What exactly is meant by the term health and wellbeing policy? Surprising as it may seem, this simple question is far more difficult to answer than at first glance. For while it is well-known work is good for health (both mentally and physically), too much of it seems to swing the finely-balanced pendulum dangerously the other way.
"What HR professionals need to decide is whether health and wellbeing is about providing lettuce for lunch or about far less obvious but potentially more effective things," says David Batman, group medical officer, Nestle UK. "Simply giving staff more autonomy in their jobs will reduce the level of stress they suffer. This impacts blood pressure and heart conditions. To me, just giving people the opportunity to do their job will have a far more significant impact on the health of a company's employees than persuading them to give up smoking and eating more healthily in the staff canteen."
Batman made these comments at Business in the Community's first Business Action on Health Summit held in London in May. His thinking is tantalising: is it more effective to simply invest in good management rather than in what would traditionally be recognised as healthy workplace policies.
It is a question that evidently causes debate: "The fact you can't buy health and wellbeing services that meet some form of occupational health standards and prove some sort of benefit worries me," says national director for health and work Dame Carol Black, author of the Government's Working for a Healthier Tomorrow report. "There is so much of this journey left to do, but we're not helping ourselves; we've created an uncoordinated system."
According to Best Companies, compiler of the Sunday Times Best Companies to Work For list, wellbeing is one of eight factors measured, but it uses the widest definition of what it is. Included are elements such as the amount of overtime employees work and whether work exhausts them. HR magazine asked Best Companies to analyse how employees from thousands of its surveys reported their wellbeing over the past few years. Its results also show how difficult a concept it is to pin down.
The analysis found that despite 2009 being the year where employees worked the fewest hours since 2005, their overall sense of wellbeing was also reported to be down - at 63.8% compared with 64.9% in 2008. Simply reducing hours worked does not, it seems, solve wellbeing problems.
What supports Batman's thinking though is the link Best Companies found between those who do overtime and those who reported stress-related symptoms. The graph (left) shows the two are directly related, with stress rising as hours worked increase. With half (52%) of employees saying they already feel exhausted when they come home from work (without overtime), the notion that wellbeing is as much about the ability to control one's job perhaps gains greater credence.
Ian Jameson, a specialist developer of wellbeing programmes, is currently visiting the top five small and medium-sized companies and top two large organisations ranked by Best Companies to ascertain exactly what makes up wellbeing. He says: "In my experience the best corporate wellbeing programmes use basic initiatives to counterbalance the negative effect a busy, stressful working environment has on employees. All the businesses I have visited take a proactive approach to reduce these negative effects in the first place."
While it is clear wellbeing issues need joined-up thinking, the benefit of having remedial policies cannot be underestimated. HR director of Parcel Force Peter McDonald says simply: "I nurture wellbeing for commercial advantage. Absence at Parcel Force is 5%; it costs us £8.5 million per year. A reduction to 4% would result in a saving of £1.7 million per year - or 10% of our net profit. These are the sorts of figures that financial directors take notice of." So important is absence that Parcel Force records it on a weekly basis, with wellbeing part of the performance reports sent to the board. He adds: "Wellbeing is important because of the less obvious costs too: replacement drivers on unfamiliar routes take longer to deliver, or they don't have the same rapport with our regular customers. We know service goes down if absence is high."
McDonald admits his wellbeing offering is no more advanced than that of other firms - it comprises rehabilitation, EAPs, communications and health benefits. It is perhaps an admission that it is difficult to ascertain the contribution each constituent actually makes. But the hunt is on to determine how certain policies produce specific results.
"Old-style wellbeing is like walking downstream of a river, rescuing employees who are flailing around in the water, needing saving," says Margaret Samuel, chief medi-cal officer at EDF Energy. "What we need to do is turn around and walk upstream to find out why so many of these employees are ending up in the water in the first place; we need to find the source of the emergency."
At EDF programmes exist that involve talking to staff about the underlying causes of ill-health. This, says Samuel, helps demedicalise the reasons for absence. It uses cognitive behavioural therapy to help staff develop coping skills, for instance. "You can forget this though if you don't have the right culture in your organisation," she warns. "Anyone at EDF who suffers stress will have a line manager and therapist meeting, but the employer is at the centre of the meeting."
The results, she says, speak for themselves. In 2003, 23% of people suffering stress took time off. By 2007 this had reduced to 10%. "All managers are trained in how stress can affect people, while staff can take their own 'resilience index' test to see where they are on the stress curve," she says. "It's preventive and it works."
The good news is if wellbeing is 'got right' so much more follows on. OC Tanner/Towers Perrin's annual engagement survey among 13 different countries recently found wellbeing and opportunity was the number one driver for engagement. Michelle Smith, VP of business development at OC Tanner, says: "Where there were weak scores for wellbeing, engagement was only 35%, compared with the 76% score for engagement where wellbeing was high." She adds: "Add in wellbeing policies that make staff feel 'appreciated' and the engagement in low-scoring firms can be raised to almost that of high-scoring engagement companies."
The art, it seems, is not just buying wellbeing services, but knowing exactly what contribution they make and how they impact on company performance. It is a tricky science, but the reward could be well worth the effort.
% of employees reporting stress-related symptoms in the past 12 months
because of overtime worked
22.85 - up to 10 hours less
23.24 - no overtime
31.85 - up to 10 hours
39.16 - 10 to 20 hours
42.45 - 20 to 30 hours
46.87 - over 30 hours