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Steve Boorman

Abermed

Medical Director

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Steve Boorman, Royal Mail’s ex-chief medical adviser, on health and well-being

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In these difficult economic times, businesses are becoming more aware of the huge impact that the well-being of their workforce can have on the bottom line.

Staff absence alone now accounts for the loss of an estimated 175 million working days a year in the UK. But too many companies regard occupational health services as purely reactive and something that come into play only when an employee becomes sick or unwell.
 
This approach is not just short-sighted but costly, however. Ensuring good health is about balancing prevention with intervention. What a lot of employers don’t realise is that presenteeism can cost two to three times as much as sickness absence.
 
Recent statistics published by charity Nuffield Health found that 30% of employees were more likely to go into work when ill as a result of feeling insecure due to the economic downturn. But it is easy to forget that unwell people are generally less productive and also more difficult to manage. 
 
As a result, they can potentially cost their employer more than if they stayed off work. Nuffield estimates that presenteeism costs UK business dearly: up to £15 billion a year. 
 
One of the problems is that organisations tend to focus too much on the safety aspects of health and safety legislation. But their duty of care extends to protecting the health of the workforce too, which includes psycho-social as well as just physical risks.
 
Workplace health
 
Therefore, HR departments have an important role to play in ensuring that they supply occupational health services that meet appropriate standards. Training is crucial, particularly when it comes to providing line managers with the appropriate tools to help them understand occupational health matters.
 
Prior to joining Abermed, I spent more than 20 years at Royal Mail, in roles that included 10 years as chief medical adviser and seven years as director of corporate responsibility. In 2002, the organisation faced a major crisis following financial losses amounting to over £1 million per day and fines arising from a failure to meet regulatory targets.
 
The situation saw workforce morale plummet, but Royal Mail had traditionally relied on offering a high quality, efficient service in order to provide it with competitive advantage. This meant that its personnel were critical in contributing to quality, costs, reliability, and consequently, company performance.
 
The policies developed and applied during my time at Royal Mail are now being employed by a range of UK organisations in a variety of sectors that are likewise attempting to tackle the issue of absence management.
 
What we implemented was a broad-based workplace health and enhanced management programme for Royal Mail’s then 200,000 employees, which turned a £1 million per day loss into a £1.5 million per day profit. This involved introducing what was described by the CBI as a ‘carrot and stick’ approach as we found this the most effective tack to take.
 
The ‘carrot’ took the form of better dialogue and communications between local managers and staff, simpler and more effective management practices and more involvement by the workers themselves in helping to improve their workplace. This activity was supported by a series of policies devised with the aim of boosting workforce health and wellbeing. 
 
Empowering line managers
 
The ‘stick’, on the other hand, entailed enhancing the process of recording absence and enabling managers to use long-established absence rules more effectively. These procedures were reinvigorated and given a company-wide boost in 2004 under the ‘Absence to Attendance’ programme, which was rolled out across Royal Mail to devolve more responsibility to local managers. 
 
On analysing its data, meanwhile, the organisation found that the cause of more than three quarters of sickness absence was not strictly medical in nature, but instead related to stress, bullying, harassment and personal problems.
 
As a result, efforts were made to tackle stress through improving awareness, reducing risk and making adjustments to ease any conflicts between workloads and home life. Such activity, combined with the provision of better support and access to help when problems arose, were all assigned equal weight in order to improve attendance levels. 
 
Line managers were also tasked with communicating the broader implications of widespread absence so that staff understood the effect that it had on company performance. They were likewise supplied with enhanced tools to help them actively identify the cause of individual absences. The term ‘manage rather than medicalise’ became commonplace and two factors were critical to this approach.
 
The first was keeping in regular contact with the sick through ‘return to work’ one-to-one interviews. Comprehensive policies played an important role here by providing local managers with the resources they needed to be supportive. The policies were also useful in helping to explain to employees the effect that their absence had on the business, its cost base and most importantly, its reputation. 
 
The second consideration was in maintaining good attendance records as these enabled line managers to discuss patterns of absence behaviour with individual staff members. This information supported the one-to-one interviews in seeking to establish underlying causes and identify possible ways that managers could help. 
 
Business sense
 
A key factor in the success of Royal Mail’s occupational health policies and procedures was that they were applied by management teams at all levels and the constant vigilance and effort made by the whole organisation paid off.
 
According to ‘The Value of Rude Health’ report, which the organisation commissioned the London School of Economics to write in 2008, a three-year investment of around £45 million resulted in £220 million of savings along with a measurable impact on quality of service, productivity levels and sales performance.
 
There was likewise a visible link between reduced absence rates and the quality of communication with employees working in the depots. Figures provided by the in-house HR reporting team also revealed that absence rates dropped from 7% to 5% between January 2004 and June 2007. This improvement has continued over subsequent years, with current levels now around 4%.
 
I think it’s important to stress that this success wasn’t achieved by targeting the sick, lame and wounded and forcing them to work, but was instead the result of an overall improvement in management practices.
 
For employees, providing better support and care when they were ill was complimented with policies to help improve engagement and commitment. For managers, being able to take more effective control of the absence situation enabled them hit targets more easily. 
 
What this scenario demonstrates is that investing in and improving employees health and well-being is not only the right thing to do ethically. It also makes perfect business sense too.
 

Steve Boorman was formerly chief medical adviser and director of health and safety at Royal Mail, but is now medical director for UK occupational health services at private occupational healthcare provider, Abermed.

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Steve Boorman

Medical Director

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