"Many employers have unwisely put themselves in a double bind by buying quite so enthusiastically into the wellbeing agenda of recent years,” says occupational health physician Dr Adrian Massey in his book Sick-Note Britain: How Social Problems Became Medical Issues. It’s a view that will find plenty of sympathy among the multitude of commentators who think wellbeing is a nebulous concept unrelated to real-world problems. But contrary to Massey’s contemptuous view of the workplace welfare movement, there is plenty of evidence to suggest that investing in employees’ health brings with it copious benefits to productivity, sickness absence rates and even the company bank account – as long it’s done right.
“The evidence is clear that healthier organisations are more profitable, and equally employees that are in good health are more productive at work,” says Dr James Chandler, policy adviser at the Work Foundation. And it’s evidence that is becoming harder to ignore. The British Safety Council summed up the problem with a strongly worded call to arms in its 2018 report Not Just Free Fruit: Wellbeing At Work, admonishing that health and wellbeing should not be “relegated to the bottom of managers’ ‘to do’ lists, absent from strategy meetings, exempt from financial forecasts”, adding that the link between wellbeing and productivity is “undeniable and calculable”.
The negative picture it paints of wellbeing’s lack of attention is perhaps slightly unfair, however. “Compared to where we were 10 or 15 years ago, when it was talked about in terms of ‘health and safety’, not ‘health and wellbeing’, there’s been a lot of progress,” says Rachel Suff, senior employment relations adviser at the CIPD.
“Many more employers are recognising they have a certain responsibility for people’s health and wellbeing at work.” Data from the CIPD’s 2018 Health and Wellbeing at Work report is also promising – it found that 40 per cent of employers have a standalone wellbeing strategy to support their wider organisational strategy, and 55 per cent said that employee wellbeing is on senior leaders’ agendas.
But despite the encouraging statistics, a general lack of knowledge around the most effective way to improve employee wellbeing, coupled with little academic study into the area and a commercial market saturated with products, means companies could be paying for initiatives that are actually bringing them minimal return on investment – and others may have decided against investing at all. Why is wellbeing such a difficult nut to crack?
Part of the issue is that the term itself covers a wide range of areas, including physical, mental, emotional and social health, and the idea of being ‘well’ can be interpreted any number of different ways. “If I asked 10 experts what ‘wellbeing’ is, I’d probably get 10 different definitions,” says Marcus Herbert, corporate operations specialist at Nuffield Health. “It’s not just whether a person is free from disease so they can turn up to work – it’s whether they are the best version of themselves at work.”
Eleck Dodson, head of occupational health at the Metropolitan Police, agrees. “The word ‘wellbeing’ means so many different things to so many different people in so many different contexts, and there is no strict guidance around what workplace wellbeing should look like,” he says. The Met has affirmed its commitment to the concept by developing a two-year health and wellbeing strategy setting out how it plans to improve the physical and psychological health of its employees.
It had to begin with the basics. And for companies struggling to get an employee health initiative off the ground, the best place to start is simply defining its purpose – whether that’s reduced sickness absence, improved productivity or better resilience. With that comes an understanding of those it’s intended to benefit, yet a surprising number of organisations fail to consider this.
“If a wellbeing initiative doesn’t relate to the needs of the workforce, it’s not going to work,” explains Herbert. He advocates undertaking a survey to get baseline health metrics and ascertain the workforce’s risk of developing conditions like heart disease and diabetes. “Once you know your workforce’s highest risk, you can start to create wellbeing initiatives that are geared towards that,” he adds.
But if organisations are unsure where to start, tailoring the programme is only half the issue. With little academic study into the effectiveness of wellbeing initiatives, it’s no surprise that tactics across the board are varied. “One of the problems is people are running off in different directions and not taking an evidence-based approach,” says Nick Pahl, CEO of the Society of Occupational Medicine.
Lack of evidence was also found to be an issue by the team behind a Cochrane Review of research into the effectiveness of strategies for improving the implementation of workplace health practices, describing the available evidence as “sparse and inconsistent”.
It appears organisations are more reliant on the general logic that wellbeing is a positive thing, rather than any tangible proof. “In many cases, it’s unclear what the most effective intervention is, and more work needs to be done” says Pahl. “Take mental health first-aid training and sit-stand desks – we’re not saying ‘definitely not’, but if you’re going to invest, why not invest in something where there’s evidence?”
But an absence of concrete academic proof isn’t an excuse for organisations to not undertake their own research, argues Herbert. “The recommendation would be to at least do some reading. If you’re not looking for the initiatives that have the biggest impact, you’re unlikely to find what works for you,” he says. And whether organisations choose to take the time to assess all the available options or simply click the first hit from their internet search, either way they are met with a profusion of possibilities.
With the issue having jumped up corporate agendas in recent years and demand for services increasing, the market has followed suit. “The whole area of health and wellbeing is really busy, and it can be hard for an organisation to make informed choices,” says Suff. “Everyone is producing some kind of product they say is going to work,” adds Pahl.
Along with an increase in choice comes a higher chance that firms will make inappropriate decisions. “Because it’s desirable for an organisation to demonstrate an interest in wellbeing, there’s a risk they’ll pay lip service rather than engaging in a meaningful way,” says Chandler. He advocates avoiding less effective initiatives at the more “superficial” end of the spectrum, such as offering employees free fruit and gym memberships, and instead working towards creating a healthier working environment where wellbeing is ingrained in the company’s culture – although as Pahl admits, looking at whether the organisation has the “right kind of culture” is more difficult than just going for the superficial things.
Culture change may sound like a mountainous task, but the ability to successfully foster that healthy environment is not just reserved for larger organisations. One of the key ways is to simply make sure those at the top are engaged with promoting wellbeing. “To get any change at organisational level, you have to have senior management buy-in, but it’s also important that buy-in is perceived as genuine,” says Chandler. That equates to managers practising what they preach and adopting a good work-life balance.
Similarly, the role of line managers is also severely underutilised when it comes to implementing a wellbeing strategy. “There’s a really big gap in the level of education and support that line managers receive in health and wellbeing, with only a third of organisations training them in areas like managing sickness absence,” says Suff. “Good management doesn’t need to be expensive. If your line manager is supportive, that can make as much difference – if not more – as having a free gym membership.”
But perhaps more difficult than getting managers on board is getting the employees themselves to commit. As Herbert succinctly explains, “The secret to a successful wellbeing initiative is adherence and engagement” – so depending on the nature of the workforce, employees will engage with a wellbeing strategy in a variety of different ways.
Employers also have a role to play in educating their workforce about why it’s important they look after their wellbeing in the first place, and how they should do that. “People are aware that things like smoking are bad, and exercise is good, but there will be gaps in their knowledge of successful behaviour changes,” says Herbert.
He also recommends businesses try to adopt a proactive approach to wellbeing – especially when it comes to employees’ mental health. Despite one in four people experiencing a mental health problem in a given year, according to charity Mind, this remains an area where organisations are even less confident. Pahl describes employee mental ill-health as one of two “big issues for workforces” (musculoskeletal issues being the other), and according to a 2017 study by Deloitte, it costs UK employers up to £42bn a year. Yet the CIPD’s Health and Wellbeing at Work report found that only 6 per cent of organisations have a standalone mental health policy.
But it’s not necessarily something employers are purposefully ignoring. “Organisations don’t recognise their health and wellbeing policies aren’t addressing the right issues because they simply don’t understand the impact of these conditions,” says Chandler.
So how can they effectively support workers’ mental wellbeing? Herbert suggests offering initiatives that will help before they reach crisis point: “At the moment, the go-to initiative is to provide cognitive behaviour therapy,” he says. “While it’s definitely effective, it would be better if it wasn’t the first interaction people have.”
Despite the boons that come from having a comprehensive workplace wellbeing strategy, unlike workplace health and safety, it’s not a legal requirement. But that’s not necessarily a bad thing, argues Herbert. “In the 1960s, we used to think it was ridiculous that exercise could be good for our health, whereas now everyone knows that doing some kind of physical activity results in improved health,” he says.
“As time goes on, we’ll have a better awareness of how we all have physical, mental and social health, and what has a positive and negative effect on them.” Ultimately, adds Chandler, “it’s a positive development that it’s now even desirable to care about employee wellbeing, and it signals that society is moving on in that way.”