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Workplace health: policy and management practices

About

What is covered

This interactive flowchart covers workplace policy and management practices to improve the health and wellbeing of employees, with a particular focus on organisational culture and context, and the role of line managers.
The aim is to:
  • promote leadership that supports the health and wellbeing of employees
  • help line managers to achieve this
  • explore the positive and negative effect an organisation's culture can have on people's health and wellbeing
  • provide a business case and economic modelling for strengthening the role of line managers in ensuring the health and wellbeing of employees.
It also aims to promote and protect the health of older employees over 50 years in particular to promote and provide leadership, organisational policies, activities and interventions that:
  • improve the health and wellbeing of older employees (those aged over 50 in paid or unpaid work),
  • extend their working lives and
  • meet their specific needs.
The recommendations are for employers, senior leadership and managers (including line managers) and employees. They will also be of interest to those working in human resources, learning and development teams, professional trainers and educators, occupational health, health and safety, trade unions and professional bodies. In addition, they may be of interest to other members of the public.

Updates

Updates to this interactive flowchart

2 March 2017 Healthy workplaces: improving employee mental and physical health and wellbeing (NICE quality standard 147) added.
23 March 2016 Recommendations from updated guideline about older employees, aged over 50 in paid or unpaid work added.
25 November 2015 Recommendations from updated guideline added.

Person-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Your responsibility

Guidelines

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Technology appraisals

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this interactive flowchart is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the recommendations to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Medical technologies guidance, diagnostics guidance and interventional procedures guidance

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account. However, the interactive flowchart does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the recommendations, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Short Text

Everything NICE has said on workplace policy and management practices to improve the health and wellbeing of employees in an interactive flowchart

What is covered

This interactive flowchart covers workplace policy and management practices to improve the health and wellbeing of employees, with a particular focus on organisational culture and context, and the role of line managers.
The aim is to:
  • promote leadership that supports the health and wellbeing of employees
  • help line managers to achieve this
  • explore the positive and negative effect an organisation's culture can have on people's health and wellbeing
  • provide a business case and economic modelling for strengthening the role of line managers in ensuring the health and wellbeing of employees.
It also aims to promote and protect the health of older employees over 50 years in particular to promote and provide leadership, organisational policies, activities and interventions that:
  • improve the health and wellbeing of older employees (those aged over 50 in paid or unpaid work),
  • extend their working lives and
  • meet their specific needs.
The recommendations are for employers, senior leadership and managers (including line managers) and employees. They will also be of interest to those working in human resources, learning and development teams, professional trainers and educators, occupational health, health and safety, trade unions and professional bodies. In addition, they may be of interest to other members of the public.

Updates

Updates to this interactive flowchart

2 March 2017 Healthy workplaces: improving employee mental and physical health and wellbeing (NICE quality standard 147) added.
23 March 2016 Recommendations from updated guideline about older employees, aged over 50 in paid or unpaid work added.
25 November 2015 Recommendations from updated guideline added.

Sources

NICE guidance and other sources used to create this interactive flowchart.
Workplace health: management practices (2015 updated 2016) NICE guideline NG13

Quality standards

Healthy workplaces: improving employee mental and physical health and wellbeing

These quality statements are taken from the healthy workplaces: improving employee mental and physical health and wellbeing quality standard. The quality standard defines clinical best practice for healthy workplaces and should be read in full.

Quality statements

Making health and wellbeing an organisational priority

This quality statement is taken from the healthy workplaces: improving employee mental and physical health and wellbeing quality standard. The quality standard defines clinical best practice for healthy workplaces and should be read in full.

Quality statement

Employees work in organisations that have a named senior manager who makes employee health and wellbeing a core priority.

Rationale

Giving a senior manager responsibility for health and wellbeing shows the organisation’s commitment to a healthy working environment. The named manager can lead on healthy work initiatives and provide line managers and employees with support to improve working conditions. This can benefit both the organisation and its employees by increasing productivity, lowering staff sickness levels and improving job satisfaction and staff retention rates.

Quality measures

Structure
a) Evidence of arrangements for a named senior manager to have responsibility for making employee health and wellbeing a core organisational priority.
Data source: Local data collection, for example, job description, minutes of senior management meetings and organisational policies related to health and wellbeing.
b) Evidence of arrangements for implementing an employee health and wellbeing strategy.
Data source: Local data collection, for example, an employee health and wellbeing strategy with metrics and details of the progress made.
c) Evidence of arrangements to incorporate health and wellbeing in all relevant policies and communications.
Data source: Local data collection, for example, absence and stress management policies, minutes of management strategy, planning and board meetings and communications with staff.
Outcome
a) Employee sickness absence rates.
Data source: Local data collection. National data from the Chartered Institute of Personnel and Development’s annual absence management survey.
b) Employee retention rates.
Data source: Local data collection. National data from the Chartered Institute of Personnel and Development’s resourcing and talent planning survey.
c) Employee satisfaction rates.
Data source: Local data collection, for example, staff survey results such as the NHS staff survey. National data from the Chartered Institute of Personnel and Development’s employee outlook survey.

What the quality statement means for different audiences

Organisations have a named senior manager who is responsible for making employee health and wellbeing a core priority. This role includes ensuring that health and wellbeing is included in the organisation’s strategic and business management plans, and leading on initiatives to improve employee health and wellbeing.
Line managers recognise the importance of health and wellbeing and take it into account, for example, when planning tasks and designing jobs.
Employees know which senior manager is responsible for their health and wellbeing at work. They also know that the organisation they work for is committed to a healthy working environment and that jobs will be designed with this in mind.

Source guidance

Definitions of terms used in this quality statement

Senior manager
For a medium or large organisation (employing 50 or more people) the senior manager who takes responsibility for health and wellbeing would usually be a member of the executive team. Or they could be another senior member of staff who can influence that team. In smaller organisations the owner, or the person responsible for the day to day running of the organisation, could take on this role.
[Expert opinion]
Health and wellbeing
Health relates to a person's physical and mental condition. Wellbeing is the subjective state of being healthy, happy, contented, comfortable and satisfied with one's quality of life. Mental wellbeing relates to a person’s emotional and psychological wellbeing. This includes self-esteem and the ability to socialise and cope in the face of adversity. It also includes being able to develop potential, work productively and creatively, build strong and positive relationships with others and contribute to the community.
Core priority
Organisations in which health and wellbeing is a core priority will have a health and wellbeing strategy or plan. It will also be included in all relevant policies (for example, absence and recruitment policies) and communications, and the organisation will develop or promote and coordinate health and wellbeing activities.
[Expert opinion]

Role of line managers

This quality statement is taken from the healthy workplaces: improving employee mental and physical health and wellbeing quality standard. The quality standard defines clinical best practice for healthy workplaces and should be read in full.

Quality statement

Employees are managed by people who support their health and wellbeing.

Rationale

A line manager can have a significant influence on employee attitudes and behaviours. Making health and wellbeing a central part of the line manager’s role is a way of helping to ensure employees feel valued, content and able to discuss any concerns before they reach a crisis point. This can also improve productivity.

Quality measures

Structure
Evidence that supporting employee health and wellbeing is included in any documents outlining the skills and knowledge that line managers need.
Data source: Local data collection, for example, job descriptions and performance reviews.
Process
a) Proportion of line managers whose job descriptions include supporting employee health and wellbeing.
Numerator – the number in the denominator whose job description includes supporting employee health and wellbeing.
Denominator – the number of line managers in the organisation.
Data source: Local data collection, for example, job descriptions.
b) Proportion of line managers whose performance reviews include an evaluation of how they support employee health and wellbeing.
Numerator – the number in the denominator whose performance reviews include an evaluation of how they support employee health and wellbeing.
Denominator – the number of line managers in the organisation.
Data source: Local data collection, for example, appraisal documentation.
Outcome
a) Employee sickness absence rates.
Data source: Local data collection. National data from the Chartered Institute of Personnel and Development’s annual absence management survey.
b) Employee retention rates.
Data source: Local data collection. National data from the Chartered Institute of Personnel and Development’s resourcing and talent planning survey.

What the quality statement means for different audiences

Organisations (senior management teams including the chief executive and departmental managers) make line managers aware that supporting employee health and wellbeing is a central part of their role. This is done by including health and wellbeing in their job descriptions and performance reviews and emphasising it during recruitment. Organisations also ensure that line managers have adequate time, training and resources to support the health and wellbeing of employees.
Line managers are aware of the important role they have in supporting the health and wellbeing of employees, as highlighted in their job descriptions and performance reviews. They put this into practice in the way they manage employees and design jobs and person specifications.
Employees work in an environment where they know line managers aim to protect and support their health and wellbeing.

Source guidance

Workplace health: management practices (2015 updated 2016) NICE guideline NG13, recommendations 1.6.1, 1.6.4 and 1.9.2

Definitions of terms used in this quality statement

Support employee health and wellbeing
Taking action to maintain people’s health and wellbeing at work, for example:
  • offering employees help and encouragement to build supportive relationships
  • being open and approachable to ensure employees feel free to share ideas
  • consulting regularly on daily procedures and problems
  • recognising and praising good performance
  • identifying and addressing issues and concerns and taking any action needed as soon as possible to prevent problems escalating
  • identifying sources of internal and external support
  • agreeing relevant and realistic job targets
  • carrying out stress risk assessments and developing workplace solutions to reduce this risk.
[NICE’s guideline on workplace health: management practices, recommendations 1.8.1, 1.8.2 and 1.9.1]
Health and wellbeing
Health relates to a person's physical or mental condition. Wellbeing is the subjective state of being healthy, happy, contented, comfortable and satisfied with one's quality of life. Mental wellbeing relates to a person’s emotional and psychological wellbeing. This includes self-esteem and the ability to socialise and cope in the face of adversity. It also includes being able to develop potential, work productively and creatively, build strong and positive relationships with others and contribute to the community.

Identifying and managing stress

This quality statement is taken from the healthy workplaces: improving employee mental and physical health and wellbeing quality standard. The quality standard defines clinical best practice for healthy workplaces and should be read in full.

Quality statement

Employees are managed by people who are trained to recognise and support them when they are experiencing stress.

Rationale

Line managers are in regular contact with the employees they are responsible for, so they are in a good position to identify the early signs of stress. They can also help prevent the symptoms escalating into illness and sickness absence.

Quality measures

Structure
Evidence of arrangements to ensure that line managers are given training in how to recognise and support employees when they are experiencing stress.
Data source: Local data collection, for example, training records and copies of training documentation.
Process
a) Proportion of line managers who are trained to use a stress risk assessment to identify and respond to sources of stress.
Numerator – the number in the denominator who are trained to use a stress risk assessment to identify and respond to sources of stress.
Denominator – the number of line managers in the organisation.
Data source: Local data collection, for example, training records and copies of training documentation. National data from the Chartered Institute of Personnel and Development’s annual absence management survey.
b) Proportion of line managers who are trained to recognise the causes of stress.
Numerator – the number in the denominator who are trained to recognise the causes of stress.
Denominator – the number of line managers in the organisation.
Data source: Local data collection, for example, training records and copies of training documentation. National data from the Chartered Institute of Personnel and Development’s annual absence management survey includes details of organisations that have trained line managers to identify and manage stress in their team.
c) Proportion of line managers who receive information on sources of support for stress both inside and outside the workplace.
Numerator – the number in the denominator who receive information on sources of support for stress both inside and outside the workplace.
Denominator – the number of line managers in the organisation.
Data source: Local data collection, for example, induction and training records and copies of training documentation. National data from the Chartered Institute of Personnel and Development’s annual absence management survey.
Outcome
a) Identification of stress in employees.
Data source: Local data collection, for example, records of referrals and support offered to employees experiencing stress. National data from the Chartered Institute of Personnel and Development’s annual absence management survey.
b) Support for employees experiencing stress.
Data source: Local data collection, including staff survey results such as the NHS staff survey. National data from the Chartered Institute of Personnel and Development’s annual absence management survey includes details of organisations that have introduced flexible working options, changes in work organisation (such as job role adaptations) and training provided to build personal resilience.

What the quality statement means for different audiences

Organisations (senior management teams including the chief executive and departmental managers) ensure that line managers receive training in how to recognise and support an employee when they are experiencing stress. This includes how to develop workplace solutions to reduce the risk and knowing when to provide additional support. Support could include, for example, a referral to occupational health or elsewhere, both in and outside the workplace.
Line managers undertake training in how to recognise and support an employee when they are experiencing stress. This may involve using a stress risk assessment. They are also trained to develop workplace solutions to reduce the risk. In addition, they are aware of occupational health and other sources of support both in and outside the workplace and know when to refer employees to these sources of support.
Employees have a line manager who is trained to recognise when they are experiencing stress and knows what to do to help. Action could include, for example, making changes to how their job is carried out, or temporarily reducing the workload. It could also include referring them for support from occupational health or elsewhere, both in and outside the workplace. This will help employees to continue in work.

Source guidance

Definitions of terms used in this quality statement

Stress
Stress is a natural, but sometimes distressing, reaction leading to a psychological and physiological tension that is referred to as the 'flight or fight' response. It may be positive or negative. Stress has many causes. Some may be work-related, for example, excessive workload and a poor work–home balance. Other factors include financial worries or family issues. In most cases (and with appropriate help) people will adapt and cope. However, sometimes stress can lead to psychological or physical health problems.
[Adapted from NICE’s guideline on workplace health: long-term sickness absence and incapacity to work, glossary; NICE’s guideline on workplace health: management practices, recommendation 1.9.1; and expert opinion]
Support when experiencing stress
Support can involve addressing work issues and understanding how to carry out a stress risk assessment. In addition, it can involve identifying internal services (such as occupational health services, if available) and external services that may be able to help. (The latter could include fitness for work occupational health services, an employee assistance programme or the employee’s GP.)
[Adapted from NICE’s guideline on workplace health: management practices, recommendations 1.8.2 and 1.9.1 and expert opinion]

Employee involvement in decision-making

This quality statement is taken from the healthy workplaces: improving employee mental and physical health and wellbeing quality standard. The quality standard defines clinical best practice for healthy workplaces and should be read in full.

Quality statement

Employees have the opportunity to contribute to decision-making through staff engagement forums.

Rationale

Empowering employees to be involved in organisational decisions and practices that have a direct impact on them shows that the organisation they work for values their opinions. It can also lead to improved working practices and, in turn, improved job satisfaction, resulting in a more content and healthy workforce as well as higher levels of commitment and productivity.

Quality measures

Structure
a) Evidence of arrangements for staff engagement forums that enable employees to contribute to decision-making.
Data source: Local data collection, for example, dates of staff engagement forums, communications with staff encouraging attendance, staff engagement forum agendas and minutes (including contributions made by staff).
b) Evidence of arrangements for feedback to employees on actions taken as a result of their contribution.
Data source: Local data collection, for example, staff engagement forum and team meeting minutes, organisational newsletters, posters or emails.
Outcome
a) Employee satisfaction rates.
Data source: Local data collection, for example, staff survey results such as the NHS staff survey. National data from the Chartered Institute of Personnel and Development’s employee outlook survey.
b) Employee engagement.
Data source: Local data collection, for example, numbers attending staff engagement forums and staff survey results such as the NHS staff survey.
c) Employee retention rates.
Data source: Local data collection. National data from the Chartered Institute of Personnel and Development’s resourcing and talent planning survey.

What the quality statement means for different audiences

Organisations (senior management teams including the chief executive and departmental managers) ensure that employees are encouraged to voice their opinions and actively seek them through staff engagement forums. Staff engagement forums are included in organisational plans and published reports, such as the annual report. Organisations give regular feedback on ways that employee opinions have been considered, for example, at staff meetings or through newsletters, posters or emails.
Line managers ensure that they give employees the support and encouragement they need to contribute to decision-making, for example, by giving them time and support to attend staff engagement forums.
Employees have the opportunity to voice their opinions, and their organisation takes these into account when making business decisions that affect them. Employees receive regular feedback on how their opinions have influenced the organisation’s decisions.

Source guidance

Workplace health: management practices (2015 updated 2016) NICE guideline NG13, recommendation 1.5.2

Definitions of terms used in this quality statement

Staff engagement forums
Staff engagement forums are used to get employee views on organisational decisions and on how working practices can be improved. This can improve business productivity because employees often have the most experience and information about the effectiveness of company policies and systems. In addition, it can improve employee satisfaction because if their ideas are taken on board it is clear their opinion is valued.
Some organisations may feel other methods are more effective such as: small team meetings, working groups, the appointment of wellbeing champions, use of digital media, suggestion schemes or attitude surveys.
[Expert opinion]

Equality and diversity considerations

Some employees may find it difficult to contribute to staff engagement forums because, for example, they have a physical disability or find it difficult to read or write. Others may worry that they will be discriminated against if they give their opinion. Organisations must ensure all employees are given the support they need to contribute. They must also ensure that no discrimination occurs and that employees are supported to share their comments, in confidence, if necessary.

Effective interventions library

Effective interventions library

Successful effective interventions library details

Implementation

Pathway information

Person-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Your responsibility

Guidelines

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Technology appraisals

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this interactive flowchart is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the recommendations to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Medical technologies guidance, diagnostics guidance and interventional procedures guidance

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account. However, the interactive flowchart does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the recommendations, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Supporting information

Glossary

health relates to a person's physical or mental condition; wellbeing is the subjective state of being healthy, happy, contented, comfortable and satisfied with one's quality of life
the action of leading a group of people or an organisation, or the ability to do this; the ability of an organisation's management to make sound decisions and inspire others to perform well
people with direct managerial responsibility for an employee
being at work when you should be at home because you are ill

Paths in this pathway

Pathway created: June 2015 Last updated: May 2017

© NICE 2017

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