Dr Jonathan O’Keeffe, Regional Medical Director at International SOS, assesses corporate health-risk profiling and how to get it right for long-term survival.
Unattended health risks can threaten the profitability and indeed the existence of a company over time. Risk managers may be tasked with evaluating hazards as diverse as global infectious disease outbreaks such as pandemic influenza and the impact of sickness absence due to chronic illness.
The challenge is compounded by regional and country specific differences in health regulation; for example, organisations working outside their home country may not be aware of local regulations for notifiable illnesses.
To sustain and help grow operations an organisation must prioritise worker wellbeing. Studies show a very clear relationship between worker health and productivity. Unnecessarily high absenteeism rates due to illness or injury are the equivalent of a chronic low level haemorrhage in a patient. Precious resources are consumed and lead to signs of systemic strain elsewhere.
Dame Carol Black and David Frost CBE’s UK report in 2011, Health at Work – an Independent Review of Sickness Absence, put the cost to employers, who pay sick pay and associated expense at £9bn a year. One US-based study titled The Assessment of Chronic Health Conditions on Work Performance, Absence, and Total Economic Impact for Employers, (Journal of Occupational & Environmental Medicine June 2005) estimated the total cost of chronic ill-health at 10.7% of the total labour costs for the company under research. To attract, retain and develop good people, an organisation should ensure it has all the aspects of corporate health in place, from a policy set out at leadership level to the sound standards and procedures that support this.
This requires a good understanding of the component elements of corporate health and how they interrelate. Best practice examples exist in each area and there is a path for companies to move towards a system for continuous health improvement. Companies should start by completing a ‘health risk profile’, an exercise to see where the main risks lie, flagging areas for targeted attention.
Corporate health is multi-faceted. It may be described under nine main priority headings:
• Occupational Health
• Travellers and Expatriate Health
• Site Specific Medical Care
• Health Incident Planning
• Medical Data Management
• Health Policy, Standards and Procedures
• Health Promotion & Wellness
• Community Health
To properly capture health risk, companies should start with a baseline assessment of their policies, standards, procedures and existing resources in each of the nine areas. This ‘health risk profile’ can then be tested against a list of common or serious adverse outcomes. The nine areas should be fully integrated wherever possible. Aspects that operate independently or regional variations in implementation introduce Babylonian type problems where each component speaks its own vernacular, leading to confusion and ultimately worker harm. Standardisation and integration on the other hand reduces complexity. It permits us to analyse health data, conduct trending and engage in a cycle of continuous improvement. Regional, country and unit level performance can be compared and ambiguity over where attention should be focussed evaporates.
A proper risk assessment process is the foundation of all good health and safety systems. First identify the health hazards in each area. Then, estimate the risk (combination of frequency and severity of impact) for each hazard. Put in place controls that are practical and evidence-based to reduce the risk to a level as low as reasonably practicable. Monitor the effect of these controls to understand the success or failure of your interventions. Risk managers should recruit internal and external expertise to help complete the picture in each area. The HR, travel risk, procurement, security, business continuity and occupational health and safety professional each holds information pertinent to the company health profile. Combining their experience and knowledge will allow the organisation to maximise the return from investing in worker health. It is the equivalent of stemming the haemorrhage – supporting the patient’s blood pressure with the right medicine will result in survival in the longer-term.