Health and wellbeing: BT staff get message of interdependency

BT’s chief medical officer, Dr Paul Litchfield, wants the organisation’s employees to take more responsibility for their own health and wellbeing, says Tynan Barton

For Dr Paul Litchfield, chief medical officer at BT, tackling health and wellbeing in an organisation involves a culture shift from dependency to interdependency, with individuals taking responsibility for themselves and others around them.

Litchfield believes it is essential to look at how to improve the health and wellbeing of a workforce and not to focus on the adverse consequences of sickness absence. In the past 10 years, he says, BT has taken “what we hope is a more enlightened approach that says if you try to improve the health of your people and if you can nudge them to improve their health and wellbeing, and support them in doing so, you will get a more engaged and productive workforce.

“We look at it in terms of overlapping circles of engagement, performance and wellbeing. We see those as inextricably linked and if you impact one, then it will impact another.”

Sickness absence is an issue for any employer because it directly affects the bottom line. Even if an organisation pays only statutory sick pay, there is a direct cost of absence. If employees are not at work, not performing particular tasks, not providing services and not liaising with customers, that can hit profitability. “The higher the level of sickness absence, the greater the impact will be on the business,” says Litchfield.

BT does not addresses sickness absence in isolation but in the wider context of its health and wellbeing strategy, he says. “We want to support people so they are able to come back to work. If they cannot come back to work, it can lead to a frustration of contract and the relationship [may] come to an end.”

Litchfield says some employers still hold the traditional view that if an individual is genuinely sick, the employer should accept that, and there is nothing it can do. “I think that is unrealistic,” he says. “It means the employer is abdicating responsibility, but it has a responsibility to help an employee back to work. We know that if someone is ill, good work is good for their health.”

BT’s health and wellbeing strategy focuses on primary prevention, early intervention and rehabilitation. Just over 25 years ago, it was a public sector organisation, and still has a low rate of staff turnover. “We are shifting attitudes and behaviours from a command-and-control background,” says Litchfield. “We come from a dependent mindset and have been shifting that to one where people take more responsibility for their own actions. We intend to shift to an interdependent mindset where people also think of those around them and how to improve the health and safety of others. It will be a long journey, but we are aiming to get there.”

Healthy lifestyle minimises risk

BT uses its health promotion programme, Work Fit, to encourage staff to adopt a healthy lifestyle to minimise the risk of chronic disease. This year, employees are taking part in the company’s Work Fit Get Active programme, which sees teams of staff aiming to take 10,000 steps a day. “The programme has been quite successful in improving education and focusing on activity,” says Litchfield. “The general message is to focus on four main factors: physical activity, proper nutrition, moderation of alcohol and tobacco avoidance.”

Litchfield says the biggest staff health issues facing many organisations are mental health and musculoskeletal disorders, so BT targets early intervention with a programme for both these conditions. Any employee with a musculoskeletal injury has access to a free advice line to a physiotherapist who can help them self-manage their condition. “With 50% of people, that is all they need,” says Litchfield. “With the other 50%, we arrange access to a physiotherapist close to home. The driver is to get people back to normal activities. It is about helping people to get their lives back.”

In the two years it has been running, BT’s programme has seen success, with just over 200 cases going through the system. About 55% of those employees have recovered fully and returned to work, and 25% have improved significantly. Without the programme, a significant number of staff would not have been able to return to work, says Litchfield.

In the past year, BT has set up a mental health service that mirrors its musculoskeletal programme. “The mental health service is accessed through occupational health and is much more therapeutic,” says Litchfield. “It involves self-help, computerised cognitive behavioural therapy (CBT) if appropriate, or face-to-face CBT.”

Two years ago, the organisation introduced a mental health first aid course for managers, which teaches them how to recognise when an employee is showing signs of distress. They can then direct the employee to sources of professional help. In the first year, 20% of BT’s people managers took part in the course, and this year a further 20% have been trained.

Mental health good practice

Litchfield says mental health issues appear to be increasing in workforces, while musculoskeletal conditions are decreasing. He has worked with other telecommunications companies to address these problems and sits on a social dialogue committee that meets in Europe to discuss issues of common interest. Litchfield has also helped to develop mental health good practice guidelines for all European Union countries, although he says it took a lot of persuasion with trade unions.

As an organisation with a long history and low staff turnover, BT has a mature and ageing workforce. It removed its default retirement age in advance of the legislation requiring all organisations to do so that came into force this month, and applies an age-neutral approach to health and wellbeing.

Litchfield says that within this policy, BT configures its support services to take account of age demographics and health issues that are likely to occur in older workers. “We develop services with our age demographic in mind, but say it is age neutral. If we start to develop specific policies and initiatives for older workers, it can fairly rapidly become misunderstood or perverted, and start to stigmatise older workers.”

Career history: Dr Paul Litchfield

• Qualified in medicine on 7 July 1977.

• After a brief spell in the NHS, he joined the Royal Navy in 1978 and specialised in occupational medicine.

• After originally signing up for five years, Litchfield left the navy in 1994.

• In 1994 he joined the Civil Service Occupational Health Service, an executive agency of the Cabinet Office, as medical director.

• Joined BMI Health Services in 1996.

• From BMI, Litchfield joined BT on 1 January 2001.

• He is most proud of getting mental health on to the workplace agenda and promoting a more sophisticated view of health in general, while helping to minimise some of the stigma around mental health.

• Litchfield is a Fellow of the Royal College of Physicians and of the Faculty of Occupational Medicine. In 2007, he was awarded the Order of the British Empire for services to occupational health.


BT at a glance

BT is a global telecommunications services organisation that serves customers in more than 170 countries. Its main areas of business are fixed-line services, broadband, and mobile and television products.

BT has 75,660 full-time employees in the UK.

BT can trace its history back to the Electric Telegraph Company, which was incorporated in 1846 and was one of the first telecommunications organisations in the UK. The Electric Telegraph Company amalgamated with other organisations, and the group was transferred to state control under the Post Office.

In 1981, the British Telecommunications Act came into force and started the process by which British Telecom was transferred to private ownership.

In November 1984, more than 50% of British Telecom shares were sold to the public. The government sold its remaining shares in 1993, and the company was renamed BT in 1991.

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