#HealthAtWork Investing in a workforce fit for the future - Year 1 of the Health at Work Policy Unit Karen Steadman - Senior Researcher, TWF NHS Employers Diversity and Inclusion Partners - 9th December 2015

Health at Work Policy Unit (HWPU) Dame C Black, ‘Working for a Healthier Tomorrow’, 2008 Launched on October 21 st 2014 Aims: To provide an independent, authoritative and evidence-based voice in debates around health, wellbeing & work To represent the views of a range of stakeholders To translate evidence into policy recommendations Work Programme: 1)Production of a series of ‘white papers’ & policy briefs 2)Responding to and influencing political debate 3)Acting as a repository for information, good practice and evidence-based solutions Sponsors: Bupa, Napp pharmaceuticals & British Safety Council

The Health at Work Policy Unit – Year 1 1.The Way Forward: Policy options for improving workforce health in the UK 2.Fluctuating Conditions, Fluctuating Support: Improving organisational resilience to fluctuating conditions in the workforce 3.Healthy, Working Economies; Improving the health and wellbeing of the working age population locally 4.Living long, working well; Supporting older workers with health conditions to remain active at work

Context Government objectives: Boosting productivity & reducing deficit Achieving full employment & halving disability employment gap Challenges: Increase in chronic disease in working age, ageing population, higher retirement age Implications for health, social and welfare systems, productivity, individuals, families and society Job quality impacting on health Key to this is a healthy, productive workforce and more good quality work

Policy challenges: 1.Incentivising employers to take action 2.Supporting individuals with long-term conditions 3.Driving action at local level 4.Supporting older workers with health problems

Who do we need to engage? Workforce health Government – DH, DWP, BIS, Treasury, DCLG Employers Local government Health bodies (HWBs, CCGs) Individuals Business community (LEPs, Growth Funds) Voluntary and charity sector Health & social care professionals

1. Incentivising employers to take action Context: Workplace key setting for addressing working age health Workplace health & wellbeing programmes shown to reduce costs, absence and turnover, improve staff satisfaction Policy Challenge: Many employers still do not recognise the benefits – costs too high, implications too small, not their responsibility etc. Other do not know where to start, or are limited by capacity (esp. smaller) To find ways to incentivise, encourage, and support more employers to take action on employee health and wellbeing.

1. Incentivising employers to take action Policy Gaps: Gov. investment in well-targeted measures & guidance to incentivise employers to act in their own interest, their employees’ interests, & in the interests of society. Next steps: 1.Assess the feasibility of further fiscal incentives to encourage employers to introduce workplace health interventions. 2.Investigate the current and potential role of Income Protection Insurance as a means of providing both sick pay and rehabilitation support to employees 3.Offer clearer, more up to date and proactive advice and guidance to employers

Estimated long-term conditions in the UK working age population by 2030

2. Supporting individuals with long-term conditions Context: Long-term and fluctuating health conditions can make finding, retaining and progressing in work difficult Reasons complex – many cultural, attitudinal and structural barriers which must be addressed Many people with LTCs would like to work and can work with the right support Good quality work is often beneficial for health, while bad quality work can be detrimental The challenge is to provide appropriate, timely support which helps people to return, remain in, and be productive at work Engaging health systems, welfare systems & employers Developing good quality work

2. Supporting individuals with long-term conditions Policy gaps: Access to and quality of existing support Recognition of employment as a determinant of health and a key aspect of recovery Sufficient, timely access to specialist support Next Steps: Improve access to ‘Access to Work’ Align health and social care outcomes frameworks to highlight work as an outcome Making provision of high quality support for people with LTCs a priority for Work Programme 2

3. Driving action at local level Context: Devolution agenda recognises value of local solutions – esp. in providing targeted support, co-ordinated among local partners Few local areas are in this space on health and work – happening despite policy rather than because of it Challenge: Ill-health significant cost to local economies, but limited resources & scope to manage & rewards accrued elsewhere Considerable variation in need, priority & activity Lack of national governance structures to encourage & support local activity

3. Driving action at local level Policy Gaps Supporting local, specialist providers to provide tailored back to work support Getting health and employment on the local agenda Next Steps: Increase local engagement in the planning, development and delivery of “Work Programme 2”. Statutory requirement for at least one local business leader to sit on every Health & Wellbeing Board Renew the statutory guidance for Joint Strategic Needs Assessments (JSNAs) to include a more standardised set of measures, including health and employment measures

4. Supporting older workers with health problems Context: Ageing workforce and increasing retirement age Leaving work early due to ill-health ever more significant Many forced out of work early – declining health and poor support Policy Challenge: Finding effective ways to extend working lives and prevent early retirement among older workers with LTCs Barriers are poor knowledge about support, lack of workplace flexibility, age-related stigma Address regressive attitudes, and improve support

4. Supporting older workers with health problems Policy gaps: Employers and healthcare professionals need to be better equipped to manage the dual challenge of older age & poor heath Identifying and promoting appropriate interventions Promoting a forward view of the ageing workforce Next Steps: Integrating specialist support for older workers into occupational health and back to work services Encouraging individuals and employers to plan early on for the health challenges of working in later life Changing attitudes and creating an age friendly working environment

2015/16 Work Programme Topics of ‘white papers’ 2015/16: SMEs and health (launched 24 th Nov 15) Young people with chronic conditions – transitions into work (in development) Long-term conditions & specialist back to work programmes Personalisation of care and employment Policy briefs: The case for early intervention Good work Fit For Work service

This Won’t Hurt a Bit: Supporting small business to be healthy, wealthy and wise 99% UK private sector business are SMEs: employees Sickness absence lower, but presenteeism high and higher likelihood of falling out of work directly onto ESA Lack of resources for traditional workplace health support Business case harder to make – financial benefits limited, often depends on the individual goals of the owner- manager Difficulty accessing SMEs – finding out what they need and what would actually help.

This Won’t Hurt a Bit: Supporting small business to be healthy, wealthy and wise Challenges: Taking a strategic approach to SME employee health and wellbeing Developing and delivering SME appropriate training, resources and support Improving SME access to advice and support. Recommendations: Taking a strategic approach to SME employee health & wellbeing Developing and delivering SME-appropriate training, resources & support Improving SME access to advice and support

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