Practices and Combinations of Practices for Health and Wellbeing at Work

On the one hand, the evidence of links between workplace health and wellbeing, employee engagement and work performance is robust and reliable. On the other hand, although some practices show promise of effectiveness, we do not have strong evidence that single workplace health and wellbeing practices by themselves - such as resilience training or mental health first aid training - reliably improve worker health, wellbeing, engagement and performance.

In this research, we build on the observation that the leading organisations on managing employee health and wellbeing adopt a range of different practices (e.g. resilience training, workplace health promotion, management development), often combined in an integrated and coherent health and wellbeing strategy. We examine the factors that enable or hinder the implementation of workplace health and wellbeing practices and whether certain combinations of practices are more effective than other combinations, or effective for some types of organisations and not others. In these respects, we will consider the influence of factors in organisations' wider regional, sectoral and economic contexts as well as factors internal to organisations, including levels of engagement, health, wellbeing and performance prior to the introduction of new health and wellbeing practices.

We will also examine what combinations deliver the best return on investment - that is the combinations of practices that are most cost effective.

One central concept in our research is the notion of high quality work - that is work characterised by, for example, workers having a say in how they do their work, clear roles and performance expectations, manageable work demands, supportive co-workers and job security. We will investigate whether, for example, the features of high quality need to be present in a job for other health and wellbeing practices to have effects, or whether some health and wellbeing practices can compensate for otherwise low quality work.

Our research has five major elements.

First, we will use data from Britain's Healthiest Workplace Survey (BHW) to examine which combinations of health and wellbeing practices are most effective for which types of organisations. BHW is an annual survey that has been conducted over the past six years. The survey has collected data from over 600 organisations and around 100,000 employees. Participating organisations include smaller organisations and organisations from the public and private sectors. BHW collects data on a range of workplace health and wellbeing practices and outcomes, job quality, employee engagement, and organisational performance.

Second, we will take a more detailed look at organisations in the survey and link survey responses to specific performance indicators in organisations, in order to get a more detailed and nuanced picture of workers' experience of workplace health and wellbeing practices and how these experiences may influence employee health, wellbeing, engagement and performance.

Third, using questions on return on investment in BHW as well as other sources of data, we will look at which practices and combinations of practices are most cost effective for returning gains in worker wellbeing.

Fourth, based on multiple interviews in a range of organisations conducted over a 12 month period, we will examine how organisations go about implementing health and wellbeing practices, and the different contextual factors that influence that process.

Fifth, we will engage in an on-going process of integrating knowledge from the other four elements of the work in order to build an evidence-based model of how organisations implement different combinations of practices. The model will act as both a guide to practice and a basis for further refinement and development in future research.

The impact of the programme will capitalise on RAND's extensive experience and networks of policy and user groups and build on the UEA team's experience and networks developed partially through the ESRC funded Work, Learning and Wellbeing programme of the What Works Centre for Wellbeing as well as other research projects. Engagement with all beneficiaries throughout the programme will ensure we reach end users directly through our impact activities and indirectly through engagement with and dissemination to those who provide services or who otherwise inform or influence end users.

Beneficiaries fall into four major groups:

1) End users such as workers, line managers, senior managers and business owners.

2) Those that are close to end users, including GPs, trade union representatives, management consultants, HR professionals, occupational health/psychology professionals.

For the end users and those close to them, benefits will come from improved understanding of workplace health and wellbeing initiatives for productivity, for society and for their own sakes; how to make local adjustments in workplaces to protect and promote health and wellbeing; and through tools to aid decision making (e.g. cost effectiveness calculator).

3) Intermediate users, such as Local Enterprise Partnership board members, employer groups (Chamber of Commerce, Small Business Associations), County/City councils, public service commissioners.

For intermediate users, benefits will come through improved understanding of: the (cost-) effectiveness of health and wellbeing interventions, impact on performance and productivity; local modifiable contextual factors that could facilitate adoption of good workplace health and wellbeing practices by employers - especially those geared towards reducing health or wellbeing inequalities or inequalities to decent quality work; and calculators for evaluating the cost-effectiveness of interventions.

4) High-level users, such as regional and central Government civil servants (Departments of Business, Energy and Industrial Strategy and Work and Pensions, Health & Safety Executive, Public Health England), influencers (professional and trades institutions and bodies such as the Institute of Directors) and What Works Centres (especially National Institute of Clinical Excellence {NICE}, What Works Centre for Local Economic Growth, What Works Centre for Wellbeing).

The benefits for high-level users are similar to those for intermediate users. Improvements in understanding will be more sophisticated than other user groups, and will encompass a stronger understanding of the evidence-base, the limitations of the evidence-base and gaps in the evidence. There will be enhanced understanding of modifiable factors that can be amenable to change through policy or guidance and enhanced understanding of societal benefits of workplace interventions to improve wellbeing through, for example, improvements in national, regional and sectoral economic performance, tax revenues, and health service spend.

We have requested over £85,000 for our impact activities. This figure does not include staff time to organise these activities. Impact activities include a steering group with representatives from many of the beneficiaries listed above and an employer forum (East of England Regional Task Force for Workplace Wellbeing). We have a highly interactive and user-led approach to dissemination, focused on user-uptake and implementation of knowledge. Our dissemination with user groups will be multi-channel and engaging, including workshops, presentations to professional audiences and at practitioner conferences, work with practitioner bodies, work with organisations and dissemination of research through the What Works Centre for Wellbeing. Our Pathways to Impact statement gives more details.