1. Public Health Responsibility Deal
Health at Work Network Partnership Forum
Wednesday 21 November 2012

2. Public Health Responsibility Deal
Siân Williams
Royal College of Physicians London

3. An evidence-based approach to
improving workforce health
and engagement
Health and Work
Development Unit

4. NICE guidance for the workplace
• obesity
• physical activity
• smoking cessation
• long term sickness absence
• mental wellbeing

5. An evidence-based approach to improving
workforce health and engagement

7. Does the trust actively promote healthy National (282 trusts)
food choices , for example using signs, -------------------------------------
pricing and positioning of products to Number %
encourage healthy choices in:
Staff restaurant 173 61
Hospitality 142 50
Vending machines 90 32
Shops for staff and clients 86 31

9. National (282 trusts)
-------------------------------------
Number %
Does the trust offer overweight and obese 86 31
staff multicomponent interventions
If yes is the person providing the 64/86 74
programme trained in obesity management

10. Minimum score Maximum score
Summary score

13. An evidence-based approach to improving
workforce health and engagement

14. Public Health Responsibility Deal
Bridget Juniper Mike Tyler
Work and Well-Being Ltd Lockton Companies LLP

15. Employee Health & Well-Being
What are you REALLY paying out?

16. Introductions
• Dr Bridget Juniper - Work and Well-Being Ltd
• Mike Tyler – Lockton Companies LLP

17. Points to Cover
• Absence - The need for numbers
• What do we mean by a healthy workplace?
• Running the numbers – Worked Example
• Balanced Scorecard for Health & Well-Being

18. Absence - The Need for Numbers
If you cannot measure it, you cannot improve it (Lord Kelvin)
Numbers inform decisions
Track improvements
Currency of budget holders

19. What is Health?
“Health is a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity’(1948)

20. How does work impact on the overall well-being of staff?
Work and Well-Being Ltd workandwellbeing.com

21. Cost Burden - Absence
Sickness Absence Data
• Incidence, frequency, reasons
Direct Costs
• Salary costs
• National Insurance contributions
• Bonuses/overtime
• Pension contributions
Indirect costs
• Management time
• Lost business
• Penalties
• Temporary cover
• Impact on other staff
• Approx 10% of salary and NI

22. Cost Burden - Absence
Lost time rate
Person days lost to absence x 100
Total days available during period
Frequency rate
Number of spells of absence x 100
Total number of staff during period
Bradford Factor
Bradford Score = S² x D
S is the total number of spells (instances) of absence of an individual over a set
period
D is the total number of days of absence of that individual over the same set
period

23. Cost Burden - Presenteeism
Lost health-related work productivity
Absence cost multiplier of 1 - 7
Non – productive employees

24. Cost Burden - Attrition
• Attrition rate (c15%)
• Proportion due to
impaired well-being?
• Cost of replacement:
– 18 months salary for
senior managers
– 6 months salary for
hourly paid

25. Worked Example

26. Worked Example – Remedial Health
Costs

27. Worked Example – Preventative
Health Costs
Absence has steadily
risen over past 3 years

28. Employee Health and Well-Being Dashboard

29. Cost Burden - Absence
Absence Numbers Absence Costs
Total absence = £1,240,644 or £963 per employee

30. Worked Example – Absence,
Presenteeism and Attrition
Absence:
£1,240,644
85 % short term
Presenteeism:
£2,481,288
(x 2 multiplier used)
Attrition:
£807,300
(60% of total cost)

31. Worked Example – The Final
Reckoning
A, P&A
£4,529,232
£5,361,650
£5,361,650 = 15% of salary costs or £4162 p/employee

32. Is the Balance OK?
• What is your overall aim ?
– Performance
– Benevolence
– Attracting talent
• Based on the evidence, where will
you make the best return?
– Remedial vs Preventative?
– Enhancing performance of those
attending work?
– Expediting RTWs and rehabilitation?
– Reducing absence levels (STA or
LTA)?
– Improving retention?
– Other ‘An ounce of prevention is worth a pound of cure’

33. Return on Investment - Absence
• If reduce absence to 1.43% from 1.79% currently
– Absence cost = £991,129 (down from £1,240,644)
ROI = Gain from investment – Cost of investment
Cost of investment
£249,514 – £50,000
£50,000
ROI = 3.99

34. Return on Investment
• If reduce Presenteeism costs by 20%
£496,256 - £50,000
£50,000
ROI = 8.92
The cost of waiting for people to get sick far
exceeds the cost of helping healthy people to
stay healthy

35. Balanced Scorecards
• Developed to recognise businesses are complex but there is a
need to have a robust framework that works at multiple units of
analysis in a consistent way.
• Forces congruence and requires quality measures with
definition of success.
Learning & Growth Internal Processes
•Employee capabilities •Improve existing processes
•Information Sysytems •Develop new processes
•Motivation & empowerment
Customer Financial
•Satisfaction •Revenue growth& mix
•Loyalty •Productivity
•Market share •Asset utilisation

36. Balanced Employee Health
Scorecards
CORPORATE LEVEL
Learning & Growth Internal Processes
•Employee capabilities •Improve existing processes
•Information Sysytems •Develop new processes
•Motivation & empowerment
Customer Financial
•Satisfaction •Revenue growth& mix
BUSINESS UNIT LEVEL
•Loyalty •Productivity
•Market share Learning utilisation
•Asset & Growth Internal Processes
•Employee capabilities •Improve existing processes
•Information Sysytems •Develop new processes
•Motivation & empowerment HEALTH SCORECARD
Customer Financial
•Satisfaction •Revenue growth& mix
•Loyalty •Productivity
•Market share •Asset utilisation

37. Working Example
Guiding Principles HEALTH SCORECARD
• Provide a healthy safe and
positive environment SUPPLIERS PROCESSES
• Engage employees at work Supply of data Compliance with
Quality of data routines
• Focus on improving their Satisfaction levels Accident rates
performance Safety record
• Promote a culture of well – being Promotion of health
• Deliver a range or programmes initiatives
and tools to encourage
improvements in overall health
EMPLOYEES FINANCIAL
and resilience
Turnover Cost of programmes
• Provide a network of well-being Satisfaction scores Employers liability
champions Absence rates costs
• Focus on preventative health Bradford Scores Inflation of costs
management

38. Further Information
bridget.juniper@workandwellbeing.com
mike.tyler@uk.lockton.com

39. Public Health Responsibility Deal
Zoe Eccleston
Pepsico

40. Health and Wellness at PepsiCo
Encouraging a Life-style approach to health
and wellbeing

41. The UK Government's Vision
We want to create a society where the positive links
between work and health are recognised by all, where
everyone aspires to a healthy and fulfilling working life,
and where health conditions and disabilities are not a
bar to enjoying the benefits of work
Improving health and work: changing lives
UK Government Response to the Black review, 2008

42. 3 critical factors
• Health Action Teams
• Integrated Occupational Heath Teams
• Employees recognise their responsibility to engage with their
health

43. Purpose of our health and wellbeing
Protection and surveillance
of specific occupational health conditions Preventing
Returning to work health
• Musculoskeletal disorders conditions
• Mental health conditions
Staying in work – 3 programmes to reduce
4 common health conditions
responsible for 50% of preventable deaths
Nutrition Cardio Encouraging
Stroke good health
Exercise
Diabetes
Smoking cessation Cancer

44. Our model
• “One life, your choice” our internal campaign encourages
employees to start by making one change to positively
affect their health and build on this
• The programme aims to provide a culture at work that
reinforces positive health behaviours
• Occupational health working with Health Action Teams
(HAT) when engaged and enthusiastic are the best
crossroads of the employer-employee-health journey

45. Programme aims
Employees interested in their own health
Employees educated and doing something to improve it
Sustained results supported by recognised, trusted partners
Improved health statistics

46. One life your choice
4 main themes
Smoking
Diet and Hydration
Exercise
Mental resilience
Delivered by
Engagement
Educated choice
Support
Sustained behaviour change

47. Programme evaluation
• We recognise major short-term changes are hard to achieve
• Our focus is on realistic and sustainable change in the mid to
long-term
• We know this will require significant management support
and we are committed to that
We assess impact & investigate effectiveness on business
indicators:
• Absenteeism
• Engagement
• Productivity

48. zoe.eccleston@pepsico.com