Coronary heart disease (CHD) is the UK’s biggest killer, causing 82,000 deaths each year, according to the National Health Service (NHS).
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Employers can help to prevent the causes of heart disease by promoting healthy lifestyles in the workplace and getting staff back into work after they have had a heart problem. Lifestyle choices have a direct link to CHD. Smoking, high cholesterol, high blood pressure and diabetes all can lead to problems and, ultimately, a heart attack.
By making some simple lifestyle changes, employees can reduce the risk of getting CHD. This includes being physically active, giving up smoking and eating a balanced diet. British Heart Foundation (BHF) research, carried out in December 2012 with YouGov, found that nearly one in five workers (18%) perform absolutely no physical activity during working hours and only 27% manage 20 minutes’ activity or less over the working day.
Many organisations adopt a staff wellbeing strategy to help introduce lifestyle changes. But Chris Andrews, managing director of workplace fitness organisation Personal Touch Fitness, says it is important for employers to understand what health issues their staff have in preparation for introducing a health strategy.
“If an organisation has a spare room, it can offer employees classes to do fitness activities such as pilates,” she adds.
Nutrition is another vital aspect of any strategy aimed at avoiding heart problems, says Andrews. “Employers can hold nutrition seminars to help teach employees about healthy choices, healthy living and how to maintain healthy hearts,” she says. “The nutrition seminars can have focused topics, for instance an employer could hold one to discuss cholesterol.
“These seminars are good because employers can be interactive with their staff and take a hands-on approach to helping them maintain a healthy heart. Employers can have a whole health and wellbeing strategy that will educate employees about heart fitness and introduce activities to help them get fitter.”
Devising a healthcare strategy need not be complicated. Barbara Dinsdale, lifestyle manager at charity Heart Research UK, says employers can take simple steps to encourage healthy lifestyles in the workplace. “It depends on the organisation and the capacities and facilities they have got, but they can promote healthy eating, exercise and quit-smoking programmes,” she says. “It’s a holistic approach. Sometimes we support employers with simple exercise and sometimes we do lifestyle questionnaires. These programmes are popular with employers. We concentrate on health promotion, rather than rehabilitation.”
Long lunch break
Another simple approach could be to give staff an extended lunch break. According to the BHF’s research, one in five employees (20%) do not take a lunch break and nearly one-third (32%) think employers do not care much about their health. The onus seems on employers to make a change, with more than two-thirds (68%) of respondents believing their boss should take responsibility for their general health at work.
Doctor Katie Tryon, head of clinical vitality at insurer PruHealth, says awareness of heart conditions is vital. “Employers should use a three-step process to raise awareness,” she says. “First, give staff the right information in a manner appropriate to them, so they can digest it easily. Second, make it easier for employees to make healthy lifestyle changes with the information provided to them.
“Things like subsided gym membership and subsided food in the canteen come into a good employer approach. Finally, reward employees for making healthy changes. That can be through an incentive reward programme or cash initiatives.”
Tryon says lifestyle changes, such as eating more healthily, call for a long-term strategy, which can be a problem for employees, many of whom tend to look for short-term solutions to improve their health.
Organisations need to engage their employees in thinking longer-term about their health, says Tryon. “People have to invest in their own health over a number of years in a complex way to prevent them getting heart disease or heart-related issues,” she adds.
Where an employee has taken sickness absence because of a heart condition, their employer should ensure an individual risk assessment takes place before the employee considers returning to work because different heart conditions have varying recovery times.
Lisa Purcell, a project manager and physical activity specialist in the British Heart Foundation’s heart health resources and community support team, says: “The employee should be given the opportunity to return to work gradually over a few weeks, if required.
“For example, they could do two to three mornings in week one, then five mornings in week two, and so on. This ensures the employee doesn’t overdo it, which might result in them having to go on sick leave again.
“Finally, the employer should try to ensure that the employee does not feel pressured to be up and running at their usual pace too soon, but rather supported to ease back into work in their own time.”
Case study – Stagecoach UK
Stagecoach UK’s Healthy Heart Bus project, which ran from 2010 to 2012, involved more than 3,000 employees in its bus division.
The voluntary heart health screening project was offered in partnership with independent hospital provider BMI Healthcare.
June Ashton, HR manager for the Stagecoach Group’s UK division, says: “Our chief executive, Sir Brian Souter, came up with the idea after speaking to a cardiologist. He personally funded half of the project because he feels passionately about healthcare.”
A bus was refurbished as a mobile cardio-screening unit and toured Stagecoach’s UK bus depots, providing free heart health check-ups for thousands of employees. Staff received individual advice on ways to improve their heart health or access further medical tests through their doctor, if required.
“The project was well received,” says Ashton. “Initially, people were sceptical about taking part, but eventually they came round to the idea of getting themselves checked out.
“It helped make a practical difference and, for some members of our driving team, it identifi ed health issues that have been able to be addressed more quickly.”
The organisation worked closely with the trade unions Unite and RMT on the project to ensure that staff were entirely comfortable with the initiative.
Viewpoint: Dr Yousef Habbab
Employers can be involved in managing heart disease from the very start of the employment process, if a potential recruit declares that they have a heart condition. If the employer has an occupational health provision, the employee will be contacted to clarify the clinical picture and the likely impact the condition may have on their employment, in terms of capability to undertake the role and the need for any necessary adjustments.
An employer may also become aware of an employee suffering a cardiac condition, either through sickness absence or deterioration in performance. Occupational health’s involvement is important at that stage to assess the employee, request further information from their GP or specialist, then provide appropriate guidance to the employer on how to support the employee at work.
An employer can get involved in preventing cardiac conditions, but this is often overlooked, either because of fi nancial restraints or a lack of specialised knowledge about how to implement an effective health promotion programme.
With coronary heart disease causing more deaths than any other single disease, efforts should be made in the workplace to encourage employees to adopt a healthy lifestyle and avoid the risk factors for heart disease, which include obesity, diabetes, high blood pressure, high cholesterol, physical inactivity and smoking.
Encouraging employees to adopt an active lifestyle, including some form of moderate exercise, for example cycling or fast walking, for at least 30 minutes a day, can help to improve their health.
Other measures include offering a healthy menu option in the workplace canteen and issuing health promotional information through leafl ets, online channels or social media, helping to raise awareness of heart problems and tackle this major killer.
Dr Yousef Habbab is senior occupational physician and deputy to the medical director of Axa PPP healthcare’s Health Services division.