Engaging your board and building your business case

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The role of a health and wellbeing lead in any NHS organisation, and with the support of all staff, should be fundamental to driving the health and wellbeing agenda. Securing support for this agenda at the highest level within the organisation is a key element of this role. This section provides you with the tools to engage your board and obtain that support.

Why is it important to engage the board?

The board is a key influential group that makes strategic decisions about resources and priorities that affect the organisation. Without board engagement it can be difficult to achieve wider organisational support. The board is interested in the successful operation of the organisation in terms of achieving high-quality patient care while ensuring financial sustainability. 
You should highlight the impact that improved employee health and wellbeing can have on core organisational outcomes. This will make sure that health and wellbeing is seen as central to the core business of the organisation rather than an optional add on which is nice to have but not essential.
Evidence from organisations that have successfully implemented health and wellbeing, and achieved positive results across the whole organisation, indicates they did this with the full engagement and support of the board.

The importance of a board and clinical lead
Showing the impact of health and wellbeing
Create a business case
Obtaining the data
Presenting key data

The importance of a board and clinical lead

A health and wellbeing champion on the board should ensure that employee health and wellbeing is:

  • reported on and discussed at board meetings on a regular basis
  • considered in all organisational decisions
  • embedded in the wider operation of the organisation through policies and procedures.

The question about who is going to be the champion for this area of work should be put when engaging with the board so that they have a chance to discuss it and for a volunteer to come forward or for one to be appointed.  It is important that the champion is involved in setting the strategy and driving the work forward, supported by the health and wellbeing lead and representatives from staff across the organisation.

Health and wellbeing depends on the culture of an organisation and any change in culture needs to be driven through strong board or equivalent level leadership. Two role descriptors have been developed to help NHS organisations identify skilled leaders, to drive and champion staff wellbeing across the organisation. The job roles covered in the descriptors are for a senior/board lead and a clinical lead. 

Show the impact of improving health and wellbeing

Start by providing information on the current organisational impact of sickness absence. To gain support for change you will also need to show the impact expected from implementing health and wellbeing interventions. 

Calculations that show what could be saved by the organisation for a percentage reduction in sickness absence can highlight the importance of the issue to the board. Look at our interactive web based sickness absence savings calculator which will help you collect data that could be used to measure your employee health and wellbeing.

It is important to show how sickness absence and other data impacts on organisational performance measures such as infection control rates, mortality rates and agency staffing costs. Presenting such evidence begins to show in an analytical way the impact that employee health and wellbeing can have on business performance and in many cases patient experience and satisfaction.

NHS England’s Health and Wellbeing Framework diagnostic tool has been designed to help you assess your organisation and should be used alongside the Health and Wellbeing Framework document. We recommend completing the tool with your health and wellbeing steering group (or equivalent) and board lead for staff health and wellbeing. The tool includes a handy dashboard which summarises your organisation’s status against the framework.

Create a business case

Creating a business case is a great way to engage your board and persuade them of the benefits of health and wellbeing. Think about the financial costs and benefits to having healthy and engaged staff and the impact this will have on patient outcomes. Below are a few things to consider when writing your business case: 

Costs

Think about the human costs associated with a business case. What are the repercussions of not doing anything? You could include sickness absence return to work savings, cost of any specific resources, identify savings from this investment, return on investment, hard versus soft costs and staff turnover figures. Other advice and things to consider:

  • concentrate on financial savings within the fiscal period
  • link to past successes
  • recruitment/succession planning.

Benefits

Look for the organisational wins and the implications of the board accepting and rejecting the case, as well as continuing to raise the profile of health and wellbeing in your trust. You could include increased staff engagement/morale, patient audit results, social networks, productivity resilience, reduction in sickness absence rates/reasons, agency spend and stress factors. Others advice and things to consider:

  • Key Performance Indicators (KPIs)
  • friends and family tests
  • Keogh/Francis/Berwick.

Timescales

Identifying your sponsor early will give your business case the boost it needs to be driven forward. You can clarify the reporting arrangements and diarise when these will be needed. Your project plan should be included in this section focussing on short, medium and long-term planning. When will the programme start, how long will this run for and at what points will you evaluate.

Project Team

Who sits on your project group will be dependent on the type of initiative the business case is focussed on, but may include:

  • users
  • OH/HR
  • board
  • staff side
  • governors
  • estates
  • communications
  • infection control
  • health and safety
  • health and wellbeing champions
  • lead for key areas.

Key risks

Establishing what the barriers to the business case success is crucial to avoiding any additional questioning by the board. Some possibilities are:

  • low attendance
  • staff being released from day jobs
  • lack of engagement
  • culture
  • sustainability
  • patient risks
  • impact on the trust targets/objectives.

Obtaining the data

All the data suggested should be available to you from within the organisation with the exception of the national figures.  Organisational data on sickness absence rates and causes for absence should be available to you from human resources and payroll colleagues.  You may wish to enlist the help of someone with statistical experience to help you develop the figures in support of your business case.

National data will either be available from human resources colleagues who will know the target rate for the organisation and have access to figures published nationally or from the NHS Digital website.  

Presenting the data

It is essential when engaging with board members or making a presentation that you present up to date data that will grab the attention of your audience and relate to the wider policy and operational issues with which they are dealing. It is important that you are aware of the health and wellbeing data which is required for external monitoring purposes.
One of the first pieces of data that you will need to present is the organisation’s sickness absence rate and a comparison to the national or regional average figures. It is also helpful to put these figures in the context of performance over a number of years, especially if they have fluctuated.
Presenting the data in a number of different ways also engages the board in the real meaning of the figures. You might consider showing absence as:

  • Total number of hours lost
  • Total number of days lost (assuming an average day)
  • Total number of weeks lost
  • Equivalent number of FTEs that have not been providing patient care.

Data from HR and payroll should enable you to identify the main causes of sickness absence and number of days lost.

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