Railway Health and Wellbeing Roadmap The High Level View

Version 1 February 2014

‘GB railway is an industry where everyone takes responsibility for HEALTH and WELLBEING and benefits from it’The roadmap identifies a collaborative intention for better employee health and wellbeing within the railway industry.

A roadmap has been developed through a detailed industry conversation as to how health and wellbeing can be improved

This document represents ‘The High Level View’ of the roadmap. If you would like a more comprehensive understanding of the roadmap and the process used to develop it then please refer to ‘The In-depth View’.

The roadmap can be seen in two layers:

• A graphical interpretation of the main information for general discussion • Detailed plans that elaborate on the 5 key strategic themes of the roadmap

The roadmap was developed in collaboration with a number railway professionals and health and wellbeing experts who are thanked for their input. The companies represented at the workshops were:

Endorsements – ORR, RSSB Board, RDG???

Abellio Greater Anglia

Alstom (UK)

Arthur D. Little UK

Arriva Trains Wales

ASLEF

Atkins

ATOC

Balfour Beatty Rail Ltd

Bam Nuttall

Bombardier

Capita

Carillion Plc

Chiltern Railways

Costain Rail

Cross Country

Department of Health

Department for Transport

East Coast

East Midland Trains

Ergonomics Design Safety Consultancy Training Research

Eversholt Rail

First Great Western

First Group

Freightliner

First Trans Pennine Express

GB Rail Freight

Health & Safety Executive

Health Management Ltd

Health@Work

Heathrow Express

Hesketh Work & Health Ltd

IPA

London Travel Watch

Passenger Focus

Marum Healthcare Ltd

Mersey Rail

Network Rail

Northern Rail

ORR

PACTS

RSSB

RMT

Southeastern

Southern

South West Trains

Transport for London

TSSA

Unipart Rail

UNITE

Work and Well-Being Ltd

The timing is right for a more collaborative way of working to improve railway employee health and wellbeing

Through a variety of cross-industry and sector initiatives many industry professionals with an involvement in managing health have shown an openness and desire to come together to improve the health and wellbeing of railway employees. They also recognise that this work should increase employee productivity and reduce the cost of health impairment within the industry.

This willingness to act comes at a time when health is of increased focus for rail companies because:• The regulator has formally drawn attention to regulatory failings within organisational management.• The railway value for money study recognised the high industry cost in this area.• Franchising and the Network Rail Final Determination now include health and wellbeing requirements.

The Government itself has recognised that employee health and wellbeing will affect the continuing competitiveness of UK industry because: • An ageing workforce and changes in its composition will increase costs of employee management.• Rising costs of chronic disease and ill-health shall alter current arrangements for health management.• Low engagement rates of UK employees within their workplaces creates a productivity deficit.

Through collaboration GB rail companies can collectively gain control of some important health and wellbeing figures

1. Most importantly, HLOS figures put the number of people working on behalf of GB railway at approximately 120,000 people. The collaborative vision for the roadmap is: ‘GB railway is an industry where everyone takes responsibility for health and wellbeing and benefits from it’. If the key figures below can be controlled and at the same time the vision be met then the lives of many railway people can be positively affected.

2. The estimated cost to the rail industry of direct and indirect sickness absence is thought to be £316m per annum. We wish to understand this figure more fully and to improve it for industry stakeholders.

3. The estimated costs of presenteeism is thought to be £474m per annum. This figure would be a significant cost to industry in addition to sickness absence. We wish to fully understand the usefulness of this figure, as it is open to question, and if appropriate how to manipulate it to create improvements for industry.

4. Total spend on Occupational Health (OH) and wellness programmes is evaluated to average out at £201 per person per annum. As with the other figures there may be a wide range between industry organisations for this figure but we are aware that the majority of the spending is on reactive activities. With better understanding we wish to know how well the money is spent and where possible create initiatives to spend it better.

5. Lost Time Rate (LTR) across the rail sector is approximately 3.9%. This figure varies markedly amongst different types of role within an organisation. We wish to improve the reliability of this figure and given a better understanding of absence and presenteeism understand by how much it could be improved.

6. An LTR reduction of just 0.4% would deliver savings in sickness absence costs alone of £32m per annum.

Collaborative action can be facilitated by the railway health and wellbeing roadmap

Following agreement from the RSSB board and the arrangement of industry oversight, the following will be delivered through the roadmap:

• A Health and Wellbeing policy group with senior cross-industry representation will be set up to oversee and promote the work recognised within the roadmap.

• RSSB will take on day to day support of the roadmap and associated groups.

• Project tasks will be picked up by the RSSB Health and Wellbeing project and through the R&D health research topic.

• Other railway sector groups and rail companies will take on tasks as appropriate to assist their membership and organisational strategies

• Trade unions and representatives of railway people will be fully involved.

• Industry professionals will be asked supply experience and knowledge through involvement in steering groups, conferences and identification of good practices.

• Key priority tasks have been identified and have a budget for development.

• The business case for health and wellbeing activities will be continuously maintained, developed and reviewed to guide project development and ensure industry commitment.

What can railway companies do to become involved?

The roadmap will involve a collaborative effort between a number of companies with a mix of effort and reward. Rail companies and their leaders can become involved by:

1. Acting as a champion for health and wellbeing whilst operating and improving their business in a way that minimises the negative impacts and maximises the ben-efits of working in the railway environment.

2. Setting up health and wellbeing programmes and policy where required; looking to meet basic legal requirements, to be an employer of choice and where practical to align to roadmap initiatives to increase impact and reduce cost.

3. Recognising the cross-industry Health and Wellbeing Policy Group and providing support and cooperation as needed.

4. Seeking to drive improvement in the management of health as well as safety risks within the company and across the industry.

5. Supporting RSSB’s involvement in facilitating actions from the roadmap.

6. Allowing company staff to participate on steering groups, seminars, R&D projects and conferences.

7. Being willing to share good company practices and improve the reliability of health data internally and across the industry.

Industry LeadershipRail leaders promote that rail is a good place to work and invest

Clinical KnowledgeWe understand how to keep more people in work

Reporting and MonitoringIndustry can demonstrate control over health

Employee EngagementEmployees believe the industry is a place where they can thrive

Behavioural ChangeAlongside societal aims we contribute to the healthier lives of people

Set up policy group

Engage board level champions

Develop a cross industry health and wellbeing charter

Inf uence Policy

Ongoing communication and engagement agenda

Review and agree a set of voluntary medical stds

Risk based guidance for rail organisations

Shift focus from reactive to proactive health management

Increase provision of health training via supply of/links to training materials

Cross industry health data system specif cation

Short term data solution

Set up industry system

Analysis and Intelligence

Act on Findings

Stimulate and reduce costs of health market

Develop wellbeing strategy

Promote employees role in personal health and wellbeing management

Undertake initiatives to support health in the supply chain

Rehabilitation strategy and business case

Evaluate effects of absenteeism and presenteesim within rail system

Increase employee say in health management

Use specialists to review health in common rail environmentsResearch better job design (incl. stress)

Support employee engagement

Railway Health and Wellbeing Roadmap

Strategic Theme 2014/2015 2016/2017

CP52018

CP6Our

VisionGB railway is an industry

where everyone takes responsibility for Health

and Wellbeing and benefits from it

• Acollaborativeapproach• Sharebestpractice• Keepitsimple

• Evidencebaseddecisionmaking• Onesizedoesnotfitall• Costeffective

Principles of Working

Ownership - Through stakeholder ownership and input the roadmap should continually evolve toward industry needs.

Industry Leadership Roadmap Detail

Industry Leadership

CP5 CP6 KeyBold and underlined words are top prioritiesCBA – Cost Benefit AnalysisCP – Control Period NSARE – National Skills Academy for Railway Engineering

2014/2015 2016/17 2018

To create health change within the rail industry those operating at the highest levels of the railway system hierarchy need to: • Showleadershipdirectiontowardasharedvisionforhealthmanagement• Raisetheprofileandpriorityplacedonhealthandwellbeingmanagement• Engagewiththosethatcancreatechangewithinindustry

Important links

Set up policy group

• Establish a Health policy group with governance

• Policygrouphasremittodrivecollaborative industry action

A policy group is needed to carry out tasks in this section and provide oversight to all other sections

Engage board level champions

• Identifyandengageindustryboardlevel champions &develop an executive health and wellbeing information pack

• Develop CBA for health and wellbeing

• Supportorganisationaluseofproactivehealth policies and strategies

Board level champions facilitate speed and quality of actionsCBA justifies ongoing work

Develop a cross industry health and wellbeing charter

• Develop a voluntary organisational health and wellbeing charter / standards and consult with industry

• Provideoversightforimplementation&monitoring

• Promotecrossindustrycollaborationand support for organisational policies and programmes

Voluntary charter/ standards create a common level of working & drive other tasks identified therein

Ongoing communication and engagement agenda

• Hold health and wellbeing conference

• Workalongsideorganisationalhealthand wellbeing programmes (NR, TOCs, ORR, RSSB …Others)

• Helptofosterhealthlinkstootherindustries

• Re-evaluatehealthandwellbeingroadmap for next CP

The conference facilitates and promotes actionWorking alongside other programmes targets action

Influence policy

• Supportindustryresponsetofranchising

• AssistRTSwholesystemapproachtothe rail way by influencing the people section. Incl assisting NSARE

• Influencenextcontrolperiodplanning

• NROHprogramme‘Everyonefitforthefuture’ CP6

• ORRHealthProgrammeCP6

Contractual requirements and programmes drive future activities

Success measures and indicators• Surveyofemployer’sattitudestowardshealthandwellbeingatwork• Increasesinperceptionofrailindustryasagoodplacetowork–getindependentreviewfrombusinesscommunity• Positivemovementinthecostofimpairedhealthwithintherailindustry–industrysurvey• Evidenceofhealthandwellbeingprovisionwithinrailindustrystrategies

Outcome

Rail leaders promote that rail is a good place to work and invest

Clinical Knowledge

CP5 CP6 KeyBold and underlined words are top prioritiesOH – Occupational HealthNICE – National Institute for Health & Care ExcellenceCBA – Cost Benefit Analysis

2014/2015 2016/17 2018

To adequately understand how the health industry relates to and integrates with the railway industry there is a need for senior clinical leadership within rail. This clinical leadership should advise and provide direction for the clinical development of industry’s health capabilities but also be aware of the role of the organisation in the management of health. Clinical leadership can inform industry-wide as well as individual practice enhancing all aspects of health and wellbeing management.

Important links

Review and agree set of voluntary medical standards

• A clinical leadership sub group is developed from the Health and Wellbeing Leadership group

• Strategyforclinicaleffectivenessconsidered

• Researchapproachestomedicalstandards

• Develop a set of voluntary medical standards for effects of health on work and seek adoption within industry

A Clinical Leadership group is needed to lead other tasks within this section and inform other groupsVoluntary medical standards informs employee conditions and cost effectiveness

Risk based guidance for rail organisations

• Bestpracticereviewwithinandoutsideof industry

• Develop voluntary guidance/ standards based upon effects of work on health

• Promoteeffectsofworkonhealthstds/guidance and inform rail organisations

Voluntary standards based on effects of work on health informs risk activities and behavioural changes

Develop a wellbeing strategy

• Plansdevelopedforobesitymanagement and the ageing workforce

• Develop indicators for individual health risks

• AccessforalltoqualityOHservices

• Researchcognitivedeclinewithintheworkforce

Health risk indicators informs activities that drive individual behavioural changes

Stimulate and reduce costs in the health market

• Railwayknowledgeforpractitioners

• Identifykeyrequirementsforsuccessfully engaging a third party health provider

• OHGuidanceforknowledgeablecustomer

• Reviewintroductionofamoreuniformand/ or less complex range of medical standards which would cover the whole railway industry

• Openinguptheaccreditationscheme

• Provisionofclinicsfacilitiesavailableto rent in railway centres by landlords such as Network Rail, as occurs with other railway related services

Uniform medical standards across mainline, underground and heritage increase the effectiveness of providers working in each sector

Rehabilitation strategy and business case

• RecogniseNICEguidanceandCBA’sforrehabilitation within rail

• Looktostimulatemarketwithrelevant health professionals eg Physiotherapists

• Increaseuseofnewhealthtechnologies / tools in rail where there is a case to do so

Rehabilitation specialists cut costs of health issues and reduces absence issues

Success measures and indicators• No.ofincidentswhereOHclinicalleadershipleadstobetterindustrymanagement–costsavingsidentified• IncreasedsupportforOHeg.voluntaryhealthstandards,noofproviders,noofprofessionals–No.ofOHProvisions• Measuresinplaceforthechangingdemographicsoftheworkforce

Outcome

We understand how to keepmore people in work

Clinical Knowledge Roadmap Detail

Reporting and

Monitoring

CP5 CP6 KeyBold and underlined words are top prioritiesCBA – Cost Benefit Analysis2014/2015 2016/17 2018

Health data collection is needed in order to create cases and make reasoned decisions to drive change within the industry. Data collection needs to be coordinated in order to compare information from many different sources. Whether for use in the clinical or managerial setting the desired outputs from any data collected should be understood during the planning stage for collection. Important links

Short term data solution

• IndustryagreementtobulkuploadintoSMIS

• Railcompany’sbulkuploadofkey(top5/10) health risks (yearly)

• RSSB begin analysis of key health risks

Short term data collection speeds the capability to analyse data

Cross industry system specification

• Developrequirementsfrominformationcollected by Initial investigatory work

• Developarolesandresponsibilitymatrix

Good system specification enables better development of the system

Set up industry system

• Developmentofadatasystem

• Developmentofhealthdatacausalclassification and data collection

• Railcompaniessetupinternalsystemto link to cross industry data

The system and its arrangements enable the delivery of good data based information

Analysis and intelligence

• Developmentofsuitableproactivemetrics and benchmarking facilities

• Models are developed to analyse health data

• Analyse if employees are healthier for longer

• IndustryseekspossibleusesofHealthand wellbeing monitoring technology

Analysis of data helps develop better CBAs and improves decision making for development of health risk controls

Act on findings

• Shiftfundingfromreactiontoprevention

• Publishinghealthdata

• ImproveddatausedforbetterCBAs

• Increasedspecialistresourcesinindustry if justified by data

• Industrycandemonstratecontroloverhealth

CBAs improve decision making for further resource investment

Success measures and indicators• Acrossindustrydatacollectionsystemisestablishedwithinindustry• Increasedlevelofunderstandingofindustryhealthriskmanagement–Reasonsforabsence/work-relatedillhealth/RIDDOR/individualhealthriskindicators• No.ofrailwayorganisationspubliclypublishinghealthdata(e.g.toshareholders)

Outcome

Industry can demonstrate control over health

Reporting And Monitoring Roadmap Detail

Employee Engagement

CP5 CP6 KeyBold and underlined words are top priorities

2014/2015 2016/17 2018

Employee engagement is thought to be generally low within the UK and a potential barrier to growth in the economy. A motivated an employee is willing to give their best to their job. It shows how well motivated, energisedandinspiredtheyareto‘gotheextramile’.Throughactiveengagementindustryproductivitycanbeenhancedtoimprovesuccessfuloutcomesforall.“Thisisabouthowwecreatetheconditionsinwhichemployeesoffermoreoftheircapabilityandpotential.”–DavidMacleod–authorofUKGovernment’s‘EngageForSuccess’report.

Important links

Evaluate effects of absenteeism and presenteesim on rail

• Seektounderstandthecausesofabsenteeism

• Seektounderstandthecausesofpresenteeism

• Seek to manage the causes of absenteeism

• Seek to manage the causes of presenteeism

• Seektoincreaselengthofservicelevels and reduce/maintain death in service figures

Understanding the causes of absenteeism and presenteeism can support the engagement of employees

Increase employee say in health management

• Unions/SafetyRepsandOrganisationsform a sub group with employees to increase employee say in health

• Work/lifebalanceissuesarereviewed • Worktoimprovehealthsurveillanceresponse from employees

• Asurveyshowsemployeesrecognisework is good for health

Employee engagement can be a significant enabler to other projects

Use specialists to review common rail environments

• Employ Hygienists, ergonomists & other specialists to review common rail environments for health hazards

• Promotestressmanagementwithintheworkplace

• Wherepossibleseektoimprovefacilities used by railway employees

Professional understanding of common risks can be spread widely and used for data matrix

Research better job design (incl. Stress)

• Developknowledgearoundjobdesign

• Improvejobrolessotheydonotadversely affect health

• Developunderstandingoffatigue/shiftpatterns

• Reviewroleofrestandrecoveryinhealth management

• Measureemployee‘burnout’

and fatigue related safety issues

Better job design in key to a healthier and more productive work environment

Support employee engagement initiatives

• AgreeindustrystrategyforEngagement

• IncreasesophisticationofEngagementsurveys

• Linktoworkofengageforsuccess

• Linkengagementandhealthandwellbeing

• Reviewemployeeresilienceactivities

• Increasestoproductivityrelatedtoengagement scores

Linking health and wellbeing to engagement activities makes them sustainable

Success measures and indicators• Numberofpeoplelosingworkduetoillhealth/noofpeopleinrehabilitationschemes/rolesprovidedforthosewithmentalhealthissues.• Employeeengagementscoresimprove–organisationalanecdote• Increasesinproductivity–organisationalanecdote

Outcome

Employees believe the industry is a place where they can thrive

Employee Engagement Roadmap Detail

Behavioural Change

CP5 CP6 KeyBold and underlined words are top prioritiesRTS – Rail Technical Strategy2014/2015 2016/17 2018

Health data collection is needed in order to create cases and make reasoned decisions to drive change within the industry. Data collection needs to be coordinated in order to compare information from many different sources. Whether for use in the clinical or managerial setting the desired outputs from any data collected should be understood during the planning stage for collection. Important links

Increase provision of health training via supply of/links to training materials

• Defineandrecogniselinemanagerrolein health.

• Industry educational and competence requirements are mapped

• Developacompetenceframework

• Developorrecommendtrainingmaterials

• Promote widespread health training

Cross industry agreement on the educational and competence requirements will allow for a collaborative approach to improvement

Shift focus from reactive to proactive health management

• Promoteuseofproactivehealthmanagement policies

• Improved management of individual health hazards through focus groups

• Tools developed to improve understanding of risk assessment and surveillance

• Promoteuseofindividualhealthriskindicators

• JustifyincreaseduseofoccupationalHealth and Wellbeing expertise

for effects of work on health issues

Tools for health risk assessment and surveillance can make it easier to achieve to meet legal requirements in this area

Promote employees role in personal health & wellbeing management

• Promotionofhealthactivitiestoemployees

• Individualkeyhealthriskindicatorsareused by employees

• Employeesdevelopwork/lifeplans • Nudgingactivitiesinkeyareasaredeveloped

Work relies on health risks indicators being developedHealthier workers should carry fewer health risks

Undertake initiatives to support health in the supply chain

• Undertakeworktounderstandthecontext of health up and down the Supply Chain and consider improvement incentives

• Reviewmanagementofhealthintoequipment that enters into the rail system

• Influencedesignoftechnologyandroles with people in mind

• Understand&influencetherailwaysupply chain system

• Guidancedevelopedrecognising:Transient employees, health conditions and risks passed on to those lower down the supply chain.

• Innovationofnewequipmentthatcanimprove health

Getting the supply chain right can prevent difficult health issues entering the railway system

Success measures and indicators• No.ofhealthcoursesandtrainedemployeeswithintheindustry• Surveyuseofhealthsurveillanceschemeswithinindustry• Surveyprovisionandcontextofhealthandwellbeinginitiatives(whatisavailable,reactive/proactive,activeorpassiveroleoforg(e.g.contractout)–create

specific category for the supply chain including RTS impact

Outcome

Alongside societal aims we contribute to the healthier lives of people

Behavioural Change Roadmap Detail

These definitions were used to help guide the workshop attendees on the interpretations used for this work.

Occupational Health Contemporary thinking and the ORR recognise that health has three fundamental elements.

• The effect of work on health (eg airborne contaminants, asbestos, musculoskeletal disorders, mental health)

• Fitness for work (eg safety critical tasks, drugs and alcohol testing, health assessments)

• General wellbeing (eg obesity, smoking, sickness absence management, rehabilitation)

Industry consensus, including the Industry Safety Meeting (ISM), now supports rail employers actively embracing these three elements.

Wellbeing The three components of employee wellbeing, taken from Wellbeing, Productivity and Happiness at Work (Ivan Robertson and Cary Cooper, 2011), are said to be:

1. Psychological wellbeing – for example, the ability to handle the stresses of everyday life and maintain a positive attitude and sense of purpose

2. Physical wellbeing – for example, the amount of exercise, sleeping habits, alcohol

3. Social wellbeing – for example, a positive and supportive social network

Engagement Employeeengagementisameasureofhowmotivatedanemployeeistogivetheirbesttotheirjob.Itshowshowwellmotivated,energisedandinspiredtheyareto‘gothe extra mile’.

Engagement is uniformly measured via staff surveys and typically asks questions about pride in their company, would they recommend as a great place to work, belief in company vision and goals, a willingness to go beyond their job requirements and whether they are considering leaving at the present time.

Companies with high levels of employee engagement experience greater profitability, reduced absence and greater levels of employee wellbeing, amongst many other benefits.

See http://www.engageforsuccess.org/ for more information.

Employee engagement should not be confused with how we communicate and interact with our people.

Presenteeism The term presenteeism is often interpreted in different ways. Robertson and Cooper (2011) suggest three attributes to the term:

1. Attending work when unwell

2. Puttinginlonghoursbutnotworkingallofthetime(oftenknownas‘facetime’)

3. Working at a reduced level because of distractions (for example, going online)

The workshops identified an additional attribute:

People who have a health risk factor that inhibits their ability to do their job (for example, obesity and manual work).

Appendix: Definitions used to guide the development of the roadmap

The purpose of the roadmap is to encourage collaborative action in order to achieve a common vision for health and wellbeing improvement within the GB railway industry.

The roadmap should be updated regularly in order to make it increasingly relevant to the common goals of those working with it.

It is important that those with ideas for change and adaptation of the roadmap feedback comments so that they can be considered at the next update.

Please provide comments about the railway health and wellbeing roadmap to: whwp@rssb.co.uk