A New Vision for Health & HR

Number One Health’s New Vision for Health and Human Resources (HR)

It’s the quality of the relationship that counts, plus the effort you put into making it work



Human Resources: the management and development of people. People who rarely spend a whole life time well. People who may be born with illness or disability or have either or both thrust upon them for short or long periods.

Some health problems may be work-related but whether caused by work or not these problems will have an impact on employee productivity and effectiveness. 

In all good businesses HR is strongly linked to the business needs. However, in few businesses is the management of health linked to the business needs. As a simple example, an employee strains an ankle at football and takes time off work. If the employee is waiting to see a physiotherapist it makes some sense for work to pay for early treatment so the employee can get better quicker and get back to work quicker.

My observation is that the traditional links between HR and health are too narrow to truly help the business needs.

Some, but not all, HR managers see their duty on health as covered once they have signed off on a Private Medical Insurance (PMI) scheme. However, by its nature PMI has exclusions and in many cases excludes primary care, pre-existing conditions and rarely gives cover for cancer.  The perfect employee in these terms only ever breaks a leg, has no pre-existing conditions and never gets cancer.

Other HR managers feel that their duty on heath is covered by appointing a doctor either full time or ad-hoc.  However, few drill down to 'what sort of doctor do I actually need?’  Doctors offer themselves as GPs or Occupational Health (OH).  Some try to be both and claim a 'Chinese wall' operates to separate their functions, however this makes no sense.  A GP acts on behalf of an individual employee not a company. An occupational health doctor acts as a middle ground between an employee and a company. The role of a GP and an OH are mutually exclusive.

Sadly some OH doctors have the same ‘legacy status' as old software. Their views and opinions date from a clubbable era where they were mates with a long departed Chief Executive and their actual interest in helping to manage and improve the health of employees in the business is limited. They take a stand to defend their corner and will not let managers interfere with their role and their lack of collaboration with the business can at times be antagonistic. This is clearly less than ideal.

In the UK the problems for HR managers is made more difficult by an unusual health landscape in which 90% of health care is free and only 10% private.   Logically, no company would want to pay for something which is free but is that true? If you were offered a free postal service but that service had long waiting-times, erratic delivery patterns and poor customer service would you make the business decision to stay with the free service or would you pay for a more personable, customer-orientated, timely and efficient service?  The NHS is free but with exponentially rising health care costs and only a linear increase in revenues, the quality of what is free has to be variable in both quality and location (postcode lottery).

So what is Number One Health’s New Vision for Health and HR

The new vision, in fact, goes back to core principles adapted in the early days by Unilever, Marks and Spencer’s, Cadburys, Tata of India and many other successful international companies (see quotes at end).  

The new vision is based around the fact that the health and well-being of employees can be helped by the company in such ways that it increases the productivity and retention of the employees and these lead to increased profits.

The company that is serious about its business needs to be serious about the health and well-being of its employees. It wants to:
Ensure maximal productivity of all employees
Encourage healthy lifestyles
Reduce and manage stress
Reduce and manage musculo-skeletal injuries
Reduce and manage sickness absence
Efficiently manage return to work after illness or disability
Integrate the disabled into its business

Such a company realises that costs need to be seen in terms of ‘opportunity costs’. In simple terms does it cost me more to do nothing!

This new vision is far wider than the ticking 2 boxes 1) I have PMI 2) I have an assigned doctor (of some sort).  

The new vision is for HR and senior business executives to work together with an assigned medical team or person as part of a 'Health Improvement Team for the business’ (HIT). This team would have as its remit clear aims and objectives which can be measured, costed and scored alongside improved business effectiveness.  

Areas covered would include all those listed above and amongst other issues:
Toxic Managers (how do we deal with an upstream problem that is causing down stream stress and affecting staff retention?)
Stress audits
Sports injury related return to work
Industrial injury related return to work
Home stress
Carer stress
Chronic disease management
Pandemics
Surgery
Dentistry
Cancer 
Vaccines
Duty of care
Travel
Corporate manslaughter

The HIT would help the business manage predictable health problems of employees, react effectively to the unpredictable ones and look across the local health landscape. For example, if local NHS services are excellent in areas A,B,C these would be used, if poor then an alternative would be costed and balanced against the loss of productivity caused by waiting for a ‘free’ service.


Partnering with a health services provider vs contracting for health
(If we are together nothing is impossible. If we are divided all will fail)

Number One Health believe that contracts to cover the required aspects of health care are too complex to be meaningful or manageable. Contracts can cover simple aspects like fee per procedure etc but there needs to be allowance for the health care related problems and questions outside of any such contractual strait-jacket. These items can be covered by a retainer and/or fee per new incident.

A learning organisation is ‘human beings cooperating in dynamic systems that are in a state of continuous adaptation and improvement.’

Number One Health believe in understanding your business and its success factors. We believe in ‘relational dealings …characterised by fewer, longer term contracts that require deeper involvements and cultural adjustments to achieve success. Rather than looking over a defined and often entrenched, boundary at each other, firms have to consider mutual goals, joint performance measures, formal information and communication, system linkages, C3 (cooperation, coordination and collaboration) and softer issues such as building trust and commitment. The task of managing collaborative contracts is more time-consuming, difficult and specialised than the ‘choreography’ of internal, organisation processes….’

We also believe that ‘establishing a regular pattern of inter-firm interactions that support the transfer, recombination or creation of specialised knowledge is likely to bring considerable benefits to both partners.’

Our high relationship model with your company includes:
Proactive relationship management
Joint objectives
High-level commitment
No-blame culture
Avoidance of adversarial practices
Visibility of performance measurements
Joint planning
Open communications


Others who previewed our New Vision for Health and HR


If every business had a health care programme think what a difference it would make in human and economic terms Lord Sieff when Honorary President of Marks and Spencer ‘On Management '

True wealth, which is health
Leonardo Da Vinci

Despite the National Health Service there is much left undone and much scope for medical care at work Marcus Sieff (Marks and Spencer)

....to be lacking in consideration in any way for the life, health and happiness of the employee is the most short-sighted policy a firm can adopt William Lever Founder of Unilever

In order that people may be happy in their work, these three things are needed: they must be fit for it, they must not do too much of it, and they must have a sense of success in it John Ruskin (1851)

It is important to emphasise here that staff health and well-being is more than just the absence of disease. Rather, it puts an emphasis on achieving physical, mental and social contentment. As our Interim Report made clear, there is a strong business case for investing in staff health and well-being. Organisations that prioritised staff health and well-being performed better, with improved patient satisfaction, stronger quality scores, better outcomes, higher levels of staff retention and lower rates of sickness absence.

Staff health and well-being priorities need to be fully aligned with the wider public health priorities of increasing exercise; tackling obesity; reducing smoking and excessive drinking; and improving mental health.


Undertaking such assessments, and shifting the focus of staff health and well-being services towards prevention and health promotion, will require a remodelling of occupational health services............

…. training in health and well-being should be an integral part of management training and leadership development…………….

At the heart of our vision was the concept of a comprehensive, proactive staff health and well-being service, commissioned and delivered to common standards and in consultation with staff and their representatives.

Spending on staff health is sometimes erroneously considered a poor use of scarce resources. As our earlier report made clear, we believe that investment in staff health and well-being services will more than pay for itself through reducing sickness absence and improving productivity.

Dr Steve Boorman (NHS workforce review)