It was in July 2009 that HR magazine first interviewed Breckon Jones, employee health and vitality manager for Unilever. Back then the £28-billion multinational behind such brands as Dove, Surf and Knorr had just launched a major new health and wellbeing initiative - Fit Business - and it predicted big results.
The company is no stranger to wellbeing projects (its 2004 Vitality project was credited by the Institute of Health & Productivity Management as preventing a loss of £560 per head in absenteeism costs), and the rest of a ROI-needy HR community has been waiting to hear the results of Fit Business project. With the cost of absence now approaching this £570 figure (the last CBI/AXA study calculated it at £517), the pressure to show wellbeing policies actually have demonstrable business improvement results has never been greater. Yet at the same time, strong evidence supporting this aim remains stubbornly elusive. Many commentators believe simple reductions in the number of days off are too crude; that wellness research assumes only healthy workers are productive, when unhealthy workers may still be just as likely to do their work. So, does Unilever's pilot - the results of which we are now able to share here, one year on - add to, or detract from, the view that health and wellbeing projects do have business benefits?
At first glance, the top-line findings look impressive (see graph, p14) - in terms of improvement in the overall health of staff involved in the pilot and associated interventions. The proportion of employees showing a BMI index described as overweight/obese or very obese fell 26% among factory workers and 9% among office staff; resting heart rates deemed 'above average fitness' or at 'athletic' levels rose 26% for office staff and 17% for factory workers, while movement into the normal range for blood pressures were increased. The results show the number of days staff took at least 30 minutes of exercise rose from 3.03 to 3.17 for office workers, and from 3.14 to 3.32 for factory staff.
But the crucial question is this. These are health results only. Does the fact staff are a little less fat, and take a little (but not much) more exercise really mean Unilever will see a bounce in productivity and efficiency among its staff - and a reduction in absence?
The results were evaluated by Myriam Cherti, from the Institute of Public Policy Research. Speaking to HR, she says: "The greatest impact was indeed seen with the BMI of employees, but we did not see much difference in exercise levels. As a researcher, the best we can say is that the findings are indicative of some positive change. I'm happy to say it has had a positive effect, that it had an indicative impact on productivity, but we can't say anything for certain. We can't say X intervention produced Y result to any form of statistical significance. In fact, when we asked about people's perception of stress, for instance, they didn't report any lower levels of stress during the trial period."
Words like 'indicative impacts' sound a lot less striking than the impressive changes posted in overall health. So has this study said a lot about the ROI of health and wellbeing initiatives, or nothing at all?
Alan Walters, HR director of Unilever, says: "Obesity is the biggest public-health problem of our time, with 61% of the UK population now overweight. If we want Unilever to perform at its best, our people need to perform at their best too."
Obesity is cited as an issue that needs to be solved but one problem is that while obese people are more likely to suffer muskuloskeletal problems than those who are not, it is only part of a complicated health matrix. There as just as many studies that show, for instance, it is smoking that most strongly impacts absence, not weight. A study by economist Petter Lundborg at Free University Amsterdam (which looked at sickness-related absences among more than 14,000 workers in Sweden) found smokers take nearly eight more days' sick leave per year on average than their non-smoking colleagues.
"Employers can sometimes take a patronising stance when it comes to these health-productivity issues," says Hugh Robertson, senior policy officer, TUC and board member of the British Occupational Health Research Foundation. "Other evidence reveals people that are actually slightly overweight live longer than those of average weight. Our view is that work itself promotes health, and that a proper work-life balance is what counts more than people's physical condition. Low pay is actually the biggest determiner of ill-health; 'health and wellbeing' policies won't change this."
But Unilver's Jones is adamant the results are valuable. "We see enough in the data to justify rolling this pilot out across the entire 7,500 Unilever population," he says. "We acknowledge the health of people will not be the same as the rest of the workforce, but that's actually a reason to continue this project." One statistic Jones is proud of is that the number of days staff involved in the pilot were absent through illness fell to 4.9 days for office workers (normally 5.7) and to 5.9 days for factory workers (normally 7). "We've worked out that the pilot has given us a 3:1 ROI," says Jones.
Of course, one further complication is, unsurprisingly, the impact of the recession. Jones acknowledges sickness absence was already on a downward curve at Unilever, even before the pilot started. Many HRDs looking at health and wellbeing initiatives (including the judges of HR magazine's Excellence Awards, see shortlist p34), are highly sceptical about the results of health projects. They see lower absence rates as anything but an improvement in health, and everything about staff wanting to be seen to be in the office.
"It's a tricky business, trying to find measures that people will accept," admits Tony Massey, medical director, Vielife. "A good ROI should be something along the lines of 6:1.My view is that you can measure results, even if it's only to show that if you give people a lunch break, customer service among, say, call-centre workers, will be better first thing in the afternoon than it was before the policy was introduced. But HRDs need to select what they will be measuring, and do it before the policy is introduced, and after."
HRDs should also not forget that health improvement is also a long-term change, not something easily identifiable in just one year. Perhaps the most striking results of Unilever's project then are the more subtle measurements predicting the future health of its employees. More than half (54%) of those taking part in the pilots had cholesterol levels deemed to be 'at risk'. By the end of the trial period, this fell to 36%. Some 20% of workers were at either 'medium' or 'high' risk of developing cardiovascular diseases in the next 10 years. After the interventions, this had fallen to 17%. Both sets of results are significant enough to be able to say the company will directly be able to alleviate or eliminate serious future illness among its staff.
Even subtler still is one observation no one can argue with: Unilever staff report being 'happier'. With plenty of evidence showing happiness determines healthiness, maybe this measure is not so puffy as it first sounds. But how do you prove the ROI of this? That's the next big question confronting HRDs.
BENCHMARKING TO IMPROVE THE HEALTH OF THE NHS
According to the November 2009 Boorman Review, the cash-strapped NHS could save £555 million (or 3.4 million lost working days) each year with better regard for employee health and wellbeing. Among its recommendations were that NHS trusts should have a prevention-focused health and wellbeing strategy for all staff; that senior management should be made accountable for staff health and wellbeing (which will be measured as part of the annual assessment of NHS targets); and there should be early interventions for staff with muskuloskeletal and mental health conditions.
CIPD research shows absence in the health service stands at 11 days per employee per year, which is significantly higher than the public-sector average of 9.7 days, and the private sector of 6.4 days. In April 2010, a new online survey - NHS Opinions - was launched, and has already secured the health opinions of 50,000 staff across various NHS trusts. HR teams will be able to access information on employees' current health and wellbeing, the individual support they receive from their trust, and how they think services can be improved. Trusts that sign up to receive the survey will be able to benchmark their performance against national and regional averages.
Chris Heather, chief executive of NHS Opinions, said: "This data could prove an invaluable tool for trusts to measure and improve employee health and wellbeing. It will enable their HR teams to assess the services they offer staff every few months, and quickly implement improvements."
There is a belief that just by announcing absence will be measured is enough to make some difference. Third-party absence management provider FirstCare works with 17 NHS trusts, and reports it has reduced absence levels by an average of 26% in just one year. Aaron Ross, its CEO, says if such systems were introduced nationally, the NHS would save £760 million in its first year, leading to savings of £1.3 billion in three years.
WALKING THE TALK
For the past few years, promoting walking has been touted as one way of measuring change in employee health and performance levels. First came the national '10,000 steps' campaign, while in April this year there was 'Walking to Work Week', supported by £1.9 million of government funding. National charity Living Streets, which runs the Walking Works Campaign, believes employers should ditch corporate gym memberships in favour of simpler 'less intrusive' ways of promoting employee health.
"Encouraging staff to walk all or part of their commute is an excellent way to get some activity into their day," says Tony Armstrong, CEO of Living Streets. Successes have included teams that have taken part in the Global Corporate Challenge - a competition to see whose employees can walk the furthest. In 2009, British Gas entered 952 teams (6,664 employees in total). Armed with pedometers, employees lost an average of 5.3kg (more than 35 metric tonnes of fat in total) after staff completed more than 5.5 billion steps. Car usage fell by 75%, while walking became the number one way staff travelled to work.
Although links to business performance metrics were not measured this time, staff surveys showed two-thirds of employees believed they had boosted energy levels in the office and 66% reported better fitness. In May British Gas said it would be seeing what difference it makes to staff sickness levels.
