Work that is good for our health

November 14, 2017

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by Gail Irvine, Policy and Development Officer, Carnegie UK Trust

On 7 November, the Carnegie UK Trust joined the Society of Occupational Medicine and the College of Medicine at a House of Lords luncheon on ‘Good Work,’ hosted by Lord David Blunkett of Brightside and Hillsborough. Gail Irvine reflects on the day’s discussions and how it will inform the deliberations of the Trust’s Short Life Group for Measuring Job Quality.

Job quality is a multi-faceted concept, and deciding what dimensions can be meaningfully captured and tracked in a national set of metrics will be the challenge that our Measuring Job Quality group seeks to address. Our working lunch in the House of Lords last week, attended by employment and health policy stakeholders and medical practitioners, was an invaluable opportunity for the Trust and our Measuring Job Quality partners to look at what those key dimensions and indicators might be with regards to workplace health and wellbeing.

It will be surprising to many to learn that some of the well-known conceptual frameworks of job quality fail to take account of health and safety at work. Why? ‘There is a perception in some quarters that this problem has been solved.’

While this is not entirely the case – there clearly remain jobs where the health and safety risk is very real – it is certainly true that the majority of jobs available in today’s post-industrial economy, and a significantly strengthened health and safety culture, mean that most of us work in far less dangerous and demanding physical environments than in the past. However, as one medical practitioner at our event noted, ‘people may not be losing their fingers at work anymore – but they are losing their minds.’ Participants perceived a growing crisis of mental health care. They felt that deeply entrenched practices and professional values, from both medical professionals and business managers, are failing to support employees to tackle the root causes of ill health.

If poor mental health, exacerbated by workplace culture, can be seen as a profound emerging issue, then the challenge facing disabled people is a longstanding and intractable one. Less than half (48%) of working age disabled people are in employment compared to around 80% of the non-disabled population. Moreover, disabled people who are working are more likely to be under-employed and low-paid; to report difficulties in work-life balance; to be dissatisfied with their sense of achievement at work; and to feel less engaged by their employer.

On top of this, almost 1 in 3 working-age people in the UK have a long-term health condition which puts their participation in work at risk. Employers are being urged to do more to support people who develop health conditions to remain in work, particularly as more of us are living longer. However, moving from a compliance-focused health and safety culture to proactively building a more holistic system which supports healthier workplace environments requires a significant shift.

At our discussion we heard examples of how large employers can use strategic HR functions and even procurement levers to encourage better working cultures through their supply chain. But while the link between good employee health and enhanced workplace productivity is strong, it can still be very difficult, particularly for smaller employers, to dedicate the necessary resources to this issue when they are focused on day to day business management. It was also pointed out that, however well-intentioned, employers have to respect their employees’ privacy and should not become too paternalistic or prescriptive in their expectations of employee health and behaviours.

The link between work and wellbeing is complex, and there is no simple formula to ensure that the former broadly contributes to the latter. Still, our participants usefully suggested two single changes, on the levels of management and medical practice, which might reap dividends:

  1. The risk of reputational damage is a significant driver of corporate behaviour. How can we encourage a culture change so that being seen as a ‘bad’ employer or manager carries the same social stigma of, for example, drink driving?
  2. Medical professionals need to be supported to make a systematic shift from treating symptoms to a more holistic approach. Clear guidelines and frameworks are required to support practitioners to refer patients onto the appropriate non-medical, community services which can support the patient to tackle the root causes of their ill health. ‘Social Prescribing’ approaches, such as the one which is now well integrated among practitioners in South Yorkshire, offer a useful blueprint.

In terms of what indicators should be used to measure if work enhances wellbeing, potential survey questions might be: ‘Does your manager care about your wellbeing?’ ‘Have you required a medical appointment in the past 12 months because of your work?’ and – tackling a complex issue in everyday language – ‘On a scale of 1 to 5, how would you rank your “Sunday night dread?”

Our working group will be considering these and other questions the UK needs to be asking to get a sense of how much quality work exists in our economy over the coming months. If you have any thoughts on what really matters for job quality and how we measure it, we would like to hear from you. Get in touch with me at [email protected] or tweet using the hashtag #CUKJobQuality