HEALTHCARE 100 MASTERCLASS
Why healthy staff means happier patients
Investing now in staff health and wellbeing has long-term benefits for NHS organisations - not least through reduced sickness absence and greater motivation. Jennifer Taylor finds out how employers can embed this
There are a number of imperatives for NHS organisations – and boards in particular – to make the health and wellbeing of staff a top priority.
A growing body of evidence and an increasing range of guidance directs NHS organisations to improve the health and wellbeing of their staff, but there is a strong intuitive case that this makes sense. Staff who are fit, healthy and well, and are supported by their employer to maintain this, give more of themselves to the organisation.
“There’s an equally strong business case for prioritising staff health and wellbeing,” says NHS Employers director Dean Royles. “Investing time now in embedding a culture that supports the health and wellbeing of staff will have long term benefits to NHS organisations.”
Critical to embedding such a culture in an organisation is the full support of the board and engagement with delivery of an agreed health and wellbeing strategy.
Mr Royles says “Our work with NHS organisations indicates very strongly that where NHS trusts have boards that are fully engaged in embedding and improving health and wellbeing, they see much greater success in the health of the workforce, in the quality of services they provide and the effective use of resources.”
This is a view backed up by a recent audit of implementation of National Institute for Health and Clinical Excellence public health guidance for NHS staff. Conducted by the Health and Work Development Unit, a partnership between the Royal College of Physicians and the Faculty of Occupational Medicine, the audit covered 63 per cent of trusts in England and nearly a million staff.
“The audit has shown convincingly the importance of senior leadership and the board taking the health and wellbeing of NHS staff seriously,” says Dr Sian Williams, clinical director at the Health and Work Development Unit, Royal College of Physicians. “Where boards are actively leading on staff health and wellbeing, the specific activities required to improve health and wellbeing are more likely to happen.”
Part of the audit looked at board engagement. It found that 95 per cent of trusts had a named board member with responsibility for staff health and wellbeing; two thirds of trusts had health and wellbeing as a regular board agenda item (at least annually); and just 44 per cent of trusts had an overarching policy for staff health and wellbeing.
The audit then investigated implementation of the NICE guidance and found wide variation between trusts and the range of guidance implemented within them. Trusts that had health and wellbeing as a regular board agenda item were significantly more likely to have taken actions to implement the NICE workplace guidance compared with trusts that did not. Trusts with an overarching strategy or policy for staff health and wellbeing were significantly more likely to have specific policies on obesity, physical activity and promoting mental wellbeing than trusts without one.
Further impetus for making this drive a priority is its inclusion in the NHS operating framework for 2012-13 and recent recommendations made by the NHS Future Forum, both citing the implementation of NICE public health guidance as key to improving staff health and wellbeing.
Plans are afoot to conduct a second audit in 2013. In the meantime a project is ongoing with a selection of trusts to discover the drivers behind trusts scoring well on board engagement. “We want to find out what it is that enables some trusts to take this seriously [since] those trusts have better patient outcomes,” says Dr Williams.
Many trusts may be planning cost improvements that seek to make savings by reducing the size of the frontline workforce – a likely unpopular initiative. But the same end could be achieved by improving staff health, leading to reduced sickness absence and reduced use of agency staff, and a more engaged workforce. “Knowing that they’ve got to make £20bn savings this could be an easy win [for boards],” says Dr Williams.
NHS Employers is actively working to engage NHS boards and directors outside of HR who often believe that the health and wellbeing of staff is not their responsibility. Dean Royles has written jointly with former NHS deputy chief executive David Flory to NHS finance directors outlining the benefits to organisations.
Julian Topping, programme lead for health and wellbeing at NHS Employers, says: “If you’ve got directors of finance or nursing directors that are as engaged in driving this forward as the HR director is, then there’s much more of an impact.”
Dean Royles adds: “NHS Employers is committed to supporting NHS organisations and their boards to embed the principles of staff health and wellbeing and to support delivery against the range of productivity challenges currently facing the NHS.”
In early May, in London, Birmingham and Leeds, NHS Employers is running a series of free events targeted at NHS board members and direct reports. Attendees will hear from respected national commentators alongside real life accounts from NHS colleagues leading highly successful local programmes to embed health and wellbeing, reduce sickness absence and agency spend.
What should your organisation be doing to improve staff health and wellbeing?
- Ensure your board has an executive lead for health and wellbeing
- Have a strategy which is readily available to staff, patients and visitors showing what is being done and why
- Schedule regular reports to the board and discussion of progress against strategy
- Engage with staff and staff-side representatives
Case study: York Teaching Hospital Foundation Trust
If a health and wellbeing strategy is to have maximum impact, it must move beyond reducing sickness absence as its sole objective. In 2008 York Teaching Hospital Foundation Trust engaged its board in a sickness absence project and has since broadened it to the physical, mental and social needs of staff. “By improving all of those aspects they’re more engaged, motivated and committed to come to work,” says the trust’s director of HR Peta Hayward.
Making a case to the board for extending the project was easy. Its £100,000 initial investment produced a drop in sickness absence rates of 4.5 per cent in 2008 to 3.1 per cent in 2011 (nearly equivalent to two wards of staff). The number of staff off long term sick fell from 98 to 29 over the same period.
Projects have included changing the canteen food with the help of the board and directors who attended tasting sessions. A staff member is recognised monthly for going above and beyond the job and their stories motivate the board to keep health and wellbeing a top priority. Teams of staff, directors and the board participated in the 16-week Global Corporate Challenge to increase physical activity, work in teams and boost staff morale.
Ms Hayward says: “Staff see that the value the organisation has isn’t about just being tough on people and being financially driven. It’s about saying ‘we want you to enjoy coming to work’.” That ethos is being led by the board.
Trust chair Alan Rose says: “As a board we have a holistic appreciation of how supporting and enhancing the wellbeing of our staff is ultimately aligned to trust performance and achieving our mission of safe, effective and sustainable healthcare.”