The NHS is supposed to improve the wellbeing of all, but many of those working for the service don’t feel well themselves. Stress is endemic. Employee absence due to illness costs £2.6bn a year – and then there are the NHS employees who turn up to work despite the fact that they are ill. The NHS would seem, ironically, to be a sick workplace.
This morning it was reported that its CEO, Simon Stevens, is to launch a far-reaching employee wellness initiative. Staff will be offered exercise classes, health checks, and programmes to help them quit smoking. They will also be nudged to cycle to work and encouraged to eat healthier food.
The NHS is not alone in embracing such schemes: 75% of the largest US companies have already introduced similar initiatives, and altogether spend $6bn a year on improving employee wellness. Some offer light-touch health interventions such as free gym memberships. Others go further. The past few years have seen management fads that include walking meetings and treadmill desks; some firms have started to make employee wellness a condition of employment, with bans on smoking or requirements for twice-weekly gym attendance.
It seems that the 20th-century work ethic is being replaced with a 21st-century work-out ethic.
But the evidence doesn’t inspire confidence in corporate wellness initiatives. Only a small percentage of employees tend to participate; less than half of employees who are offered health screening take up the offer, for instance. Of those with problems, less than one-fifth actually agree to some kind of health intervention. After an intervention is made, most drop out. Even for those who stick to their health plan, the results are modest. The CEO of the NHS lost 20kg after participating in a workplace wellness initiative. The average participant only loses around 1kg.
What employee wellness initiatives do achieve is to inspire a sense of guilt among employees for not being healthy enough. One study of the extensive employee health programme at a Swedish company uncovered a palpable sense of anxiety. One employee who had been sent to the company’s in-house health school nervously told the researchers: “In these times when people are laid off due to the global financial crisis, you need to stay fit.”
The real driver of ill health in the NHS is not unhealthy workers, it is unhealthy work practices. Nearly 100,000 employees in the NHS are on zero-hours contracts. The kind of irregular working hours and endemic uncertainty created by such contracts plays havoc with people’s health.
Another likely factor in the ill health of NHS workers is widespread cost-cutting initiatives. According to the NHS’s own statistics, less than a third of employees think there are enough staff to do their jobs properly. At the same time, staff are often being asked to take on tasks only vaguely related to their job. GPs routinely complain, for example, that they spend more time doing administration than talking with their patients.
In light of all this, it should come as no surprise that 38% of NHS staff suffer from work-related stress. This makes the NHS the most stressed-out place to work in the country. It is hard to see how a few Zumba classes will fix this.
To make real improvements to employee wellness, the NHS should stop focusing on unhealthy employees and start building healthy work practices. NHS workers need proper resources to do their job. This costs money.
But an equally important step is to eliminate the many pointless tasks and interruptions which stop NHS workers from doing their core tasks. Nurses want to care for patients. They don’t want to be accountants, management consultants or social workers. If the NHS can minimise disruptions, then staff are more likely to feel immersed in their work. When this happens, employees report high levels of wellbeing. The sad thing is that the way work in the NHS is set up today creates constant interruptions, distracting staff from actually getting their job done. No wonder a bottle of wine in front of a mind-numbing TV show is the therapy which so many seek out when they clock off.
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