Leading by Example? Why the mental health and well-being of staff in Further Education is a leadership issue Education is a leadership issue 1 February 2011 Improving the Health and Wellbeing of FE Staff Wellbeing of FE Staff Dame Carol Black National Director for Health and Work
Why invest in the health and well-being of FE staff? ll b i f FE t ff? “The rewarding but difficult work of education can not be carried out well by people who are stressed and tired, but can be done well by staff with energy commitment but can be done well by staff with energy, commitment and a positive outlook .” - Well-being facilitator • • All staff are role models for students and can demonstrate how to lead a All staff are role models for students and can demonstrate how to lead a healthy and balanced lifestyle • • Staff well being may affect institutional performance (a study by Staff well-being may affect institutional performance (a study by Birkbeck College in partnership with Work Life Support (2007) suggests that there are links between average teacher well-being in schools and pupil performance – 8% of variation in SAT scores show significant p p p g correlation with staff well-being) • Improved health and well-being can reduce absence and improve g retention of staff
The Boorman review The Impact on Service Delivery and Outcomes Th I S i D li d O … over 80% of staff felt that their health and well-being impacts 52.8% 60.0% 50.0% upon patient care, and virtually 32.5% 40.0% none disagreed… di d 30.0% 13.2% 20.0% 1.1% 10.0% 0.4% … yet only 40% think that their 0.0% Strongly Agree Neither Disagree Strongly institution cares about their institution cares about their A Agree Disagree Nor Di N Di Disagree Agree health and well-being. Trust A Trust B Trust C Trust D Absence Rate 4.21% 4.04% 4.58% 4.70% 10.5% 9.79% 11.65% 17.02% Turnover Rate … data correlation Agency Spend 1.70% 2.96% 1.71% 4.57% also showed some l h d Patient Satisfaction 78.9 76.4 77.4 67.5 significant MRSA rate 0.65 0.88 1.56% 0.95% relationships… Health Check – Quality Excellent Excellent Weak Fair of Services f S i Health Check – Use of Excellent Excellent Weak Weak NHSHealthandWellbeing Resources The Boorman review Source: RAND Europe
What is our overall goal? What is our overall goal? Healthy, engaged Well-managed workforces organisations • A high-performing, resilient workforce kf • Enhanced productivity Contributing to: • A well-functioning society • Better economic performance
A new vision for health and work A new vision for health and work A Review of the health of the working-age UK population, commissioned in 2007 by the Secretaries of State for Health and for Work and Pensions. “At the heart of this Review is a recognition of, and a concern to remedy, the human, social and Working for economic costs of impaired health and well being economic costs of impaired health and well-being a Healthier in relation to working life in Britain. Tomorrow The aim is … to identify the factors that stand in the way of good health and to elicit interventions, including changes in attitudes, behaviours and practices – as well as services – that can help overcome them.” ” Working for a healthier tomorrow, 2008 Prevent illness, promote health, intervene early, improve the health of the workless.
Costs of working-age ill-health Costs of working age ill health Financial Social • Overall costs of working-age “If people are not healthy enough ill-health in UK exceed £100 to work – or are inadequately billion per year supported through ill health to supported through ill health to make a return to work possible – • Around 172 million working it is not just the individual or the days were lost to sickness business which is affected. The business which is affected The absence in 2007, at a cost to b i 2007 t t t bottom line is often the impact on the economy of over £13 his or her family and children.” billion (CBI) Lane Lecture, University of Black Report, 2008 Manchester, November 2007
Factors that stand in the way Factors that stand in the way C lt Culture beliefs and attitudes – needing change b li f d ttit d di h • Misconceptions about health and work – e.g. “need to be 100% fit” • Inappropriate ‘medicalisation’ of complex psycho-social problems • Poor retention in work of those with disabilities or chronic disease • Managerial attitudes, organisational behaviour, unable to make business case. Inadequate systems Inadequate systems • Inflexible system of sickness certification – the ‘sick note’ • No pathways of rapid intervention to keep you in work or return you to it • Health, work and well-being not part of training curricula or clinical practice • Poorly-supported healthcare professionals. No OH advice for GPs. Lack of Primary Care involvement y • Rehabilitation to work not a performance measure for responsible local health bodies • Configuration of Occupational Health services: no national standards. Configuration of Occupational Health services: no national standards. Next generation • Little attention to building mental and emotional resilience in our future workforce
Why are people off work? Why are people off work? • Two-thirds of sickness absence and long- term incapacity is due to mild and treatable conditions often with inappropriate conditions, often with inappropriate ‘medicalisation’, needing vocational rehabilitation: • Depression, anxiety, stress-related mental health problems (est. cost £28.3 bn in 2008) • Musculoskeletal conditions – mild and often soft tissue (est.cost £7 bn in 2007) “ The art of medicine remains the art of identifying the patient’s problem (which is something more the patient s problem (which is something more than diagnosing the disease) .” Sir Douglas Black – echoing Sir Robert Platt
Different problems need different approaches Symptoms: 2/3 of cases Chronic conditions: 1/3 of cases • Often mild Often mild • Examples Examples • Symptoms not ‘diseases’: – chronic rheumatic diseases – back pain – endogenous depression g p – musculo-skeletal symptoms – musculo-skeletal symptoms – stress – bipolar disorders, schizophrenia – anxiety, mild depression – diabetes, cancer • Few investigations required Few investigations required – post-trauma disability • Diagnosed with relative ease • Investigations more extensive • Intervention needs to be early, y, often non-medical, good • Diagnosis can be difficult vocational rehabilitation, regular • Treatment – good medicine, good flexible contact between employee and employers, plus rehabilitation l l h bilit ti employer. • Prevent chronicity • Prevent deterioration
Health of teachers Health of teachers Reported rates of occupational stress, depression or anxiety are twice as high in the teaching profession than that for all other occupations all other occupations. A National Association of Head Teachers (NAHT) survey found that 40% of teachers reported having visited their doctor with a stress-related problem in the previous year. 20% of teachers considered they drank too much and 15% believed they were alcoholics. The National Union of Teachers reports that around half of teacher ill health retirements around half of teacher ill health retirements take place for stress / psychiatric illnesses.
Costs of mental ill-health at work Costs of mental ill health at work Total cost to UK employers is estimated at £ 26 bn per year (2006: Centre for Mental Health), including £ 2.4 bn in replacing staff who leave because of mental ill- health health £ 8.4 bn in sickness absence (40% of the average 7 days off sick per year is for mental health problems); but £15.1 bn in reduced productivity at work. £15.1 bn in reduced productivity at work. Presenteeism ‘Presenteeism’ loses 1.5 times the working time lost due to absence - costs more as more common in higher-paid work NICE : If mental illness costs employers £ 28.3 billion per annum in 2009: - prevention and early identification of problems should save employers at least 30%, i.e. £ 8 billion November 2009 NICE each year guidance presents the - for a 1,000 employee company annual costs could business case business case. b be reduced by £250,000. d d b £250 000 • www.nice.org.uk/PH22
The old system, and the need for early intervention • Work-related health problems often not life-threatening, but life- GPs issued diminishing (MSDs and mental health diminishing (MSDs and mental health ‘sick note’ sick note conditions) • No clear pathways of vocational rehabilitation or standards: treatment all too often slow and inefficient, often with a poor outcome for the patient p p • GPs have no easy access to expert help or OH advice, or vocational rehabilitation • Repeated Medical Certificates can lead to worklessness lead to worklessness • Problems are often mild and treatable
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