Investing in staff

Programmes and services that support staff health and well-being are a worthy investment, which will save trusts money and improve patient care. That’s the principal message set out in the NHS Health and Well-being Review’s Final Report, which we delivered to the Department of Health in November.
The final report shows that the NHS loses 10.3m working days annually due to sickness absence alone, costing £1.7bn per year. With a future public spending squeeze seemingly inevitable, provider organisations cannot afford to lose so much every year as a result of staff absence, reduced productivity, and continuing bills for temporary staff.
Reducing service-wide absence rates by a third would mean an extra 3.4m working days a year, and annual direct cost savings of over half a billion pounds (£555m).
There is no doubt that these savings can be achieved through well constructed programmes and effectively targeted investment. Organisations which have invested strategically in health and well-being services have achieved major reductions in absence rates, with BT reducing rates by 30 per cent from 3.5 per cent to 2.43 per cent in five years, and in Royal Mail by 40 per cent from 7 per cent to 4.2 per cent over a similar period.

Engaging staff
The Review discovered that NHS trusts who have devoted serious resource to improving workforce health and well-being often outperformed commercial organisations in the reduction of absenteeism. Sandwell and West Birmingham Hospitals NHST, for example, saw rates fall from 4.78 per cent to 3.86 per cent in just two years, having implemented an impressive trust-wide staff engagement programme.
Gloucestershire Hospitals NHS Foundation Trust provides an excellent example of how targeted investment in improving staff health can drive down absenteeism. As our report showed, musculoskeletal problems are the single largest cause of sickness absence in the NHS. Recognising this, the Trust introduced an OH department based Physiotherapy Musculo-Skeletal Disorders (MSD) assessment service for NHS staff. This resulted in a reduction in sickness absence from 13.6 to 6.8 days; a decrease in waiting time for MSD appointments and the majority of patients being assessed and managed by physiotherapists without the need for medical input, with significant cost savings for the Trust.
West Suffolk Hospitals NHS Trust achieved similar success. The trust spent £21,000 introducing a system of priority referrals to a local physiotherapist for injured staff. The system achieved over £170,000 of savings in the direct cost of musculo-skeletal injuries. Days lost as a result of sickness absence also fell by 40 per cent.
Both of these trusts are sterling examples of how investment in occupational health services can be generate a significant financial return as a result of cost reduction and reduced absenteeism. However, the case for change set out in our Report is not solely a financial one.

Effective delivery
The Final Report also concluded that organisations with healthy, happy staff are far more effective in delivering high quality patient care. An overwhelming majority of staff we surveyed believed the state of their health directly affected the quality of the care they were providing. Our research showed that trusts who maintained and improved their staff’s health and well-being scored higher on general performance measures such as patient satisfaction and Annual Health Check Scores for ‘quality of services’ and ‘use of resources’.
Addenbrooke’s hospital, part of Cambridgeshire and Peterborough NSHFT, is an example of a high performing trust that has benefited from a comprehensive, organisation-wide commitment to improving staff health. The hospital received an ‘excellent’ rating for quality of services in last year’s Annual Health Check, and achieved the highest possible scores for safety and cleanliness, dignity and respect, standard of care, and waiting times.
Addenbrooke’s is a shining example of the strides that can be made when hospital management commits to investing in the health and happiness of their staff. Regular staff health-check days offer employees blood pressure and BMI checks, dietary guidance and exercise and fitness advice. A health and well-being intranet site has been set up, offering information about public health initiatives like the Know Your Limits campaign. And an admirable amount has been done to motivate staff and encourage them to enjoy their work, with the hospital organising fitness focused social events like five-a-side tournaments.
Organisations like Addenbrooke’s are reaping the benefits of improved occupational health provision; it’s no surprise that last year’s Annual Health Check also gave them an ‘excellent’ rating for ‘use of resources’. Gloucestershire Hospitals NHS Foundation Trust, West Suffolk Hospitals NHS Trust, and Addenbrooke’s hospital, along with many other high performing organisations, have demonstrated what can be achieved when time and resource is devoted to supporting staff health and well-being.

Commitment required

Unfortunately, occupational health provision across the NHS is patchy at best. To ensure that staff and organisations are fully equipped to meet the challenges of the coming months and years, a service-wide culture change is required, placing far greater emphasis on the importance of workforce health and well-being.
This increased commitment should be supported by board level responsibility for staff health and well-being, ensuring that workforce health becomes part of the core business of the organisation. Proper resourcing for occupational health and staff support services is imperative, with a clear understanding that this represents investment that will deliver both long-term savings and improved patient care.
Our Review sends a clear message to the leaders of the largest workforce in Europe about the importance of occupational health. Employers have no greater resource than fit and motivated employees. This is why it is all the more important that they invest in the health and well-being of their staff.