Since the publication of Securing health together (SH2) in 2000, with its ambitious targets to cut ill health, Britain has seen Dame Carol Black's ground-breaking report Working for a healthier tomorrow and later joint-report on health at work and sickness absence. But, as all the various initiatives, challenge funds and pilot projects have come and gone, progress has been criticised by some as lacking project follow-through and famously, in the case of healthcare, "having more pilots than British Airways", important though piloting of proposals is.
With an ageing workforce, technological changes, more insecure and 'gig' working, higher numbers of small-to-medium-sized enterprises (SMEs) and self-employed as well as increased overall employment figures -- the need for better workplace health management in the UK is fast-reaching a crescendo.
Preventing ill health
For the public policy green paper on prevention (Advancing our health: prevention in the 2020s), IOSH advocates action in many areas to prevent work-related ill health, including on providing healthy workplaces, supporting mental health at work and tackling fatigue.
For workplaces, these include timely implementation of the Thriving at Work and Good Work reports, together with training of managers in health and wellbeing, health and safety protection for older and vulnerable workers, and tax-breaks and subsidies for occupational health provision. We also highlight the need for research into musculoskeletal health at work and exposures to new technologies and improved air-quality for outdoor workers.
While, for mental health, we recommend more education about what constitutes 'good work' and how employers can ensure that this is what they are providing, together with government policy that requires and supports its provision and improved access to occupational health services.
And for tackling fatigue, we underline the need for awareness of the impact of issues such as: sleep apnoea; intelligent shift work rotas; good sleep hygiene; the right to switch off; reducing commuting; flexible hours; and preventing harassment.
Twenty years on since SH2 was launched, can we honestly say there's been anything like enough progress? Sadly not. And as, once again, public policy-makers ask questions on how best to improve health at work and support a multi-generational and multi-ability workforce, the answers still include the same key elements -- upskilling, multidisciplinary working, resourcing, leadership, worker involvement and effective regulation. So, in IOSH's recent submissions to two important UK consultations on cutting work-related ill health and associated job loss (see boxes 1 and 2), we've continued making the compelling case for sustained action on workplace health.
We argue that 'good work' is good for health and wellbeing and all work should be good, affording all ages the opportunity to benefit from safe, healthy and supportive employment. We promote worker-friendly, human-centred workplaces that are advantageous, not only to individuals, families and employers, but also to communities, economies and societies. And we emphasise that by preventing occupational harm and offering tailored modifications that actively support rehabilitation and healthy, extended working lives, the country can help to stop losing valuable knowledge, skill and experience from our workplaces and avoid premature retirement and burnout.
Reducing job loss
For the public-policy consultation on reducing job loss (Health is everyone's business: proposals to reduce ill health-related job loss) IOSH strongly agrees that, in addition to government support, there is a role for employers to support employees with health conditions not already covered by disability legislation and agree there should be guidance and case studies on this.
Furthermore, IOSH argues that enshrining this in a proposed new 'right to request work(place) modifications on health grounds' could help employees stay in work and that any employee able to demonstrate such a need should be eligible.
Recognising that SMEs and the self-employed represent a significant portion of the workforce and the economic pressures on them, we have repeated our calls for bespoke incentives and support the proposal for vouchers or subsidies prioritising high-quality occupational health (OH) services. In addition, we suggest tax-breaks for therapy for certain non-work-related injury and illness and employer-subsidised access to public gym or sports facilities.
And, in order to help ensure uptake and monitoring, we recommend wide promotion of approved services and the use of performance indicators to help evaluate efficacy. While, to support sustainability, we highlight the need to plan for and develop the OH workforce and the use of anonymised national data on work-related sickness absence and interventions to inform public policy.
Finally, we have also taken the opportunity to reiterate our calls for a strong multidisciplinary approach that harnesses the non-clinical input of trained occupational safety and health professionals (OSH), as part of workplace teams, helping organisations to better manage OSH risks, support rehabilitation and sustain inclusive, diverse workforces.
So, as the UK heads for a new government, it's vital that public policy focus on health at work is properly prioritised. We need to tackle the record numbers of cases of work-related stress, depression or anxiety (last year reaching 602,000 cases) and the 300,000 people with long-term mental health problems losing their jobs each year.
As well as preventing avoidable human suffering, better OSH management can help stem the estimated £22bn annual cost of work-related ill health, with £9.8bn due to new cases and over £12bn due to occupational cancers. These failures make no sense for individuals, for business or for our society. Governments need to value health at work as a top priority and fully resource effective long-term strategies as an investment for everyone's future, not a cost.