Time to re-think ‘workplace health’

Something has really been bothering me recently about ‘workplace health’ initiatives.

We seem to have got into a real mess about the PURPOSE of this type of focus.

The employer perspective is of the importance of PRODUCTIVITY and the WASTAGE caused by people being ill or off work.    As a result the initiative’s success is measured in terms of sickness absence, rather than in terms of employee wellbeing as a positive condition.  The questions shifts from – what can we do to enable people’s wellbeing? (the salutogenic perspective) to – what can we do to stop people being off-sick? (the pathogenic perspective).  Back to the use and abuse of measurement issue – what we get is a punitive system that performance manages levels of sick leave and game playing starts – people take annual leave or use flexi time, rather than reporting a sick day.  Or presenteeism – people coming to work and pretending to work even when they are not fit to be there, perhaps passing on infections to colleagues in the process. Recorded sick leave goes down, employers herald this a success, but the wellbeing of the workforce has not improved.  Public health professionals are complicit in this, they make the case for workplace health initiatives in terms of the cost of days work lost.

The other thing that bugs me is that workplace health initiatives purely see the workplace as a site of health promotion or traditional public health ‘lifestyle’ interventions.  We use the workplace to tell people about the importance of eating 5-a-day but then don’t give any thought to whether or not they can get affordable healthy food during their working day.  We use the workplace to train people in emotional resilience – telling them they have to be resilient to stress – this means that if they go off with stress it becomes the employees fault for not being resilient enough (nothing to do with workplace stressors at all!).  So in essence we are telling people to be healthy and happy (and therefore productive and not waste employer’s resources) but give very little thought to the physical, social and economic conditions in which they are doing their work.

The bottom line is – we need to re-think workplace health. Continue reading

The use and abuse of measurement

There seems to be a bit of a thing going on this week about terms like measurement, targets, payment by results, outcomes.  It has been going on a while in conversations I have had (both face to face and on-line) and a number of systems bloggers are writing about it but it all seems to be getting a bit busier this weekend…it seems to be coming to a head.

So to start with I’ll mention all the activity that has prompted me to turn to the keyboard to add to the conversation – or if not adding to it then at least summarising where my own thinking is going to. Continue reading


Way, way back I wrote a post on Systems perspective on health and wellbeing where I touched on the problems associated with performance frameworks derived from the concept of ‘outcomes’.  Although the post was ages ago, it’s still something that is current in my mind – not least because my friend who I mentioned in that post is currently writing a paper about this very issue.  I read through an early draft and am looking forward to his next version.

My exploration into projects, which started with this post, has just brought me into touch with some interesting material – you know, when someone else explains really well what you have been thinking but have been unable to articulate. Continue reading

The social technology of (performance) measurement

The other day I was in a relatively informal meeting with 4 others when I found myself in a rant about ‘measuring’ – outcome indicators; performance measures; targets – whatever you want to call them, in essence they are all attempting to describing something in numerical terms.

The trigger for my rant was someone saying the recent corporate line – that we needed to agree on a small number of measures that would be used as Outcome Indicators (means of quantifying the achievement of an outcome) for our ‘priority’ outcomes – in fact we are to agree on precisely 3 measures for each priority outcome.

My rant started with the words “But why” and my argument fell into two broad areas. Continue reading

A Systems perspective on health and wellbeing

The other evening, I went out with a colleague and friend of mine – T. Well I say colleague, we used to work for the same organisation – now we work for different organisations but within the same partnership arena.  When we worked together, we routinely had a friday night drink during which we discussed society, organisations, management and so on – at the time he had just finished a social policy PhD and I was embarking on my MBA.

It’s been a while since we have seen each other outside formal meetings.  In our conversation the other evening, we started talking about complexity.  T has an emerging interest in the complexity of individual’s lives and the tension created when organisation’s have to be accountable for the ‘outcomes’ they achieve through their interventions.  Entire voluntary sector funding regimes are founded on organisations making claims for the outcomes they can create.

Contemporary public health research has an underpinning systems perspective.  The most reproduced model is that by Dahlgren and Whitehead which shows a series of influences on the health and wellbeing of an individual.  In Newcastle upon Tyne, I have been involved in work to raise awareness of this ‘holistic perspective’, most notably with our Mythbuster brochure.

What my discussion with T made me realise, is that to date, I have not seen health theory expressed using the language of Systems (the academic/intellectual discipline).  So here is my first iteration…

Continue reading