The urgency of health and wellbeing at work action and reflections on the Mayfield Review

In this edition of the Evolve podcast, Prof Sara Connolly of the University of Leicester speaks with Dr Chris van Stolk, Executive Vice President at RAND Europe, part of the original Evolve team. Chris was recently on the advisory group to the Keep Britain Working (Mayfield) review due to his longstanding experience on research and action to improve health and wellbeing at work. In this podcast he comments on the urgent need to make progress on maintaining and getting people into employment and highlights the importance of helping young people avoid long-term exclusion from the labour market. 

Transcript

00:00:00:00 - 00:00:29:04

Helen Fitzhugh

Welcome to the Evolve Workplace Wellbeing podcast. This podcast is part of a toolkit of free, evidence informed workplace wellbeing resources provided by the Workplace Wellbeing Research team at the University of East Anglia in the UK. You can find the resources on www.evolveworkplacewellbeing.org

00:00:29:06 - 00:01:12:10

Sara Connolly

Hello and welcome to the Evolve Workplace Wellbeing podcast. My name is Sara Connolly. I'm based at the University of Leicester. In today's podcast I'm speaking with Doctor Chris van Stolk. Chris is executive vice president at Rand Europe and also part of the Evolve family. Chris has worked extensively on health and wellbeing in the workplace. His work has focused on improving the health and wellbeing of staff at the NHS in the UK, on maintaining and gaining employment for those with common mental health conditions, building an evidence base for health interventions in workplace settings and looking at the relationship between productivity and health and wellbeing outcomes.

00:01:12:12 - 00:01:13:12

Sara Connolly

Welcome, Chris.

00:01:13:14 - 00:01:18:06

Chris van Stolk

Well welcome Sara. It feels like a bit of a homecoming, almost.

00:01:18:08 - 00:01:30:23

Sara Connolly

Indeed, indeed. So, Chris, just to start things off, I wondered if you could tell us a little bit about your career journey and what has led you to be interested in workplace wellbeing?

00:01:31:00 - 00:01:52:12

Chris van Stolk

Well, I think it's like many people who work in this space. It was a bit of circuitous in a way that I was at the LSC, my main research interest was really public administration and trying to understand how the civil service could be more effective. And so that leads you into topics such as motivation and what motivates civil servants, incentives, all of these different things.

00:01:52:14 - 00:02:11:14

Chris van Stolk

And eventually it also led me to health and wellbeing. So what if health is a key driver of performance and productivity? So I was quite lucky then to go to Rand's, a research organization in Cambridge, and they, one of the first commissions I had there, because we are contract research organization, was to support the Boorman review of the NHS.

00:02:11:16 - 00:02:32:02

Chris van Stolk

And this was a review into NHS staff health and wellbeing. And so that felt to me like very adjacent to my research interests at the time. And of course, that took me on a journey and, and, and I stayed involved with the health and wellbeing of NHS staff since that period. So over the last 15 to 20 years, and also, of course, led me to other research projects.

00:02:32:04 - 00:02:57:06

Chris van Stolk

So ultimately, I guess I have to be honest, I never set out, to study health and wellbeing in the workplace. But I went on a journey that took me there. And I guess what I learned from that journey is how key health is to, to human productivity, to wellbeing in the workplace. Of course, this seems like an obvious statement, but believe you me, I think when I started 15 to 20 years ago, this concept was relatively new.

00:02:57:06 - 00:03:07:17

Chris van Stolk

So I've really been, you know, it's been a, you know, intellectually really interesting to work in this space. And we've done some wonderful studies and of course, some wonderful work together, with you as well. Sara.

00:03:07:19 - 00:03:30:24

Sara Connolly

Thanks, Chris. And yes, we, we also work together on the making a business case for investing in health and wellbeing for the NHS staff, which was published by the, IPPO. Yes. I mean, it has been great working together. Chris, I just wondered if you could say a little bit more about, the flavour of some of those projects that you've been involved in.

00:03:31:04 - 00:03:49:06

Chris van Stolk

Yeah. So, so I think there's been a number of research projects, too many to name really Sara. But the two that stand out to me was a review I was asked to do for government, looking at psychological wellbeing in work. And really, the observation there was, is that so many people in the benefits system had, have common mental health issues.

00:03:49:08 - 00:04:07:14

Chris van Stolk

I think the prevalence there is about 60% of people have either, as a primary, or as a secondary condition. And so the government was really keen to figure out what was going on, but also how these people could be supported back into work, but also how people with common mental health issues could be maintained in employment because of course, this comes at a tremendous cost, you know, to the taxpayer.

00:04:07:14 - 00:04:36:19

Chris van Stolk

I mean, this is, you know, quite a substantial part of benefit expenditure. The review, broadly, had a number of recommendations but what we decided to do with those was to try to pilot them, and they led to some of the biggest pilots that DWP has undertaken, and principally also, for those of you who work in this field, it led to sort of thinking about how individual placement and support, which is, of course, an intervention for people with severe mental health issues, whether that intervention could also be used for people with common mental health issues.

00:04:36:21 - 00:04:56:06

Chris van Stolk

And of course, what we found through the windows pilots is that it was rather effective at, at also addressing issues for, for that particular group, especially when we looked at maintaining employment or gaining employment for those individuals. So I guess it led to some extent to the mainstreaming of individual placement support, and subsequently it's been used in other areas as well -

00:04:56:06 - 00:05:19:06

Chris van Stolk

Addiction services and what have yous. Another research project that I've been closely associated with was, Britain's Healthiest Workplace. It was a project we did together with Vitality Health, Financial Times and Mercer, later on AON, and what we really set out to do was survey large employers and their employees to understand really what was going on in those workplaces in terms of the health and wellbeing of staff.

00:05:19:08 - 00:05:40:09

Chris van Stolk

All kinds of interesting findings came out of that. But there was also a feedback loop that we had there, in a sense that we produced reports for employers, how they could improve health and wellbeing in their workplace. We also produced feedback to the employees who were participating, how they could support their health and wellbeing. And first and foremost, of course, it produced wonderful data for us to, interrogate.

00:05:40:11 - 00:05:59:01

Chris van Stolk

I guess one of the findings that stood out for me, from all of that work that took place over about a ten year horizon, is that, year on year, what we saw was, sadly, worsening health and wellbeing in the workplace as we measured it. And I guess particularly an area that stood out for me was worsening mental health.

00:05:59:01 - 00:06:17:01

Chris van Stolk

And maybe we come back to that and of course, how that impacted productivity and the productivity in terms of how we defined it, was sort of that sum of absenteeism, people not being at work, and presenteeism, people while at work, being unwell. So we looked at all of those issues over time, and that was kind of interesting.

00:06:17:01 - 00:06:35:13

Chris van Stolk

It gave us sort of a data set over time. And I guess another thing that stood out for me was the fact that, employees’ perception of what was going on in the workplace was so fundamentally different from the employers’, perception. And I think that took me to issues around awareness about promotion. There was a disconnect, clearly, between those two.

00:06:35:13 - 00:06:46:17

Chris van Stolk

And that cannot be a good thing if you're trying to, you know, produce, results together, I guess, or outcomes together. So that stood out for me. But there's many more, of course, that I could discuss as well.

00:06:46:19 - 00:07:25:18

Sara Connolly

Thank you. I'm glad you mentioned, Britain's Healthiest Workplace, because obviously it has been such an important resource for researchers tracking, both the emergence of different kinds of workplace wellbeing interventions, but also the evidence base, on the ways in which they work. And, you know, to blow our Evolve trumpets a little. That's the data that we use for the business case calculator people can use on the, on the website to, to get indicative, savings and benefits associated with, with those, kinds of interventions.

00:07:25:20 - 00:07:54:10

Sara Connolly

And, and so, Chris, I mean that that's all really very interesting. And that set of experiences is probably why you were invited to be part of the advisory group for the big government commissioned report on, Keep Britain Working, or as known as, the Mayfield Report. I wondered if you could say a little bit about the work of that commission, and then maybe some of the findings from, from the recommendations from the report.

00:07:54:12 - 00:08:19:12

Chris van Stolk

Yes. Thank you. Sara, I don't want to necessarily, overstate my role within that. This is very, very much something that the Charlie and his team, took forward. But you do find that, I think, and you may have the same thing, that over, over time as you work on a specific topic, and with government that you almost become a little bit to institutional memory because people come and go, civil servants are rotated around, ministers come and go and what have you.

00:08:19:12 - 00:08:37:18

Chris van Stolk

So, so I think, to provide a little bit of continuity, that space in a similar way, perhaps even more so that, you know, Carol Black, of course, has, has done the same thing, I think, with, the Mayfield Review, from, from my perspective, it was, you know, very much building on work that has already taken place.

00:08:37:20 - 00:09:05:24

Chris van Stolk

And I think that was also all done on purpose. So obviously there were the Black reviews in the past, there was my review on, psychological wellbeing at work. It was a Farmer/Stevenson review. We haven't been short of reviews, if that makes sense. And so I think Charlie understood that and really wanted to build on that. So in the sense is that some of the themes that, you will find in the Mayfield review are not necessarily new, but I think restating them and the urgency around them, I think is really, really critical.

00:09:06:04 - 00:09:24:10

Chris van Stolk

So to basically keep this on the policy agenda first and foremost. And the second thing is also because of something I said earlier, some of the metrics that we are tracking in this space are not getting any better. And it also leads researchers like myself to think about, well, what have we accomplished after 10 to 15 years of 20 years working in this field?

00:09:24:10 - 00:09:37:23

Chris van Stolk

I then have to give myself a little bit of credit. We don't know what the counterfactual would have been without, without some of the work that we've done and so on. But there is something around that in a sense of have we been able to at least redress some of the challenges that we have in this piece?

00:09:38:00 - 00:10:11:22

Chris van Stolk

And I think that was what Charlie wanted to look at. And I think if you then look at the system that we have in place, within, the United Kingdom or in England, it feels very fragmented, especially when we compare it to some of the, our European neighbours or even the US, where we have the silos, you know, in our, in our system be it the employers, insurers, be it the NHS, working to slightly different incentives and not taking an holistic approach around the individual to address some of the challenges there might be in terms of actually maintaining, good health and wellbeing in the workplace.

00:10:12:00 - 00:10:32:12

Chris van Stolk

And I think, Charlie very much took that point and then tried to understand really what each one of those actors be it employers, be it governments be it, to a lesser extent, insurers. I can come back to that in a second. Employees could do to actually sort of, not necessarily resolve this issue, but to try to improve that situation.

00:10:32:14 - 00:10:57:01

Sara Connolly

Thanks, Chris. I wondered if I could ask you just, two things there. One is about the urgency of the matter. So you'd mentioned earlier about the, growing preponderance of mental health problems in the workplace. And I guess the other thing is actually the growing numbers of people not working that are of working, of working age.

00:10:57:01 - 00:11:05:00

Sara Connolly

And I wonder if you could say a little bit more about the composition of, of that and some of the factors, underpinning that.

00:11:05:02 - 00:11:27:16

Chris van Stolk

Yes. And I mean, and that's a really worrying trend, of course, when you have, a large number of individuals within our society who are economically inactive and even worse so when you then look at our younger population and where you see, you know, quite a significant number of, young people who are not in employment, education or in training.

00:11:27:18 - 00:11:48:08

Chris van Stolk

So, again, also economically inactive in the broader sense, so that there are a couple of things that stand out. First of all, this number has been increasing since Covid, and that is not so unusual if we look at other, European countries or even the US. But in all of those countries it's increased and then it's sort of, you know, that plateaued or it went down again.

00:11:48:10 - 00:12:05:22

Chris van Stolk

And what was interesting in the UK is that it didn't, so it became a bit of a British disease. So all of a sudden you have, you know, this, this pool of people increasing, so rather than, you know, sort of stabilizing and decreasing as you saw in European countries. So that's that means that Britain is a bit of an outlier there.

00:12:05:24 - 00:12:28:05

Chris van Stolk

And the other thing that worries me quite a bit when I look at those statistics, and I'm sure that's also prompted some of Charlie's thinking, is that we see some of the rapid growth in the youngest population. And the reason why that's worrying is because, you know, many of the evidence suggests that obviously, when you become economically inactive to reactivate somebody at that point is actually really rather difficult.

00:12:28:05 - 00:12:57:10

Chris van Stolk

So it could very well be that we're losing people at quite a young age. And, even though perhaps the older age group is still the most, you know, most significant part of that population, you see the most rapid increase in the younger population. And then if you look at benefit expenditure, on, on sickness related sort of benefits, you then start to get into really big numbers, you know, you, you know, 60 billion and then potentially projecting this to go to 100 billion by 2030.

00:12:57:12 - 00:13:13:15

Chris van Stolk

And there's also the real question about, you know, all the fiscal pressures that we have within our system, in our society, there's a real question around sustainability of that. Well, basically it's not sustainable. So we, we then have to really look for solutions in terms of actually how we can sort of tackle this issue.

00:13:13:17 - 00:13:42:00

Sara Connolly

Thanks very much. It just as you were speaking, it just reminded me of when I was a graduate student and long term unemployment was the big issue. And yeah, there was a lot of academic research about hysteresis that, you know, the experience of unemployment made unemployment in the future more likely and much more difficult to escape from, and a scarring effect on long term income, earnings and of course, ultimately pension.

00:13:42:02 - 00:13:57:20

Sara Connolly

And so I guess the same mechanisms are at play here. All the more worrying because the, these, that this growing number is all at the beginning of their career. And I wanted to also pick up on the point you made about incentives.

00:13:57:22 - 00:14:17:21

Chris van Stolk

I think incentives, all across the system in some ways, Sara, in a way, and the misalignment of those. But I think it's fair to say, I think just to pick up on this theme is that we've had a very significant issue around fit notes, in, in our system and in a sense is that the fit notes, hasn't really done or given us, what we needed it to do.

00:14:17:21 - 00:14:36:10

Chris van Stolk

I think as Carol Black suggested it, I think many, many years ago, the idea was to really, that to be an activating policy, focusing on what people could do rather than what they could not do. But ultimately, I think and I have some sympathy here, is that GPs, look after the health of their patients. You know, that's their first and foremost.

00:14:36:15 - 00:15:01:02

Chris van Stolk

And I think it's been very, very difficult to get GPs to engage with the concept of work and workplaces. And as such, the fit note hasn't given us, you know, what we needed to do within the system and perhaps we cannot expect it to do that either. I mean, Charlie talks about the reform of the fit note, and so on, but there is also something about, perhaps not asking GPs to do something that they haven't been able to do over the last 20 years.

00:15:01:02 - 00:15:15:12

Chris van Stolk

So, I mean, I think so I think we need to kind of balance all of that. So if GPs are not going to be that lever then we need to think about, you know, who else is going to be that lever. And, and that takes us back to the occupational health profession of course, a profession that's been under a lot of pressure.

00:15:15:12 - 00:15:35:07

Chris van Stolk

You know, we don't have many occupational health physicians in the UK. It takes us to employers and, and really for them to start more, more, thinking more about proactive measures and preventative measures that they can take. And it also talks to the individual to some extent. Right? So I think in terms of incentives, we need to think quite widely, you know, what is the incentive of an employer to do something?

00:15:35:07 - 00:15:55:17

Chris van Stolk

What is an incentive of an employee? What is an incentive of a of the health system? In a way. And as I mentioned, some of these things are kind of misaligned. And even worse, I mean, perhaps there's always going to be some misalignment, but perhaps worse, they work against each other, you know, you know, so that is that is also, I think, an observation that I would have, so this is something that we need to address.

00:15:55:19 - 00:16:08:14

Chris van Stolk

I think Charlie sees it as an employer first kind of strategy, you know, his, his review. And that's, of course, also very interesting. You know, I mean, he's a businessman so I guess coming from the John Lewis context and sort of thinking, well, maybe this is something that employers should run with.

00:16:08:19 - 00:16:37:05

Sara Connolly

Thanks. I definitely want to come back to the employer responsibility, but, I wanted to quickly pick up on something about occupational health because I think this is also an extremely important factor, as you mentioned. You know, it's it's a, it's an occupation under pressure. But also from my conversations with employers, it's quite often a function that is bought in, rather than internal to the organization.

00:16:37:11 - 00:16:54:00

Sara Connolly

And of course, you know, the biggest number of firms or employers in the UK are small and medium sized businesses who may not have that function within their organizations. So I wondered if that was something that you thought was, was pertinent here.

00:16:54:02 - 00:17:13:11

Chris van Stolk

Yeah, I think it is. It is absolutely essential. And, and you're right, many services are bought in and be it, you know, different aspects of occupational health, different sort of aspects of health and wellbeing interventions. And as you mentioned, there's also things that do not get bought in at all because we're dealing, you know, the majority of employees in the UK are, employed by SMEs.

00:17:13:11 - 00:17:34:16

Chris van Stolk

And of course, they have might have limited resources and certainly a limited knowledge, you know, in terms of actually procuring some of those services. So a lot of ideas around this are not new really. But it's it's really about pooling, often gets discussed in terms of actually whether you could provide a standard offer to groups of employer employers, for instance, you know, that that that are of a good standard.

00:17:34:18 - 00:17:53:11

Chris van Stolk

Typically we don't necessarily have to worry so much for large employers, many large employers, you know, get this agenda. There is probably more of a challenge of coordination and actually making better arrangements with their providers so that they actually can have the data back or different mechanisms by which they can sort of, coordinate the activities that they're doing and also targets are better.

00:17:53:13 - 00:18:10:10

Chris van Stolk

But we've looked at, sort of SMEs from a variety of different directions, whether they could sort of be, you know, tag along with the supply chains of large employers, let's, let's say national grids, you know, they work with tons of SMEs, whether their SMEs could sort of tag along with the National Grid is doing.

00:18:10:10 - 00:18:35:17

Chris van Stolk

And clearly some of that is happening. Jaguar Land Rover, okay before that ransomware attack, but you know what I mean. There have been some thoughts around John Lewis to do this as well and so on. And working perhaps with some of their farming partners in this business. So, there's a lot of ideas out there. It's just, the, the fact is that many of these things are a little bit fragmented to the, you know, not, not that well coordinated, working well in one space, perhaps, and then another and so on.

00:18:35:17 - 00:18:37:21

Chris van Stolk

So there's a lot of learning to be done, I think.

00:18:37:23 - 00:19:02:03

Sara Connolly

No. Absolutely. And then just thinking about the responsibility for employers and, you said that the big firms get it. I mean, you know, of course, I mean, if you have staff that are not working because they're, away on long term sick leave, or if you're, if you're getting high rates of turnover because staff, are not well.

00:19:02:03 - 00:19:31:04

Sara Connolly

I mean, these are really quite serious costs for all businesses, do you think that that's a way of presenting the argument and the responsibility to employers that there's a benefit, a business case for it in investment and activity here, or is it more that there's a sort of a moral case that actually, you know, these are your employees and you know that you have a duty, to look after them, within the workplace?

00:19:31:09 - 00:19:50:22

Chris van Stolk

Yeah. So so I think it's obviously both, Sara. But I think, I would never understate the importance of the business case. And I think the business case is pretty clear and obvious. But you have to make this case over and over again in different contexts for different audiences, different sectors and what have you. The business case is relatively overwhelming.

00:19:50:22 - 00:20:19:21

Chris van Stolk

I mean, in a sense is, we, most, businesses, especially in the UK, because we are very much a service oriented economy. They are very human capital heavy. Right? So the human capital is going to be by far the most, you know, the your most expensive expenditure that you have within an organization. Now, if you then look at Britain's Healthiest Workplace and you say on average we lose about, let's say 40 productive days per worker, which is, you know, if you if you take a percentage, 20, 25% or something along those lines.

00:20:19:23 - 00:20:38:07

Chris van Stolk

So you basically start, being productive again if you use the tax calendar, you know how they do that by the end of February, that's is quite, a strong statement. And of course, I would what I always tell people if this was for instance, you IT system, you say, well, we would take our IT system offline for two months of the year.

00:20:38:07 - 00:20:55:04

Chris van Stolk

There would be an uproar. But somehow we tolerate this in terms of our human capital. So there is a lack of awareness, a lack of knowledge. And I think what that speaks to really is that perhaps we've been talking to the wrong audiences. And I don't want to necessarily, underplay the significance of our HR colleagues and what have you.

00:20:55:06 - 00:21:18:14

Chris van Stolk

But we really need to probably bring the senior leaders, the CEOs, the chief operating officers, the finance directors, the directors, the company directors on board with this agenda, because once they start understanding that, they start asking themselves questions, not just in terms of, well, this is rather intolerable in terms of this loss, but also are the interventions that we're putting in place actually effective, which gets you back to the occupational health point.

00:21:18:16 - 00:21:38:06

Chris van Stolk

It's like, you know, what are we doing about this? And are we getting a bang for our buck for this kind of expenditure? So I think it's absolutely critical, in terms of, thinking of it along those lines. But it's also fair to say that employers have challenges at present in our economy. And that's perhaps also, again, where there's a misalignment.

00:21:38:06 - 00:22:08:22

Chris van Stolk

So, again, I don't want to necessarily start commenting here on tax policy or, the new regulatory interventions, but it's pretty clear that if you increase employers national insurance that that loads an  additional cost onto our employers. If you, change employment law, that again, has some cost implications for employers. And the sad reality for it is, is that the first places that get cut within that setting is, of course, you know, expenditure, discretionary expenditure on health and wellbeing training and all of these different things.

00:22:09:03 - 00:22:25:00

Chris van Stolk

So we need to be very careful. I think, with the policy levers that we have and ideally these policy levers, you know, point in the same direction. There is something, I think, speaking in our favour in a way, is when I started, first started, you know, working in the UK and, and I'm originally Dutch and I came to the UK.

00:22:25:00 - 00:22:40:24

Chris van Stolk

And so it felt to me that the human capital was quite cheap in the UK so there was very little investment in human capital and what have you. People could be replaced by migrants and, you know, there seemed to be an endless stream of workers and talents and skills and so on. That, of course, is not something we have any longer.

00:22:40:24 - 00:23:05:06

Chris van Stolk

Right? I mean, there's a lot of global competition for skills. First and foremost, there is a pressure on migration. But if I was working for a very large employer, I would be saying, well, look, I need to really look after the stock of my human capital because, you know, this is really the only game in town. And if I want to differentiate myself from my competitors, the really, probably one of the key aspects of that will be whether I look after my human capital better than they do.

00:23:05:06 - 00:23:23:04

Chris van Stolk

Right? And in terms of getting more productivity out of it. So that's that's, I think, where we are right now. And I think that's dawning on many, many employers. But it's really important that people like ourselves. And you've helped me tremendously in that over the years, Sara is keep making the business case, showing the return on investment, showing what can be done.

00:23:23:05 - 00:23:27:02

Chris van Stolk

You know, what the cost is to businesses of doing of, of, of, of not getting this right.

00:23:27:04 - 00:23:45:12

Sara Connolly

Thanks. Thanks very much, Chris. And you mentioned that you’re Dutch and I was also thinking about, you know, this problem of long-term sick leave was often described as a Dutch disease, you know, sort of 20 years ago. So I wondered if you thought there were any learnings from the experience in the Netherlands?

00:23:45:14 - 00:24:01:12

Chris van Stolk

I think they are. And I think, you know, the, the model there, of course, is very different from the UK. I don't want to start comparing health systems because that's always, always difficult to do. But of course the NHS is configured in a slightly different way than the Dutch health care system where we have social insurance funds.

00:24:01:16 - 00:24:21:01

Chris van Stolk

But broadly what's happens there is that, of course, when somebody becomes, sick. Well, while in the workplace, in terms of long-term sick, there is a model whereby, there's a lot of coordination between employers, the socially assurance funds and also governments, and they all have their responsibilities within that system to reactivate this individual, basically.

00:24:21:01 - 00:24:42:12

Chris van Stolk

And that also means if you have the insurance involved, the employer involved in this sort of co-production model, that's there's also a real incentive for those, for those, all three and in some ways the government perhaps a little bit less, but certainly for employers and social insurance funds to actually take preventative action as well. And because you don't want to be in a scenario where you start, but you have to spend a year with an individual working on all kinds of issues.

00:24:42:12 - 00:25:15:19

Chris van Stolk

So that system, has been relatively effective. You know, we've been able to address, this, what you call the Dutch disease, which in fact, it was. And that we've made very significant progress in terms of actually maintaining and getting people in employment. There are still challenges, clearly, but in any system. So that's also speaks, again, to the first point I made, I think when we started this discussion is really you need to make sure that the incentives are aligned within that system so that employers, you know, sort of have that incentive to push in one way and next the insurance can come in, and really quiet about insurers in the UK.

00:25:15:19 - 00:25:44:17

Chris van Stolk

That's another interesting thing. And then, of course, government doesn't become sort of, the lender of last resort. So in a way, that's, that's really what we need to redress. And again, Charlie's view on that is very employer led right. And, but, but, you know, I think ultimately my sense is if there's a Mayfield Two or Mayfield Three, whatever comes next is we really need to think about all of those, incentives around the system and making sure that they're aligned as well.

00:25:44:19 - 00:26:10:09

Sara Connolly

Thanks. And I'm glad you mentioned about the insurers, because I think that is an important missing part of, of, of this discussion. I think that was one thing that was maybe a little bit controversial when the Mayfield report was published, which was actually about the responsibilities to the individual and I wondered if there was any, if you had any sort of reflections on that at all?

00:26:10:11 - 00:26:31:19

Chris van Stolk

Well, yes, I guess I do in a way, but I think with Charlie set out in a way, it's, and what I liked about Charlie, Charlie's review is that he made it a very human, right, in a sense, is that he spoke a lot about fear, right. And people, why people do not act. And I think that is that is quite an interesting.

00:26:31:19 - 00:26:48:17

Chris van Stolk

He spoke about fear, amongst employers in a sense that employer, when they're faced with a tricky situation, a complex situation, and they don't want to get it wrong in a sense, there's all kinds of bear traps for employers to fall into, not least around employment law tribunals. And I know it can be a very tricky thing for a line manager to deal with.

00:26:48:17 - 00:27:07:05

Chris van Stolk

And so therefore, a lot of people just, you know, derogate their responsibility in a way and allow, and get third parties to deal with it or if they don't want to deal with it themselves. And, and in fact, what's, what's one of Charlie's observations was, is that there is a lot of inaction. Sometimes the contact disappears between employer and employee when somebody goes off sick just at a time

00:27:07:05 - 00:27:30:05

Chris van Stolk

when you probably need, you know, that contact to augment. And I think on the individuals’ side, there is a fear and probably sometimes justified around disclosure in a sense.  You may not be doing well, you may just sort of, you know, you may be struggling with a few things, but you find it really hard to disclose that to your line manager, to your employer, to colleagues, and what have you, because you worry about the ramifications of that disclosure.

00:27:30:05 - 00:27:56:15

Chris van Stolk

And that's not entirely, unjustified. Because there is good evidence to suggest that if you disclose a mental health condition, for instance, to your HR department, you're much more likely to face disciplinary action than if you don't. And so that that there are still very big challenges there. And so I think, ultimately what's, Charlie's, tried to, to reflect on within all of that, is that we need to sort of change that culture to some extent.

00:27:56:15 - 00:28:11:13

Chris van Stolk

Right. And the sense is that, you know, we we need to get, we need to sort of have a certain degree of openness. We need to have contact, we need to have communications, so on, and then try to also figure out what, what are some of the barriers and I think, for instance, to come back to the Netherlands.

00:28:11:13 - 00:28:28:00

Chris van Stolk

But I also would like to go to, Scandinavia. Perhaps I'll leave Greenland out of it, I don't want to cause any political controversy here, but, but if you go to Denmark, what you do see is that openness and communication is everywhere there and so on. So, so at that point, it makes the issues much easier to resolve.

00:28:28:00 - 00:28:38:18

Chris van Stolk

But so I think in terms of individual responsibilities, I think that's that those are the things that stood out for me in terms of actually where I thought Charlie was really helpful in terms of shining a light.

00:28:38:20 - 00:29:02:23

Sara Connolly

Oh, absolutely. So, Chris, we've covered quite a lot of ground, around the NHS, employers, government, the occupational, the importance of occupational health and the individuals. I mean, if, if you were to, our audience is, you know, people working in business, working in HR, are there any particular messages, take homes that you'd like to, give our listeners.

00:29:03:00 - 00:29:08:23

Chris van Stolk

Many I would say Sara, but I'll keep it simple. Maybe I'll use the rule of three. Maybe allow me three.

00:29:08:23 - 00:29:10:22

Sara Connolly

Three sounds good. Yeah.

00:29:11:00 - 00:29:35:13

Chris van Stolk

The first thing I would say is that there's a lot of hot air out there, and, in terms of people trying to sell you all kinds of different things and so on. I think always think in your mind about what the evidence base is behind some of these things. And so, if you can, go to the CIPD different type of website where you can find some of this information.  Used to be the What Works Centre had a lot of good, good information.

00:29:35:17 - 00:30:06:13

Chris van Stolk

The University of East Anglia, Evolve, of course, you know, look at all of these, all of these things and just make sure that you're comfortable that you're actually procuring, something that's evidence based. The second thing I would say is don’t, because you're doing things, doesn't necessarily mean you're going to be effective, you know? So it comes back to a point I made earlier, in a sense, it’s that there will be very low awareness, in your organization about what you have in place, and probably even more so, people might struggle to access it because you might be offering it at inconvenient times.

00:30:06:15 - 00:30:27:01

Chris van Stolk

You might not. It might, it might be in a different location from the location that most of your workers are. And so I think that is a key thing. So I think the promotion and sharing of that information is absolutely critical. And then I guess a third observation I would have is, that is around participation. If you get all of those things right, you then look at participation.

00:30:27:03 - 00:30:49:01

Chris van Stolk

Because ultimately what you find is that if there is good participation, also from the at risk groups coming in for the health, wellbeing interventions that you have in place, you can actually make some good headways. You can have, have an effect and you can actually address some of those issues and you can find some of those, you know, that information in the Evolve business risk, in the calculator in terms of the ROI calculator that you developed, Sara.

00:30:49:03 - 00:31:08:17

Chris van Stolk

So you can make a difference in terms of, head start, moving the needle. And especially also with engagement and participation, it's really important if line managers participate, the leaders of the organization, that is important to them. And that really signals a very important thing that gets you close to the organizational culture piece, which we always talk about.

00:31:08:22 - 00:31:29:05

Chris van Stolk

So I would say, to our, practitioner audience, I would say evidence base, promotion and awareness and then participation. Don't lose sight of those things. And also, I would say stay the course. I think there's a lot of headwinds here and there's a lot of reasons why you might say, you know, let's move away from this agenda or let's do a little bit less of this and that and so on.

00:31:29:10 - 00:31:34:13

Chris van Stolk

This is going to be your biggest expenditure. So you're going to have to look at look after it. And there's very few alternatives.

00:31:34:19 - 00:31:58:00

Sara Connolly

Fantastic. Because those are all actionable as well so that's that that's really fantastic. Thank you Chris. So Chris, you mentioned you've been working in this workplace health and wellbeing space for, you know, 15, 20 years. And obviously there have been new and evolving challenges. You know, ten years ago presenteeism wasn't really something that people talked about.

00:31:58:04 - 00:32:09:08

Sara Connolly

Now the CIPD measure it. So I wonder looking forward, what do you see the big, workplace wellbeing challenges in the next 5 to 10 years?

00:32:09:10 - 00:32:35:07

Chris van Stolk

Well, I hate to say this, Sara, but I think, it's pretty obvious from what I said before, the thing that, potentially keeps me up at, at at night, as a father also, is the poor state of the mental health of our young people. And, I think we, they are a relatively small cohort, our young people, I mean, and shrinking in a sense, in that we don't have as many young people as we used to as a proportion of our population.

00:32:35:07 - 00:32:58:06

Chris van Stolk

So we need to look after them really well. And they are, of course, also going to be our future in terms of, and who's going to pay my pension or who's going to, you know, as a, you know, support my social care when I eventually need it. So all of these things I think are absolutely, critically important. But I also I want my children to lead, a fulfilled life, you know, to have a, you know, hopefully a life, you know, full of interesting challenges and ideas like I had.

00:32:58:06 - 00:33:22:11

Chris van Stolk

And so I think that is our, our key challenge. And I, if I look at in fairness at our social expenditure and, and this is maybe, maybe making a political point, and I don't mean it to be a political point or critical of one particular administration, because I think this has been an ongoing issue for all sort of, the different, governments that we've had is that we've chosen to direct our social expenditure more and more towards our older generation.

00:33:22:14 - 00:33:39:18

Chris van Stolk

And, we are sadly neglecting by, by doing that, our younger generation. And I think it's showing I think we're fraying a little bit. And there's of course other things as well, social media, technology, which plays a role within all of that. So I don't want to downplay that. But this is a group and a generation that we need to look after.

00:33:39:18 - 00:33:56:05

Chris van Stolk

And, and if you look at the mental health trends that I have been speaking about, if we look at inactivity rates amongst young people and so on, all of these things are trending in the wrong direction. So that's where we need to intervene. So, so that's I think it requires a little bit of policy attention from my point of view.

00:33:56:07 - 00:34:17:19

Sara Connolly

Thank you very much. That sort of argument about investing in their present and their future and our future really, really very important. Well, Chris, thank you so much for your time this afternoon. It's been a really stimulating, conversation. And, I'd like to thank, you know, our listeners, too, for, engaging with our podcast.

00:34:18:00 - 00:34:19:11

Sara Connolly

So thank you very much, Chris.

00:34:19:15 - 00:34:23:17

Chris van Stolk

My pleasure.

00:34:23:19 - 00:34:34:16

Helen Fitzhugh

Please do visit www.evolveworkplacewellbeing.org   We look forward to seeing you next time.