given birth to a new trend, ‘presenteeism’, which can have equally damaging consequences on the bottom line. Presenteeism is defined as ‘the feeling that one must show up for work even if one is too sick, stressed or distracted to be productive; the feeling that one needs to work extra hours, even if one has no extra work to do’.

The term was coined by Cary Cooper, then professor of organisational psychology and health at the University of Manchester. According to Cooper, ‘The phenomenon of presenteeism is another dangerous symptom of the explosive degree of pressure in the workplace.’

Prevention is better than cure

Industry and government initiatives place emphasis on making return to work and rehabilitation a fundamental part of the claims process. But these initiatives are not tackling the causes of absence.

Indeed, the TUC has suggested that the tough new measures created to combat absenteeism are forcing people to work when they are genuinely sick, and any programme that offers incentives for good attendance could contribute to the growing issue of presenteeism. So we need to find a way to balance out the crackdown on absenteeism, in order to avoid pushing up levels of presenteeism.

The fundamental need is for businesses to put in place a proactive employee risk management strategy which focuses on creating a positive environment and cultivates a happy, healthy and motivated workforce. In order to do this we need to understand the trends and patterns in an organisation.

Good independently controlled management information that tracks employee absence is vital. What is also essential is a collaborative approach to employees, which provides them with well-being care, early intervention when they are ill or injured, and rehabilitation and physiotherapy.

Forward-thinking employers have introduced health and well-being initiatives that are helping employees to lead healthier lives and be more motivated in the workplace. These include well-being audits, confidential health advice and regular health checks tailored to the needs of each individual.

This must all be set in a culture of positive health, where employees are empowered to take responsibility for their own well-being. The employer’s role is to provide easily accessible advice, guidance and, where relevant, practical support.

Making the changes

Employers, who recognise that performance and well-being go hand in hand, are now embracing these audits, early intervention absence management services and access to expert medical and lifestyle advice through employee assistance programmes. These can be particularly helpful for employees who may need to develop their own coping strategies. In turn, this can reduce the anxiety and depression which accounts for at least 30% of all absence. The National Health Service simply does not have the resources to provide early access to the right sort of help.

Confidentiality is key. Businesses must arrange programmes that employees can trust to be private. That said, they must identify the cases where problems are generated in the workplace by excessive work demands, bullying or harassment. These can be addressed through line manager education and the setting of positive health performance targets.

My own organisation undertook an internal review of staff well-being based on the Health and Safety Executive’s pilot stress audit. The exercise was conducted across each of our six UK sites, and took measurements in the areas of support, change, relationships, control, demand and role, in line with HSE guidelines. Overall, the results were extremely positive.

However, they did reveal that management working in services which were available 24 hours a day, such as advice lines and assistance, were presented with more day-to-day challenges, such as ease of communication, and were more susceptible to stressors than other colleagues.

Conducting an internal audit is not just about identifying existing issues, it also plays a key role in highlighting potential problems. Our own audit helped us update our approach to employee health management and identified areas that needed to be addressed before they were instrumental in causing higher levels of absence. It has also helped the business to comply with the new HSE guidelines.

Nurturing assets

Businesses depend on people to deliver commercial success. Those employers who promote a sense of working smarter and healthier rather than harder and faster and who employ positive health and well-being strategies, will help staff create a positive work-life balance. And, however hard it is to break the long hours culture, bosses should show leadership by taking responsibility for their own work-life balance and by respecting that of their employees.

- Chris Thomas is people and customer director of FirstAssist, Tel: 020 8652 1313; LATEST UK FIGURES

According to the latest annual CBI-AXA Absence Survey, workplace absence cost the UK economy £12.2bn in 2004, compared to £11.6bn in 2003.

There is concern that £1.7bn of that cost is due to staff ‘pulling sickies’ rather than absence resulting from genuine ill-health. The survey shows that absence cost £495 per employee in 2004, compared with £475 per employee in 2003.

The overall figure of £12.2bn represents the cost of covering salaries for absent staff, the resulting overtime and temporary cover, and lost service or production time. The survey of over 500 organisations also shows that 6.8 working days were lost per employee. Other key findings are as follows:

- The total number of days lost to absence across the UK economy fell by 4.5% to 168m in 2004, from 176m in 2003. That brings total absence back in line with the level seen in 2002 (166m days). The CBI believes rising labour costs and growth in average earnings are the reasons why the total cost of absence has increased despite the lower absence level.
- Organisations fear as many as 23m of the 168m working days lost to absence last year were a result of unwarranted absence, or staff ‘pulling sickies’. This represents a cost of £1.7bn, broadly the same figure recorded in the previous survey.
- Three-quarters of respondents suspect that some employees take illegitimate long weekends by calling in sick on Fridays or Mondays, with 74% of organisations saying there was a link between patterns of absence and the unauthorised extension of the weekend. Two-thirds said there was an increase in absence around Bank Holidays.
- Genuine minor illness was the main cause of absence across the economy.

The second most significant cause of absence was stress among non-manual workers, and recurring illness (eg back pain) among manual workers.

John Cridland, CBI deputy director-general, said: “Employers understand that staff are not invincible. They accept that the majority of absence is due to genuine minor illness, and nobody is saying genuinely ill staff should drag themselves to work. But let’s be honest about this - there are some employees out there who will gladly award themselves a day off when they are in good health, at the expense of their employers and hard working colleagues.

“With summer almost upon us, employers may well be concerned about staff granting themselves days off that they are not entitled to. Organisations suspect that staff ‘pulling sickies’ cost the UK economy £1.7bn last year alone, a bill we simply cannot afford to pay in today’s fiercely competitive global market.”

The survey, which has been conducted every year since 1987, also shows manufacturing firms reporting higher absence levels than service sector companies, with seven days lost per employee compared with six. Manual workers have significantly higher absence rates than non-manual employees.

The average for manual workers was 8.4 per employee in 2004, compared with six days per employee for non-manual staff.

Absence varied greatly across the UK. The south-west lost the most working days to absence, followed by the north west, the west Midlands and northern England, Yorkshire and the Humber and the south east. Average absence levels were recorded in Scotland, the east Midlands, Wales, the east of England and southern England. The lowest absence levels were recorded in Northern Ireland and Greater London. However, the survey tends not to show lasting links between absence and region.

Larger organisations reported higher absence levels than smaller ones.

Those employing over 5,000 staff averaged 8.3 days per employee, while companies with less than 50 employees averaged 4.5 days. The CBI believes smaller firms have lower absence rates because absence is dealt with by senior management. The survey found that when senior managers are put in charge of absence, 2.3 fewer days are lost per employee, compared with absence dealt with by line managers.

Eighty-seven per cent of organisations are taking action to reduce absence, and return-to-work interviews are the most common absence management policy.

Two-thirds of respondents have a stress management policy and 60% have rehabilitation schemes in place.

The survey also shows that while long-term absence accounted for just 6% of all absence cases in 2004, it was responsible for 34% of total time lost through absence.