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The relationship between Leading & Lagging occupational health

MODULES: 
OHS 7003: MANAGEMENT OF 
OCCUPATIONAL HEALTH AND WELLBEING 
Health & Well-being Strategies 
And Intervention 
(19 Feb 2019) 
Version 1 (2019) 
Peh Yong De, Nigel 
[Nigel.peh10@gmail.com] 
Announcement 
■ Remember to submit your Assignment 1 before 23.55 on 22 Feb (Fri) 
■ Turnitin for Assignment 2 will be opened after the end of next class on 
26 Feb 
■ Class on 5 March (Tue) will be shifted to 9 March (Sat), 10am to 1pm 
Recall from last lesson (12 Feb 2019) 
■ The relationship between Leading & 
Lagging occupational health 
indicators 
■ Discuss the basis of “detailing actions“ for 
assignment 2 
■ Remind about the top 3 Occupational 
Diseases in Singapore and discuss about 
the guidelines issued by WSHC for 
appropriate control to minimise such 
diseases at workplace. 
■ Concluded that all 3 guidelines has similar 
working principle of PDCA. 
Content for 19 Feb 19 
 Key implementation challenge themes for 
employers 
 Collective actions for stakeholders 
 Types and levels of intervention in workplace 
health and wellbeing interventions 
 Conclusion 
Key implementation challenges for employers 
Failure to see mental health and wellbeing as a priority 
Mental health and wellbeing policies are reactive and driven by staff 
events or experience, not proactive and preventative 
Lack of insight around current performance (including recruitment, 
retention and presenteeism) 
Poor evidence base to measure return on investment of wellbeing 
strategies 
Lack of collective knowledge of best practice 





1. Failure to see mental health and wellbeing as a priority 
■ High operational demands, with insufficient energy, time and resources available to 
acknowledge and address workforce health and wellbeing. 
■ Less than 50% of business decisions has taken employee wellbeing to at least a 
moderate extent 
■ 52% of organisations believe employee wellbeing is only a focus in their business when 
things are going well. 
2. Mental health and wellbeing policies are reactive and driven 
by staff events or experience, not proactive and preventative 
■ Historically, action to improve the management of and support for employees with poor 
health was often only taken by employers following an internal or external trigger such as 
employee’s occupational health illness incident. 
■ Reactive actions are often taken in response to an incident, such as increased reporting 
of poor levels of health in the organisation or following an individual case. 
■ This is supported by data from Chartered Institute of Personnel and Development (CIPD), 
which show that 61% of organisations’ approach to employee wellbeing is much more 
reactive than protective. 
3. Lack of insight around current performance (including 
recruitment, retention and presenteeism) 
■ A lack of clear data around the impact of health on an organisation is a key challenge. 
■ Measuring workplace wellbeing and its impact on business performance is not easy. 
■ Due to the stigma associated with mental health, conditions and incidents tend to be 
under-reported and reasons for absence not given. 
■ There is also no clear consensus on how to properly measure presenteeism* 
* Defined as the loss in productivity that occurs when employees come to work but function 
at less than full capacity because of ill health. 
 In 2013, the UK Government launched a workplace well being tool to help employers work
out the costs of poor employee health to their organisation and create a business case for 
taking action. 
 For example, The Time to Change campaign introduced the free Organisational Health 
Checks – an audit process and tool to help employers identify key gas in workplace 
wellbeing provision. 
4. Poor evidence base to measure return on investment of 
wellbeing strategies 
■ Measuring the return of investment (ROI) for workplace wellbeing initiatives poses a 
barrier to encourage companies to invest. 
■ Almost no employers had a plan for or the ability to measure the return on investment 
within workplace wellbeing. 
■ Furthermore, results around ROI measurement are mixed. For example, the 
comprehensive 2013 RAND Employer Survey on Wellness Programme Effectiveness 
across 60,000 US staff showed that wellness programmes were having only modest, if 
any, effect on healthcare spend. 
■ Due to the lack of positive evidence, fewer employers are taking on measurements of 
wellbeing. 
■ For example, whilst 100% of US employers providing wellbeing services to their employees
expressed confidence that their activities reduced absenteeism and health-related 
productivity losses, only 50% had actually evaluated their impact. Furthermore, only 2% 
reported actual savings estimates. 
5. Lack of collective knowledge of best practice 
■ Organisations vary in their level of engagement with workplace wellbeing (see Figure below). 
■ Some are more advanced, understanding its role in reaching peak organisational 
performance, and investing in the area as a strategic priority. 
■ However all these organisations, regardless of their stage, all expressed an interest in 
understanding what best practice looks like. 
■ This collective lack of information acts as a barrier to action. 
Collective actions for stakeholders 
■ Successfully implementing a workplace health and wellbeing improvement strategy 
requires organisations to overcome the challenges highlighted in the earlier slides. 
■ It requires employers to take responsibility for creating a culture of awareness and 
support for employee health. 
■ The following Figure illustrates the required continuum of pivotal actions for 
employers along the implantation cycle for workplace wellbeing programmes. 
The implementation life cycle for 
workplace wellbeing programmes 
1 2 



Collective actions for stakeholders 
■ Examples of the types of interventions that could be used to address employee 
needs and organisational culture characteristics include: 
1. Mental health anti-stigma and awareness-raising activities 
2. Providing training to employees on mental health awareness and how to manage 
their own mental health 
3. Training for manager on workplace wellbeing 
4. Setting up a network of mental health champions or coaches in the workplace 
5. Purchasing an employee assistance programme that gives employees access to 
telephone or face-to-face counselling when required, and it is well promoted and 
uptake is monitored. 
6. Creating a best-practice mental health policy. 
Collective actions for stakeholders 
■ Successful and sustained change requires that employees understand their own state of health and 
wellbeing as well as recognising and support colleagues. As port of a culture of awareness of the 
importance of health, employees need to: 
1. Engage in their own health 
– Take responsibility for improving their own health literacy by accessing available information, 
learning about options of support and actively participating in strategies that promote health and 
wellbeing. 
2. Speak up 
– Employees can contribute to achieving better overall workplace wellbeing by getting actively involved 
in discussions on health and wellbeing in the workplace, as well as inputting the design, 
management and performance measurement of their employer’s wellbeing strategies and action 
plans. 
3. Support colleagues 
– Employees can support improvements in overall workplace health and wellbeing by ensuring fellow 
colleagues are aware of both how to raise concerns and also what actions to support co-workers. 
– There is no one-size fits all solution, so knowing what options are available, and taking a flexible 
approach is important. 
Types and levels of intervention in workplace 
health and wellbeing interventions 
■ Three (3) main categories of health intervention have been proposed by WHO and 
are commonly used in the design and implementation of: 
1. Primary – – -> Prevention 
2. Secondary – – -> addressing the severity of illness 
3. Tertiary – – -> address the associated disability or incapacity 
Types and levels of intervention in workplace 
health and wellbeing interventions 
■ Most interventions implemented in the workplace adopt a Primary or Secondary 
disease prevention approach that aims to reduce health risks. 
■ Primary prevention aims to implement interventions, where the main objective is to 
improve the health status of the whole population, regardless of individual risks. 
■ Secondary and Tertiary prevention inventions work with exposed individuals in order 
to reduce or reverse the negative consequences of a disease, in a worksite; 
Secondary interventions reduce return-to-work time. 
■ Examples of interventions that have been claimed to improve employee health and 
increase workplace wellbeing include: gym access and fitness at work, stress 
management, smoking cessation, back care, weight reduction/nutrition programs 
and medication for chronic conditions. 
Some examples of targets and interventions 
at each layer 
Refer to Article for supporting evidence of 
Intervention 
• Table A2.2.: Evidence source for reasons for introducing workplace wellbeing schemes 
• Appendix 3: Evidence relating to nutrition, physical activity and smoking cessation in the 
workplace. 
• Appendix 4: Evidence Relating to Musculoskeletal disorder and Health and Safety in the 
workplace. 
Workplace wellbeing programmes and their impact on 
employees and their employing organisations: A scoping 
review of the evidence base 
Conclusion 
 There is no one-size fits all solution, differences in employee needs will require different 
intervention strategies and reliance on one strategy alone is unlikely to yield significant 
results. 
 Therefore intervention strategies should cover multi-layers (Primary, Secondary & 
Tertiary) as well as the suitability of the strategies to the employee at the workplace 
condition. 

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