1. Intrductin/Strategy Statement Health and Wellbeing Strategy Health and wellbeing is nw recgnised as mre than a matter fr individual attentin successful rganisatins have recgnised that gd health is a key enabler t gd business. The health, safety and wellbeing f staff directly cntribute t rganisatinal success and pr wrkfrce health has a high cst. The NHS wrkfrce is large, and imprving the health f NHS staff and their families has enrmus ptential in preventing future ill health nt nly fr them but als fr the wider cmmunity. Lrd Darzi s Review High Quality Care fr All stresses that we all have a part t play in making urselves and ur cmmunities healthier and this is even mre pertinent given the resurce cnstraints facing the NHS as a whle. Fr the purpses f this strategy health and wellbeing is seen as embracing the whle persn physical and mental health bth inside and utside f the wrkplace and is greater than simply an absence f ill health and disease, it is a feeling f physical, emtinal and psychlgical wellness. As part f Eurpe s largest emplyer the NHS has an pprtunity t be an exemplar f gd practice and shuld be seen as a rle mdel in relatin t the health and wellbeing f its staff and prmting health and wellbeing amngst the wider ppulatin. 2. Visin Buckinghamshire Healthcare NHS Trust is cmmitted t being the emplyer f chice within Buckinghamshire and recgnises that an imprtant aspect t achieving this is the prmtin and maintenance f the physical and psychlgical health and wellbeing and safety f its entire wrkfrce. Our visin is clear, t be the first chice healthcare fr the peple f Buckinghamshire and beynd, a place which puts their needs first. In rder t deliver this visin we need a highly skilled, mtivated, engaged and healthy wrkfrce. Staff engagement and health, safety and wellbeing is a pririty and will be delivered in an envirnment where staff are well managed, valued fr their cntributin and are develped within available resurces. This will be delivered by: Implementing ur clinical and staff engagement strategy in partnership with ur cnsultative cmmittees Equipping managers t better manage staff, including safety, health and wellbeing and staff satisfactin Prviding an ccupatinal health and wellbeing service which are fcussed nt nly n interventin but n preventin Implementing a strng, management f sickness absence and attendance plicy with the supprt f a case manager.
Furthermre building a reputatin as an emplyer that cares abut the wellbeing f it emplyees can attract and retain staff reducing recruitment ad assciated csts - and achieve ne f ur HR strategic aims f being recgnised as an emplyer f chice. Investing in staff health and wellbeing can bring benefits fr bth patient care; by having strng and cnsistent teams f staff, and financially because healthier and happier staff are likely t be mre prductive and mtivated and deliver safe patient care. 3. Aims The NHS has a duty f care t its staff, which is enshrined in the NHS Cnstitutin and cmmits the Trust t prviding supprt and pprtunities t enable staff t maintain their health, wellbeing and safety at wrk. The aim f this strategy is t set ut hw the Trust will manage staff health, wellbeing and safety in the wrkplace and hw it will measure and evaluate the success f its wellbeing prgrammes. 4. Backgrund / Cntext a. Impact f wrk n health and the cst f sickness absence Dame Carl Black s review f the health f Britain s wrking age ppulatin (Wrking fr a healthier tmrrw) makes the pint that wrk can be gd fr health and that the wrkplace can have a key rle in prmting the health and wellbeing f its emplyees. But the envirnment in which ne wrks can als lead t ill health t. Evidence suggest that the healthcare envirnment can be inherently mre challenging t health than ther nn-health sectrs and NHS staff are mre prne t wrk related injury and illness, being 1.5 times mre likely t fall ill and 1.7 times as likely t sustain injury, accrding t Dr. Steve Brman s 2009 NHS Health and wellbeing reprt. But whilst health and safety measures and infectin cntrl measures may curb expsure t many f the ptential hazards, the healthcare envirnment is a highly pressurised envirnment; cnstantly under public scrutiny and the wrklad is cnsiderable and bth physically and psychlgically demanding. And there is evidence t that there is a link between physical and mental health and wellbeing. It is unsurprising then that the three largest cntributrs t ill health in the NHS is related t musculskeletal injury, mental health/stress and skin cmplaints and sickness absence amng the public sectr emplyees averages 10.7 days per year and it is estimated that this csts the NHS 1.7b in sickness absence, every year (sme 1.3b is estimated t be attributed t mental health prblems). Absence due t sickness has a significant impact n the Trust each year; n staff, n services and financially. In additin t the impact n the health and wellbeing f individuals and their families, sickness absence puts added pressure n thse clleagues wh undertake additinal duties during absence f staff and impacts n ur ability t deliver services t patients and client. And when lcum r agency staff are used this has a significant financial cst t. In 2005 the frmer Healthcare Cmmissin fund that levels f patient dissatisfactin crrelated with the use f bank and agency nurse staff which culd be assciated with sickness cver.
Althugh health prfessinals are well infrmed n hw t maintain gd health and the cnsequences if they d nt, accrding t a MORI pll carried ut in 2009, health prfessinals are just as vulnerable as the general public t the unhealthy lifestyles. b. Presenteeism Presenteeism, defined as cming t wrk and perfrming at less than full capacity as a result f ill health, is as much f an issue fr health care as absenteeism and the csts f Presenteeism has a significant impact n prductivity and efficiency. Presenteeism amng staff with mental health prblems is thught t cst 1.5 times the amunt f wrking time lst thrugh absenteeism. Darzi s next stage review, published in 2008 emphasised that a healthy wrkfrce is integral t ensuring the highest quality f care pssible fr patients and that patients needed t be treated by health prfessinal wh are in gd health themselves. A Swedish study f 4000 peple fund that peple in the caring prfessins were amng thse mst likely t g t wrk when ill and research by the Sainsbury Centre fr Mental Health wuld seem t suggest that Presenteeism was particularly prevalent in the NHS where staff are encuraged t remain at wrk when they are ill and amng mre senir staff and thse with mental health issues. A lng wrking hurs culture, having a senir rle, wrking in a small unit, guilt abut taking time ff fr ill health and fear f repercussins, especially fr mental health prblems all increase the likelihd f Presenteeism. c. Health and wellbeing prgrammes Health and wellbeing prgrammes in the cmmercial sectr shw that these can cut the amunt f sick leave taken and speed up return t wrk after illness. Healthy emplyees are three times mre prductive than thse with pr health and the evidence suggest they are als likely t be safer emplyees t. Given the cst t the NHS and the ptential impact f pr health n quality f care and patient safety, investing in health and wellbeing prgrammes and adequately resurced services fr preventing ill health and managing ill health prmptly can save mney and imprve patient care. The wrkplace is an effective lcatin t address the challenges t the health f NHS staff and their families and the wider cmmunity, after all the average persn spends a third f their waking urs in the wrkplace, and up t 40 years f their life at wrk and s the wrkplace ffers the pprtunity t educate and supprt staff t exercise mre, smke less, eat mre healthily and prvide t prvide access t health and wellbeing services t target thse areas f high risk. It is clear that a greater fcus n wrkplace health ver the cming years has the ptential t deliver benefits fr emplyees, their families, the wider cmmunity and the rganisatin thrugh imprved emplyee prductivity and wellbeing. Occupatinal health services have a key rle nt nly in managing health issues in the wrkfrce, fr example supprt staff wh return t wrk after perids f sickness absence, but als in practive preventin and health prmtin. With an aging wrkfrce health prfessinals, in line with the general ppulatin, will be mre vulnerable t lng term cnditins assciated with aging, such as diabetes, arthritis, heart disease and declining cgnitive functin.
Wrkplace can either prmte r undermine mental health and wellbeing depending n hw wrk is rganised and managed. Gd relatinships at wrk with clleagues and managers are prtective. Pr cmmunicatin, lack f rle clarity r departmental bjectives can increase wrk related stress. Hwever high levels f jb satisfactin and feelings f accmplishments can stave ff burnut. 5. Respnsibilities This sectin prvides an verview f the respnsibilities the rganisatin, managers and supervisrs and the individual has in relatin t health and wellbeing: a. Respnsibilities f the Trust: The NHS Cnstitutins cmmits the Trust, by law, t prviding supprt and pprtunities t enable staff t maintain their health, wellbeing and safety at wrk. Develping and implementing effective plicies and prcedures Prviding training and infrmatin and guidance fr managers and staff Prviding access t ccupatinal health and wellbeing and ther advisry services Reprting n the status f emplyee wellbeing, including perfrmance, activities, initiatives and pprtunities Establish effective mnitring s as t be able t evaluate the impact f health and wellbeing prgrammes b. Respnsibilities f senir managers: Senir managers influence the culture in the areas they are respnsible fr. Their specific respnsibilities include: Setting an example as a rle mdel by adpting and prmting the strategy Prmting behaviurs cntributing t psitive staff wellbeing Ensuring effective cmmunicatin between management and staff, particularly thrugh rganisatinal change Ensuring that bullying, harassment and discriminatin are nt tlerated Wrking with managers and the Trust s HR and OH functins t initiate lcal wellbeing initiatives c. Respnsibilities f the line manager/supervisr Line managers and supervisrs have a respnsibility t lk after the health and wellbeing f their staff. This includes:
Setting an example as a rle mdel by adpting and prmting the strategy Take the health and wellbeing f their staff seriusly, listening and respnding t their needs and helping them alleviate, as far as reasnably practicable, wrkplace stressrs Seek advice frm HR prfessinals arund the implementatin f relevant plicies, e.g. management f sickness absence, whilst ensuring effective measures are in place t mnitr sickness absence. Seek apprpriate advice and supprt when dealing with cmplex staff health prblems Encurage staff with health prblems t seek help thrugh ccupatinal health and wellbeing services, e.g. cunselling, physitherapy, stress, smking cessatin etc. Cnsider whether there may be an underlying health prblem when there is cncern abut an individual s perfrmance Ensuring that bullying, harassment and discriminatin are nt tlerated Prmte behaviurs cntributing t psitive staff wellbeing Prmte the health and wellbeing strategy and supprt wellbeing initiatives and activities, enabling reasnable access fr staff Ensure staff are fully trained t discharge their duties Ensure staff are prvided with develpment pprtunities Attend relevant training as required including management, mandatry training and health and safety training Ensure effective measures are in place t mnitr and manage sickness absence d. Respnsibilities f the individual All staff have a respnsibility t lk after their wn health and wellbeing. This includes: Registering with a GP Taking advantage f vaccinatin prgrammes fr infectius diseases Seeking advice prmptly abut fitness t wrk when symptms arise Seeking prfessinal advice abut ill health, managing illness and accessing apprpriate treatment, advice and supprt Nt cming t wrk when ill, unless part f a managed recvery prgramme. Taking advantage f the ccupatinal and health and wellbeing services prvided by the Trust Taking advantage f health prmtin and advice, guidance and infrmatin prvided by the Trust
Attending mandatry training prgrammes as specified by the Trust Sharing ideas fr prmting health and wellbeing in their place f wrk Raising issues that affect their health and wellbeing r that f their clleagues with the line manager, HR r member f the senir management team e. Respnsibilities f the Health and wellbeing Prject and Actin Grups Terms f Reference The Health and wellbeing Actin Grup terms f reference cmmit the Trust t prvide a frum fr the develpment and implementatin f gd health and wellbeing acrss the rganisatin and sharing f best practice and a cnsistent apprach t the management f health and wellbeing in the wrkplace: 1. Name f Cmmittee a. (Brman) Health & Wellbeing Actin Grup 2. Purpse f the Cmmittee a. T prvide a frum fr the develpment and implementatin f gd health and wellbeing acrss the rganisatin and sharing f best practice and a cnsistent apprach t the management f health and wellbeing in the wrkplace 3. Objectives and Key Tasks a. Define what health and wellbeing lks like at Buckinghamshire Hspitals b. Define the rles f varius stakehlders in terms f their rle in the verall prcess c. Cnsider natinal best practice, infrmed guidance and the implicatins f legal cases d. Prmte health, safety and wellbeing acrss Buckinghamshire Hspitals e. Prvide effective cmmunicatin f strategy, plicy, preventins, interventins and facilities f. Identify and build n existing gd practice and initiatives within divisins g. Make recmmendatins fr actin t address patterns and deficiencies in practice, which may be cntrary t health and wellbeing at wrk h. Advise n the prvisin f training and develpment pprtunities fr managers and staff and integrate best practice int learning activity i. Make recmmendatins fr the develpment f perfrmance standards and mechanisms fr mnitring health and wellbeing at wrk at a divisinal and an rganisatinal level j. Champin health and wellbeing within each divisin k. Prmte health and wellbeing specifically in regard t rganisatin transfrmatin 4. Membership a. Membership will cmprise champins frm each divisin f the Trust. 5. Frequency f Meetings a. T be agreed 6. Qurum a. Chair b. Human Resurces
c. Wrkplace Health d. One third f membership 7. Reprting Arrangements a. The grup will reprt in t the Wrkfrce & HR Cmmittee 8. Term f Grup a. T be reviewed after 12 mnths 6. Delivering the Trust s Health and Wellbeing prgramme The Trust s HR and Wrkfrce Cmmittee, chaired by the Directr f HR, mnitrs activity. The health and wellbeing prject team, made up f representatives f the HR and ccupatinal health and wellbeing team drives the prgramme frward and the health and wellbeing actin grup, with representatives frm acrss all f the divisins are respnsible fr champining health and wellbeing, prmting and sharing gd practice in the areas in which they wrk. The Trust s Health and wellbeing Actin Plan is based n pririties identified thrugh Brman s natinal NHS health and wellbeing review, natinal public health agenda, as well as areas identified thrugh ur surveying f staff and wrkfrce infrmatin and highlight the individual, team and rganisatinal factrs that prmte wellbeing and hw these factrs are being addressed: Physical health and wellbeing gyms, exercise, weight management, smking cessatin, fast track physitherapy (prmtin f physical and nutritinal health) Mental and emtinal wellbeing prmtin f ur fast track cunselling services, stress management wrkshps, infrmatin fr managers Health prmtin health checks/assessments, linking t natinal campaigns (e.g. alchl and drugs, change fr life), vaccines, health sheets, valuing staff wellness days Advice and signpsting plicy advice, emplyment law, cmmunicatin, e.g. intranet, crprate inductin (drawing attentin t principles and plicies) Organisatinal wellbeing and peple management case manager, health summits, leadership and management training s that managers are cnfident in supprting health and wellbeing, fr example; in managing change, wrkplace stressrs recgnising that effective leadership is vital t building and sustaining an rganisatinal culture where staff can thrive. Ecnmic wellbeing prmting pprtunities t have fun and save mney; we have a rbust staff benefits and ffers page n the intranet. HR interventin identify trends in sickness and develp apprpriate interventins as infrmed by ur wrkfrce infrmatin and surveys, e.g. fast track services, stress htspts (stress management wrkshps) This strategy supprts the recmmendatins frm Brman, NHS Future Frum and the Public Health Respnsibility Deal, Healthy Lives Healthy Peple.
7. Embedding health and wellbeing It is ur intentin t develp engagement mechanisms t identify ther areas where the Trust can supprt the health and wellbeing f its entire wrkfrce making it accessible fr all. Already we have: Leadership and representatin at Executive and Bard level Engaged ur cnsultative cmmittees, prviding regular updates at JMSC, JCNC and HR and Wrkfrce Gvernance meetings. Staff side representatives are active in ur Health and wellbeing Actin Grup Established a prject and actin grup; all staff grups acrss the rganisatin are represented, t drive health and wellbeing thrugh the rganisatin Cnsulted with staff - carrying ut an nline and paper survey acrss the entire wrkfrce and review the findings as well as respnses t the NHS natinal staff survey. Using ur prject and actin grups t review the findings and act upn the key findings We have a rbust and well defined intranet available t all staff with tw specific areas prmting health and wellbeing and staff resurces Health and wellbeing is part f the annual appraisal and pdp review f the rganisatin We will cntinue t fster relatinships and wrk with the lcal NHS authrity, ther public sectr emplyers in Buckinghamshire thrugh the Healthier Cmmunities Strategy framewrk. We will leverage ur membership f Rbertsn Cper Business Wellbeing Netwrk Grup and NHSEmplyers best practice t develp and infrm ur strategy and deliver the fllwing: Early interventin t encurage early return t wrk fr peple wh are ff sick Empwering and enabling staff t better understand and address their wn health risks Active cmmunicatin abut healthy, safety, infrmatin activities and services available Reducing sickness absence levels 8. Key Indicatrs Experience shws that rganisatins which adpt a psitive apprach t imprving health and wellbeing acrss the rganisatin may achieve substantially reduced csts assciated with Absenteeism Reductin in bank and agency usage Staff turnver Risk management Staff and patient satisfactin Imprved prductivity and perfrmance The measures by which we will assess whether ur interventins have been successful include: Metric Surce Ntes Mnitring perid/interval Sickness absence ESR % f FTE lst verall and by medical cause (may als be brken dwn int staff categry) Mnth, Annually
Incidence f lng term (>4 weeks) and shrt term sickness absence Prevalence f zer sickness absence ESR ESR We will use Bradfrd Scre t identify n. staff wh scre 0-299, 300 999 and 1000+ (this is a rlling figure) Taking ut leavers, we will see the number f staff with Bradfrd scre f 1+ and subtract this frm ur ttal number f staff Number and per 1000 staff emplyed Incidence f ill-health retirement Finance Dept and NHS Pensins Agency Staff turnver ESR Numbers f jining and leavers expressed as a % f average number f emplyees during measurement perid (remve redundancy and junir dctrs) Agency and lcum csts Wrkfrce Reprts Numbers f shifts and cst f agency nurses and dctrs Quarterly, Annually Annually, annual 5 year mving average Annually Mnthly, Annually The Trust will mnitr the respnse rates in relatins t questins n health and wellbeing in staff surveys and prduce crprate and divisinal actin plans n sharing the imprvements and addressing the cncerns these raise. Self-rated health NHS staff survey KF scre and number and % f respnders Disability frm pr NHS staff survey KF scre and number mental health and % f respnders Perceived managerial NHS staff survey KF scre and number interest in persnal and % f respnders health and wellbeing Adequacy f adjustments at wrking fr lngstanding illness/disability NHS staff survey KF scre and number and % f respnders Jb satisfactin NHS staff survey KF scre and number and % f respnders Enjyment f wrk NHS staff survey KF scre and number and % f respnders Vilence at wrk NHS staff survey KF scre and number and % f respnders Harassment at wrk NHS staff survey KF scre and number and % f respnders
Metrics t mnitr activities f ur ccupatinal health and wellbeing services: Metric Surce Mnitring perid/interval Numbers f referrals frm OH recrds Mnth, year managers Numbers f self referrals OH recrds Mnth, year Numbers f telephne OH recrds Mnth, year enquiries handled Number f email enquiries OH recrds Mnth, year handled Number f sharps injuries OH recrds Mnth, year managed Number f vaccinatins given OH recrds Mnth, year Number f wrkplace visits OH recrds Mnth, year Number f health surveillance OH recrds Mnth, year assessments made Numbers f training/lectures OH recrds Mnth, year delivered Number f fast track OH recrds Mnth, year physitherapy referrals Number f fast track cunselling referrals OH recrds Mnth, year 9. Plicies and ther related dcuments and initiatives The rganisatin exercises a duty f care thrugh this strategy and thrugh the fllwing related plicies, guidelines and initiatives (this list is nt exhaustive) Occupatinal Health and Wellbeing Plicies Bereavement guidance Dignity and respect at wrk plicy Equal pprtunities plicy Health and safety plicy Flexible wrking plicy Management f sickness absence and annual leave plicy Stress management plicy and risk assessment Whistleblwing and Raising Cncerns in the Wrkplace Fast track cunselling Fast track physitherapy Stress management wrkshps Leadership and management prgramme HCA inductin and develpment prgramme Valuing staff health days Health prmtin activities Cycle t wrk scheme Onsite exercise and prmtin f cunty wide services
Staff benefits and ffers Eyecare Internatinal NHS Natinal staff survey Health and wellbeing survey
References NHS Health and Wellbeing Brman Review Nvember 2009 http://www.nhshealthandwellbeing.rg/ 'Wrking fr a healthier tmrrw', March 2008, Dame Carl Black s review f the health f Britain's wrking age ppulatin http://www.dh.gv.uk/en/publicatinsandstatistics/publicatins/publicatinsplicyandguidance/dh_0 83560 High quality care fr all: NHS Next Stage Review final reprt, June 2008, Prfessr the Lrd Darzi f Denham KBE http://www.dh.gv.uk/en/publicatinsandstatistics/publicatins/publicatinsplicyandguidance/dh_0 85825 Rbertsn Cper Business Wellbeing Netwrk Grup http://www.rbertsncper.cm/business-well-being-netwrk NHS Natinal Staff Survey http://www.nhsstaffsurveys.cm/cms/ Sainsbury s Centre fr Mental Health http://www.centrefrmentalhealth.rg.uk/emplyment/presenteeism.aspx NHSEmplyers http://www.nhsemplyers.rg/healthywrkplaces/pages/hme-healthy.aspx Public Health Respnsibility Deal http://www.dh.gv.uk/en/publichealth/publichealthrespnsibilitydeal/index.htm The NHS s rle in the public s health, a reprt frm NHS Future Frum 2012 http://www.dh.gv.uk/prd_cnsum_dh/grups/dh_digitalassets/dcuments/digitalasset/dh_132114. pdf Healthy Lives, Healthy Peple White Paper, Nvember 2010 http://www.dh.gv.uk/en/publichealth/healthyliveshealthypeple/index.htm