HEALTH: GLOBAL NETWORK Studies in behaviour change to improve the health of the world Powered by MAKING WORK A HEALTHIER 4 PLACE 2015 CONTENTS INTRODUCTION On behalf of the Global The breadth, depth and variety of thought demonstrated here is simply astounding and worth reading in full. Chief Medical Officer We are privileged to have been able to call on such a wide Network I would like to variety of world-leading experts from a range of disciplines, thank the contributors backgrounds and contexts. Each of these pieces includes 8 36 a challenge or recommendation to our network on how of this seminal collection we can radically improve the health of the world through IMPROVING workplace health and behaviour change. We are united WORKPLACES EMPLOYEE in our recognition of the unique opportunity we have to OF THE FUTURE ENGAGEMENT make a difference in the workplace and through that, public health, as employers operating in health systems and communities across the globe. Working together we will develop and take forward these recommendations to achieve a global impact; going far beyond what we could have achieved individually and proving the power of partnerships to transform the health of the world. 74 A NEW ROLE FOR CMOS Dr Paul Zollinger-Read Bupa CMO On behalf of the Global CMO Network 98 120 PUBLIC AND With thanks to our contributors, the Global Chief Medical Officer Network and our secretaries: COMMUNITY DIGITAL Caroline Stanger, Gareth Lyon and Sarah Mullin HEALTH OPPORTUNITIES 2 3 INTRODUCTION Health systems under strain The Global CMO Network To that end we have asked 32 Our mission is to It has been widely remarked that The Global Chief Medical Officer of the world’s leading experts in the world faces a “health crunch”. Network has been established workplace health and behaviour improve the health The happy advent of rising life to make a unique contribution change to take part in our and wellbeing of expectancy across the board is to this goal – harnessing the research project. adding demographic pressure to experience, energy and inspiration The contributors come from a less welcome blend of rising of clinicians in senior decision the world a wide range of backgrounds healthcare costs and growth in making roles in some of the – small innovative business, non-communicable diseases which world’s biggest companies. respected academics, charities, are already straining the capacity Our mission is to improve the specialists in particular conditions and resources of healthcare health and wellbeing of the and Chief Medical Officers systems around the world. world, working with others. themselves. It is this breadth of This crisis cannot be averted We are motivated to combine contributors which has helped through business as usual and the experience, energy and us to avoid relying too heavily on hoping that “something will inspiration of a committed any one conventional approach. come up”. network of clinicians in commerce with global reach. Radical new approaches, partnerships and delivery models We are driven by the belief that need to play a role alongside and the private sector has a role to in support of existing systems. play in tackling the biggest health Together we will challenges in the world, working push the boundaries with other civil society players, governments and UN Agencies. of possibility and Together we will push the innovate through boundaries of possibility and collective action innovate through collective action. Having met and agreed on this mission we have decided to commission research in order to discover what the greatest opportunities are in workplace health. We were of the view that in order to bring about significant, scalable and sustained improvements in workplace health, we would need to focus on behaviour change. 4 5 Each of these contributors collection to which the Global But in reality each of these pieces have been asked to identify CMO Network is proud to put touches on two or more of So what’s next? what they see as being the key its name to. For ease of reference these themes. recommendations for sustainably we have categorised these We believe that all of the ideas in the research are worthy What is particularly noteworthy improving workplace health research pieces into five themes: of pursuing, scaling and developing for more people. is the broad consensus on through behaviour change and 1. Workplaces of the future the critical success factors for As a network we have agreed that we will take some of to issue the Global CMO Network – shaping the work environment interventions in workplace health. these ideas forward collectively. We are however equally with a challenge for how we to promote health. We have made an effort to distil could practically implement determined that the range of thinking here should be these down into a form which can their recommendations. 2. Improving employee made as widely available as possible to anyone who engagement serve as a basis for the network’s would wish to build on it. Research – enabling good choices. future initiatives in this area and for the individual initiatives of our We are therefore making a commitment to promote We have received a wide range 3. A new role for CMOs member companies, as well as this research and to help make connections for any of high quality, insightful and – shifting corporate mindsets. creative responses to this project. any other organisation which organisation interested in pursuing any of these ideas. Each of these contributions are 4. Public and community health wishes to adopt them as follows: To that end we will be disseminating this research - looking outwards. worthy of significant consideration widely and would welcome contact from any in their own right and has helped 5. Digital opportunities organisations wanting to build partnerships to develop to shape our thinking. Together – making it personal. and implement these ideas. they constitute a seminal research As a network we will be meeting regularly to determine which challenges or combination of challenges we will take forward. Critical success factors for workplace health behaviour change By the end of our meeting we will have an outline of the work we will be undertaking as a network in the future, 1. The use of behaviour change techniques to 6. The use of digital channels as a key enabler and our plans for reaching out to and partnering with motivate and genuinely involve people in for scaling, personalising and segmenting other organisations to improve the health of the world. decision making i.e. co-creating solutions interventions. with them, often at large scale and using Thinking of health in a holistic way, incorporating We are certain that the research contributors we have social networks. 7. psychological and physical health. worked with to date have a valuable role to play in developing and implementing these projects. Some of 2. Employees are empowered to take control, Appreciating what matters to employees on to get involved and make a difference, 8. them will be joining us at the meeting. Others will be a broader level, including the health of their especially through volunteering. working with us on the delivery of aspects of our future families and communities as well as broader work. All of them will be invited to be Friends of the 3. The use of appropriate incentives to change population health. Network and recognised as allies and ambassadors for behaviour. These might include financial, improving the health of the world. Taking action early, enabling and supporting competitive or reputational incentives. 9. people to be healthy every day. This report is therefore both a manifesto for future action 4. The environment and context needs to and a catalyst for things to come. Our network is open, 10. Leadership matters – visible ownership be structured so that choices are made growing, collaborative and ambitious to act. It is also and participation by CEO, CMO and senior automatically (nudge theory). Small changes therefore an invitation to anyone out there who would leadership teams. can have a big impact, recognising that 90 join us on this journey. percent of decisions are made using ‘fast, 11. The ability to demonstrate measurable return instinctive and emotional thinking’ (system 1). on investment that brings value to the company We will make a transformative impact on the health of and improves health, wellbeing and productivity the world. We understand the scale of the challenge 5. Connecting people to a bigger purpose beyond of employees. before us and the need to move on from words to work. themselves and enabling them to be recognised for doing so. ‘Happiness lies in serving others’. That work starts today. 6 7 Workplace health. CMO or CHO? Culture as context. And unintended consequences WORKPLACES by Alan Newman 10 Creating dynamic workplaces: OF THE FUTURE a pathway to healthier workers and productive businesses by David Dunstan 14 shaping the work environment Theories and techniques for influencing to promote health health behaviours in organisations by Ivo Vlaev 18 Occupational health interventions for developing and developed countries by Paul Dolan 22 Health improvement in the workplace by Richard Jenkins 28 Minimalist, oblique and non-obvious by Rory Sutherland 30 Workplaces and the self-management of co-morbidity by Stephen Bevan 34 8 9 WORKPLACES OF THE FUTURE Consider the example of a school Item 4 women were smokers. Today it’s Workplace health where a small number of parents If we want to change behaviour about 22 percent for both sexes and were consistently late dropping we have to change the context. has been for the last four years or CMO or CHO? Culture as context. their children off. This irritated the Supermarkets are behaviour so.