The NHS should take the lead in preventing long-term conditions in the workplace, write Simon Leary and Caitlin Francis

The proportion of healthcare spend devoted to public health prevention activity is tiny, at 3 per cent, although the cost of treating and caring for people with long-term conditions consumes about 78 per cent of all healthcare expenditure in the UK.

Employers, according to a recent report by PricewaterhouseCoopers, can play a vital role in helping to prevent long-term conditions among their employees and in the wider community. The report for the World Economic Forum, Working Towards Wellness: accelerating the prevention of chronic disease, found that employers have a lot to lose if they ignore the impact of long-term conditions on their employees and much to gain from addressing it. As the largest employer in the UK the implications for the NHS are clear.

People spend more time at work than in anywhere else, so the workplace is an obvious setting for activities aiming to prevent long-term conditions, particularly as the sedentary and stressful nature of many occupations means that work is frequently a contributing factor.

Preventing long-term conditions in the workplace needs a proactive strategy, with the focus on leadership, culture, people and process. The following steps are integral to success:

Take the pulse

By assessing your employees' health you can provide a baseline from which to measure progress. That will help you understand how to design the scope, content and approach of your wellness strategy.

It is important to embed a culture of health by adopting the principles of healthy living in your organisation. A healthy and supportive working environment will help the NHS to become a true 'health' system rather than one that primarily treats illness.

Managing and measuring change means committing the appropriate resources to improve the health of your working population - long-term benefits will outweigh short-term costs. PCTs could, for example, include wellness performance metrics (such as staff turnover and absenteeism) in provider contracts.

You will enhance the effectiveness of your wellness strategy by supporting health programmes in the wider community - with local authorities, large local employers and the voluntary sector. Commissioners and employers both bear the costs of long-term conditions and can help tackle unhealthy lifestyles.

Senior figures in an organisation can lead by example by demonstrating their personal commitment to a healthy work environment through active and visible participation in wellness activities and by engaging with employees and local communities on health initiatives. Strong leadership was identified as the key success factor when implementing wellness initiatives by those surveyed for the Working Towards Wellness report.

Tackling staff turnover

The NHS is not protected from the effects of unhealthy employees. Significant sums are lost each year through absence, disability and chronic illness, including work-related stress. Sickness absence costs an average trust£5.4m a year, so implementing workplace wellness initiatives could provide a powerful tool. For example, mental resilience programmes to help employees manage workplace stress have been used to good effect by private sector employers, such as the IT and pharmaceutical industries.

Good staff retention improves continuity of care, patient safety and productivity, with each 1 per cent reduction in staff turnover in the NHS saving 1 per cent on the wages bill in cash and efficiency saving. While there are many reasons for high staff turnover, the report found that work-life balance initiatives and healthy lifestyle perks were important tools for organisations to help retain staff and attract talent.

Promoting a healthier workplace can help to improve the public perception of the NHS. At the same time, it may encourage staff to be better ambassadors, which is crucial for long-term sustainability.

By taking the initiative on workplace wellness, PCTs and trusts have a great opportunity to make a difference to the long-term health of staff - including the traditionally hard to reach populations, such as blue-collar men - while at the same time see measurable improvements in the effectiveness of their workforce and their overall financial performance. -

Simon Leary is a partner and Caitlin Francis a senior consultant in PricewaterhouseCoopers' health industries practice.

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