The evolution of health and wellbeing strategies

evolution of health and wellbeing

Need to know:

  • Legislation and government policy has helped to shape workplace health and wellbeing strategies.
  • Employers’ approaches have shifted from reactive to proactive, with early intervention, prevention and education all key elements of today’s strategies.
  • Once seen as an executive perk, health and wellbeing strategies are now designed to support all employees.

Health and wellbeing strategies are a common part of today’s workplaces, with employers using a range of initiatives to support employees. But, it has not always been this way; looking back over the years shows how strategies have evolved, and where they may go next.

The first health benefits emerged in the mid-nineteenth century, when chocolate and cash plans started to shape employer thinking. Brian Hall, managing director at BHSF, says: “[Organisations] such as Cadbury’s and Rowntrees pioneered many workers’ rights and benefits including healthcare. Around the same time, the first cash plans were launched to enable workers to access healthcare in exchange for a weekly contribution of 1d [one penny].”

While contribution levels increased over the years, these types of plans continued as the main way for workers to fund healthcare until 1948 when they came to a shuddering halt, says Adrian Humphreys, head of group risk and healthcare at JLT Employee Benefits. “Many of these plans initially went into run off when the NHS was created but, as gaps in the free healthcare system emerged, they were able to evolve and continue,” he explains. “Private medical insurance (PMI) was introduced around then but this didn’t really take off until the 1960s when wage freezes resulted in a benefits boom as employers handed out company cars and health insurance to incentivise executives.”

Safety first
The concept of employee health and safety can also be traced back to Quaker employers such as Cadbury’s. Many of these employers established works councils, giving employees a means to improve conditions. Trade unions also pushed for better safety standards, and while government responded with workplace regulations on a fairly ad-hoc basis, the Health and Safety at Work Act 1974 represented a major change in thinking.

Rachel Suff, employment relations adviser at the Chartered Institute of Personnel and Development (CIPD), describes it as momentous. “It’s been incredibly effective at reducing workplace accidents and deaths with figures from the Health and Safety Executive (HSE) [published in November 2016] showing that, by 2016, fatal injuries to employees had fallen by 85% and reported non-fatal injuries had fallen by 77%,” she says. “However, the focus of the act was very much on physical health and, with a shift away from industrial work, workplace risks have changed considerably since 1974.”

This shift in risk has meant that psychological health problems have become more of a workplace issue. The HSE responded to this in 2004 with the launch of its stress management standards. The government also highlighted the issue with the publication of its first national framework for mental health and employment, Working our way to better mental health, in 2009.

Employee assistance
The benefits arena also stepped up its support for psychological health, with, for example, the provision of employee assistance programmes (EAPs) increasing significantly over the last 10 years: the Employee Benefits/Health Shield Healthcare research 2017 showed that 95% of employers offer EAPs as a core benefit compared to 48% in 2007. EAPs are now readily packaged as a free value-added service within group risk and PMI products to ensure as many employees as possible have access. There is a growing awareness that mental health is a workplace issue, says Glen Parkinson, managing director for health services at Axa PPP Healthcare. “There’s more pressure on employees today; always-on technology means there’s very little downtime and lifestyles move at a much faster pace,” he adds. “Employers recognise the value of supporting their employees’ mental health.”

As well as broadening the remit of workplace health and wellbeing, there has also been a shift in the way employers deal with health issues. A good example of this can be seen in the way occupational health has evolved over the years. Tom Grant, director of the Commercial Occupational Health Providers Association (COHPA) and managing director at Managed Occupational Health, says: “Occupational health used to focus on supporting employees who were off work but it’s become more proactive. We’re talking to employers much more about wellness and how to help their employees maintain their health.”

Prevention strategy
This can be seen in the emergence of more tools that focus on wellbeing and prevention. On the mental health side these include resilience training and mental health first aid courses to help people spot the early signs of a problem, while on the physical health side, fitness challenges, walking meetings and wearable devices encourage individuals to lead a healthier and less sedentary lifestyle.

Technology has also played a part in shaping employers’ health and wellbeing strategies. While any workplace health problems would typically be dealt with by an organsation’s doctor or nurse on a face-to-face basis, more employers and employees can now access advice by phone or online. A good example of this is the growth in virtual doctor services, where employees can use online video chat to speak to a GP at their convenience.

There has also been a shift in the perception of health benefits. “PMI used to be regarded as a perk for senior executives,” says Parkinson. “Today, employers are much more aware of the link between health and productivity, so health and wellbeing has become an integral part of the HR strategy.”

And with this meaning that more employers now offer a variety of health and wellbeing initiatives to all of their employees, it should lead to a UK workforce that is more healthy, happy and productive.