Workplace health: management practices

Context

There is strong evidence to show that work is generally good for people's physical and mental health and wellbeing (Is work good for your health and well-being? Department for Work and Pensions; Annual report of the Chief Medical Officer surveillance volume, 2012 Department of Health).

It meets important psychosocial needs in societies in which employment is the norm and is central to someone's identity, social role and status ('Is work good for your health and well‑being?'). Work can also reverse the ill‑health effects of unemployment.

However, these benefits do depend on the type of work involved (Good work and our times, Good Work Commission). There is also a positive association between wellbeing, job satisfaction and an employee's job performance. Many studies have also shown a relationship between supportive supervision and job satisfaction. These findings provide a strong case for employers to consider investing in the wellbeing of their employees on the basis of likely performance benefits (Does worker wellbeing affect workplace performance? Department for Business, Innovation & Skills).

During 2013/14, 1.2 million working people had a work‑related illness. Half a million of these were new illnesses (Health and Safety Statistics Annual report for Great Britain 2013/14, Health and Safety Executive). Work‑related illness and workplace injury led to the loss of an estimated 28.2 million working days in 2013/14. Injuries and new cases of ill health resulting largely from current working conditions cost society an estimated £14.2 billion in 2012/13 (based on 2012 prices).

People's health can be damaged at work by, for example:

Lack of control over the work (including a lack of opportunity to take part in decision‑making), conflicts in workplace hierarchies, and covert or overt discrimination can also affect health.

All these factors are most prevalent among people who are in jobs that are low paid, unsafe and insecure (Fair society, healthy lives, The Marmot review). On the other hand, the Good Work Commission in 'Good work and our times', noted that 'employees and employers alike recognise that these days guaranteeing job security is unrealistic'. It also pointed out that employers have a role in ensuring people are equipped with transferable skills that will be an asset in the future.

The World Health Organization has highlighted the importance of ensuring the culture of an organisation promotes health and wellbeing (Healthy workplaces: a model for action). A 'healthy' culture, for example, would include having fully implemented policies on:

Good line management has also been linked with good health, wellbeing and improved performance (Working for a healthier tomorrow, Department for Work and Pensions).

Poor‑quality leadership, on the other hand, has been linked with stress, burnout and depression (Mental capital and wellbeing: making the most of ourselves in the 21st century, Government Office for Science). It can also affect how well employees relate to the organisation, their stress levels and the amount of time they spend on sick leave (See the, Affinity Health at Work final research phase project report on preventing stress: promoting positive manager behaviour phase 4: How do organisations implement the findings in practice?; funded by Health and Safety Executive, Chartered Institute of Personnel and Development and Investors in People.).

A Confederation of British Industry (CBI) report highlighted the importance of providing adequate training for line managers to help them support employees with a health condition to remain at work (Getting better: workplace health as a business issue). Furthermore, the Workplace Wellbeing Charter (which provides an opportunity for employers to demonstrate their commitment to the health and wellbeing of their workforce) recognises the importance of line managers in their standards.

Evidence suggests that people going to work while they are sick ('presenteeism') is a more costly problem for employers than absenteeism (Sainsbury Centre for Mental Health policy paper 8 on mental health at work: developing the business case). This is partly because it is more likely to occur among higher‑paid employees.

'Presenteeism' may be caused by the culture of an organisation or the nature of the work – or both (people may come to work when they are unwell because they don't want to let their team members down). It leads to poorer longer‑term health outcomes (Working while ill as a risk factor for serious coronary events: the Whitehall II study Kivimäki et al. 2005; The future of health and wellbeing in the workplace Advisory, Conciliation and Arbitration Service). A study examining the prevalence of presenteeism in the UK found that nearly 60% of the sample reported presenteeism during a 3‑month period (Poor health but not absent: Prevalence, predictors and outcomes of presenteeism study Robertson et al. 2012.). The majority of participants (67%) indicated that the primary pressure to go to work while sick came from themselves. A substantial minority (20%) also indicated that their manager was a source of pressure.