The document discusses health, well-being, and work. It notes that society benefits when more people can work productively for longer. Good work and workplaces that support health and well-being can help prevent issues that limit working, like common mental health problems. Integrating occupational health, health promotion, and illness prevention can create synergy and benefit both worker health and business performance. Sedentary work is a growing issue, but interventions to promote activity, like sit-stand desks, show positive results.

1. Investors in People
Health and Wellbeing Seminar
Dame Carol Black
Expert Adviser on Health and Work
Department of Health and Public Health England
Principal, Newnham College Cambridge
Health and Wellbeing
in the working
environment

2. Content – What is new or developing ?
• Awareness of impact of demographics
• Importance of ‘good work’ and good workplaces
• Mental Health and resilience
• Staff Engagement and its relationship to wellbeing
• Role of the manager : NICE Guidance
• Sedentary workers
• Integration of services

3. Work, health and society
Society needs the maximum number of productive years from as
many people as possible. Those not working depend on others.
The ratio of earners and wealth-generators to dependants (children,
pensioners, unemployed) needs to be as high as possible.
Childhood Working life Retirement
Being sufficiently healthy is a condition for work, and
maximising disability-free life as a proportion of total
life is therefore a desirable goal for individuals, health
professionals and society.

4. Fuller working lives
A Framework for Action, DWP June 2014
Life expectancy is increasing – by 2030 those over 65 will increase by
50% and those over 85 will double. One third of children born today will
live to be 100.
•both a huge opportunity and a huge challenge for Government, impacting
on every aspect of society. But compared with 50 years ago, people
exit the labour market earlier.
• Of those between 50 and state pension age, 28% are out of work
- of these 25% have retired, and 60% see another job as unlikely.
•Over 50% of adults have already stopped working by the year before they
reach state pension age ...
…. many are sick, disabled or carers, or have given up looking for work

5. The world of work is changing
• The industrial landscape is changing, and a knowledge-
based economy has emerged
• Globalisation of labour markets, leading to a
work-anywhere culture
• Transferable skills needed, with flexibility, upskilling,
lifelong education and training
• Female employment projected to increase, reaching
47.5 % of the total in 2020 UK
• Many people wanting or having to work after 65
• Fewer permanent ‘core’ staff, with out-sourcing
and zero-hours contract work
• Concept of ‘good work’ and good workplaces
The pattern of
damage at work
is changing.
Mental ill-health
is increasing.

6. Good Employment :
Essential characteristics
Good work Good workplaces
• Stable and safe
• Individual control
• Fair work demands
• Flexible arrangements
• Opportunities training,promotion
• Promotes Health and Wellbeing
• Prevents isolation, discrimination
• Shares information
• Reintegrates sick /disabled if
possible
• Visible senior leadership
• Appropriately trained
managers
• Integration of OHS with
health promotion and
illness prevention
• Monitoring &
measurement
• Empowering employees
to care for their own
health
• Enabling staff

7. What prevents us from working
– or from working well ?
• Common mental health problems
• Musculo-skeletal problems
• The quality of work and the workplace
- organisation of work
- managerial behaviour and leadership
- absence of ‘good work’
• Other important reasons
- long-term conditions – mental and physical
- psychosocial/ home-related problems
- lack of education and/or skills.

8. Common Mental Health Problems :
What and Why
• Stress, anxiety, mild depression
- high prevalence across populations
- little or no objective disease or impairment
- most episodes settle rapidly, though symptoms
often persist or recur
- essentially whole people, should be manageable.
• These symptoms are often an expression of, or
reaction to, poor work, poor workplaces, and/or
poor leaders or managers.
• Health interventions such as drugs, EAPs, CBT etc
may help BUT not address the real root problem(s).

9. • Government, directly and through arms-length bodies :
- Health and Safety Executive (HSE)
- Acas (Advisory Conciliation and Arbitration Service)
- Special health authorities e.g. NICE
• Employers
- public, private, large, medium, small
• Health Professionals
- and their organisations e.g. RCPsych
• NGOs
- e.g. MIND, Tomorrow’s People, Comic Relief,
MHFA
Mental Health and Work : UK Progress

10. Government Initiatives supporting
Mental Health in the Workplace
• Mandates – to NHS, local government, etc.
• “No health without mental health” cross-Dept strategy
• “Time to change” National Anti-Stigma Campaign
• Public Health Responsibility Deal (Department of Health)
Health at Work Network, Mental Health pledge
• Achieving Better Access by 2020
• Chief Medical Officer’s Annual Report 2014
• Closing the Gap: Priorities for essential change in MH

11. Wellbeing, Mental Health
and Engagement
• Wellbeing includes our psychological state
• High levels of staff engagement are not sustainable without wellbeing.
• Engagement without wellbeing can lead to a burned-out workforce.
•Robertson and Cooper have shown that the top driver for employee
engagement is the extent to which employees believe that their senior
management has a sincere interest in their wellbeing.
•Approximately 25% of the variation in reported levels of employee
productivity is predicted by a combination of:
- psychological wellbeing
- perceived commitment of the organisation to the employee
- access to appropriate resources, and
- good communication.
Donald et al, 2005

12. Engagement and Disengagement
Lack of motivation and sub-optimal health cause UK workers to work
below peak productivity, holding back potential growth. Study of 5000 workers
•About half of people do not go above and beyond at work because they
think it won’t be acknowledged or rewarded.
•Over a third of teams are experiencing extra stress and
pressure due to staff ill health and absences
•One in four staff admit they don’t want to win new business
as it will only mean more work for them.
•Failure to unlock employees’ ‘discretionary effort’ costs businesses
dearly, cutting a potential £6 billion – equivalent to 0.4 per cent of
GDP – from the UK economy in 2012.
BUPA/Centre for Economics
and Business Research,
December 2013

13. Train your Managers
• Good line management is key to good workplace health.
• Managers should focus on:
– effective communication with the
employee and other members of staff
– awareness of the issues and the
ability to empathise
– developing open culture with employees feeling
able to discuss their problems.
• Learning about mental health enables managers to judge when
they need to refer employees to outside help.
• There are many sources of advice and good training courses.

14. Re-integration into Work :
after Mental Ill-health
Time to Change, survey of the public,
October 2014
•7% rise in willingness “to work with
someone with a mental health
problem” (69 to 76%)
Promote health and wellbeing.
OECD Report 2011 :
•Globally, employment opportunities for people with
mental ill-health are low, many of those who are
employed struggle in their jobs, and disability caused by
mental ill-health is frequent and rising.

15. Re-integration into Work : Cancer
• 109,000 working-age UK people diagnosed
with cancer each year
• 775,000 working-age UK people have had
a cancer diagnosis
• Research shows that cancer patients
want to work … but
… long term cancer survivors are 1.4 times
more likely to be unemployed.
• One in four survivors say their cancer
prevents them working in their
preferred occupation
• The average fall in household income for a
family of working age with cancer is 50%...
. . . and 17% lose their home.
MacMillan Cancer Support
- change in culture
is needed.
Cancer is becoming a
long term condition

16. Source: Maddams J, Utley M, Møller H. Projections of cancer prevalence in the
United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202.
The number of UK people living with
cancer is set to double by 2030
Predicted numbers:
2010 2 million
2020 3 million
2030 4 million
(with over 2.5 m diagnosed
over five years earlier)

17. NICE: Public Health Draft Guideline
Workplace policy and management practices to improve
the health and wellbeing of employees
• makes recommendations, focussed on organisational culture and
the role of line managers
• for employers, managers and employees, and those working in
Occupational Health, health and safety, Trade Unions etc.
Aims to:
• promote supportive leadership and help line managers achieve it
• explore the positive and negative effects organisational culture can
have on workpeople’s health and wellbeing
• provide a business case and economic modelling for managers.

18. Integration : Total Worker Health
• Traditionally, workplace Health and Safety has been separated from
Health Promotion.
• NIOSH (National Institute for Occupational Safety and Health, USA)
is now emphasising Total Worker Health :
“ Growing evidence supports the effectiveness of combining these
efforts through workplace interventions that integrate health
protection and health promotion. ”
“ Integrating health protection and promotion will create synergy,
enhance overall health and wellbeing of the workforce, and
decrease the likelihood of workplace injury and illnesses.”
“ Having a psychologically-healthy workplace and having a profitable
and sustainable business are linked.”

19. Gains in health
wellbeing,
fitness for duty
Absence of
illness or injury
incidents
Illness/injury
incidents
Gains in
company
performance
Cost
minimisation
Loss
Control
Organisational Health and
Safety
Strategic, integrated
Harm Minimisation
Compliance, systems,
culture
Integration : Total Worker Health
Slide courtesy of Anne-Marie Feyer and Niki Ellis
ExpandedExpanded
value chainvalue chain
goes beyondgoes beyond
absence ofabsence of
injuryinjury

20. Health and Wellbeing Programmes
Depend on circumstances – place, time, organisation
• Consult staff – then design.
• Mental Health : Prevention 1st
, 2nd
and 3rd
!
- counselling, mediation, yoga, stress management ,
resilience training
• Physical Health : (also benefits mental resilience)
- health assessments, running clubs, discount on
gym membership, fit bug, smoking cessation, dietary
changes in canteens, Well Point, physiotherapy,
pilates, reflexology, etc.
• Lifestyle : - make the most of money, well done letters,
flexible retirement policies, lifewise flexible working,
reading clubs, choirs, garden allotments .

21. Sedentary workers
Welcome
to a new
dawn
In Scandinavia 90% of office workers have sit-stand desks, in Britain 1%.
On average British people sit for 8.9 hours each day, 70% of that at work.
Research provides compelling evidence that sitting for more than 4 hours :
- shuts down enzymes that burn harmful blood fats
- reduces calorie burn and disrupts blood-sugar levels
- increases insulin levels and blood pressure.
Prolonged sedentary working increases risk of heart disease, diabetes, etc.

22. Sedentary workers
• Australian studies show the ameliorating influence of
workplace interventions to promote standing breaks and
sit-stand adjustable work stations.
• These interventions led to improved health-risk markers,
improved productivity quality and efficiency, and greater
sense of collaboration among employees.
Healy G., Eakin EG et al, Preventive Medicine 2013
• These examples provide cost savings to both the health
service and the employer, along with knock-on positive
effects on the productive lives of others, e.g. carers.

23. Investors in People
The most important asset your organisation has is its people. The
biggest asset they have is their health and wellbeing. It therefore
makes good sense to look after it.
The IiP Health and Wellbeing Award recognises businesses that go the
extra mile. How do your Health and Wellbeing practices stack up? Our 20
question test will help you compare against the very best.
Key features:
- Explores the key enablers of healthy workplaces
- Establishes how well your plans and policies are implemented
- Develop your personal action plan
How does it work?
- Take 10 minutes to complete 20 questions
- Results give a clear picture of how your organisation is performing
- Download your personal Health and Wellbeing report
We know how to get
the best from people.