The focus on productivity remains a key priority for government. In the session we looked at the impact of health and well being initiatives on increasing productivity.

1. Productivity:
What’s the impact of health & wellbeing?
Professor Jim McManus, Chartered MCIPD
Director of Public Health, Hertfordshire County Council
Visiting Professor in Practice, LSE PSSRU
Generation Q Fellow, The Health Foundation
@jimmcmanusph

2. www.hertfordshire.gov.uk
When I came back to work
after Cancer
• How did my employer do?

3. www.hertfordshire.gov.uk
The Problem for Employers – it’s costing
you
• 2/3 of sickness absence avoidable
– Smoking related ill health
– Musculoskeletal ill-health
– Mental health and stress related
– Increasing risk of preventable disability in
employees with age
– The more risks you have, the more illness
you have (multiplicative effect)

4. www.hertfordshire.gov.uk
Its costing
you!
2/3 of
sickness
absence
avoidable
The more
risks you
have, the
more illness
you have

5. www.hertfordshire.gov.uk
It’s costing you
Established relationship between lifestyle related risk factors
(smoking, inactivity, obesity) and productivity absenteeism and
health claims. (Buron et al,2005, Wellsource, 2006 & University of
Michigan, 2006)
• Smokers 5 times as likely as non smokers to have sickness
absence EVERY year from ‘flu and chest infections (£50m a year
to Hertfordshire employers due to absence)
• Goettler et al (2017) Obesity and overweight costs employers
http://bmjopen.bmj.com/content/7/10/e014632

6. www.hertfordshire.gov.uk
What is the root issue?
• There is a flow from low risk to high risk to
disease for the working age population
• This leads to:
• Diseases of lifestyle
• More risk, more absence
• Compound risk, compound absence
• Low productivity
• Mental health major issue in absence,
performance and work based disputes

7. www.hertfordshire.gov.uk
Productivity Decreases with Number of Health Risks
Excess
Productivity
Loss
Productivity
Loss (%)
Base Cost
Number of Health Risks
(Journal of Occupational and Environmental Medicine 2005;47:769-77 (n = 28,375))

8. www.hertfordshire.gov.uk
Absenteeism Increases with Number of Health Risks
Number of Health Risks
(Journal of Occupational and Environmental Medicine 2005;47:769-77 (n = 28,375))
Base work
loss
days/yr
Excess
Work Loss
days/yr
work loss
days/yr

9. www.hertfordshire.gov.uk
Some Trends...
• Health and Safety
• Occupational Health
• Stress
• Psychological Contract
• Trauma
• High Performing Workplaces/High Productivity
Workplaces (IES and CIPD, 2018)

10. www.hertfordshire.gov.uk
What if....?
• We stopped seeing these as dimensions of
productivity and considered them essential
elements of the psychological contract....
• We’ll do as an employer what we can to keep
you emotionally and physically well, you take
that up and do your bit
• A package of measures from work conditions to
leave to...???.

11. www.hertfordshire.gov.uk
Good health as a driver of productivity
• Resilience
• Positive Psychosocial Environment
• Equality and Diversity – Being who you are
• Good Physical Health
• Poor Physical Health
• NICE Guidance
These are all dimensions of productivity

12. www.hertfordshire.gov.uk
Population Health Management Model.
This shift will impact on employers
Case
Management
Specialist Disease
Management
Supported
Self Care
Population-
wide health
and
wellbeing
Case
Managemen
t
Specialist
Disease
Management
Supported Self
Care
Population-wide
prevention
NOW THE FUTURE
PreventiveAction

13. www.hertfordshire.gov.uk
Employers: Health in Four Voices
Authoritative Professed
• What policies say • What Managers Say
Operant Internalised
• What we actually do
“Pull yourself together”
• “It’s not safe to be
vulnerable”

14. www.hertfordshire.gov.uk
A four domains Model
What can
this offer
HR?
Health
Improvement
Health
Protection
Culture &
Leadership
Policies
Organisation
Systems

15. www.hertfordshire.gov.uk
Health Improvement
Diet
Space
Water
Physical Activity
Down Time
Psychosocial Environment
Use of devices
Sleep
Social Engagement
Bonding & Belonging
Access to Help
Health
Improvement

16. www.hertfordshire.gov.uk
Health Protection
Trauma and Emergency Readiness
Vaccines
Health & Safety
Stressors
Exposures
Money worries
Health
Protection

17. www.hertfordshire.gov.uk
Culture and Leadership
Is your culture one where
mental health can be
considered as just
another dimension
of being well or
unwell?
How does your culture
deal with ill-health?
Culture &
Leadership

18. www.hertfordshire.gov.uk
Health Improvement
What do your polices do
to get people back to
work?
How does your
policy support people
with drug or alcohol
issues?
What do your systems
do?
Policies
Organisation
Systems

19. www.hertfordshire.gov.uk
Mentally Healthy Workplaces...
• Systems approach
• From preparing for employment to getting and
keeping people in employment and helping
employers’ create and keep healthy workplaces
• Seeing the wood for the trees
– Do Identify what you can do to build a
positive psychosocial workplace for
everyone
– Don’t do it alone
– Don’t buy every intervention going

20. www.hertfordshire.gov.uk
Mentally Healthy Workplaces
• Do: Look at best practice (Mental Health Foundation
for example)
• Do: Set goals
• Do: take a lifecourse, recovery approach
• Don’t: Focus only on employees suffering from
mental illness
• Do: Start at the organizational level
• Do: Empower your managers
• Don’t: Confuse mental health initiatives with perks
• Do: Take a capability approach “what can
employees do” when recovering

21. www.hertfordshire.gov.uk
Mentally Healthy Workplaces...
• Invest in building the resilience of your
managers and staff . This is really important for
business success and employee wellbeing.
• Encourage your staff to develop a self care plan
– Work-Life balance
– Self time
– Sleep
– Diet
– Activity
Experience of doing this
Personally and with many others
And some evidence it works

22. www.hertfordshire.gov.uk
A Schema
• Australian Model
https://www.comcar
e.gov.au/promoting/
Creating_mentally_
healthy_workplaces
• This diagram is a
good schema to
look across the
system

23. www.hertfordshire.gov.uk
Some Tools

24. www.hertfordshire.gov.uk
Mentally Healthy Workplaces
• How do you care for the people in your workplace who
care for others?
• Remember that Counselling is not always the answer
• Train people up in basic mental health issues and make
sure people with issues know where to go to.
• Look again at your policies.
– How do you help people with mental health issues
balance work and life and come back into work?
– How do you stage work returns when people have
been unable to work?
– How do you handle the unpredictable journey of
recovery?

25. www.hertfordshire.gov.uk
A Mentally Healthy Workplace
• Look again at your diversity policy –
– it's probably the case that you're serving some
protected characteristics much better than others.
– Do you make one diversity strand touchy feely and
others are privatised?
• Think about person-organisation fit.
– Are you a workplace where the people who really fit
are able to be open about mental health issues
without stigma?
– Can they be open about what's important to them?
(Their gender, sexuality, faith, disability,
whatever....)

26. www.hertfordshire.gov.uk
Vaping / E-cigarettes
• Contentious issue for some still
• Balance of evidence strongly supports e-
cigarettes are much much safer than smoking
• Harm reduction approaches
• Evidence reviews and guidance for employers
available
• This is a major opportunity for employers but
recognise it also presents challenges
• https://www.gov.uk/government/collections/e-
cigarettes-and-vaping-policy-regulation-and-
guidance

27. www.hertfordshire.gov.uk
Thank you
jim.mcmanus@hertfordshire.gov.uk
@jimmcmanusph