When it comes to workplace wellbeing, it is telling that it’s a lot easier to talk about what isn’t working than what is. There is rarely much agreement within organisations as to what ‘wellbeing in the workplace’ actually means. In the absence of this, attempting to measure it is challenging.
Further, the role and power of the individual making the final decision on workplace wellbeing strategies can vary hugely from one organisation to the next. Decisions could be made by heads of health and safety, occupational health, HR, the chief medical officer or the CEO, or even, if there is one the head of wellbeing. Benefits professionals looking to communicate the benefits of wellbeing in a consistent manner are faced with the reality that the people working in all of these roles have different agendas.
“For health and safety, for instance, there is a greater focus on preventing the workplace making people ill in the first place, which is not something that tends to be on HR’s agenda, although we believe it should be,” comments Aon head of health management Charles Alberts.
Furthermore, companies are failing to assess employee needs, with two in three still reliant on an annual engagement survey and a third unaware of their absence cost to business, according to a recent survey for Health Shield.
It perhaps comes as no surprise then that employers also struggle to measure the effectiveness of the initiatives they put in place. Where they do have metrics they are reluctant to share them with advisers and providers, rendering the thorny question of ROI on wellbeing challenging for advisers to engage with.
“Around 80 per cent of employer respondents to our Britain’s Healthiest Workplace survey say they don’t measure ROI,” notes VitalityHealth director, corporate wellness strategy Shaun Subel. In spite of all the challenges, everyone in HR circles instinctively knows they should be doing wellbeing. In Sir Richard Branson’s famous words: “If you look after your staff, they will look after your customers”.
“There are companies that have been ‘doing’ wellbeing for around 15 years now and they’re doing it well,” says Willis Towers Watson Health & Benefits head of sales and marketing Mark Ramsook. “These companies have got volumes of data. They set clear objectives. They measure and analyse. Wellbeing is embedded in their culture. And they include a clear focus on prevention.”
Back to the drawing board
In the absence of agreement about what employee wellbeing involves and how it can be put into operation, ineffective and unsustainable programmes seem commonplace. HR professionals would do well to go back to the basics to understand what they offer, what their staff want and what they are trying to achieve.
In a seminal study ‘Is work good for your health and well-being?’, carried out by Waddel & Burton in 2006 for the Department for Work & Pensions, wellbeing is described as ‘that part of an employee’s overall wellbeing that they perceive to be determined primarily by work and can be influenced by workplace interventions’. In other words, employee insights are essential to help inform the choice of programme.
This isn’t just about products and services, as pointed out by Aviva head of health propositions Alastair Antell, who says: “Along with insurance solutions, all businesses will benefit from looking at their culture and ensuring wellbeing is fully incorporated into their operations.”
What does success look like?
ROI necessitates a focus on the tangible things they can be measured: absence and benefits usage, for example. It’s obviously a useful metric if, for example, reducing absence is a priority.
However, all bar one of the providers approached for the purposes of this article were unable to put a figure on average ROI for their products, the exception being Health Shield. The provider calculates its health cash plan can save an average company nearly £230 per employee on absence costs.
Simplyhealth has some data to support cash plans in terms of ROI, although proving the direct causation of outcomes is difficult to achieve given the number of factors that impact a typical workforce. Baywater Healthcare is a private company providing respiratory equipment to NHS patients in their homes. Since providing its 230-plus employees with a Simplyhealth cash plan over two years ago, absence has reduced by around 50 per cent. But many metrics may have contributed to this success.
Baywater Healthcare CEO Adam Sullivan says: “The cash plan was definitely a contributory factor to the reduction in absence but it’s also down to caring management, promotion of good wellbeing, employee training and amendments to the sick pay scheme which involve proactively managing absence to the Bradford Factor (the theory that frequent short unplanned absences are more disruptive to employers than less regular longer ones).”
Clearly, not all of these aspects are tangible, which suggests that meaningful success measures need to go beyond ROI and into the realms of engagement and presenteeism.
VOI or ROI?
Value of investment (VOI), as opposed to ROI, is something that more and more employers are starting to appreciate as a way of looking at the positive outcomes of wellbeing programmes, says Alberts.
Coming up with a VOI figure involves analysis of everything that contributes to wellbeing. It involves collating facts and figures from various sources, including engagement surveys, benefit and intervention usage, onboarding and exit interviews, bonus data and customer service statistics.
“Reducing benefit spend is much harder to achieve in the short to medium term, as it tends to take many years for health risks that have progressed to be reduced or eliminated altogether,” he adds.
A particular advantage of the VOI approach is that it helps companies take into account the majority of staff, with a focus on prevention. Benefits usage on the other hand only includes those already ill or injured.
“A lot of the interventions are back end loaded,” says Subel. “They only touch a few employees as they’re focused on the sick. Employers need to breach this by looking at the things that impact presenteeism: lifestyle choices, poor general health and work environment factors such as workload and bullying.
“You need to bring prevention to the fore and focus on the things that affect the majority in order to come to meaningful measures.”
This is what Vitality has done with its own workforce. The provider focuses on three overall data sets. Firstly, wellness data – the kind of information that can be obtained from Vitality’s shared value products and services, such as levels of physical activity and biometric screening results.
Secondly, administration data – for example, reported absences, bonus percentages, call centre statistics such as efficiency and quality at work.
Finally, Britain’s Healthiest Workplace survey data – self-reported data that looks at lifestyle choices, mental and physical health, work engagement and presenteeism.
“Through these data sets we see beneficial impacts on various aspects such as quality of work, higher work engagement and a longer tenure with the business,” adds Subel.
What’s coming down the line?
At the smaller company end, advisers should expect to see a demand from employers for increased choice with regards to benefits, such as the ability to increase the lump-sum multiple or enroll a spouse paid for by salary deduction, says Benefiz director Tim Gillingham.
“A barrier would be the removal of salary sacrifice for most benefits and the P11D liability for certain benefits that is increasing as the cost of benefits generally increases,” he adds. “The ability for employers to offer consolidated loans is an interesting new area but for the smaller employer it’s probably too early in its development.”
For larger companies, expect to see an increased focus by the Health & Safety Executive on preventing work-related stress. There’s a growing trend in the Health & Safety industry to ‘add the Health back into Health & Safety’, says Alberts. Also expect to see more embedded – free – wellbeing services in insurer products, he says. “There will therefore be a greater role for advisers to play to help employers make sense of all the options at their disposal.”
Finally, more established wellbeing programmes will come up for review with employers wanting to look at how they can do things better and get more of their people engaged.
“Offering wellbeing programmes is one component,” adds Alberts. “With experience behind us the challenge is how to get more people to engage with them to ensure employers get the most value for money.”
THE LIMITATIONS OF BENEFITS USAGE DATA
Vitality’s Britain’s Healthiest Workplace survey last year asked around 32,000 employees across 167 organisations, among many other things,about various different interventions offered by
their employers with a view to finding out what is used and what is positively impacting health.
As the table below shows, on average across all company sizes, 34 interventions are offered. Employees are aware of 10 but only 3 are actually used. Therefore the ROI on these benefits is likely to be very low. But this metric alone doesn’t tell employers anything about their engagement and presenteeism levels: only about touch-points when people are already sick or willing to seek help for
|Number of employees||<100||100-199||200-499||500-999||1,000-2,499||2,500-4,999||5,000+|
|Average number of health and wellness interventions offered by the employer||16.8||20.5||25.4||30.3||30||34.8||37.5|
|Average number of interventions of which employees are aware||7.7||8.2||10.8||10.6||10.8||10.3||9.5|
|Average number of interventions used by employees||3.2||2.9||4.1||4||3.3||3.2||2.7|