Chapter 13 The Workplace Setting © John Hubley & June Copeman 2013

Workplaces can be classified by Size The kind of activity that takes place The organization of workspace Workplaces can be classified by: Size: ranging from large employers employing thousands (such as local government and National Health Service and private companies), down to small businesses employing a few and individuals who are self-employed The kind of activity that takes place: factories manufacturing products; open-air work such as farming, building sites and road construction; offices, call centres, shops, mobile-servicing and repairs The organization of workspace: individual offices, open-plan, shop floor, mobile services, working from outside locations and from home

Patterns of working Patterns of work are constantly changing with new kinds of work emerging such as call centres and computer-based home working and some kinds of work such as mining in decline.

Workplace health policies A useful approach is to set up policies in a workplace that cover specific health topics such as smoking, heart disease, alcohol and HIV/AIDs and the actions by management and workers to address those issues.

Types of health promotion programme Awareness programmes Lifestyle change programmes Supportive environment programmes Peersman et al. 1998 What kinds of health promotion can be carried out in the workplace? A systematic review of the effectiveness of workplace health promotion (Peersman et al. 1998) identified three types of programmes. Awareness programmes which aim to increase workforce level of awareness in relation to specific health topics. Typical activities include health fairs; posters, newsletters, educational classes; and health screening. Life style change programmes directly aim at changing employees’ health behaviour through a variety of approaches such as skills training and self-help. Supportive environment programmes aim to promote a sustainable healthy lifestyle through creating a workplace environment that supports and encourages healthy choices, such as a smoking ban and the provision of healthy food choices in the canteen.

Typical 3-stage health promotion programme Initial health risk appraisal which involves an assessment of personal health habits and risk factors; Estimation of the individual’s future risk of death/adverse health outcomes; Provision of educational methods and counselling about ways to change personal risk factors. A typical worksite health promotion programme follows a set pattern: (1) an initial health risk appraisal which involves an assessment of personal health habits and risk factors; (2) an estimation of the individual’s future risk of death/adverse health outcomes; and (3) provision of educational methods and counselling about ways to change personal risk factors.

Teamwork in workplace health promotion Health and Safety Officers. Occupational Nurses and Physicians. Occupational Hygienists. Ergonomists. Occupational Psychologists. Trade Union Health and Safety Representatives. Health and Safety Officers are employees with responsibility for health and safety, fire safety etc. – mainly exist within larger employers. Occupational Nurses and Physicians have a role in screening, assessing risk to health, and giving advice on reducing risks, and rehabilitation. Occupational Hygienists have skills in assessing and in making specific technical recommendations on reducing risks from noise, gas etc. Ergonomists advise on adaptations to the workplace to suit employees and tend to have particular expertise in issues of handling, workstation design etc. Occupational psychologists are involved in advising on organizational structures and procedures, well-being of workers and advice on stress-related issues. Trade Union Health and Safety Representatives are often employed by large national trade union offices. Local branches of trade unions can have elected lay health and safety officers and individual workplaces have elected health and safety representatives. Recognition and rights of health and safety representatives are set out in the 1974 Health and Safety at Work Act and the Safety Representatives and Safety Committee Regulations (1977).

Figure 13.1 The Workplace health good practice planning tool Health services as a workplace The National Health Service is the largest single employer in the United Kingdom with more than one million employees. As part of the Framework Action for Primary Care the Health at work in primary care project, the Health Development Agency proposed the tool (adapted from Wynne 1995) in Figure 13.1 for planning health promotion interventions within primary care workplace settings (HDA 2001). This follows a similar approach to the health promotion planning cycle we introduced in Chapter 1 and identifies the following six key stages for planning workplace health promotion. Set up support structures for workplace health. This involves gaining commitment to workplace health from the employer and senior staff and assessing what resources in terms of staff time and finances are allocated to workplace health and what additional resources might be available in future. Gather information. Key information required includes details of: the work environment, sickness absence, staff turnover, ill health/early retirements, referrals to occupational health, complaints, insurance claims and grievance procedures. Develop a strategic action plan. This should include the following: a statement of intent from the partners; aims of the workplace health programme; resources to be allocated to the programme; details of who is responsible for carrying out specific areas of the programme; activities included within the programme; scheduling, evaluation and review of the programme. Implement and monitor plan. This will depend on the specific actions involved but would be expected to involve the carrying out of activities, monitoring of progress against targets, reporting of achievements and regular communication with staff and feedback about the changes being introduced. Evaluate the plan. Collection of information and assessment of the impact of the programme. Review plan and support structure. All staff should be involved in building up a picture of what worked well and which areas could be improved. While developed for health promotion within primary care workplaces, the model in Figure 13.1 provides an excellent basis for planning health promotion within all workplace settings.