working for a healthier tomorrow cbi absence and well-being conference, 2008 carol black dbe...
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Working for a healthier tomorrow
CBI Absence and Well-being conference, 2008
Carol Black DBENational Director for Health and Work
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CBI survey results – a compelling case for change
• This year’s survey adds new weight to the emerging consensus on a new approach to health and work in Britain:
• Costs of sickness absence to business creates compelling case to invest in the health and well-being of employees
• But employers want help to do so. Only 3% of those surveyed felt they didn’t need government support to tackle sickness.
• Urgent need for Government action – for fitnotes; for improved partnership working with GPs and healthcare professionals; and for improvements in tackling public sector sickness absence too.
• Powerful evidence of effectiveness of early intervention – the fundamental premise for a new Fit for Work service.
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The cost to business
• In 2006, CBI reported sickness absence amounted to:
• 7 days per employee• a total of 175 million working days lost• a cost to the economy of £13.4 billion
• 2007 shows a small improvement:
• 6.7 days per employee• a total of 172 million working days lost • a cost to the economy of £13.2 billion
• But adding indirect costs takes this figure to an estimated £20 billion. A huge burden on UK business
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The cost to the economy
• Overall costs of sickness absence and health-related worklessness among those of working age is in excess of £100 billion per year - equivalent to GDP of Portugal and more than the annual NHS budget
• Total costs to the taxpayer, in terms of benefits and forgone tax revenue, are over £60 billion per year
• 2.65 million people are on incapacity benefits with direct costs of £12.5 billion a year
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And there are other costs – economic and social
• Costs of those ill at work “presenteeism” likely to be greater than absence costs – estimated cost due to mental ill-health alone is £15 billion (Sainsbury Centre for Mental Health)
• While the human costs are potentially even greater than the economic costs
• 30% of children who have a parent with a disability or health condition live in poverty (HBAI)
• Children living in workless households are more likely to suffer from worse health, and worklessness themselves as adults (National Statistics, National Audit Office)
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Remit of my Review
• Comprehensive review of the health of working age people
• Considers the myriad factors that influence health and well-being, including being in work or workless, and having long-term health conditions
• Seeks to lay foundations for necessary and wide-ranging reform – but partnership between business and Government is pivotal to achieving this.
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A new vision for health and work
• The contributions of over 260 responses to the Call for Evidence, and especially the support of organisations like the CBI, have provided a clear and compelling case for reform
• At the heart of this vision are three key objectives:
1. prevention of illness and promotion of health and well-being;
2. early intervention for those who develop a health condition; and
3. an improvement in the health of those out of work.
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1. Preventing illness and promoting health: the role of the workplace
• 75% of working age people in Britain are in employment – and so spend high proportion of waking hours in the workplace
• The workplace offers great scope for targeting messages and initiatives about healthy living – with potential impact on both employees and their families
• Need to go beyond essential compliance with health and safety legislation and promote health and well-being more generally
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The business case for employers to invest in employees’ health
PwC research:• Studied evidence from 55
UK case studies and wider literature
• Wide variety of employers – all sizes and sectors
• Many employers invest in employee health from a sense of corporate social responsibility
• But results show a business case for investing in employees’ health
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From compliance to leadership
• Responses to the Call for Evidence highlighted many health and well-being initiatives which employers are already undertaking in the workplace
• But many employers are not aware of the business case for investing in employees’ health
• And there is a lack of understanding of the type of health and well-being initiatives employers can implement
• Small and medium-sized enterprises (SMEs) especially struggle to find accessible, affordable sources of support and advice
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From compliance to leadership - recommendations
• Government should initiate a business-led health and well-being consultancy service, offering tailored advice and support and access to occupational health at a market rate – geared especially towards smaller organisations.
• Government should work with employers and representative bodies to develop a robust model for measuring and reporting on the benefits of employer investment in health and well-being.
• Employers should use this model to report on health and well-being in the boardroom and in company accounts.
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A new tool to evaluate the benefits of investing in employee health
• In partnership with BITC’s Business Action on Health campaign, PwC are building on their original work to develop a free-to-use evaluation tool for measuring the economic benefits of investing in employee health
• Launching a pilot in July. Keen for CBI and its members to help us by agreeing to take part in this pilot.
• Signal your commitment to promoting health and well-being and help us develop and enhance the tool.
• Sign up today at www.workingforhealth.gov.uk free of charge!
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2. Sickness Absence and Early Intervention
• The CBI survey shows:
– Sickness absence varies widely across different firms
– Substantial savings from the worst organisations achieving average rates of absence
– Public sector behind the private sector
– Large organisations behind smaller organisations
– Positive impacts from health and well-being initiatives
– 18% of employers still have no sickness absence management policy
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2. Sickness Absence and Government Action
• Smaller organisations average intervention time in sickness absence is 5 days. For the private sector it is 8 days. For the public sector it is 10 days.
• Why Wait? The supportive employer should look to intervene sooner
• But clear that employers want Government to do more to help
• The majority want Government to prioritise the move from the sicknote to a fit note
• Also, improved partnership working with GPs and other occupational health professionals is seen as critical
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Dealing with illness: from sick note to fit note
• Current sick note reflects assumption that being ill means absence from work
• Needs to be overhauled, so that focus is on what a patient can do rather than on what they cannot
• Paper-based sick note should be replaced by electronic fit note
• Would aid communication between GPs and employers, as well as enabling improved monitoring and analysis of trends
• Strongly welcome the support of CBI and many others for the move to a fit note
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Improved partnership between employers and healthcare professionals
Vital that employers, healthcare professionals and the publicbetter understand the positive links between work and health
• Work is generally good for both physical and mental health and well-being – not the converse – and the beneficial effects of work outweigh the risks
• Individuals can return to work even if not 100% fit – and work can aid recovery
• A sick note may not be a good thing
• Employers must have sickness absence policies designed to enable an early return to work which aids sustained recovery
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Dealing with illness: changing the perceptions of healthcare professionals
Healthcare professionals, andespecially GPs, must:
• Better understand the positive links between health and work
• Be equipped to engage with patients and employers to explore options for returning to work
• See a return to work as a key indicator of clinical success in the treatment of working age people
• Refresh and expand occupational health as a speciality
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Healthcare Professionals’ Consensus Statement
Ground-breaking Consensus Statement, signed on 5 March 2008 by the leaders of the healthcare profession, is a pledge to promote the link between good work and good health.
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Early intervention for those who develop a health condition
What’s not working:
• Fallacy persists that individuals should only be at work if 100% fit
• No clear pathway of rehabilitation for work-related ill-health
• This belief has led to sub-optimal treatment of patients and out-dated procedures for certification of sickness absence
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Dealing with illness: early intervention
• Changing perceptions and establishing the new fit note is not enough - GPs must be able to refer patients quickly to the treatment or care which will support early return to work
• CBI shows that the majority of absence (95%) is short-term, under 20 days in duration
• But 5% of absence spells are longer-term and account for 40% of all time lost
• Huge savings can be made with co-ordinated, health and work focused interventions
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Early intervention: a Fit for Work service
• Recommend that a new Fit for Work service be piloted - should be based on case-managed, multidisciplinary support for people in the early stages of sickness absence
• The Fit for Work service must be available to all so that access to occupational health support is no longer the preserve of the few
• Fit for Work should be complementary to in-house provision of occupational health and other rehabilitation services
• GPs would use the new fit note to refer patients to the Fit for Work service
• Patients with ‘red flag’ conditions (recurrent conditions, or serious underlying conditions) would be referred onwards at the earliest opportunity
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But timing is crucial…
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How the new model could work
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3. Improving the health of those who are out of work
• Current arrangements for handling sickness at work all too often lead to individuals losing their jobs and moving onto incapacity benefits
• This happened to around 350,000 people last year
• Cost to public purse of each claimant is around £5,250
• With over 600,000 unfilled vacancies in the UK, returning the workless to employment is vital to business and the economy
• We need to equip people with not just the health support, but also the skills and confidence to access employment opportunities and return to work
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Integrating employment, health and skills
This Review joins other recent reports to Government – the challenge in taking this forward is how to fully integrate the employment, health and skills agendas
Reducing dependency, increasing opportunity: options for the future of welfare to work.
by David Freud
Review of the health of the working age
population: Working for a healthier
tomorrow
by Dame Carol Black
Prosperity for all in the global economy – world class skills
by Lord Leitch
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Final thought
“Health is created in places where we live, love, work and
play”
World Health Organisation