Improving the Health and Wellbeing of FE Staff Wellbeing of FE - - PowerPoint PPT Presentation

Leading by Example? Why the mental health and well-being of staff in Further Education is a leadership issue Education is a leadership issue 1 February 2011

Improving the Health and Wellbeing of FE Staff Wellbeing of FE Staff

Dame Carol Black National Director for Health and Work

Why invest in the health and ll b i f FE t ff? well-being of FE staff?

“The rewarding but difficult work of education can not be carried out well by people who are stressed and tired, but can be done well by staff with energy commitment but can be done well by staff with energy, commitment and a positive outlook.”

• Well-being facilitator
• All staff are role models for students and can demonstrate how to lead a
• All staff are role models for students and can demonstrate how to lead a

healthy and balanced lifestyle

• Staff well being may affect institutional performance (a study by
• Staff well-being may affect institutional performance (a study by

Birkbeck College in partnership with Work Life Support (2007) suggests that there are links between average teacher well-being in schools and pupil performance – 8% of variation in SAT scores show significant p p p g correlation with staff well-being)

• Improved health and well-being can reduce absence and improve

g retention of staff

The Boorman review Th I S i D li d O The Impact on Service Delivery and Outcomes

… over 80% of staff felt that their health and well-being impacts upon patient care, and virtually di d

none disagreed… … yet only 40% think that their institution cares about their

Trust A Trust B Trust C Trust D

institution cares about their health and well-being.

Absence Rate 4.21% 4.04% 4.58% 4.70% Turnover Rate 10.5% 9.79% 11.65% 17.02% Agency Spend 1.70% 2.96% 1.71% 4.57%

… data correlation l h d

Patient Satisfaction 78.9 76.4 77.4 67.5 MRSA rate 0.65 0.88 1.56% 0.95% Health Check – Quality f S i Excellent Excellent Weak Fair

also showed some significant relationships…

Source: RAND Europe

• f Services

Health Check – Use of Resources Excellent Excellent Weak Weak

NHSHealthandWellbeing

What is our overall goal? What is our overall goal?

Healthy, engaged workforces Well-managed

• rganisations
• A high-performing, resilient

kf workforce

• Enhanced productivity

Contributing to:

• A well-functioning society
• Better economic performance

A new vision for health and work A new vision for health and work

A Review of the health of the working-age UK population, commissioned in 2007 by the Secretaries of State for Health and for Work and Pensions. “At the heart of this Review is a recognition of, and a concern to remedy, the human, social and economic costs of impaired health and well being

Working for

economic costs of impaired health and well-being in relation to working life in Britain. The aim is … to identify the factors that stand

a Healthier Tomorrow

in the way of good health and to elicit interventions, including changes in attitudes, behaviours and practices – as well as services – ” that can help overcome them.” Working for a healthier tomorrow, 2008

Prevent illness, promote health, intervene early, improve the health of the workless.

Costs of working-age ill-health Costs of working age ill health

Financial Social

• Overall costs of working-age

ill-health in UK exceed £100 billion per year “If people are not healthy enough to work – or are inadequately supported through ill health to

• Around 172 million working

days were lost to sickness b i 2007 t t t supported through ill health to make a return to work possible – it is not just the individual or the business which is affected The absence in 2007, at a cost to the economy of over £13 billion (CBI) business which is affected. The bottom line is often the impact on his or her family and children.”

Black Report, 2008 Lane Lecture, University of Manchester, November 2007

Factors that stand in the way Factors that stand in the way

C lt b li f d ttit d di h Culture beliefs and attitudes – needing change

• Misconceptions about health and work – e.g. “need to be 100% fit”
• Inappropriate ‘medicalisation’ of complex psycho-social problems
• Poor retention in work of those with disabilities or chronic disease
• Managerial attitudes, organisational behaviour, unable to make business case.

Inadequate systems Inadequate systems

• Inflexible system of sickness certification – the ‘sick note’
• No pathways of rapid intervention to keep you in work or return you to it
• Health, work and well-being not part of training curricula or clinical practice
• Poorly-supported healthcare professionals. No OH advice for GPs.

Lack of Primary Care involvement y

• Rehabilitation to work not a performance measure for responsible local health

bodies

• Configuration of Occupational Health services: no national standards.

Configuration of Occupational Health services: no national standards. Next generation

• Little attention to building mental and emotional resilience in our future workforce

Why are people off work? Why are people off work?

• Two-thirds of sickness absence and long-

term incapacity is due to mild and treatable conditions often with inappropriate conditions, often with inappropriate ‘medicalisation’, needing vocational rehabilitation:

• Depression, anxiety, stress-related

mental health problems (est. cost £28.3 bn in 2008)

• Musculoskeletal conditions – mild and
• ften soft tissue (est.cost £7 bn in 2007)

“ The art of medicine remains the art of identifying the patient’s problem (which is something more the patient s problem (which is something more than diagnosing the disease) .”

Sir Douglas Black – echoing Sir Robert Platt

Different problems need different approaches

Symptoms: 2/3 of cases

• Often mild

Chronic conditions: 1/3 of cases

• Examples

Often mild

• Symptoms not ‘diseases’:

– back pain – musculo-skeletal symptoms Examples – chronic rheumatic diseases – endogenous depression – musculo-skeletal symptoms – stress – anxiety, mild depression Few investigations required g p – bipolar disorders, schizophrenia – diabetes, cancer

• Few investigations required
• Diagnosed with relative ease
• Intervention needs to be early,

– post-trauma disability

• Investigations more extensive

y,

• ften non-medical, good

vocational rehabilitation, regular contact between employee and

• Diagnosis can be difficult
• Treatment – good medicine, good flexible

l l h bilit ti employer.

• Prevent chronicity

employers, plus rehabilitation

• Prevent deterioration

Health of teachers Health of teachers

Reported rates of occupational stress, depression or anxiety are twice as high in the teaching profession than that for all other occupations all other occupations. A National Association of Head Teachers (NAHT) survey found that 40% of teachers reported having visited their doctor with a stress-related problem in the previous year. 20% of teachers considered they drank too much and 15% believed they were alcoholics.

The National Union of Teachers reports that around half of teacher ill health retirements around half of teacher ill health retirements take place for stress / psychiatric illnesses.

Costs of mental ill-health at work Costs of mental ill health at work

Total cost to UK employers is estimated at £ 26 bn per year (2006: Centre for Mental Health), including £ 2.4 bn in replacing staff who leave because of mental ill- health health £ 8.4 bn in sickness absence (40% of the average 7 days

• ff sick per year is for mental health problems); but

£15.1 bn in reduced productivity at work. ‘Presenteeism’ £15.1 bn in reduced productivity at work. Presenteeism loses 1.5 times the working time lost due to absence - costs more as more common in higher-paid work NICE: If mental illness costs employers £ 28.3 billion per annum in 2009:

• prevention and early identification of problems

should save employers at least 30%, i.e. £ 8 billion each year

• for a 1,000 employee company annual costs could

b d d b £250 000

November 2009 NICE guidance presents the business case

be reduced by £250,000.

business case.

• www.nice.org.uk/PH22

The old system, and the need for early intervention

• Work-related health problems often

not life-threatening, but life- diminishing (MSDs and mental health GPs issued ‘sick note’ diminishing (MSDs and mental health conditions)

• No clear pathways of vocational

sick note rehabilitation or standards: treatment all too often slow and inefficient, often with a poor outcome for the patient p p

• GPs have no easy access to expert

help or OH advice, or vocational rehabilitation

• Repeated Medical Certificates can

lead to worklessness lead to worklessness

• Problems are often mild and treatable

The workplace: findings of the

P d t di f l f H lth W k d W llb i

Black Review (2008)

• Poor understanding of relevance of Health, Work and Wellbeing
• Employers unaware of the business case for investing in health and

well-being

• Accessible and affordable sources of support and advice rarely

available for small and medium-sized companies (SMEs)

• Line managers’ behaviour crucial, but there is often little training
• Employers inflexible about necessary adjustments for those with

disabilities or chronic disease disabilities or chronic disease

• Often no policy on handling mental ill-health
• Often no sickness-absence policies to promote return to work

O te

• s c

ess abse ce po c es to p o

• te etu

to

• Patchy Occupational Health services, of variable quality
• No national standards available to employers when they purchase
• ccupational health or well-being services

And yet, the workplace provides great potential for prevention & promotion

Health promotion and ill health prevention in the workplace

Advantages of the workplace: Advantages of the workplace:

• a microcosm of society, as to age, gender, income, ethnicity
• powerful communication and education structures
• a culture of health at work can reinforce positive health behaviours
• a culture of health at work can reinforce positive health behaviours
• good employer/employee relationships can sustain healthy behaviour
• infrastructure for measurement of health outcomes is often in place

i t ti b fit l l d th bli

• interventions can benefit employees, employers and the public purse
• families of employees extend impact further.

Promotion of health in the workplace

The promotion of physical health and fitness and the prevention of and fitness, and the prevention of physical disease, are highly- desirable goals, often pursued by companies. But the promotion of positive p p mental health and fitness is done by too few companies. Physical health influences mental well-being.

Positive Workplaces Positive Workplaces

Key features common to those organisations which have achieved success in promoting health and well-being:

• Senior visible leadership

Senior visible leadership

• Accountable managers throughout the organisation
• Attention to both mental and physical health improvements

p y p

• Systems of monitoring and measurement to ensure continuous

improvement

• Empowering employees to care for their own health
• Fairness

Fl ibl k

• Flexible work

Health and well-being need to be embedded in every aspect of an organisation’s structure and work aspect of an organisation’s structure and work

HSE Management Standards HSE Management Standards

The standards define a desirable set of conditions to work towards:

• Demands which includes issues like workload, work patterns
• Control which is how much say the person has in the way they do

their work

• Support which includes encouragement and resources provided by

the organisation & line management

• Relationship includes promoting positive working to avoid conflict

Relationship includes promoting positive working to avoid conflict

• Role which ensures people are aware of their role in the
• rganisation and there is no conflict in roles
• Change covers how organisational change (large or small) is
• Change covers how organisational change (large or small) is

managed and communicated by the organisation

http://www hse gov uk/stress/standards/ http://www.hse.gov.uk/stress/standards/

Black Review: Health, Work and Well-being Initiatives

Fit Note In use from 6 April 2010 11 ‘Fit for Work’ service trials Live 2009 -2011 P blic sector e emplar Boorman re ie

• f NHS staff health in

Recommendations Public sector exemplar: Boorman review of NHS staff health in England Recommendations included in NHS Operating Framework 2010/11 National Standards for provision of OH services Published Jan 2010 National Standards for provision of OH services Published Jan 2010 Council for Health and Work Established 2009 Regional co-ordinators of health, work and well-being Live 2009-2011 Education and training initiatives for GPs and secondary care professionals Live 2009-2011 Working our way to better mental health: a framework for action Published Dec 2009 Occupational Health Adviceline for SMEs Live 2009-2011 Challenge Fund for Small and Medium Enterprises Live 2009-2011 Free interactive Workplace Wellbeing Tool Launched 2010

All intended to help maximise health, wellbeing and productivity.

From ‘sick note’ to ‘fit note’ From sick note to fit note

Fit note: GPs share responsibility with employers: GP kno s health condition and impact Sick note:

• For the past eighty
• GP knows health condition and impact
• Employer knows job

years or more, a GP assessed a person’s health and ability to work.

• The old form

required the doctor

Adjustments being made:

• Phased return to work

P t ti ki

required the doctor to state whether or not the patient could work, and how long

• Part-time working
• Working from home
• Flexible start times

, g they should refrain from work if sick.

• Partial ability to work
• Flexible start times
• Different tasks
• Practical adjustments in the
• Partial ability to work

was not considered.

Practical adjustments in the workplace.

Importance of Fit for Work Service Pilots

• Identifying underlying

problems with rapid problems with rapid referral

• One stop supported
• One stop supported

approach Practical support in

• Practical support in

non-medical areas

• OH input as required

These measures are to help people remain These measures are to help people remain in work or return to work more quickly

Leicester City & Leicestershire Fit f W k S i Fit for Work Service

• Move management of sickness absence from the

di l d l i t ti l h bilit ti

Vision

medical model into vocational rehabilitation.

• Move vocational rehabilitation closer to mainstream

primary care primary care.

C i i i P hi Dr Rob Hampton, Clinical Lead Commissioning Partnership

Advantages of Leicester FFWS Model

Convenient for patients

• Contact within 24hrs
• First appointment within a week
• Mobile phone communications
• Choice of venue for consultation: 40

surgeries, 12 MAC sites, PCT, Council and Provider premises p Helpful to GPs

• Ease of referral – no forms
• Ease of referral – no forms
• Musculoskeletal interventions funded
• Service signs Fit Notes

Service signs Fit Notes

• Service provides audit data to GP practices

Interventions: proportion of clients Interventions: proportion of clients

Musculoskeletal 15% Psychological 30% Psychological 30% Employer dialogue 50% Amended/Phased Return To Work 40% Amended/Phased Return To Work 40% Alternative employment 5% Information and guidance 20% Information and guidance 20% Referred to MACs (financial/family/legal) 40% JC Plus 5%

Leicester FfWS Client: ‘Never gave up on me, helped with all problems.’

Occupational Health Advice Helpline

• Provides SMEs and GPs with tailored occupational health

advice, by advisers with special training in Mental Health

• Majority of call are about sickness absence and attendance

management

• Increasing number about the fit note
• 90% of callers find it useful or very useful

WALES: Health at Work Advice Line Wales WALES: Health at Work Advice Line Wales ENGLAND: run in partnership with NHS Plus SCOTLAND: Healthy Working Lives Advice SCOTLAND: Healthy Working Lives Advice line

Workplace Well-being Tool Workplace Well being Tool

• Free on-line resource to help employers calculate

financial costs of employee ill-health to their

• rganisation
• Can be accessed at: www.workingforhealth.gov.uk

Mental Health: how can savings be delivered?

• Awareness training for line managers,

to increase understanding of MH issues d th i bilit t d fid tl and their ability to respond confidently and rapidly, e.g. at the Centre for Mental Health (one of many such courses).

• Prevention of directly-work-related MH

problems (around 15% of total) – e.g. by providing mentally-healthy working providing mentally-healthy working conditions and practices (see guidance by UK Health and Safety Executive)

• Better access to help for employees, particularly to evidence-based

psychological help and support while carrying on working

• Effective rehabilitation for those who need to take time off, including

regular contact with the employee during periods of absence

Case study-EoN Case study EoN

• E.ON is the world’s largest investor owned gas and electricity company
• Approx 18000 employees in the UK, over 50 sites across UK

pp p y

• Reviewed their structure, implemented strategic Business Partner roles
• Employed a specialist Case Manager and Communications Specialist

Aligned Health to the Business commercial & customer focus

• Aligned Health to the Business – commercial & customer focus
• Made health relevant to the individual

EoN-Staff Roadshows & innovative health promotion

• The number of new

cases & days lost cases & days lost through mental health related absence has reduced by 25% since launch

• Continuous reduction in

sickness absence over 2 years, approx £11.8m cost savings cost savings

Case study: Airbus Case study: Airbus

• Commercial partnership between

a large company and an NHS Trust

Results

• Saved £1.7 million of direct

Trust.

• Male-dominated environment with

7,500 employees.

Saved £1.7 million of direct costs over 3 years

• Sickness absence fell by 3

7,500 employees.

• Marketed programme around

“well-being” and not “mental

Sickness absence fell by 3 to 4%

• social benefits: one

health”, to avoid latter’s stigma.

• Mental Health First Aid courses to

Managers Shop Stewards and

employee’s partner approached a manager in a local supermarket to say

Managers, Shop Stewards and Apprentices.

• Encouraged the men to open up

a local supermarket to say the programme had improved her life too.

Encouraged the men to open up and be more honest among themselves.

p

Grimsby Institute: Introduction

Grimsby Institute of Further and Higher g Education has won many awards for employee health and well-being. Our approach is determined by the desire to provide customers (students and others) with the best possible

• service. To achieve this, we need to employ excellent staff

who perform each day to their best. If they are not at k th t d thi work, they cannot do this.

Grimsby Institute: Key to success

Health and wellbeing strategy aligned with: I tit t i i l

• Health and wellbeing team who

work with other experts.

• Institute mission, values

and business plans

• staffing procedures
• Speedy & supportive interventions

to keep people at work or accelerate returns to work

g p

• key business processes
• employee benefits

accelerate returns to work.

• Helping other organisations

understand the value of health and

• nsite catering
• charity fundraising

understand the value of health and wellbeing.

• Regular management training.
• sport and activity
• internal communications

g g g

• Extensive employee

communication.

• health and safety
• Measuring the impact.

Grimsby Institute: Results

Sickness absence:

• Level of accidents at work

dropped from 424 in 2004/05 to 253 in 2008/09

Year %age of days off Days / person /

• Quality of observed

teaching has improved

sick year 2004/05 1.62% 3.60

• Size of the organisation

has grown (£17m in 2001

2005/06 1.63% 3.60 2006/07 1.31% 3.23 2007/08 1 18% 2 61

to £47m in 2010)

• Financial health improved

2007/08 1.18% 2.61 2008/09 1.24% 2.74

p

Improving the health and well-being

• f University staff

‘Improving performance through wellbeing and engagement’ : a two year national project funded by HEFCE in partnership with Scotland and Wales to support institutions to enhance their suppo t st tut o s to e a ce t e performance through their people. The project led by the Universities of Leeds The project, led by the Universities of Leeds and Glasgow in partnership with the a number

• f Higher Education institutions, has so far

d 60% f HE i tit ti

60%

engaged 60% of HE institutions.

60%

‘ Improving performance Improving performance …

The project aims to:

• Develop a higher education specific business case for

employee wellbeing and engagement — showing what aspects make the biggest impact on performance aspects make the biggest impact on performance

• Support institutions to enhance their practice by

Support institutions to enhance their practice by developing a bank of practical case studies and resources

• Support learning and sharing across the sector by

developing an employee wellbeing network supported developing an employee wellbeing network, supported by regional meetings.

Recourse Recourse

• Recourse provides free and

confidential services to those

• rking in post 16

Recourse (formerly CUSN – the College and University Support

those working in post-16 education.

• This includes serving

Co ege a d U e s y Suppo Network) is the charity established by Teacher Support Network, in partnership ith UCU to impro e

This includes serving, former and retired staff and their dependents plus employees and former l f UCU AUT

partnership with UCU, to improve the well-being and effectiveness

• f all working in the adult, further

employees of UCU, AUT and Natfhe.

g and higher education sectors.

Recourse services Recourse services Recourse services Recourse services

• 0808 802 03 04

– 24/7 Support Line providing practical, emotional and financial pp p g p , support – Run every day of the year by fully-trained counsellors and coaches

• www.recourse.org.uk

– E-mail support from fully-trained counsellors and coaches – Web-based InfoCentre – Web-based InfoCentre – Online self assessment tools – E-newsletter

• All of Recourse’s services are completely free and confidential, thanks

to the continuing donations of the UCU and over 15,000 of its members members

How Recourse can help How Recourse can help – Daniel Daniel’s story s story

Daniel, 30, got his first post as a lecturer last year. He contacted Recourse as he was struggling ith hi kl d with his workload. Feeling anxious and pressured, his k h d b t d l work had begun to adversely affect his sleep patterns and short-term memory. Firstly, Recourse’s coach encouraged Daniel to seek medical advice He then helped

Daniel’s state of mind had improved significantly by the f

medical advice. He then helped him to realise that he needed to learn to manage his workload more effectively and, most i t tl h thi

end of the coaching programme and he had more confidence and better communication with

importantly, say no when things were getting on top of him.

his Head of Department.

M t l h lth d k Mental health and work

• Being in work generally leads to good mental health, self-

esteem and well-being B i t f k i i t d ith t l h lth

• Being out of work is associated with poor mental health,

increased likelihood of anxiety and depression, and increased use of medication

• When people return to work their mental health and well-

being generally improve Although work can pose a risk to mental health the positive

• Although work can pose a risk to mental health, the positive

effects far outweigh the risks

• People with mental health problems attach a high priority to

p p g p y work, and work can be part of the recovery process

• Poor mental health associates with low earnings, social

exclusion poorer physical health child poverty disrupted exclusion, poorer physical health, child poverty, disrupted education