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Earlier chapters in this book have focused on research and evidence. We’ve considered issues such as how organizations should take a strategic approach to health and wellbeing (discussed in more detail below), make assessments of wellbeing regularly, and take a view of employee engagement that includes wellbeing. This chapter is more practical and rather than reviewing research findings and introducing new ideas and concepts, it provides guidance on how to take a strategic and practical approach to improving and sustaining PWB in an organization.

The chapters in the next part of the book provide a set of case studies giving real-life illustrations of what has been done in a range of organizations to tackle well-being issues. The case studies vary considerably in scope, in the approaches taken and in the goals that they were designed to achieve. Although not uniform in approach, the case study chapters provide real-life examples of how to use many of the methods, techniques and processes that are part of the generic approach outlined in this chapter and based on material presented throughout this book.

A Strategic Approach to PWB

In any organization there will often be different opportunities and priorities when attempting to enhance PWB. Sometimes it may be sensible to tackle a specific issue, such as high rates of turnover or sickness -absence in a department, rather than to take an organization-wide perspective. In other circumstances, the awareness and capabilities of leadership and management across the whole organization may be the priority, or the recruitment and selection of employees with the resilience to cope with a specific and challenging set of job demands may be an urgent need. Sometimes a strategic approach may be extremely desirable but impossible to implement because of a lack of commitment, understanding or recognition from top leadership. The realities of organizational life mean that it is not always feasible, or even desirable, to follow a broad and integrated set of steps toward improved PWB. The approach described in this chapter does give a broad, integrated set of stages, illustrated in Fig. 9.1. In some settings, it may be possible and appropriate to follow the whole process from start to finish. For many circumstances it may be best to enter the cycle given in Fig. 9.1 at somewhere other than stage one, to omit some of the stages—or even to adopt an entirely different model. Despite these reservations, the model given in this chapter is extremely valuable and provides a useful template for well-being interventions. Its development is based on the experience of working in many different organizations across most sectors of the economy. The case studies in Part 5 provide good examples of taking a strategic approach in the context of real organizational settings.

Fig. 9.1
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A strategic approach to PWB

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In the following sections of this chapter each of the key stages in Fig. 9.1 is explained.

Engaging Top Leadership and Developing Managers

The impact of PWB is felt across the whole organization and to be completely successful in harnessing the benefits of high levels of PWB a strategic approach is required. Of necessity all organizations divide up into functional roles and structures. It would be impossible to perform effectively without doing so. The key functional areas that relate to PWB in an organization are Human Resources , Occupational Health, and Health and Safety. For well-being interventions to work really well it is critically important that all three of these functional areas collaborate effectively. This collaboration can only be truly effective if the organization takes a strategic approach to PWB . The benefits of high levels of PWB are potentially substantial but unless an organization takes a strategic approach these benefits may not be fully realized. The reason for this is simple—the benefits of high PWB cross different functional areas. For example, PWB can generate benefits in performance and productivity, sickness-absence rates and talent management. To realize these benefits an HR department needs to include proper consideration of PWB issues in its talent management activities. At the very least this means evaluating recruits, not just from the point of view of skills and abilities, but also ensuring a good match between the demands of the role and the jobholder’s resilience profile —and where the match is not good providing support such as resilience training (we discuss resilience training in Chap. 8). Health and Safety or Occupational Health may take the lead on dealing with work-related stress but their contribution needs to be linked to management development programs, so that managers are helped to manage effectively for both well-being and performance. There are many other examples that could be given to show how the three key functions need to collaborate and not work in silos. The need for this integration explains why, in Fig. 9.1, top management commitment and managers’ capability to balance challenge and support are not shown as separate stages of the process. They need to be in place throughout the whole set of stages.

A strategic approach to PWB starts with recognition and commitment on the part of the top leadership of the organization. Experience has shown the authors that this is not something that is always easily achieved. Of course no top management team is likely to say that it does not recognize the importance of PWB or that it is not committed to the well-being of its workforce. In practice however, when tackling PWB that requires resources or financial support the espoused commitment may not turn into action. Frequently this is because the top team does not fully grasp the business case for PWB. Box 9.1 gives more information on a review of the business case for PWB. If you’ve read all of the previous chapters of this book the business case will be clear—relatively modest investment in PWB can lead to major improvements. The best starting point for any PWB intervention is to ensure that the top leadership team has a proper appreciation of the evidence and the resulting business case. This will make it more likely that the top team will commit resources—and more importantly recognize the importance of a strategic approach, rather than delegating PWB to one of the functional areas. The development of managers to balance challenge and support involves helping them to hold people to account properly but in a way that does not take this to the extreme and become rigid and demoralizing. Similarly they need to be able to recognize when support is needed but not default to this whenever conflict or strain arises—and let people off the hook too easily. As Chap. 7 explains much more fully, effective management and leadership ensures that people are sufficiently challenged, so that they can get the psychologically healthy experience of achieving something difficult—but that support is available to ensure that the challenge does not become impossibly difficult to deal with. The design of a development program for managers can draw on a number of established models and approaches. These include Robertson Cooper’s Leadership Impact model , work done on management competencies for preventing and reducing stress at work and work on engaging leadership—all of which are covered in Chap. 7.

Box 9.1 The Business Case for Wellness

PriceWaterhouseCooper published a report in 2008 on their review of 55 UK Case studies looking at the business benefits of wellness programmes. They found that the costs of such programmes can very quickly be turned into financial benefits. Sickness absence was shown to reduce in almost all case studies and reports of lower staff turnover, fewer accidents, and increased employee satisfaction were also common. Other benefits reported, although less frequently (although this could be because they were not measured rather than they didn’t happen) were an improved company profile, higher productivity, better health and welfare, increased competitiveness and profitability, and fewer claims. You can read the full report here https://www.gov.uk/government/publications/work-health-and-wellbeing-building-the-case-for-wellness.

Measure Baseline Metrics

An essential aspect of a strategic approach to PWB involves identifying the goals of the program and taking baseline measures of these so that the starting point is clear. Being clear about the starting position also enables practical targets and goals for improvement to be set at appropriate levels. Improved PWB has the potential to affect many outcomes for both individual employees and the organization as a whole. For the organization, links have been established between the PWB of employees and a range of important outcomes including: sickness-absence rates; productivity; customer satisfaction and sales performance, but exactly which outcomes are affected will depend on the type of intervention adopted. For example, introducing resilience training for a group of staff which is producing poor results when dealing with particularly challenging service users may help to reduce sickness-absence rates and improve the psychological health and well-being of the staff. It may not have any significant impact on the satisfaction of the service users unless it is coupled with other interventions, such as redesign of working practices, reductions in workload or better goal-setting and monitoring by management.

A good starting point is to prepare a well-being scorecard showing the possible outcomes that could become targets for the intervention. An example of such a scorecard is given in Table 9.1.

Table 9.1 A well-being scorecard
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Table 9.1 is a scorecard based on the idea of the Balanced Scorecard (Kaplan and Norton 1996) but focused on outcomes that might be influenced by PWB initiatives. The possible outcomes given in Table 9.1 are not intended to be comprehensive. They provide an illustration of the type of outcome, in a balanced (i.e. not only financial) set of four categories. The key point here is that the first step, even before a PWB initiative begins, is to identify very clearly WHY it is being undertaken and, in particular, which outcomes are expected to change as a consequence. This seems an obvious point to make but in our experience it is quite common for organizations to begin in a piecemeal way, without being clear about what results are expected. Another important issue is to be realistic about how much impact can realistically be expected. For example, conducting a stress survey, with follow-up in areas where high levels of absence are reported, will probably have a beneficial impact but it is unlikely to drastically reduce sickness-absence across the board, or have a major impact on customer satisfaction. So, on the one hand, it’s important to consider all of the possible areas where improved PWB could bring benefits but it is also important to be realistic about this, in the light of the specific PWB program that is planned.

Branding and Communication

A coherent and recognizable brand for a PWB program is an important ingredient for overall success. It is not unusual for an organization to be undertaking well-being initiatives that are not recognized as such. Examples include the provision of a telephone counseling service (employee assistance program), recognition and awards ceremonies, subsidized gym membership and stress management training. It is also common for various disparate well-being interventions to be undertaken by different functional areas across the organization—without any clear strategic connection. This takes us back to the point about the need for a strategic approach to well-being. One benefit of taking a strategic approach focused on a set of clear goals and outcome objectives is that it enables any existing initiatives to be recognized and drawn together within the new interventions to provide a coherent program, within an overall well-being brand. As explained in Chap. 3, for employees to be fully engaged with their organization they need to feel that the organization cares about their well-being. Recognition of what the organization is actually doing is much easier and more likely to be visible to employees if there is an overall positive brand that pulls together the well-being initiatives, under a catchy label. In practice, since the brand needs to reflect and incorporate the program of PWB activities, it is often better to finalize the brand and the full set of initiatives after the next stage of the process—measurement. Ideally, a full (evidence-based) understanding of current levels of PWB in an organization precedes the development of an intervention program. In practice of course, as already noted, this is not always how things are done.

Measure Well-Being Levels and Their Drivers

Chapter 5 provides a detailed account of the measurement of PWB in the workplace. As Chap. 5 explains, the best way to obtain a clear picture of current levels of PWB and information about the key organization drivers of PWB is to conduct a well-being audit.

The measurement of PWB using an organization-wide audit tool such as ASSET (see Chap. 5) is not an end in itself, although the UK government Foresight Mental Capital and Wellbeing Project (2008) produced evidence to show that even when an audit was conducted with no follow-up, benefits of almost £2 for every £1 spent were realized. The real purpose in measuring PWB levels and the organizational enablers and barriers is to provide a basis for action. The information obtained through the audit must be seen in the context of the goals set for the PWB interventions and the plans and strategy for the organization. For example, plans for the acquisition of a new division, the recent closure of a unit or a goal to improve productivity levels will all have implications for how the well-being results are seen and will influence the development of an action plan based on the results. As noted in Chap. 5, it also usually makes sense to supplement the questionnaire data with information from focus group discussions. Focus groups can be particularly useful if they take place after the audit, so that points emerging from them can be explored in more depth—and suggestions for action can be elicited from participants.

In Chap. 5 we briefly discussed the difficulties in measuring well-being in SME’s. Much of this current chapter looks at improving well-being in larger organizations, but Box 9.2 makes some suggestions for promoting positive well-being in SME’s.

Box 9.2 Suggestions for well-being initiatives for SMEs (Johnson 2011)

Recognise that stress in owner-managers of SMEs is common and make time to consider and if necessary address this.

Use business groups as sources of support, particularly if experiencing isolation.

Access and utilise the well-being tools and information available (e.g. HSE, CIPD).

Consider ‘self-training’, e.g. self-administered CBT has been shown to be useful (Martin et al. 2009).

Understand the role of managers in promoting a positive working culture, and having good levels of communication about well-being with employees.

Talk to employees about well-being. They may have some suggestions you have not considered.

Where possible implement flexible working which can improve well-being.

Where possible make work well organised and take time to make sure everyone knows what they are responsible for.

Make time for leisure opportunities to help improve well-being.

Use Results to Develop Action Plans

According to evidence collected during the Foresight project (Foresight Mental Capital and Wellbeing Project 2008), when a well-being audit is conducted and there is follow-up action the benefits are significant. Once the results are available and have been interpreted in the context of organizational strategy and the goals of PWB interventions, an action plan can be developed. A critical consideration, when it comes to implementing PWB initiatives, is to ensure that any changes made are seen as fair and equitable across the whole organization. Whether something is fair or not is best examined from two key perspectives—referred to as distributive justice and procedural justice (see Colquitt et al. 2005) . An organizational change that is seen to unfairly reward, or disadvantage, someone is breaking the rules of distributive justice—the actual distribution of rewards is unfair. Of course, sometimes in an organization it is appropriate to treat an individual or group differently. In this case, it is critical that the process (procedural justice) for deciding who should receive the reward is seen to be fair.

There is no simple prescription for what action should be taken. What is needed depends on the organization in question, its goals, history and the specific results obtained. Although there is no simple prescription, it is possible to identify broad types of interventions that might be considered. One useful way of categorizing interventions is to consider primary, secondary and tertiary interventions. Interventions can also be categorized as focusing on the individual or the organization or on the interface between the two (DeFrank and Cooper 1987 ) but the primary, secondary, tertiary framework is the one seen most commonly.

As Fig. 9.2 shows the most difficult and resource-intensive interventions are primary-level interventions. These are challenging for organizations because they involve a level of change that is more fundamental and may call for changes to how people’s jobs are done, changes to working processes and practices that are well-established. Proposals for primary-level interventions are also more likely to lead to resistance from within the organization, since they may require individuals and groups of employees to take on different roles, ways of working or responsibilities. This definitely does not imply that primary-level interventions are less valuable. In fact if taken seriously and implemented with the full commitment of top leadership they have the potential to produce the biggest payoff. In practice, organizations generally find it less challenging to introduce secondary- and tertiary-level interventions . In organizations where PWB is a problem tertiary interventions may already be in place to help support already distressed individuals. Secondary-level interventions often enable organizations to tackle PWB issues and make substantial improvements, without the challenge and upheaval of primary interventions—but with more lasting preventative impact than tertiary interventions. There are examples of very effective secondary-level interventions in the case studies in the later part of this book.

Fig. 9.2
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PWB interventions: levels of intervention

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Mindfulness training to improve well-being is a topic that is receiving increased interest as a secondary level intervention. Box 9.3 tells you more about mindfulness and how it can be used to promote positive well-being.

Box 9.3 Mindfulness

Mindfulness can be described as a psychological state involving the awareness of, and paying attention to, the moment, and can be seen as a form of meditation. It has long been viewed as relevant to the promotion of well-being (Brown and Ryan 2003 ) and recently there has been an increase in interest in using mindfulness as a way to improve well-being, and other personal and job-related outcomes such as job satisfaction, job performance, and turnover intentions (Andrews et al. 2014; Dane and Brummel 2014; Hulsheger et al. 2013 ) . Mindfulness is thought to help improve well-being by improving self-awareness through its focus on the experiences we are having at the present moment including things like physical sensations, thoughts and feelings. A number of studies have shown mindfulness to be linked with well-being (e.g. Harrington et al. 2014; Bowlin and Baer 2012 )

Lots of the research into mindfulness has been conducted in non-work settings and it’s still relatively early days but the last decade has seen a rapid growth in work-based mindfulness studies (Spence 2017 ) . The general consensus from this appears to be that promoting mindfulness in the workplace, for example as part of stress management training, can help to improve well-being at work so it is something we are likely to continue to see a focus on. One advantage of using something like mindfulness as a stress management tool is that it can be accessed from a distance. There are lots of mindfulness apps for example that allow people to access mindfulness training in bite size manageable sessions that don’t need you to take significant time out of your day or to travel anywhere.

Communicate and Implement Plans

The importance of pulling together well-being initiatives into a coherent overall brand and communicating effectively across the organization has already been explained. The communication process is particularly important when interventions are being introduced. One critical point here concerns how the purpose of the interventions is communicated within the organization. Chapter 3 examines the relationships between employee engagement and PWB. It also explains the trap that senior leadership can fall into, of focusing on a narrow “business benefits” view of engagement and well-being. Of course high levels of PWB bring benefits for the organization. That has been one of the core messages of this book. But there are also important benefits for everyone who works in an organization—and these are the priority messages that need to accompany any intervention. Top leadership needs to recognize that improving PWB for each person in the organization will deliver positive results for the organization—but there may be a lag between interventions and results. The top team also needs to resist the natural temptation to focus only on the “business benefit” angle. Ideally, communications about the PWB interventions and the resulting benefits need to genuinely prioritize the benefits to the people in the organization—whilst also honestly recognizing that this will deliver organizational benefits. In this way PWB interventions can be elevated beyond something designed to improve employee engagement or commitment or any of the “business benefits” led interventions—all of which run the risk of being seen as a management ploy to get more out of people—to become an endeavor that is “win-win” and provides something that can be wholeheartedly pursued for the mutual benefit of the organization and its members.