Improving the effectiveness of employee wellness management systems
Article by Dr Dicky Els and Terrance M. Booysen
Employee wellness and disease management issues and their effects on the workforce have become a global priority for most employers. The continued increase in preventable chronic non-occupational (and non-communicable) diseases such as cardiovascular disease, diabetes and cancer has expanded to become a growing corporate concern. As a result, the number of organisations providing health, wellness and productivity programmes has increased in many markets around the world, and includes multinationals and local organisations. While most companies globally do not currently have a documented employee wellness strategy that differentiates them from their competitors, many recognise the need for employee wellness programmes. Those companies with health promotion programmes in place acknowledge that a workplace wellness initiative contributes towards key organisational benefits and links the company and its employees to a sound value proposition, whilst it also incentivises employees to commit to the organisation.
Disconnected strategy and values
Unfortunately there are many instances where the business value, along with the economic value of employee wellness and disease management programmes, are not realised or fully attained. There are principally three main reasons why this misalignment between the business and employee value occur. Firstly, the employee wellness initiative is not aligned or integrated with the company’s Corporate Governance Framework®, and little real value is attached to employees’ and their wellness. This is further evident through the company’s lack of integrated reporting and the company trumps its profitability factors with scant regard for its people components, and less so for the environment. Secondly, the employee wellness programme is not well designed, neither developed to mitigate the organisational risk. Finally, the designated and responsible authority is not adequately empowered to leverage the employee wellness programme outcomes for the overall benefit of the organisation and its employees. Common amongst all three dysfunctions is the negligence of management to monitor chronic disease prevalence and to evaluate the effectiveness and efficiency of the wellness programme specifically relating to the business outcomes such as absenteeism and presenteeism.
Increasing role of governance
With the heightened focus being placed upon corporate governance practices, as well as the increasing stringent local and international labour laws, it is expected that companies of all sizes will be compelled to implement sound wellness and disease management systems. The necessity for such steps will be directly linked to the company’s claim of sound governance principles which support their Governance, Risk Management and Compliance (GRC) practices. In short, failure to comply with good corporate and employee wellness governance practices can have devastating consequences for all the organisation’s stakeholders. Besides the obvious corporate governance areas which a company must comply with, it is alarming that so many companies blatantly ignore the fundamental building blocks required for a healthy, well balanced and sustainable organisation. Whilst the consequences for non-compliance in South Africa generally amounts to a few or low punitive measures, many companies still treat their overall governance measures and employee practices merely as a minimalistic tick-box exercise.
SA National Health and Nutritional Examination Survey
The recently released results of the SA National Health and Nutritional Examination Survey showed that South Africans were developing lifestyle diseases such as high blood pressure, diabetes and cholesterol from a young age - starting to peak from as early as 25 years old. This study, conducted by the Department of Health, also revealed that more than half the population are living in hunger (or at risk of it), while a large percentage of the rest are obese or at risk of developing lifestyle-related illnesses. This trend demonstrates the ever-increasing need for employers to look inward and address their own corporate risk of chronic non-communicable diseases.
Taking responsibility for employee wellness
As the first step the prevalence for non-occupational diseases should be identified as a major enterprise risk in order to “scope” the wellness and disease management system. It forms the foundation of the employee wellness strategy and includes the targeted employees, health risks, non-occupational and occupational diseases, programme design and potential business outcomes.
As part of the process, the senior management of the company should, in consultation with all relevant stakeholders, define the wellness and disease management policy that addresses the nature and scale of the employee wellness programme. The policy must address the company’s commitment to the prevention and mitigation of work-related and community-based exposure to non-communicable diseases. Implementation of the wellness and disease management policy should clearly demonstrate the company’s compliance with the applicable legal and industry specific requirements. At the same time, the policy must make employees aware of their own individual obligation, personal responsibility, and the expected behaviour that can reduce corporate mortality and morbidity.
It is important that the policy is linked to the organisation’s strategy, ethical practices and the Corporate Governance Framework®. The wellness and disease management programme takes into account the financial, operational and business requirements in order to prevent illness, and at the same time promotes employee health and productivity. Corporate wellness and disease management programmes primarily entail a proactive, highly structured and substantial set of health promotion interventions. It is the employer’s social responsibility to assist employees with illnesses or adverse conditions by means of providing access to prevention, early diagnosis, treatment, and care and support that reverse lifestyle related diseases and health risk conditions. Some of the activities found within wellness programmes include the provision of information, education and behaviour change interventions to positively impact the health of employees (and their families).
Support from the board is critical
Backed by the board, the executive management must be tasked to clarify the roles and appoint the necessary person within the company who must be responsible to drive the wellness management process. The appointee can be a Wellness Manager or the Human Resources Director, but in all cases should be considered as a “prescribed officer”. According to Regulation 38 of the Companies Act (2008), the prescribed officer is a non-director that regularly participates in and exercises general executive authority, control over, and general management of the whole, or a significant portion of the business and the activities of the company. In the context of the company’s overall human capital well-being, this person would be responsible to establish, implement and maintain the wellness and disease management system in accordance to the industry and organisational requirements. Wellness Managers should ideally report to executive management because they are equally responsible to ensure good governance and sustainable development within the company. Understandably, the functions that underpin a Wellness Manager are critically important, however most of these managers -- when they are appointed within companies -- generally lack the required authority and responsibility to effect the necessary change that brings about the desired business results.
Employee Wellness Manager
The person appointed as an Employee Wellness Manager should be visionary, proactive and a value-orientated leader. They are catalysts for business sustainability, good stewards and wellness advocates that constantly influence the company to take action against poor or unethical practices, particularly where employees are concerned. Employee Wellness Managers need to initiate and drive the leadership and culture-change process within companies, but regretfully they are more often than not disempowered “business partners”. They generally struggle to obtain senior management support and sufficient financial resources to manage outcome-based wellness programmes that produce specific business and employee health care results. This leaves them stranded to implement operational controls and risk mitigation procedures that could promote significant business growth.
Conversely, to enable the functions of a wellness and disease management programme, Employee Wellness Managers must be equipped with -- amongst other -- appropriate management information that discloses employee engagement, health risk data, worker’s compensation claims and medical aid expenses. Analysing absenteeism records for instance, enables employers to manage and eliminate the potential impact of these burdens imposed on their profitability. Deeper and broader views across multiple data sets provide the company with significant measures, documents and medical records that demonstrate legal compliance and effective wellness and disease management.
Going forward, organisations will increasingly be required to evaluate and report their employee wellness and disease management initiatives, the progress, results and effectiveness of their wellness programmes and its impact on employee health promotion and disease prevention. Increasingly the enlighten shareholder will want to see these hidden risks being disclosed and reported in integrated reports. And without a proper and formalised Wellness and Disease Management Policy in place, there is little chance that the company will succeed in balancing the components in the company’s Integrated Report.
Dr Dicky Els is a Lead Independent Consultant in CGF. He specialises in Workplace Wellness and focuses predominantly on strategy development, programme design and evaluation of outcome-based health promotion programmes. For more information on our Employee Wellness Programme Evaluation or Wellness and Disease Management Audits, contact Dr Els directly on 082 496 7960 or email email@example.com or go to www.wellnessprogramevaluation.com
Terry Booysen, the CEO of CGF has presented numerous interventions to public and private audiences in and out of South Africa and has received many accolades directly linked with corporate governance. He is a regular podium presenter and is considered knowledgeable in the practice, having produced many governance, risk and compliance reports and articles over the years. More information regarding CGF can be found at www.cgf.co.za
CGF Research Institute (Pty) Ltd
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