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PHE Health and Work Clinical Champion

Dr Rob Hampton, PHE Health and Work Clinical Champion


One of the recommendations from the Improving Lives Command Paper published in November 2017 was the introduction of a Medical Champion for Work as a Health Outcome. In our conversations with patients, healthcare practitioners are used to asking questions about the lifestyle factors that underpin health such as diet, exercise, alcohol and smoking.


But there’s another important question that we need to consider: ‘How is work?’ This role aims to support colleagues in understanding the importance of work as a health outcome with guidance around having those conversations.


Good work[1]is good for us. It isn’t just about gaining economic benefit but more to do with social connections, physical activity and intellectual challenge. There is clear evidence to show that good work helps us to be healthier and happier[2].


Conversely being out of work increases our patients’ risk of ill-health. Long-term unemployment increases the risk of limiting illness and worsening mental health and the longer we’re out of work; the more likely it is to impact on our health[3]. Working can be considered a health outcome in itself, reflecting how well we are supporting individuals to adapt to or recover from their health challenges.


In general practice we have an opportunity to use our trusted relationships with the people we care for to help them maximize the health benefits of being in work.


This could mean preventing our patients from falling out of work, or for those who aren’t working because of a disability, medical condition or injury, helping them return at a time that’s right for them and their health.


It can all start with a conversation.


There’s so much we can do to help people stay in and return to work, from providing key information or boosting a patient’s confidence through to helping with pain management or coping with stress.


For example, clinicians can signpost to resources that charities have developed to help our patients, and their employers, to maintain good work and good health. Conditions covered by these resources include people with cancer, musculoskeletal pain, mental health problems and heart disease.


And crucially, we can make an impact even when our time with patients is limited.


As a Work and Health Clinical Champion I meet GP’s all over the country and I highlight the following key actions:


  • Starting conversations about work– asking patients about their work is clinically useful in itself, but it can also open up an opportunity to talk about how important work is to them, how confident they are and whether their health is proving to be a barrier.
  • Discussing reasonable adjustments– employers have a legal duty to consider reasonable adjustments but many people haven’t considered this as an option. We can raise awareness of opportunities that could be offered by an employer for instance flexibility around hours or changes to the working environment.
  • Signposting or making referrals– There will be options emerging in your area that may include NHS or community provision, services linked to local job centers or information online. Social prescribing is emerging as a great referral route for such employment support



Work from the Improving Lives paper, is already under way to help one million people with long term physical and mental health conditions stay-in or return-to the workforce. This is an ambitious plan to change the landscape and move vocational rehabilitation closer to mainstream healthcare.


Ultimately we need to ensure that people are supported by employers that are committed to creating healthier workplaces and the right health and wellbeing support for their staff. We also want everyone to understand the importance of work as a health outcome and feel supported by a health system which promotes an understanding of good work and good health. 


[1]M. Marmot, 2010. Fair Society Healthy Lives, The Marmot Review.



How to achieve better employee health and wellbeing in UK plc. Christian van Stolk, Vice President of RAND Europe

How to achieve better employee health and wellbeing in UK PLC

Imagine an employer who loses about 30 days of productive time per employee due to IT problems. It’s likely an executive would have tough discussions with the IT suppliers or the responsible manager within the organisation. Consequences would happen if the problem persisted.

Now, imagine an employer who loses about 30 days in productivity on account of an employee coming to work in suboptimal health. In most cases there are few, if any, consequences .Most employers find it much more difficult to act and many small-to-medium sized organisations do nothing at all.

Britain’s Healthiest Workplace is an annual survey of employers and their employees sponsored by Vitality Health). Last year’s survey shows that on average UK employers lose these 30 days per employee per year due to absenteeism and presenteeism (being in suboptimal health while at work).

About 28 days out of this 30 day lost per employee can be attributed to employees coming to work when in suboptimal health and being less productive. According to our analysismental health appears to be the main factor, explaining about 30 per cent of presenteeism. Mental health problems are often compounded by lack of sleep, financial concerns, caring responsibilities and issues in the workplace, such as lack of control over what one does at work or poor relationships.

There is also a significant link between mental health and musculoskeletal conditions. When looking at demographics, it is clear that the young have much higher productivity loss and poorer mental health compared to other age groups. The same goes for those employees on relatively low pay. Overall, these trends seem to be getting worse over the years that the survey has been conducted, contributing to rising productivity loss in the workplace.

Many larger employers have a range of programmes and interventions that aim to improve the health and wellbeing of their employees. However, there is a disconnect between what employers tell us is happening within the workplace and the experience of employees recorded in the surveys.

About  50 per cent of employees have access to the programmes according to employers. From the employee survey, we know that only 22 per cent are aware of the employer programme with only about one-third of this data set participating in the programme. This is a missed opportunity. Our work on the data suggests that almost 75 per cent of employees perceive a health and wellbeing benefit from participation. Analysis of employees responding to the survey over the years also finds that employees who participate or even start involvement in any employer programme improve on a wider set of outcomes: cardiovascular health; mental health; perceptions of bullying; and productivity targets. Many of those participating are also not in the at-risk groups such as the young or those on lower incomes.

A number of factors seem to be associated with higher participation in programmes and better health and wellbeing outcomes: allowing employees time during working hours to participate; senior leadership and line manager support; and external and internal reporting on human capital. These all point to the importance of senior management showing leadership – from participation in the programmes through setting health and wellbeing as a strategic priority, and finally, monitoring progress over time. The more enlightened employers understand the prize. Happier and healthier employees are important from a corporate social responsibility point of view, but promoting employee health and wellbeing also makes complete business sense.

Christian van Stolk is a Vice President of RAND Europe. RAND Europe is a not-for- profit research organisation that conducts the Britain’s Healthiest Workplace surveys annually.

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