Advice under scrutiny

Anyone who thinks that Dame Carol Black, national director for health and work, has become synonymous with grandiose theory as opposed to practical action should consider the fact that her efforts have led to the creation of an evaluation tool that has considerable potential concrete use.

The Business HealthCheck is a tool that has been commissioned by the cross-government initiative Health Work Wellbeing and developed by PricewaterhouseCoopers with the support of Business in the Community (BITC). It is being piloted as a means of calculating the return on investment in respect of the introduction of health and wellbeing intervention. Employers can access it free of charge by entering a few basic details at

So how does it work? Entering current figures for absenteeism, presenteeism, staff turnover and liabilities – including accidents, claims and insurance premiums – into the tool spreadsheet enables baseline costs to be calculated for each of these variables. The projected opportunity costs of implementing a wellness programme as well as the potential savings from reduced absence turnover and liabilities can then be calculated – and these scenarios can be used to help companies assess the business case for investing in health and wellbeing programmes.

The pilot, which started this July and has no fixed end date, is an integral part of BITC’s Business Action on Health campaign launched in October 2007 to help promote awareness of employee health and wellbeing as a strategic business issue among both businesses and general audiences.

Louise Aston, director of the Business Action on Health campaign, says “The Business HealthCheck can help those in departments such as HR, health and safety or occupational health have a dialogue in the same language as the finance director in order to make a business case for health and wellbeing, which has previously been seen as a bit of a bolt-on.

“We know that health and wellbeing has reached an absolute tipping point in terms of businesses waking up, and the number of FTSE 100 companies who reported on the subject rose from 68 per cent last year to 81 per cent this year. When the pilot for the tool ends depends on what comes out of the initial findings, but the feedback we’ve had so far is that providers welcome it.”

A jury of experts (see box) consulted by Corporate Adviser about the tool certainly volunteered a fair degree of positive sentiment and, whilst they also identified teething problems, they felt there was no reason why the majority of these shouldn’t be overcome once the results of the pilot have been analysed.

One point on which all those ask agree is that the Business HealthCheck does not in any way run contrary to the interests of providers and intermediaries who provide or offer advice on independent absence management services. Indeed, experts consider the tool complementary to such activities and see the overall Business Action on Health campaign as providing advisers and providers with increased opportunities because it is getting companies to talk about wellness.

Most experts also say the tool certainly constitutes a step in the right direction and that the Government should be congratulated for seeking to address a very real need.

Jill Pollock, wellbeing manager at Bupa, says “Organisations have been requesting a tool to help them evaluate the impact of their health investments for a number of years. Most know that investing in positive health and wellbeing initiatives is a good thing, but they have frequently failed to secure funding from key stakeholders largely because they have not been able to demonstrate the business case.

“Organisations routinely use a range of accepted tools to evaluate business progress and success, such as employee satisfaction, staff turnover and customer satisfaction analysis, but there is no universally recognised tool when it comes to evaluating health and wellbeing. There have been a number of attempts over recent years to produce such a tool, but feedback has suggested these have fallen short of the task. “

The fact that Business Health-Check seeks to shed light on the issue of presenteeism in addition to absenteeism has also been well received. But, on a more negative note, most experts are adamant that the tool is too complex to use in its current format and assumes a level of financial awareness that many people might not have. Some viewing it for the first time found it hard to understand.

Terry Huddart, senior marketing consultant at Aegon Scottish Equitable Employee Benefits, says: “To access the tool the user completes seven fields of personal/workplace information and, as far as I can tell, they have to complete this each time they use the tool as opposed to there being any password for future use. The user then downloads a file which is an Excel spreadsheet with 19 worksheets. From that stage the user experience became unclear to me.

“As this is called a tool, a user would expect a web-based application that was signposted and took them through various questions about absenteeism and ill health at work. My own view is that it would take a reasonable amount of time for somebody to be trained to use this in its current format. It is more of a database, and the user would need to have a certain degree of expertise in Excel.”

There is also a broad consensus on the point that – for absenteeism purposes – companies are only likely to find the tool as good as the quality of the absenteeism data that they have available to feed into it. Those who don’t have data on absenteeism can use ballpark industry figures that are made available for making assumptions, but this introduces a high degree of uncertainty into the results.

Dr. Doug Wright, head of clinical governance at Norwich Union Healthcare, says “There is a question as to whether companies will have the detailed data necessary to use the Business HealthCheck. Many organisations don’t record absence data sufficiently or accurately and using national data instead is not much use.”

Indeed, those companies who do have the necessary absence recording systems to make a worthwhile input of data will probably also have linked consultancy services that cover the same ground as The Business HealthCheck. Therefore, even though the tool is free, it may not actually benefit them.

Case study – National Grid pilot

Health standards manager, National Grid “One of the challenges is to get companies to report consistently across the industry on health and wellbeing in their annual reports”

Having been amongst the sponsors of the initial development of the Business HealthCheck, National Grid is now beginning to pilot the tool within its own organisation. Andy Buxton, health standards manager at National Grid, says “We are hoping to use it to more adequately define what we put into our annual report on absenteeism and health, and we expect to use it to measure the success of our wellbeing campaign we are delivering over the next few years. It will give us the basis to monitor improvements in financial terms.” Buxton particularly values its focus on providing a sound basis for a business case to invest in health and wellbeing, particularly its ability to monitor some of the more quantitative elements of a wellness programme. He would therefore expect it to support investment in programmes that will lead to improvement in attendance at work but, at the same time, he acknowledges that it is not foolproof and that it could take a while to reach its optimum. He continues “One of the challenges is to get companies to report consistently across the industry on health and wellbeing in their annual reports but individual companies can tailor some of the assumptions in the tool to suit their own needs, so there may be some discussions to produce an industry framework for how it needs to be used for comparison purposes.”

Business healthcheck – who we asked to roadcheck the new tool

Involved in the pilot

Andy Buxton, health standards manager at National Grid• Paul Lynes, head of group public affairs at Standard Life• Dr. John Marsden, head of occupational health at Boots UK• Jill Pollock, wellbeing manager at Bupa.

Not involved in the pilot

Iain Laws, account director at national specialist intermediary Enrich Reward • Dr. Doug Wright, head of clinical governance at Norwich Union Healthcare• Terry Huddart, senior marketing consultant at Aegon Scottish Equitable Employee Benefits• Linda Baker, product and mktg development director, group protection, at Legal & Generaln Positives• Supports the broad message the industry has been pushing for years• Government deserves congratulation for seeking to address a real need• Addresses presenteeism as well as absenteeism

Needing clarification• Unclear how it measures positive criteria like productivity and impact on customer service• Tends to lump a lot of insurance products into the system and is questionable in treatment of group death in service and employer’s liability• Does not breakdown absence by cause (such as stress, musculoskeletal)• Doesn’t really consider the important matter of employee engagement because it is far more of a quantitative than qualitative tool• Only measures one investment at a time and may not be a reliable link to the risk that has been impacted by the investment