HEALTH AND WELL-BEING AT WORK STRATEGY Reference Number: NHSCT/08/87 Responsible Directorate: Human Resources Replaces (if appropriate): Legacy United and Causeway Trust Health and Well-Being Strategies Policy Author/Team: Elizabeth Brownlees Assistant Director of Human Resources (Workforce Governance) Type of document: Corporate Review Date: 31 October 2009 Approved by: Trust Board Date Approved: Date Policy disseminated by Equality Unit: 9 December 2008 23 October 2008 NHSCT MISSION STATEMENT To provide for all the quality of services we would expect for our families and ourselves
Health and Well-being at Work Strategy October 2008
Introduction The Northern Trust recognises that there are many issues, both at work and at home, which impact upon an individual s health and well-being and that there are proven links between work and employee health and well-being. In providing safe and effective care and improving the health of our community, the Trust depends on a workforce which is appropriately qualified and/or experienced and committed to high quality patient and client care. As an organisation, we are committed to meeting the needs and expectations of staff where we can support staff to maximise their personal health and wellbeing. To this end the Trust has produced this Strategy document, the aims of which are to bring together all aspects of how we can support and contribute to maximising the health and well-being of staff. This will enable them to fulfil their roles within the Trust, knowing that they are valued and that their personal health and well-being is important. Work matters; it can help to improve health, reduce health inequalities and offer improved opportunities. Also, due to changing demographics, having more people in work is increasingly important for communities and the economy. We accept our obligation as an employer to create a work environment that supports and further promotes employee health and well-being. Much good work has been done in the three legacy Trusts, with various policies and procedures in place to support employee health and well-being. This strategy will bring together all these elements and ensure that they are driven forward in the new organisation. By co-ordinating our approach and identifying gaps, we can begin to draw up an action plan to consolidate existing work and achieve additional progress. Context As we spend such a large part of our waking lives in work it provides the ideal setting to promote health and wellbeing. In the long-term, investing in the health of our staff will prove valuable for the Trust as well as for us as individuals. The Trust acknowledges that staff over recent years have experienced significant change in the working environment. The implementation of major service modernisation initiatives such as Agenda for Change and consequent implications for staff s grading, Modernising Medical Careers initiatives including the foundation and specialty training programmes, the new Consultant Contract, the implementation of the Review of Public Administration (RPA), and service delivery targets and modernisation
initiatives, is challenging for staff and makes a significant impact on people. The Trust recognises the impact that such an unprecedented and prolonged period of change has on individual staff and on teams. Absence due to sickness makes a significant impact on the Trust each year; on staff, on services and financially. In addition to the impact on the health and well-being of individuals and their families, sickness absence puts added pressure on those colleagues who undertake additional duties during the absence of staff and impacts on our ability to deliver services to patients and clients. It is important that we recognise the complexities that exist for different individuals in their ability to achieve an optimum level of health and wellbeing. It is not just as simple as knowledge = action/change. There are many wider determinants of health. These can be seen in Dahlgren & Whitehead s 1991 model below: Good health enables us to get the most out of our lives. However, being healthy is a very individual concept. It differs for each and every one of us. When we think about being healthy we immediately think about the absence of disease or disability. A holistic view of health incorporates various aspects including: physical health, mental health, social health, emotional health, spiritual health and societal health (Ewles & Simnett 2004). Health is an outcome, which results from a whole range of influences in everyday life for
example genetic make-up, gender, family, social class, income, age, housing, education, work experience and environment plus many more. Mental health and emotional well-being are fundamental to our quality of life. They often have a greater effect on individuals and the community than many chronic physical diseases. A growing body of research recognises the link between mental well-being and physical health. (Investing for Health 2002) However, we as individuals can make a valuable contribution to optimising our own health and well-being. It is important that we recognise and accept that responsibility. How the workplace contributes to health and well-being Health and well-being in a work context is about a range of issues from physical health and fitness through to physical environment, employment policies, leadership and management, staff safety, change management, work-life balance, culture, including specifically how we treat each other, promoting respect and supporting diversity, to recognition for dedication, effort and achievement. Regionally and nationally there are a number of drivers that highlight the health and well-being standards in the workplace, which employers should seek to achieve. Some examples of these include Investing for Health 1, Working for Health 2, Employer of Choice 3, and Health Promoting Hospitals 4. The Health and Safety at Work Order (NI) 1978 places a duty on employers to ensure, so far as is reasonably practicable, the health and safety and welfare of their employees at work. This duty of care applies to both mental and physical well-being. Additionally, the Management of Health and Safety at Work Regulations (NI) 2003 place a duty on employers to assess risks to health. This duty to assess risk applies to risks of both physical and psychological health. Although the state of our population s health has improved many people are still suffering unnecessarily from poor health and our overall health and mortality rates do not compare favourably with other European countries. The mental and physical health and well-being of our population is not as good as it should be. (A Healthier Future 2005-2025) Work is generally good for both physical and mental well-being ( Is work good for your health and well-being? Wadell G and Burton AK (2006) and overall the beneficial effects of work outweigh the risks and are much greater than the harmful effects of long-term worklessness or prolonged sickness absence. 1 Investing for Health - Department of Health, Social Services & Public Safety (March 2002) 2 Working for Health - A Long-Term Workplace Health Strategy for N. Ireland, The Occupational Health Forum for N. Ireland & The Health and Safety Executive for Northern Ireland (March 2003) 3 Employer of Choice - Action Mental Health Consultancy & Training, TIME Associates, and Invest Northern Ireland (2002) 4 Health Promoting Hospitals - Northern Ireland Health Promoting Hospitals Regional Network
Work is a key part of our lives and can provide a sense of well-being, purpose, social contact and status. (WorkWell 2006) On 17 March 2008, the government s national director for Health and Work, Professor Dame Carol Black, published the cross-departmental report, Working for a Healthier Tomorrow, a review of the health of Britain s working age population, which confirms that recent evidence suggests that work can be good for health, reversing the harmful effects of long-term unemployment and prolonged sickness absence. The report indicates Improving the health of the working age population is critically important for everyone, in order to secure both higher economic growth and increased social justice. Strategy statement This Northern Health and Social Care Trust s Health and Well-being at Work Strategy recognises that health and well-being like any other corporate responsibility, has to be managed successfully. The Trust is committed not only to improving the health and well-being of it s staff, but is also committed to health promotion by encouraging the adoption of healthier lifestyles for staff. The philosophy which underpins this commitment is one of self help and individual responsibility within a corporate framework, promoting and supporting good practice to comply with legislation, addressing key workplace risks to health and encouraging a healthy lifestyle culture. Aims To ensure that employee health and well-being is given the attention it deserves; To have arrangements in place which will minimise any adverse effects through work on health and well-being; To have quality accessible advice and support for staff to assist them in managing their own health and well-being; That work is recognised by all as important and beneficial to health and well- being; That Trust managers show leadership regarding health promoting behaviours, and are champions for work/life balance initiatives; To encourage employees to make the right lifestyle choices throughout their working lives; To ensure that rehabilitative measures and/or reasonable adjustments to enable employees to remain/return to work are supported / promoted; That employees with health conditions and disabilities are able to optimise work opportunities; The Trust has in place a range of initiatives that will aim to improve employee health and well-being.
Trust Responsibilities The Trust Board has overall responsibility for ensuring the Trust s legal and statutory obligations are met regarding staff health and well-being. In creating an environment that promotes the health and well-being of staff, the Trust Board exercises this responsibility by ensuring there is an adequate framework of support services, policies and procedures in place which work together to the benefit of staff health and well-being and by promoting a culture of equality and respect. Chief Executive The Chief Executive is responsible for the effective implementation of the strategy and it s action plan through delegation to Directors. Directors Each Director is responsible for: Ensuring staff within their directorate are aware of the strategy for Health and Well-being at Work; Ensuring that managers are trained and understand their responsibilities in regard their human resource management role; Supporting managers on the implementation of the strategy; Facilitating staff in availing of the opportunities, which the strategy presents. Director of Human Resources The Director of Human Resources is responsible for: Ensuring the strategy and its action plan are implemented in the Trust and for leading on the implementation of the strategy and action plan; Providing advice and support to managers and staff in implementing the Health and Well-Being at Work Strategy; Ensuring appropriate training is provided for managers where necessary on relevant Human Resource policies together with a programme of management development training; Monitoring the progress and outcomes of the strategy.
Managers Managers are responsible for: Ensuring all staff are aware of the strategy and facilitating staff to avail of the opportunities it presents; Ensuring that they comply with all Human Resource policies and procedures. Participating in appropriate training in order to fulfil their roles as line managers. Employees Employees have responsibility for: Taking due care of their own health, safety and well-being and that of others who could be affected by their activities at work; Co-operating with trust policy and procedures to minimise risk and promote staff health and well-being for self and others. Staff Representatives Staff representatives have responsibility for: Advising, supporting and representing their members; Working with managers to progress the implementation of the strategy and supporting further initiatives to help improve employee health and well being; Working with managers to ensure application of the strategy. Health and Well-being at Work Steering group A multidisciplinary Health and Well-being Steering group, which includes management and staff representatives, has been established to take an overview of the framework of support services, policies and procedures in place to the benefit of staff health and well-being at work. This overview will take into account the activity of various committees, such as the Trust s Corporate Health and Safety Committee, Change and Transition Group, Occupational Health/Absence Forum. Group members are listed at Appendix 1. This group will oversee the implementation of the strategy and will develop outcome measures designed to monitor the strategy s progress and success. The Terms of Reference for the group is shown below. To provide leadership and direction towards achieving a working environment which supports the health and well-being of staff; To identify and harness existing (and previous legacy Trust) strategies policies and actions which support health and well-being; To draft a Workplace Health and Well-being at Work Strategy for consideration by Senior Management Team;
To provide a draft implementation plan to include timescales, responsible officers, consultation and communication; To incorporate mechanisms and/or measures to evaluate and review the effectiveness of the Strategy. Key Areas of Focus The Trust will focus on the following key areas in order to take forward an action plan, which will be overseen by the Health and Well-being at Work Steering Group: Raising Awareness of Health and Well-being issues Raising awareness will help staff identify the factors that have a positive impact on health and well-being as well as those which may be having a negative impact on their health, such as the causes of stress and how physical activity can help to relieve its symptoms, poor eating habits and how to change them, giving up smoking or cutting down on alcohol Smoking Cessation Giving up smoking is the single most important thing that anyone can do to improve their health and that of their families. Major diseases, which are more common in people who smoke, include: cardiovascular disease (coronary thrombosis which can lead to a heart attack; cerebral thrombosis which can lead to collapse, stroke and paralysis; high blood pressure or kidney failure); cancers (including lung, mouth, bladder, oesophagus, kidneys pancreas, and cervical); and blockage to the blood supply to the legs, which may lead to gangrene and amputation. In addition smoking can cause respiratory difficulties, for example an increase in asthma. Healthy Balanced Diet Eating a healthy balanced diet that includes all the right foods in the right amounts plays a vital role in determining the state of our physical and mental health. It can help maintain a healthy weight and help reduce the risk of developing heart disease, diabetes, stroke, and some cancers.
Physical and Mental Health/ Physical Activity Individuals should be aware of what is normal for them and of family history of medical conditions, for example high blood pressure and diabetes. Staff should remember to feel positive about themselves, keep active, get involved with activities and friends, accept themselves and any differences or imperfections they feel they have, take time to relax, limit alcohol intake, eat healthily, recognise the signs for example anxiousness, feeling worried, changes to sleeping or eating patterns, anger for no reason, difficulty concentrating or making decisions. Staff should seek help and consult with their doctor or Occupational Health to find out what help is available. Adults should accumulate 30 minutes or more of moderate physical activity on most days of the week and should try to incorporate small amounts of physical activity throughout the day to build up to or beyond the recommended 30 minutes. Managing Stress Evidence shows that prolonged periods of stress have an adverse effect on physical/mental health. There are strong links between stress and: heart disease back pain headaches gastrointestinal disturbances various minor illnesses anxiety depression By learning to relax, good time management, exercising regularly, eating healthily this should help to prevent any adverse impact on health. Organisational matters Work, as already mentioned, has an impact on health and well-being. In developing the Northern Trust as a new organisation, the Trust Board and Senior Management Team are committed to best practice in all organisational matters with the objective of making the Trust an Employer of Choice. The action plan, which is attached as Appendix 2, identifies current initiatives in the Trust and further key actions which will contribute to improving health and well-being of the workforce. The Steering Group will liaise with others throughout the Trust in it s oversight of the action plan to report to Senior
Management Team and Trust Board as required on the success of the strategy, making recommendations as necessary. Of vital importance to the strategy is the Trust s ability to carry out a Staff Survey in order to ascertain the views of staff in relation to health and wellbeing at work. This survey when undertaken will provide vital feedback and direction, which will undoubtedly be of benefit to finalising our action plan. This Strategy was agreed by Trust Board at its October 2008 meeting. It will be reviewed on an annual basis.
APPENDIX 1 Membership: Elizabeth Brownlees Sandra Ewing Roy Hamill Angela Higgins Allison Hume Alex Lynch Janet McCartney Brian McCosh Brian McCrum Lorraine McPeake Kevin O Connor Gillian Sands Asst Director of Human Resources Workforce Governance (Chair) Head of Domiciliary Care and Out of Hours Domiciliary Care Service, Emergency, Primary Care and Older People s Services Community General Manager, Emergency, Primary Care and Older People s Services Occupational Health Nurse Practitioner Head of Nursing, Workforce and Development, Emergency, Primary Care and Older People s Services Corporate Risk Register, Medical and Governance Senior HR Manager, Workforce Governance Locality Manager, Mental Health and Disability Services Clinical Psychology Manager, Mental Health and Disability Services Health Improvement Service, Women s and Children s Services Head of Occupational Health Staff Representative (AHP)
Raising Awareness of Health and Well-being Issues Action: ACTION PLAN Implementation Dates Provide a point of focus for staff information on the Trust s intranet - why the Trust is interested in staff health and well-being, information leaflets/links to other websites with information on specific health issues, further sources of help and advice Undertake a staff survey that will give feedback as to what staff feel are their main health and well-being needs and issues Increase staff participation in health promoting activities offered by the Trust for example Health Hub and after work/lunchtime lectures/workshops Promote the services provided by Occupational Health and confidential counselling service Create and publicise a Health and Well-being Events Calendar Re-tender for the current confidential staff support/counselling service and ongoing August 2008 December 2008 Smoking Cessation Action: Promote Smoking Cessation service for staff and provide support for those staff giving up smoking
Healthy Balanced diet Action: ACTION PLAN Implementation Dates In liaison with catering and dietetic staff, promote healthier ways of cooking and promote more healthy options within canteen facilities Review vending machines to ensure all machines offer health options only Review provision of information to staff so that they make informed dietary lifestyle choices Avoid commercially sponsored campaigns such as those promoting high fat foods or high sugar drinks June 2009 Ongoing Physical and Mental Health/ Physical Activity Action: Work in partnership with local councils with a view to providing discounted rates for staff at leisure centres across the Trust area Promote employee participation in walking groups and highlight Highway to Health schemes throughout the Trust Examine the feasibility of providing physical activities in the workplace at appropriate times such as after work or lunchtime - e.g. Pilates, dance and use of gym equipment Implement the Cycle to Work scheme Increase uptake of flu vaccination Evaluate and promote staff physiotherapy service Provide health and safety advice to managers and staff and workplace/ergonomic assessments Implement Zero Tolerance policy June 2009 June 2009 December 2008 In place September 2008
ACTION PLAN Provide Trust Workplace Alcohol and Drug policy and action plan Provide Occupational Health clinics for staff on specific health issues Implement psychological therapy initiatives for staff Implementation Dates December 2008 Managing Stress Action: Initiate a programme to measure and manage work-related stress across the Trust in accordance with the Health and Safety Executive Stress Management Standards Organisational Matters Achieve Investors in People re-accreditation for Northern Trust Promote and embed the Living the Values Management Framework Implement Personal Development reviews for all staff Review and update suite of HR policies for NHSCT Provide a programme of awareness training on equality and diversity including harassment and bullying Develop a policy which commits all staff to showing respect for colleagues and to enhance and support a culturally diverse workforce Review the range and uptake of flexible working policies and develop new policies as appropriate to support work/life balance Examine the feasibility of introducing a Childcare Voucher Scheme for staff Implement Internal Communications Strategy Consider the implications of change on staff affected and communicate and consult early and June 2009 September 2009 and ongoing June 2009 October 2008 Immediately
ACTION PLAN Implementation Dates adequately with staff representatives and staff in regard to management of change Provide summer clubs for staff Summer 2008