Health & Wellbeing for UK Rail

Transcription

1 Health & Wellbeing for UK Rail Roadmap Workshop 3 15 November, DRAFT 1.0 Nov 2013 Note: Wordle created from participant vision statements Copyright Institute for Manufacturing Page 1 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

2 Executive Summary This report results from a one-day workshop to map the future of Health & Wellbeing for the UK Rail industry. This is the third of three workshops to develop a roadmap to bring about commitment and understanding for a series of well-planned, effective and prioritised tasks that a diverse range of stakeholders believe will improve health and wellbeing management within the railway and therefore the health and wellbeing of the Rail Workforce and the efficiency of the sector. The workshop was jointly hosted by RSSB and ORR at RSSB in London and benefitted from the insights of 24 experts from across the relevant stakeholder groups. The workshop started with a baseline landscape and outline vision based on the pre-work that had been completed by the vast majority of participants. In setting out a Vision for Health and Wellbeing in UK Rail the group showed very strong alignment across all stakeholder groups (see 1.1) in identifying Better workforce health and physical, social and psychological wellbeing, underpinned by a culture which demonstrates that health at work is everybody's responsibility as the two key aspects of the Vision. Further factors were also seen to be important: Professionalised health and wellbeing provision in Rail A more efficient and productive railway for the benefit of everyone and An engaged and committed supply chain working together. Of relatively lower importance were: Legal compliance and moving towards broader industry bestin-class Working for the rail industry is a long, productive and attractive career An inclusive and sustainable workforce Copyright Institute for Manufacturing Page 2 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

3 Executive Summary (continued) Key Trends, Drivers and Stakeholder Perspectives prioritised by the group as having the most influence on the future context for Health and Wellbeing included the following (in order of priority see section 2 for detail): Ageing workforce / longer working life Retain the best employees Rising Obesity Improved H&W delivers productivity to benefit of all Social attitudes driving changes in work / life balance Worker health has a lower profile than worker and passenger safety ORR health programme priorities Improved Employee and Union relations / engagement (inc H&S Reps) Whole system approach to railway management (RTS) Industry reputation as an attractive place to work Dame Carol Black report indicates work is good for you There needs to be a cost benefit to health Copyright Institute for Manufacturing Page 3 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

4 Executive Summary (continued) The Health and Wellbeing Challenges faced by the Industry (which of course represent Opportunities if addressed) were prioritised as follows (see section 3 for detail): Stress, Anxiety and Depression Fatigue / shift patterns Wellbeing sustains engagement Active life styles / Active life style promotion Need for reliable leading and lagging indicators for ill health Poor health management limits ability to work Access for all to quality OH services Lack of individual resilience and adaptability Musculoskeletal disorders Absenteeism Future occupational cancer burden shift work, DEEE Sleep disorders Copyright Institute for Manufacturing Page 4 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

5 Executive Summary (continued) The group then worked to identify and prioritise the key Reponses, Actions and other Enablers that could be put in place to address these Challenges in the context of future Drivers and Needs (see section 4). The highest priorities were identified as: Emphasise key role of Line Managers in providing purpose & direction Leadership creates culture for behaviour change Employee engagement is key to delivering wellbeing ==> OH Training courses & Education for target groups (especially front-line managers) Industry strategy for Engagement All stakeholders (including individual responsibilities) agree benefits and understand roles in making positive changes. Shift funding from reaction to prevention Rail based health standards are reviewed and improved for better outcomes Best practice knowledge transfer Increase employee say in what is happening Translate proven health activities from other industries into rail Awareness of, reporting & training for stress issues A number of these priorities were explored in more detail to characterise benefits and identify outline Action Plans for delivery (see section 5) Copyright Institute for Manufacturing Page 5 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

6 Contents Executive Summary 1. Vision and Roadmap Landscape 2. Trends & Drivers and Stakeholder Perspectives 3. Health & Wellbeing Challenges & Opportunities 4. Responses & Enablers 5. Detailed exploration of Responses & Enablers Characterisation and Elevator Pitch Outline Action Plan Appendices: A. Participants B. Workshop Feedback C. Detailed exploration of Value Creation Opportunities D. Workshop Process E. Participant Perspectives Copyright Institute for Manufacturing Page 6 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

7 1.1. Vision for Health & Wellbeing in UK Rail Vision component Infrastructure TOC FOC Health Specialist Rail / External Body Supply Chain Number of participants in stakeholder group in workshop: Better workforce health and physical, social and psychological wellbeing A culture which demonstrates that health at work is everybody's responsibility Professionalised health and wellbeing provision in Rail A more efficient and productive railway for the benefit of everyone An engaged and committed supply chain working together Legal compliance and moving towards broader industry best-in-class Working for the rail industry is a long, productive and attractive career An inclusive and sustainable workforce 27% 26% 14% 18% 27% 21% 24% 9% 24% 29% 18% 18% 7% 19% 23% 12% 14% 23% 10% 21% 15% 0% 14% 0% 23% 20% 0% 13% 23% 18% 14% 0% 4% 21% 12% 18% 0% 7% 14% 8% 0% 7% 0% 4% 14% 5% 6% 21% 6% 0% 2% 7% 0% 6% 7% 4% Total Note: Not all stakeholder groups were equally represented. Stakeholder group numbers do not reflect balance of influence across sector Copyright Institute for Manufacturing Page 7 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

8 Health & Wellbeing Challenges & Opportunities Trends & Drivers Sakeholder Perspectives Required Responses and Actions Enablers 1.2. Roadmap Landscape Headlines Occ Health Well-being Social Technological Environmental Economic Past 2014 Short term Medium term Long term 2025 Vision CP4 CP5 CP6 CP7+ Dame Carol Black report indicates Social attitudes driving changes in Rising Obesity Morbidity & cognitive Ageing workforce / longer work is good for you work / life balance decline working life New Franchising 24/7/365 working environment Improved medical understanding demands better treatment Whole system approach to railway management (RTS) Political & Legal inc DfT & ORR Work-force TOCs & FOCs Network Rail Suppliers Worker health has a lower profile than worker and passenger safety Largely male workforce with most employees over 40 There needs to be a cost benefit to health Large number of contractors (80-90K) Retain the best employees ORR health programme priorities Improved Employee and Union relations / engagement Professionalised workforce Industry reputation as an attractive place to work InfraCos Health Professionals Evaluation of role of fit notes s / Whole Industry Improved H&W delivers productivity to benefit of all Effect of work on health Fitness for work Psychological wellbeing Physical wellbeing Social wellbeing Engagement Opportunity and Access Stress, Anxiety and Depression Musculoskeletal disorders Absenteeism Fatigue / shift patterns Poor health management limits ability to work Need for reliable leading and lagging indicators for ill health Access for all to quality OH services Active life styles / Active life style promotion Wellbeing sustains engagement Lack of individual resilience and adaptability Industry leadership Emphasise key role of Line Managers in providing purpose & direction Trade Union support Translate proven health activities from other industries into rail Leadership creates culture for change Clinical leadership Evidence based action Reporting and metrics Employee engagement Education & Training Behavioural change Industry strategy for Engagement Increase employee say in what is happening All stakeholders (including individual responsibilities) agree benefits and understand roles in making positive Training courses & Education for target groups (especially front-line managers) Employee engagement key to delivering wellbeing ==> OH Specific Interventions Shift funding from reaction to prevention Knowledge People & Skills Facilities & Infrastructure Standards & Regulation Supply Chain Occupational Health and Wellbeing expertise Funding Best practice knowledge transfer Real-time data collection (eg via tablet technology) Improved equipment / reduced emissions Resources (Numbers of professionals) Increasing mechanisation to eliminate hazardous tasks There is an increase in health skills purchased by the organisation IIP Rail-based medical standards are reviewed and improved for better outcomes Copyright Institute for Manufacturing Page 8 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

9 Health & Wellbeing Challenges & Opportunities Enablers Sakeholder Perspectives Trends & Drivers Required Responses and Actions Well-being Occ Health 1.3. Roadmap Landscape (See later for more readable detail) Social Technological Environmental Economic Political & Legal inc DfT & ORR Work-force TOCs & FOCs Network Rail Suppliers InfraCos Health Professionals s / Whole Industry Past 2014 Short term Medium term Long term 2025 Vision CP4 CP5 CP6 CP7+ Dame Carol Black report People as key drivers in Changes in labour market (zero hours Social attitudes driving changes Rising Obesity indicates work is good for you business (RTS) contracts; EU migration and legislation?) Design with roles and Highly skilled in work / life balance people in mind (RTS) workforce (RTS) Improved medical understanding Technology advances demands better treatment & automation 75m cost of Worsening living conditions increase demands 24/7/365 working absence for better management of health New environment VfM Study - Rail industry needs to Alliances between railway Franchising earn its investment from organisations drive performance 140m cost of Pressure from socioeconomic downturn Effects of VfM driving Increasing demands > Capability < Role of insurance companies impairment behaviours Cost of non compliance to Cost for CP6/7 Gender Occupational Safety and legislation ORR health programme priorities Health good practice (GOSH) Morbidity & cognitive Ageing workforce / longer decline working life Whole system approach to The Railway a magnet for talent railway management (RTS) (RTS) Climate change leads to temp rise Regulation on health risks, ageing Tax relief for companies that disorders & equality manage health of employees Reduced NHS results in best companies picking up non-essential health needs of employees Reduced tolerance for lack of action Government looks to industry to to prevent ill health play an increased role in health Worker health has a lower profile than Workforce and TU expectations for Retain the best employees Improved Employee and Union Industry reputation as an worker and passenger safety improved H&W relations / engagement attractive place to work D&A tests Largely male workforce with Large number of contractors (80- Protection of transient workforce Professionalised workforce most employees over 40 90K) ATOC HEROH Meet franchise Mismatch between franchise term There needs to be a cost benefit Forum requirements and whole working life to health ISLG OH manifesto CP5 charged large savings from H&W and technology Extended supply chain changing A reliable supply chain Equipment supplied with health issues managed International supply chain impacting time / cost / culture demands (eg built with ergonomics in mind) on H&W of non-gb workforce Increased demands on contractors - long working hours/tighter schedules OH professionals need a greater Better OH Contracts Evaluation of role of fit notes understanding of Rail health issues Need for reliable, timely, consistent & Improvement needed in competency Manage liabilities transparent data amongst managers Need to raise Health higher up Legal requirements seem remote Customers do not require strategic Corporate Agenda input Overcoming entrenched rail culture SEQOHS occ health competency Ensuring employment issues are not that health risk not an issue' medicalised (flexible working, shifts) UK Railway Recognised as a key contributor to the world wide integrated transport sector (RTS) Improved H&W delivers productivity to benefit of all Effect of work on health Fitness for work Psychological wellbeing Physical wellbeing Social wellbeing Engagement Opportunity and Access Industry leadership Clinical leadership Evidence based action Reporting and metrics Employee engagement Education & Training Behavioural change Specific Interventions Knowledge People & Skills Facilities & Infrastructure Standards & Regulation Supply Chain Ballast dust Stress, Anxiety and Depression HAVS Hearing loss Diesel engine exhaust Management of individual health emissions risks Toilet waste on the Fatigue / shift Biological Manual handling of Future occupational cancer burden track Musculoskeletal patterns contaminants wheelchairs shift work, DEEE disorders Poor health management limits Long term sickness ability to work Sleep disorders Stress (Trauma management following suicides) Endocrine disorders eg diabetes Heart / circulatory Respiratory Need for reliable leading and Active life styles / Active Individual Lack of individual disorders issues lagging indicators for ill health life style promotion Burnout resilience and adaptability Effects of long-distance Increased home working or working Individual underutilised commuting at remote locations Absenteeism Presenteeism Engagement Wellbeing sustains Healthier job roles improve H&W perks support recruitment & Deficit engagement engagement retention for sustainable railway Eyesight & Colour vision Access for all to quality OH Match requirements to work undertaken to services retain tacit knowledge of ageing workforce Avoidance of abuse of support Sustainable workforce through networks effective succession planning Emphasise key role of Line Managers in providing Trade Union support Collaborative industry approach to Translate proven health activities Leadership creates culture for purpose & direction common issues from other industries into rail change Companies re-evaluate More effective communication between OH Informing policy / standards Clinical effectiveness is Health professionals improve health Clinical leadership provides direction for health policies service providers and line managers development for OH managed within industry decisions within organisations development of industry s health capabilities Better cooperation between medical Improved OH guidance (eg Improved understanding of OH Guidance is developed to assist professionals eg OHS and GPs managing return to work) issues in rail by OH practitioners railway physicians Health data collection supports reasoned Health and wellbeing monitoring Action based upon sound evidence decisions to drive change. technology Need for data that is more leading Intended use of data outputs is Improved cost benefit analyses and tools Success is measured and reviewed understood during the planning stage before wider industry roll-out. Improved occupational Companies publish improved health data health reports indicating the progress of the rail industry Industry strategy for Engage ageing Embrace diversity of Increase employee say in All stakeholders (including individual Better awareness of H&W initiatives Communication leads to Employee engagement key to Industry productivity is enhanced to Engagement workforce workforce what is happening responsibilities) agree benefits and understand roles across dispersed workforce access to information for all delivering wellbeing ==> OH improve successful outcomes for all. Competency frameholders for health and Industry educational and competence Training courses & Education for target All trained on health at work as the wellbeing line managers requirements are mapped groups (especially front-line managers) norm Awareness of, reporting & training Diet, Nutrition & active lifestyle Behaviour change / nudging Link reward (or salary sacrifice) to for stress issues advice activities. health & wellbeing Hazard specific working groups Organisational roles take a holistic approach Risks are proactively Opportunity for health / safety by tackle difficult health hazards to health rather than functional addressed design (eg cab ergonomics) Logistics of remote working Rehabilitation plans reduce absence Baseline health assessment of all high risk costs workers Keep it simple Employee health and wellbeing Send signal through franchise Shift funding from reaction to Implement all 10 recommendations issues also impact passengers programme for H&W prevention in briefing Research and specialist advice to Railway conferences allow cross-fertilisation Best practice knowledge transfer Regulator's forum formulate the basics / strategy and promotion of best practice Occupational Health and Education outreach to schools Resources (Numbers of IIP Wellbeing expertise professionals) Funding Real-time data collection (eg via Improved equipment / reduced Increasing mechanisation to tablet technology) emissions eliminate hazardous tasks Job roles altered to become more engaging NSARE accreditation to include occupational health? New technology (eg otoacoustic Regional OH provider centres Smart cards enable the health of employees to emission testing) based at railway premises be tracked through their working life Review frequency of D&A testing Voluntary standards improve organisational management Voluntary standards result in the scope of health Rail based health standards are of health to agreed levels activities being fully covered reviewed and improved for better Data processing system / shared Guidance enables better contracts Supply chain standards ensure Supply chain provides tools to There is an increase in health skills Incentives and penalties? - H&W as databases developed with OH providers health is integrated into design reduce harm purchased by the organisation a contract criterion Note: Deeper colours indicate higher priority items. Copyright Institute for Manufacturing Page 9 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

10 Sakeholder Perspectives Trends & Drivers 2.1 Trends and Drivers Social Technological Environmental Past 2014 Short term Medium term Long term 2025 Vision CP4 CP5 CP6 CP7+ Dame Carol Black report indicates work is good for you 75m cost of absence People as key drivers in business (RTS) Worsening living conditions increase demands for better management of health Changes in labour market (zero hours contracts; EU migration and legislation?) Design with roles and people in mind 24/7/365 working environment Highly skilled workforce (RTS) Social attitudes driving changes in work / life balance Improved medical understanding demands better Rising Obesity Technology advances & automation Morbidity & cognitive decline Whole system approach to railway management (RTS) Climate change leads to temp rise Ageing workforce / longer working life The Railway a magnet for talent (RTS) Economic Political & Legal inc DfT & ORR Work-force TOCs & FOCs Pressure from socio-economic downturn 140m cost of impairment Worker health has a lower profile than worker and passenger safety D&A tests There needs to be a cost benefit to health Effects of VfM driving behaviours New Franchising Workforce and TU expectations for improved H&W Largely male workforce with most employees over 40 ATOC HEROH Forum Meet franchise requirements Role of insurance companies Gender Occupational Safety and Health good practice (GOSH) Large number of contractors (80-90K) VfM Study - Rail industry needs to earn its investment from government Mismatch between franchise term and whole working life Cost of non compliance to legislation Retain the best employees Protection of transient workforce Alliances between railway organisations drive performance and cost improvements Increasing demands > Capability < Cost for CP6/7 Improved Employee and Union relations / engagement Professionalised workforce ORR health programme priorities Regulation on health risks, ageing disorders & equality Reduced NHS results in best companies picking up non-essential health needs of employees Government looks to industry to play an increased role in health management Industry reputation as an attractive place to work Tax relief for companies that manage health of employees Reduced tolerance for lack of action to prevent ill health UK Railway Recognised as a key contributor to the world wide integrated transport sector (RTS) Network Rail ISLG OH manifesto CP5 charged large savings from H&W and technology Suppliers Extended supply chain changing time / cost / culture demands A reliable supply chain Equipment supplied with health issues managed (eg built with ergonomics in mind) International supply chain impacting on H&W of non-gb workforce InfraCos Increased demands on contractors - long working hours/tighter schedules Health Professionals OH professionals need a greater understanding of Rail health issues Better OH Contracts Evaluation of role of fit notes s / Whole Industry Need for reliable, timely, consistent & transparent data Need to raise Health higher up Corporate Agenda Overcoming entrenched rail culture that health risk not an issue' Improvement needed in competency amongst managers Legal requirements seem remote SEQOHS occ health competency Manage liabilities Customers do not require strategic input Ensuring employment issues are not medicalised (flexible working, shifts) Improved H&W delivers productivity to benefit of all Copyright Institute for Manufacturing Page 10 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

11 2.2 Trends & Drivers (1 to 20) Rank Driver Timescale Workshop % 1 Ageing workforce / longer working life long 13 15% 2 Rising Obesity medium to long 12 14% 3 Social attitudes driving changes in work / life balance medium 9 10% 4 ORR health programme priorities medium 5 6% 5 Whole system approach to railway management (RTS) medium 5 6% 6 Dame Carol Black report indicates work is good for you short 4 5% 7 Improved medical understanding demands better treatment medium 4 5% 8 New Franchising short 4 5% 9 24/7/365 working environment short 3 3% 10 Morbidity & cognitive decline long 3 3% 11 Pressure from socio-economic downturn short 3 3% 12 75m cost of absence Past 2 2% 13 Effects of VfM driving behaviours short 2 2% 14 Gender Occupational Safety and Health good practice (GOSH) 2 2% 15 Regulation on health risks, ageing disorders & equality long 2 2% 16 Tax relief for companies that manage health of employees long 2 2% 17 Technology advances & automation medium 2 2% 18 The Railway a magnet for talent (RTS) medium 2 2% 19 UK Railway Recognised as a key contributor to the world wide integrated transpolong 2 2% 20 Worsening living conditions increase demands for better management of medium 2 2% Copyright Institute for Manufacturing Page 11 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

12 2.2 Trends & Drivers (cont) Rank Driver Timescale Workshop % 21 Changes in labour market (zero hours contracts; EU migration and legislation?) short 1 1% 22 Cost of non compliance to legislation medium 1 1% 23 People as key drivers in business (RTS) short 1 1% 24 Reduced tolerance for lack of action to prevent ill health long 1 1% 25 Role of insurance companies short 1 1% m cost of impairment Past 0 0% 27 Alliances between railway organisations drive performance and cost medium 0 0% 28 Climate change leads to temp rise long 0 0% 29 Design with roles and people in mind (RTS) short 0 0% 30 Government looks to industry to play an increased role in health management medium to long 0 0% 31 Highly skilled workforce (RTS) medium 0 0% 32 Increasing demands > Capability < Cost for CP6/7 medium 0 0% 33 Reduced NHS results in best companies picking up non-essential health needs of medium 0 0% 34 VfM Study - Rail industry needs to earn its investment from government medium 0 0% Copyright Institute for Manufacturing Page 12 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

13 2.4 Stakeholder Perspectives (1 to 20) Rank Needs Timescale Workshop % 1 Retain the best employees medium 6 14% 2 Improved H&W delivers productivity to benefit of all long 5 11% 3 Worker health has a lower profile than worker and passenger safety short 5 11% 4 Improved Employee and Union relations / engagement (inc H&S Reps) medium 4 9% 5 Industry reputation as an attractive place to work medium 4 9% 6 There needs to be a cost benefit to health short 4 9% 7 Large number of contractors (80-90K) short 3 7% 8 Evaluation of role of fit notes medium 2 5% 9 Largely male workforce with most employees over 40 short 2 5% 10 Professionalised workforce medium 2 5% 11 Workforce and TU expectations for improved H&W short 2 5% 12 A reliable supply chain medium 1 2% 13 CP5 charged large savings from H&W and technology medium 1 2% 14 Extended supply chain changing time / cost / culture demands short 1 2% 15 Mismatch between franchise term and whole working life short 1 2% 16 Protection of transient workforce medium 1 2% 17 Customers do not require strategic input short 0 0% 18 D&A tests short 0 0% 19 Equipment supplied with health issues managed (eg built with ergonomics in minmedium 0 0% 20 Increased demands on contractors - long working hours/tighter schedules medium 0 0% Copyright Institute for Manufacturing Page 13 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

14 2.4 Stakeholder Perspectives (cont) Rank Needs Timescale Workshop % 21 International supply chain impacting on H&W of non-gb workforce long 0 0% 22 ISLG OH manifesto short 0 0% 23 Meet franchise requirements short 0 0% 24 ATOC HEROH Forum short 0 0% 25 Better OH Contracts short 0 0% 26 Ensuring employment issues are not medicalised (flexible working, shifts) short 0 0% 27 Improvement needed in competency amongst managers short 0 0% 28 Legal requirements seem remote short 0 0% 29 Manage liabilities short 0 0% 30 Need for reliable, timely, consistent & transparent data short 0 0% 31 Need to raise Health higher up Corporate Agenda short 0 0% 32 OH professionals need a greater understanding of Rail health issues short 0 0% 33 Overcoming entrenched rail culture that health risk not an issue' short 0 0% 34 SEQOHS occ health competency short 0 0% Copyright Institute for Manufacturing Page 14 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

15 Health & Wellbeing Challenges & Opportunities Well-being Occ Health 3.1 Health & Wellbeing Challenges & Opportunities Effect of work on health Past 2014 Short term Medium term Long term 2025 Vision CP4 CP5 CP6 CP7+ Ballast dust Toilet waste on the track Stress, Anxiety and Depression Musculoskeletal disorders HAVS Fatigue / shift patterns Hearing loss Biological contaminants Diesel engine exhaust emissions Manual handling of wheelchairs Management of individual health risks Future occupational cancer burden shift work, DEEE Fitness for work Poor health management limits ability to work Long term sickness Psychological wellbeing Physical wellbeing Sleep disorders Endocrine disorders eg diabetes Stress (Trauma management following suicides) Heart / circulatory disorders Respiratory issues Need for reliable leading and lagging indicators for ill health Active life styles / Active life style promotion Individual Burnout Lack of individual resilience and adaptability Social wellbeing Engagement Effects of longdistance commuting Absenteeism Increased home working or working at remote locations Presenteeism Engagement Deficit Individual underutilised Wellbeing sustains engagement Healthier job roles improve engagement H&W perks support recruitment & retention for sustainable railway Opportunity and Access Eyesight & Colour vision Access for all to quality OH services Match requirements to work undertaken to retain tacit knowledge of ageing workforce Avoidance of abuse of support networks Sustainable workforce through effective succession planning Copyright Institute for Manufacturing Page 15 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

16 3.2 Health & Wellbeing Challenges & Opportunities Rank Challenges Timescale Workshop % A Stress, Anxiety and Depression short 12 11% B Fatigue / shift patterns short 8 7% C Wellbeing sustains engagement medium 8 7% D Active life styles / Active life style promotion medium 6 5% E Need for reliable leading and lagging indicators for ill health medium 6 5% F Poor health management limits ability to work short 6 5% G Access for all to quality OH services short 5 5% H Lack of individual resilience and adaptability medium 5 5% I Musculoskeletal disorders short 5 5% J Absenteeism short 4 4% K Future occupational cancer burden shift work, DEEE short 4 4% L Sleep disorders short 4 4% M Sustainable workforce through effective succession planning long 4 4% N Engagement Deficit medium 3 3% O HAVS short 3 3% P Healthier job roles improve engagement medium 3 3% Q Heart / circulatory disorders short 3 3% R Long term sickness medium 3 3% S Management of individual health risks medium 3 3% T Presenteeism medium 3 3% Copyright Institute for Manufacturing Page 16 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

17 3.2 Health & Wellbeing Challenges & Opportunities Rank Challenges Timescale Workshop % U Stress (Trauma management following suicides) short 3 3% V H&W perks support recruitment & retention for sustainable railway long 2 2% W Respiratory issues short 2 2% X Toilet waste on the track short 2 2% Y Avoidance of abuse of support networks short 1 1% Z Increased home working or working at remote locations medium 1 1% AA Manual handling of wheelchairs short 1 1% AB Match requirements to work undertaken to retain tacit knowledge of ageing wor medium 1 1% AC Ballast dust short 0 0% AD Biological contaminants short 0 0% AE Diesel engine exhaust emissions short 0 0% AF Effects of long-distance commuting short 0 0% AG Endocrine disorders eg diabetes short 0 0% AH Eyesight & Colour vision short 0 0% AI Hearing loss short 0 0% AJ Individual Burnout medium 0 0% AK Individual underutilised medium 0 0% Copyright Institute for Manufacturing Page 17 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

18 Enablers Required Responses and Actions 4.1 Responses and Enablers Industry leadership Past 2014 Short term Medium term Long term 2025 Vision CP4 CP5 CP6 CP7+ Emphasise key role of Line Managers in providing purpose & direction Trade Union support Collaborative industry approach to common issues Translate proven health activities from other industries into rail Leadership creates culture for change Clinical leadership Evidence based action Companies reevaluate health policies More effective communication between OH service providers and line managers Better cooperation between medical professionals eg OHS Health data collection supports reasoned decisions to drive change. Informing policy / standards development for OH Improved OH guidance (eg managing return to work) Health and wellbeing monitoring technology Clinical effectiveness is managed within industry Improved understanding of OH issues in rail by OH practitioners Action based upon sound evidence Health professionals improve health decisions within organisations Guidance is developed to assist railway physicians Clinical leadership provides direction for development of industry s health capabilities Reporting and metrics Need for data that is more leading Intended use of data outputs is understood during the planning Improved occupational health reports Improved cost benefit analyses and tools Companies publish improved health data indicating the progress of the rail industry Success is measured and reviewed before wider industry roll-out. Employee engagement Industry strategy for Engagement Engage ageing workforce Embrace diversity of workforce All stakeholders (including individual responsibilities) agree benefits and understand roles in making positive changes. Increase employee say in what is happening Better awareness of H&W initiatives across dispersed workforce Communication leads to access to information for all Employee engagement key to delivering wellbeing ==> OH Industry productivity is enhanced to improve successful outcomes for all. Education & Training Competency frameholders for health and wellbeing line managers Industry educational and competence requirements are mapped Training courses & Education for target groups (especially front-line managers) All trained on health at work as the norm Behavioural change Awareness of, reporting & training for stress issues Diet, Nutrition & active lifestyle advice Behaviour change / nudging activities. Link reward (or salary sacrifice) to health & wellbeing Specific Interventions Hazard specific working groups tackle difficult health hazards Logistics of remote working Organisational roles take a holistic approach to health rather than functional Rehabilitation plans reduce absence costs Risks are proactively addressed Baseline health assessment of all high risk workers Opportunity for health / safety by design (eg cab ergonomics) Job roles altered to become more engaging Keep it simple Employee health and wellbeing issues also impact passengers Send signal through franchise programme for H&W Shift funding from reaction to prevention Implement all 10 recommendations in briefing Knowledge Research and specialist advice to formulate the basics / strategy Railway conferences allow cross-fertilisation and promotion of best practice Best practice knowledge transfer Regulator's forum People & Skills Occupational Health and Wellbeing expertise Education outreach to schools Resources (Numbers of professionals) IIP NSARE accreditation to include occupational health? Facilities & Infrastructure Funding Real-time data collection (eg via tablet technology) Improved equipment / reduced emissions Increasing mechanisation to eliminate hazardous tasks New technology (eg otoacoustic emission testing) Regional OH provider centres based at railway premises Smart cards enable the health of employees to be tracked through their working life Standards & Regulation Review frequency of D&A testing Voluntary standards improve organisational management of health to agreed levels Voluntary standards result in the scope of health activities being fully covered Rail-based medical standards are reviewed and improved for better outcomes Supply Chain Data processing system / shared databases Guidance enables better contracts developed with OH providers Supply chain standards ensure health is integrated into design Supply chain provides tools to reduce harm There is an increase in health skills purchased by the organisation Incentives and penalties? - H&W as a contract criterion Copyright Institute for Manufacturing Page 18 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

19 4.2 Responses Infra-structure TOC FOC Health Specialist Rail / External Body Supply Chain The number in the colour-coded columns shows the priority voting of specific stakeholder groups Rank Responses Timescale Total 1 Emphasise key role of Line Managers in providing purpose & direction Short Leadership creates culture for behaviour change medium Employee engagement key to delivering wellbeing which will then drive OH medium-lo Training courses & Education for target groups (especially front-line medium All stakeholders (including individual responsibilities) agree benefits and medium Translate proven health activities from other industries into rail medium Improved understanding of OH issues in rail by OH practitioners Short Industry-level strategy for Engagement Trade Union support Short Behaviour and culture change activities. medium Increase employee say in what is happening Prevention funding (switch from reactive to proactive) KISS (Keep It Simple) Better awareness of H&W initiatives across dispersed workforce Medium Awareness of, reporting & training for stress issues Collaborative industry approach to common issues Medium Health data collection supports reasoned decisions to drive change. Short Intended use of data outputs is understood during the planning stage for medium Clinical leadership provides direction for development of industry s health medium Organisational roles take a holistic approach to health rather than functional Medium Copyright Institute for Manufacturing Page 19 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

20 4.2 Responses (cont) Rank Responses Timescale Total 21 Need for data that is more leading Short Competency frameholders for health and wellbeing line managers Engage ageing workforce Companies publish improved health data indicating the progress of the rail medium Informing policy / standards development for OH Short Success is measured and reviewed before wider industry roll-out. medium Industry educational and competence requirements are mapped Short Job roles altered to become more engaging medium Action based upon sound evidence medium More effective communication between OH service providers and line short All trained on health at work as the norm long Health professionals improve health decisions within organisations medium Guidance is developed to assist railway physicians Medium Baseline health assessment of all high risk workers Medium Improved occupational health reports Short Improved OH guidance (eg managing return to work) Short Health and wellbeing monitoring technology Medium Diet & Nutrition advice (engage food services) Short Communication leads to access to information for all Medium 0 40 Improved cost benefit analyses and tools Medium 0 Copyright Institute for Manufacturing Page 20 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

21 4.2 Responses (cont) Rank Responses Timescale Total 41 Risks are proactively addressed medium 0 42 Industry productivity is enhanced to improve successful outcomes for all. long 0 43 Opportunity for health/safety by design Medium 0 44 Companies re-evaluate health policies short 0 45 Clinical effectiveness is managed within industry Short 0 46 Hazard specific working groups tackle difficult health hazards medium 0 47 Rehabilitation plans reduce absence costs medium 0 48 Better cooperation between medical professionals eg OHS and GPs Short 0 49 Employee health and wellbeing issues also impact passengers Short 0 50 Logistics of remote working Short 0 51 Link reward (or salary sacrifice) to health & wellbeing long 0 52 Embrace diversity of workforce Short 0 53 Send signal through franchise programme for H&W Short 0 54 Implement all 10 recommendations in briefing medium 0 55 Link with cancer screen medium 0 Copyright Institute for Manufacturing Page 21 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

22 4.3 Responses Linkages Ageing workforce / longer working life Retain the best employees Rising Obesity Improved H&W delivers productivity to benefit of Social attitudes driving changes in work / life bal Worker health has a lower profile than worker ORR health programme priorities Improved Employee and Union relations / engag Whole system approach to railway Industry reputation as an attractive place to work Dame Carol Black report indicates work is good There needs to be a cost benefit to health Stress, Anxiety and Depression Fatigue / shift patterns Wellbeing sustains engagement Active life styles / Active life style promotion Need for reliable leading and lagging indicators Poor health management limits ability to work Access for all to quality OH services Lack of individual resilience and adaptability Musculoskeletal disorders Absenteeism Future occupational cancer burden shift work, Sleep disorders This table shows the identified linkages between Responses and priority Drivers, Stakeholder perspectives and H&W Challenges. The right hand column indicates total number of linkages. Rank Responses A B C D E F G H I J K L TOTAL 1 Emphasise key role of Line Managers in providing purpose & direction Leadership creates culture for behaviour change Employee engagement key to delivering wellbeing which will then drive OH Training courses & Education for target groups (especially front-line All stakeholders (including individual responsibilities) agree benefits and Translate proven health activities from other industries into rail 0 7 Improved understanding of OH issues in rail by OH practitioners Industry-level strategy for Engagement Trade Union support Behaviour and culture change activities Increase employee say in what is happening Prevention funding (switch from reactive to proactive) KISS (Keep It Simple) Better awareness of H&W initiatives across dispersed workforce Awareness of, reporting & training for stress issues Collaborative industry approach to common issues 0 17 Health data collection supports reasoned decisions to drive change Intended use of data outputs is understood during the planning stage for 0 19 Clinical leadership provides direction for development of industry s health Organisational roles take a holistic approach to health rather than functional Copyright Institute for Manufacturing Page 22 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

23 4.4 Enablers Infra-structure TOC FOC Health Specialist Rail / External Body Supply Chain The number in the colour-coded columns shows the priority voting of specific stakeholder groups Rank Enablers Timescale Total 1 Occupational Health and Wellbeing expertise short Research and specialist advice to formulate the basics / strategy short Railway conferences allow cross-fertilisation and promotion of best practice Short Incentives and penalties? - H&W as a contract criterion long Best practice knowledge transfer short Resources (Numbers of professionals) long Data processing system / shared databases short Voluntary standards improve organisational management of health to agreed medium Rail based health standards are reviewed and improved for better outcomes Medium Improved equipment / reduced emissions Medium 0 11 Guidance enables better contracts developed with OH providers short 0 12 Supply chain standards ensure health is integrated into design Medium 0 13 Smart cards enable the health of employees to be tracked through their long 0 14 Increasing mechanisation to eliminate hazardous tasks Medium 0 15 Supply chain provides tools to reduce harm Medium 0 16 Regional OH provider centres based at railway premises long 0 17 Voluntary standards result in the scope of health activities being fully covered Medium 0 18 There is an increase in health skills purchased by the organisation Medium 0 19 New technology (eg otoacoustic emission testing) Medium 0 20 NSARE accreditation to include occupational health? long 0 21 Review frequency of D&A testing short 0 22 Regulator's forum Medium 0 23 Education outreach to schools 0 Copyright Institute for Manufacturing Page 23 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

24 4.5 Enabler Linkages Ageing workforce / longer working life Retain the best employees Rising Obesity Improved H&W delivers productivity to benefit of Social attitudes driving changes in work / life bal Worker health has a lower profile than worker ORR health programme priorities Improved Employee and Union relations / engag Whole system approach to railway Industry reputation as an attractive place to work Dame Carol Black report indicates work is good There needs to be a cost benefit to health Stress, Anxiety and Depression Fatigue / shift patterns Wellbeing sustains engagement Active life styles / Active life style promotion Need for reliable leading and lagging indicators Poor health management limits ability to work Access for all to quality OH services Lack of individual resilience and adaptability Musculoskeletal disorders Absenteeism Future occupational cancer burden shift work, Sleep disorders This table shows the identified linkages between Enablers and priority Drivers, Stakeholder perspectives and H&W Challenges. The right hand column indicates total number of linkages. Rank Enablers A B C D E F G H I J K L TOTAL 1 Rail based medical standards are reviewed and improved for better outcomes Best practice knowledge transfer Occupational Health and Wellbeing expertise 0 4 Improved equipment / reduced emissions 0 5 Resources (Numbers of professionals) 0 6 Increasing mechanisation to eliminate hazardous tasks 0 7 There is an increase in health skills purchased by the organisation Funding IIP 0 10 Real-time data collection (eg via tablet technology) Incentives and penalties? - H&W as a contract criterion 0 12 Railway conferences allow cross-fertilisation and promotion of best practice 0 13 Guidance enables better contracts developed with OH providers 0 14 Supply chain standards ensure health is integrated into design 0 15 Smart cards enable the health of employees to be tracked through their 0 16 Data processing system / shared databases 0 17 Supply chain provides tools to reduce harm Regional OH provider centres based at railway premises 0 19 Voluntary standards improve organisational management of health to agreed levels 0 20 Voluntary standards result in the scope of health activities being fully covered 0 Copyright Institute for Manufacturing Page 24 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

25 4.6 Linkages Key Rank Driver / Perspective Workshop % 1 Ageing workforce / longer working life 13 15% 2 Retain the best employees 6 14% 3 Rising Obesity 12 14% 4 Improved H&W delivers productivity to benefit of all 5 11% 5 Social attitudes driving changes in work / life balance 9 10% 6 Worker health has a lower profile than worker and passenger safety 5 11% 7 ORR health programme priorities % 8 Improved Employee and Union relations / engagement (inc H&S Reps) 4 9% 9 Whole system approach to railway management (RTS) 5 6% 10 Industry reputation as an attractive place to work 4 9% 11 Dame Carol Black report indicates work is good for you 4 5% 12 There needs to be a cost benefit to health 4 9% Rank Challenges Workshop % A Stress, Anxiety and Depression 12 11% B Fatigue / shift patterns 8 7% C Wellbeing sustains engagement 8 7% D Active life styles / Active life style promotion 6 5% E Need for reliable leading and lagging indicators for ill health 6 5% F Poor health management limits ability to work 6 5% G Access for all to quality OH services 5 5% H Lack of individual resilience and adaptability 5 5% I Musculoskeletal disorders 5 5% J Absenteeism 4 4% K Future occupational cancer burden shift work, DEEE 4 4% L Sleep disorders 4 4% Copyright Institute for Manufacturing Page 25 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

26 5. Detailed exploration of H&W Challenges (explored in breakout groups) TEAM Responses Team Comments Emphasise key role of Line Managers in providing purpose 1 AB YC MT & direction Leadership creates culture for behaviour change inc Behaviour change / nudging 2 RB KG CG activities. 3 Employee engagement key to delivering wellbeing ==> OH JD SW AL 4 Industry strategy for promotion of engagement in health LW LM IG 5 Shift funding from reaction to prevention CD GP 6 7 Rail based medical standards are reviewed and improved for better outcomes Increase employee say in what is happening PJ NS MH SM RG See over for outputs from breakout group exploration of Priority Responses & Enablers. Key: Black text: original team input Red text: carousel group comments indicates agreement indicates disagreement Copyright Institute for Manufacturing Page 26 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

27 Team: 1 Required Response / Action Addresses Key Drivers & Stakeholder Needs Addresses Key Health & Wellbeing Challenges / Opportunities Emphasise key role of line manager Don't assume top down approach. Create demand from staff so managers support Industry needs to recognise the role of line manager in creating engagement and enlivening the OH agenda, providing necessary training and support. DfT ORR TOCs FOCs Network Rail Workforce & TU s Put priority on OH approach in franchising process Use supportive, focused interventions on providing OH approach. Be collaborative. Have defined strategy that reorganises roles and responsibilities Actively engage and involve Tusk Have defined strategy that reorganises roles and responsibilities Partnership working Better focused staff engagement working "better together". Involvement EFQM Not just immediate line manager. Behaviour driven. Improved engagement. Reduced cost of absence. Healthier, fitter L/L workforce. Reduce T/over. Personal contact with line manager vs. impersonal. 1.0 via control. Inter-dependent teams following/working towards company objectives, goals, targets. Proactive line manager with transferable skills will result in healthier, fitter workforce/reduction of turnover. Support to line managers i.e. "HSEA" Managers come from line - reinforce old ways. Engagement. Need collaborative, aligned approach (policies/process) (ORR, TU, HR LM) Lead by example Timescale to Full Implementation The Industry Needs to Establish clear roles, responsibility and expectations. Proactive, knowledgeable managers. Train and empower managers to: - Follow process - Know benefits Recruit to that level of skill Proper evaluation of the role that is needed. Role for rail NEBOSH cerf for managers Got to use top and bottom up approach....because: This will promote and interdependent culture in leading by example. Re-educate line manager Changing the culture of management Benefit in delivering Rail Workforce H&W Benefit in Efficient & Productive Railway Likelihood of adoption and success Costs to implement (1=High / 5=Low) Key Enablers Potential barriers & how to overcome them Improved stability and consistency of approach across industry will facilitate earlier/timely intervention (chain of care). Chain of care for staff. Earlier internally. Improved stability and consistency of approach across industry. H&W model again good for cross industry awareness. Share line manager awareness of key drivers to wellbeing should lead to better integration of activities where applicable. Reduced loss/disruption due to absence/turnover. Fitter workforce more productive. Reduce loss of work through absence. With standard guidance this should be relatively straight forward (not quick) provided exec team and all levels of management bought in an leading by example. High if starting at top level down. With standard guidance should be relatively easy. Some costs associated with training and mentorship and ongoing support. elements should be in place. Will need to invest time to train/educate and mentor/support Need to be able to measure effect - engagement and leading indicators lagging. Do not understand the full range of ORG dynamics for different OH. Engagement survey/measurement Ensure right manager/staff ratios for delivery of objective No all line mangers have effective interpersonal skills in O Not all employees work to a regular line manager interface (i.e. via control). Knowledge Gaps & Next Steps in validation / evaluation: We do not have knowledge of all organisational dynamics across the industry to test overall approach. This will deliver the following benefits for the Rail workforce and the industry as a whole To provide a healthier workforce and environment that is m ore attractive to work within. Promote an independent culture. Healthier workforce who are thinking about themselves....with the following costs and likelihood of success Led from top/down and all share common goal - reduced sickness, absence and "better" management. Significant changers to attitudes and behaviours which will help change the culture. Management engagement with staff and clear leadership would promote a healthier workforce and in turn, reduce sickness absence costs. Enablers, barriers and mitigating actions include Acknowledgment that all managers are effective in leadership as others. Transitions will take time. To get managers up to speed on ID health needs of staff. Copyright Institute for Manufacturing Page 27 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

28 Team: Short Medium Long 2025 Milestones Define Gap analysis Develop TNG Establish support Implement DfT ORR Promote OH within franchising Supportive intervention Review and revise Monitor Interdependant safety culture in health and wellbeing TOCs FOCs Network Rail RSSB Suppliers Defined goals with identified training support (working groups?) led from top Highlight OH responsibility within role profits Overarching guidance Practical guidelines Ned good data and complete Training of managers on identified gaps Union reps Capability gap analysis Benchmark: Current level of absence Engagement through survey and current sickness Use of OH by managers 4 positive rsults - Engagement - Cast InfraCos Aligned strategy Workforce & TU X industry forum Agreed in partnership with unions s Setting up of information tools for managers Key Enablers eg Knowledge; People & Skills; Facilities & Infrastructure; Standards & Regulation; Partnerships & Collaboration Avoid over regulating Develop training program Adequete mentorship and support Effective monitor External Stakeholders 3 OH EAP Copyright Institute for Manufacturing Page 28 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

29 Team: 2 Leadership creates culture for behaviour change Timescale to Full Implementation Required Response / Action Addresses Key Drivers & Stakeholder Needs Engage with CEO and team; Engage stakeholders and shareholders; Understand culture drivers e.g. health; Understand positive and negative behaviour Lead by example: specify example, behaviour engaging, identify good behaviour. Comms strategy Identify good leadership behaviour Understand collaborate/individual benefits Understand benefits and enablers Policy, principles, practice Regular focus on issues. Resolution identification DfT ORR TOCs FOCs Network Rail Workforce & TU s DFT influences on franchising ORR influence on duty holders to improve Work together to improve health and wellbeing Work together to improve health and wellbeing Work together to improve health and wellbeing TFL, PJE's, ISLG, RIAG, TSA, RSSB,RDG, rail The Industry Needs to As leaders to demonstrate the right behaviour to encourage health and wellbeing. Leadership behaviour? How can we embed i.e. talk the talk but don't walk the walk Low awareness of good practice already set down in the industry....because: Effective leaders behaviour impact on culture is high Leadership charter to align with industry strategy /matrix Addresses Key Health & Wellbeing Challenges / Opportunities Industry campaign "Stoptober" Eco-social climate Needs commitment to MDs auditing e.g. feeding back Look outside rail industry for advice/experience/ good practice e.g. police, fire service, bus industry Benefit in delivering Rail Workforce H&W Benefit in Efficient & Productive Railway 4 4 Workforce are supportive towards health and wellbeing when at work Engage workforce. "Undercover boss" process. Not sure this will work. Effective surveillance and monitor should cover this. Lower cost to business. Seems to be implying lack of knowledge of H&W but expertise exists in Pub. Health England, NICE, etc This will deliver the following benefits for the Rail workforce and the industry as a whole Improve health, wellbeing, productivity and efficiency (attendance) Global improve life Likelihood of adoption and success 2 Difficult case to build to overcome worth...with the following costs and likelihood of success Starting the ball rolling Costs to implement (1=High / 5=Low) 4 Cost should not be a barrier - extension of what we are doing Key Enablers Potential barriers & how to overcome them Personal behaviour; Figure head "C Coapier" stress; Internal champion; Research best practice; Benchmark in UK, out UK; Benchmark 1) rail 2) non rail. Good point - gap to be filled - research/proof/best practice research project Changing socially acceptable practices; testing rec drugs; CEO attention Knowledge Gaps & Next Steps in validation / evaluation: Good leadership behaviour Enablers, barriers and mitigating actions include Risk Bottom line change - slow Ignorance Good idea to do through MD forum Network Rail "RSSB lead" Copyright Institute for Manufacturing Page 29 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

30 Team: Short Medium Long 2025 Milestones H&W best practice cultural model NR campaign H&W culture survey initial H&W culture survey DfT ORR TOCs FOCs H&W charter Network Rail Leadership role MD conference RSSB H&W culture research project H&W culture survey Promote to leaders Anual conference on H&W targeting our champions Suppliers InfraCos H&W survey: - Great idea - Cross sector uniform measures Workforce & TU s Key Enablers eg Knowledge; People & Skills; Facilities & Infrastructure; Standards & Regulation; Partnerships & Collaboration RM3 for health has been prepared - need to promote Benchmark other industries External Stakeholders Copyright Institute for Manufacturing Page 30 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

31 Team: 3 Employee engagement key to delivering wellbeing ==> OH Timescale to Full Implementation Required Response / Action Addresses Key Drivers & Stakeholder Needs Employee engagement key to delivering wellbeing How big a role does OH play in engagement and at what level Contingent labour Eng improves most business metrics; Carole Black; Profit >> <<Absence <<Turnover; Safer organisation; Focus on prevention; Innovation retention DfT ORR TOCs FOCs Network Rail Workforce & TU s Focus on people in bids - franchises Link with national campaigns Leadership agenda. TOCs local eng. Agenda Create rail engagement task force - with all involved PSLG ISLG RIA Suppliers The Industry Needs to Acknowledge engagement as a key business driver across all sectors. Wellbeing needs to be promoted as preventive measure against absence. Develop strategy that clearly explains causal engagement. A blueprint document for all of industry. Satisfaction -> Commitment -> Engagement -> Sustained engagement - > Improve wellbeing...because: Higher levels of engagement drives the TUE wellbeing in employees People are key asset that deliver bottom line performance More efficient, productive and profitable Addresses Key Health & Wellbeing Challenges / Opportunities Mental health. How do we remove the stigma? MSDs Still have to deliver on regulatory needs i.e. health survey Lifestyle, BMI, cardio etc Ageing workforce more positive outlook on wellbeing 45 yrs+. 33% more likely to develop illness after 45. Engaged employees make healthy choices Benefit in delivering Rail Workforce H&W Benefit in Efficient & Productive Railway 5 5 Teams work better together Decreased OH cost Benefit to employees outside of work Affect full lifestyle issues for staff More efficient; staff costs lower etc See above line This will deliver the following benefits for the Rail workforce and the industry as a whole More efficient, productive, profitable. Healthier employees make better decisions - 'research'. Share please Make rail a great place to work. Likelihood of adoption and success Costs to implement (1=High / 5=Low) 3 4 Already begun in many areas Evidence needed for SMEs Lack of consistency Low Main cost is in time to create strategy and deliver it Competency training costs...with the following costs and likelihood of success Already happening in many places but not consistent - DfT focus on people and engagement in bids. Costs relatively low - depends on clear and positive leadership. Key Enablers Potential barriers & how to overcome them Senior management visible leadership by example; Benchmarking with other industries/test priorities; Engagement is very simple; DWISOT; Eng and wellbeing can be measure via surveys. Not an overnight fix. Benefits are slow to realise; Line management competence; How to share best practice across rail; Not a high level of consistency. Enablers, barriers and mitigating actions include Need to demystify engagement for all parts of industry. Knowledge Gaps & Next Steps in validation / evaluation: Best practice case studies - causal link between engagement and finance/innovation; Create rail engagement task force to pull together and promote; Wellbeing needs to be promoted as a preventative measure; Research piece Copyright Institute for Manufacturing Page 31 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

32 Team: Short Medium Long 2025 Milestones DfT The first measure - "the before" Creation of engagement strategy blueprint for industry Route planning - "the how" Wellbeing vision and stretch target for KPIs (lost time) and sustainable engagement - loading and logging KPIs Wellbeing and engagement culture embedded ORR TOCs FOCs Input research findings to support Network Rail Measure ALL Measure ALL Measure ALL RSSB Suppliers Lead and focus programme with project team and industry support RSSB H&W culture survey InfraCos Workforce & TU s Key Enablers eg Knowledge; People & Skills; Facilities & Infrastructure; Standards & Regulation; Partnerships & Collaboration External Stakeholders Creation of rail engagement task force/forum made up of all above and lead by RSSB Task force look at external best practice Business case of wellbeing evidence Blueprint/strategy develops KPIs to prove this works (lost days) Copyright Institute for Manufacturing Page 32 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

33 Team: 4 Industry strategy for promotion of engagement in health Timescale to Full Implementation When? Required Response / Action To develop an industry wide framework for companies to subscribe to as moral, ethical 21st century employer. Mandatory or voluntary. DfT ORR Not to develop, but to support "rubber stamp" All stakeholders with vested interest. Cross functional leadership party The Industry Needs to Collaborate and develop an industry wide framework/matrix All overlaps with team 3 TOCs FOCs All stakeholders with vested interest. Cross functional leadership party Network Rail All stakeholders with vested interest. Cross functional leadership party Workforce & TU All stakeholders with vested interest. Cross functional leadership party s RSSB Addresses Key Drivers & Stakeholder Needs Addresses Key Health & Wellbeing Challenges / Opportunities Age, stress, obesity, mental health -> employee security Manual handling, working environment (lack of consistent strategy. What is health? What does good wellbeing look like? Who is doing it? Contingent labour Putting H&W on the agenda of industry leaders. Cross the board H&W metrics i.e. sickness, attendance, health Aimed at all industry personnel - past, future and present Opportunities: Fresh eyes - breaking edge; Award winning intervention!; Solution focussed (i.e. not getting fatter/older/more stressed)...because: The industry has identified key challenges relating to the current and future health conditions of its workforce and wants to implement proactive intervention Benefit in delivering Rail Workforce H&W Benefit in Efficient & Productive Railway 5 5 Brings rail companies back together if universal strategy. Reduce ill health/manage 'meaningful' RTW. Productivity - retention - staff feeling valued - "people focus" Healthy workforce = engaged workforce -> quality, pride, productivity, retention through value stream to end customer This will deliver the following benefits for the Rail workforce and the industry as a whole Productivity Engagement Retention and attraction Health Value to end customer Likelihood of adoption and success Costs to implement (1=High / 5=Low) 3 4 WIIFMI KISS Think this is v. important. It doesn't need to be overcomplicated ROI Definition of strategy (time, people) -> Marketing, deployment, buy-in (subscription by industry) -> Company buy-in (individual companies) -> Employees...with the following costs and likelihood of success Companies will reap what they sow. Success - long term measure Quick win - Engagement Long term - Sustainability Key Enablers Potential barriers & how to overcome them Best proactive within and outside -comparitors - BITC/IIP - other H&W providers (OCC health) Sheer scale of desired state (i.e. industry) Non rail environmental influences; Definition of metrics; Defining success Copyright Institute for Manufacturing Page 33 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk Enablers, barriers and mitigating actions include "Should do" rather than "maybe" Raising profile/agenda - "Sign of a good employer" Knowledge Gaps & Next Steps in validation / evaluation: Industry strategy for promotion of engagement in health; How to measure success of health interaction intervention; Define engagement metrics (health relevant - to all); Health needs assessment of workforce; Change (desire for) at CEO level; Competing priorities - (want spend elsewhere); Business partnering of HR and OH and implementing change.

34 Team: Short Medium Long 2025 Milestones What is popular? Health needs analysis Produce baseline mid 2015 Market/deploy DfT ORR Don't overcomplicate or obsess about data and targets. It will feel right if it is! TOCs FOCs Network Rail RSSB Pull Jan 2014 representative parties together Fact finding - Are assumptions right? Best practice comparitor? Develop broader objective (based on facts) Develop indicators to track progress Review Suppliers Determine priorities Determine timeframe InfraCos Workforce & TU s HR and OH safety insurers (i.e. PHI life insurance Key Enablers eg Knowledge; People & Skills; Facilities & Infrastructure; Standards & Regulation; Partnerships & Collaboration External Stakeholders Copyright Institute for Manufacturing Page 34 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

35 Team: 5 Shift funding from reaction to prevention Timescale to Full Implementation 2020 Required Response / Action Increase risk assessments, environmental monitoring Tax incentives Insurance costs Case management Financial determination rewarding preventive Procurement planning DfT ORR TOCs FOCs Network Rail Workforce & TU s Franchising Financial determination Case management, risk management, mentoring?nothing Tax incentives, insurance costs The Industry Needs to Govt. -> Franchising - Financial determination X-industry leverage - tax incentive - Insurance cost Company level - Grants - Case management - Risk/monetary/procurement - Reduce claims Addresses Key Drivers & Stakeholder Needs Addresses Key Health & Wellbeing Challenges / Opportunities More preventative activity e.g. risk assess what leads to absence or health costs; Tax incentives; Monitoring; More case management: rehabilitation/access to physio/access to medical services, blood sugar, blood pressure; Use health in branding/commercial profile; Managing absences, so shorter; Financial determination; Reward preventative activity; Attractive to shareholders; Better procurement of tools Stress: increase resilience/education; Costing framework i.e. criteria for deciding priorities and trends; Cycle 2 work scheme - promote better lifestyle; Frequency of medicals; Visibility of how much absence is costing; Vaccinations; Man handling training; Promote H&W services i.e. gym concessions Great idea for quick win within organisation; Reviewing contracts of 3rd party health providers...because: Increase money/resources Decrease absences/disruption Decrease costs, increase efficiency Promote commercial brand/shareholder Case management Stress resilience increase Med prevention - flu jabs, easily detect Training/education Benefit in delivering Rail Workforce H&W Benefit in Efficient & Productive Railway 4 4 Attractive place to work Reduce in absence Civil claims reduced Less mgmt time Higher performance Healthy culture/better engagement Reputation This will deliver the following benefits for the Rail workforce and the industry as a whole Improved positioning and reputation. Seen as good industry. 'Public perception'. Likelihood of adoption and success 2 Buy-in from the top Health surveillance as a "shoe in" to wellbeing - has to be paid for HASAWA Difficulties in detaining grants...with the following costs and likelihood of success Costs to implement (1=High / 5=Low) 4 Key Enablers Enablers, barriers and mitigating actions include... Potential barriers & how to overcome them Sr. management understanding need to change strategy Knowledge Gaps & Next Steps in validation / evaluation: How the money goes round "in detail" NR - what's the threshold re self-insure? Copyright Institute for Manufacturing Page 35 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

36 Team: Short Medium Long 2025 Milestones Businesses taking a preventative approach Reduced insurance premiums Tax incentives Financial determinations supporting preventative and not efficiency/excess cost DfT ORR Promote conferences/fora Financial PR18 determination TOCs FOCs Company strategy/policy/plan Case building activity TOCs/ATOC freight GP building case for lower premiums Dialogue Network Rail RSSB companies good practice, benchmark etc Financial PR18 Determination indicators Benchmark comparators Or HS1 or others Suppliers InfraCos Workforce & TU Consult/promote s Trade associations Key Enablers eg Knowledge; People & Skills; Facilities & Infrastructure; Standards & Regulation; Partnerships & Collaboration Using leverage f industry activities External Stakeholders Copyright Institute for Manufacturing Page 36 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

37 Team: 6 Rail medical standards Timescale to Full Implementation 24 months Likelihood of adoption and success 3451 Consistency of application: guidance but not prescription ARIOPS working group for standards Risk management approach rather than 'rule based' Liability issues Agreed needs to feed in to Europe Rail agenda for a consistent Europe wide standard DfT ORR TOCs FOCs Network Rail Workforce & TU RSSB guidance not ORR standard. Set expectation The buck starts here The Industry Needs to Pull finder out Committed to improvement s Not ORR can advise; ORR is statuary authority. RSSB is not; Standard = RSSB not ORR; +UMC Addresses Key Drivers & Stakeholder Needs ORR TOCs and FOCs RAIB reports Why would standards not be changed...because: Consistency and fairness Improve attendance Healthy = safer Increase efficiency Addresses Key Health & Wellbeing Challenges / Opportunities Best practice in other industries e.g. oil and gas, fire service Contractors Constructing better health Benefit in delivering Rail Workforce H&W Benefit in Efficient & Productive Railway 5 5 This will deliver the following benefits for the Rail workforce and the industry as a whole Healthier, happier, safer workforce Better service for passengers (more profitable railway) Likelihood of adoption and success 2 Best practice reduces risks to both organisation and employee...with the following costs and likelihood of success Minimal cost Return enormous Costs to implement (1=High / 5=Low) 5 None if paper Cost = TOCs may need to subscribe to online version Need consistency Ensure cost is managed i.e. kept minimal as in the scheme of OH/wellbeing the issue has minimal impact Key Enablers Potential barriers & how to overcome them ARIOPS; FOM; Providers (RLY cost management) Don't just ask doctors, involve HR and others from industry in creating the standard Shortage of doctors Lack of experience of doctors - bribe them with footplate rides Unions Knowledge Gaps & Next Steps in validation / evaluation: Knowledge gap of doctors and working conditions Enablers, barriers and mitigating actions include Time, effort, institutional inertia, Parkinson's syndrome Copyright Institute for Manufacturing Page 37 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

38 Team: Short Medium Long 2025 Milestones ARIOPS report Conference End point All rail OH aware Health and happiness Audit compliant A profitable working railway DfT ORR Smile sweetly and say Yes... Update TOCs FOCs Spreading the word Network Rail RSSB Spreading the word Suppliers Supplier buy-in Time... Spreading the word InfraCos Workforce & TU s Company boards aware ARIOPS agreement Key Enablers eg Knowledge; People & Skills; Facilities & Infrastructure; Standards & Regulation; Partnerships & Collaboration External Stakeholders Copyright Institute for Manufacturing Page 38 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

39 Team: 7 Increase employee say in what is happening Timescale to Full Implementation Required Response / Action Employees have ownership so it's not imposed and fully supported by board so that their ideas, voices and concerns are heard and acted on. Fully support this. Employees don t usually have a say. DfT ORR Favour inclusion of this in franchising Ensure commitments are acted on/delivered The Industry Needs to Ensure employees are at the heart of H&W TOCs FOCs Consider benefits and map against objectives Network Rail Consider benefits and map against objectives Workforce & TU Support and participate s Addresses Key Drivers & Stakeholder Needs Satisfaction/engagement/discretionary effort Cost/profit Retention of skills/staff Reduced sickness Breeds company loyalty Roles of Tusk?...because: Their commitment, company loyalty, knowledge and skill will drive the bottom line through an increased idea pool, buy-in and full understanding/acceptance. Addresses Key Health & Wellbeing Challenges / Opportunities Idea pool greater Encourages preventative solutions Buy-in/participation Increased understanding These are all benefits of increased employee engagement. This has links with other ideas so beneficial. Benefit in delivering Rail Workforce H&W Benefit in Efficient & Productive Railway 3 3 Needs absolute commitment so it's not destructive so it's positive Knowledge management and retention Staff reliability/availability Operational resilience and customer service delivery This will deliver the following benefits for the Rail workforce and the industry as a whole Network resilience and customer service delivery from engaged health individuals Likelihood of adoption and success 4 High as long as full commitment (not lip service)...with the following costs and likelihood of success A release strategy will determine/drive costs Costs to implement (1=High / 5=Low) 5 Release/involvement strategy required Key Enablers Potential barriers & how to overcome them Individual companies buy-in Industrial relations and how it's introduced Knowledge Gaps & Next Steps in validation / evaluation: What would DfT and ORR have involvement in (and others)? Enablers, barriers and mitigating actions include All boards will be competing for Top of the TOCs Copyright Institute for Manufacturing Page 39 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

40 Team: Short Medium Long 2025 Milestones Research paper (best practice) DfT ORR TOCs FOCs Sign up / agree Collate data Network Rail RSSB Commission research paper Publish paper Suppliers InfraCos Workforce & TU In my TOC unions need engagement and buy in s Key Enablers eg Knowledge; People & Skills; Facilities & Infrastructure; Standards & Regulation; Partnerships & Collaboration Implement judging and budget Identify commercial projects External Stakeholders Data and research Copyright Institute for Manufacturing Page 40 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

41 Appendices A. Participants B. Workshop Feedback C. Responses & Enablers Detailed Comments D. Workshop Process E. Participant Perspectives Copyright Institute for Manufacturing Page 41 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

42 Appendix A: Workshop Participants Name Company Alan Brookes Network Rail Andrew Livingstone Atkins Carole Bardell Costain Rail Claire Dickinson ORR Colin Greenslade ORR David Davies PACTS Diane Haggan FGW Gemma Pilgrim GB Rail Freight Ian Gooday ORR James Dalton First Group Joe Dromey IPA Keith Greenfield Heathrow Express Libby Moore South Western Trains Liz Davies RSSB Lucy Weaver Unipart Rail Mark Hall Capita Michael Thompson Chiltern Railways Nicola Spencer Northern Rail Peter Jarvis Ffestiniog Railway Medical Service Richard Burnham Amey Robert Gifford London TravelWatch and Passenger Focus Sarah Weymouth GB Rail Freight Simon Millward East coast Yvonne Campbell Southeastern Copyright Institute for Manufacturing Page 42 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

43 Appendix B.1: Feedback Joining instructions and preworkshop information Opening remarks and introduction to the workshop Facilitation of the workshop 5. Excellent 4. Very Good Piccies 3. Good 2. Satisfactory 1. Poor Structure / process of the workshop Opportunity to participate and contribute Make-up of workshop participants 99% Excellent, VG or Good (excl venue & catering) Time keeping Catering Venue Copyright Institute for Manufacturing Page 43 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

44 Appendix B.2: Feedback I found the workshop stimulating I enjoyed the workshop I found my participation worthwhile I feel I have contributed to the workshop The workshop provides useful insights 5. Strongly Agree 4. Agree 3. No comment 2. Disagree 1. Strongly Disagree 96% Strongly Agree or Agree Copyright Institute for Manufacturing Page 44 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

45 Rank Responses Comments 1 Emphasise key role of Line Managers in providing Line managers key; MDs buy in; Managers to be actively involved in staff H&W needs: "Lead by example."; Line managers are key in purpose & direction delivery 2 Leadership creates culture for behaviour change Culture; Create "demand" for H&W support so management responds (as well as leading); Create better health and wellbeing culture and supportive network for staff to feel comfortable raising issues and seeking help; How do we create a learning culture for WHWB? What works? What doesn't? 3 Employee engagement key to delivering wellbeing which will then drive OH Engagement: Wellbeing, OCC HGT; Don't fixate on industry data collection and analysis before you efficiently engage on wellbeing Front line training for H&W; Wellbeing and health integrated into management development programmes and objectives; Resilience 4 Training courses & Education for target groups training to prevent stress and burn-out modules based on CBT. Management and staff; Improve competence within wider workforce WRF (especially front-line managers) to OH issues; Attract OCC H profit to our industry. Establish links with universities to develop industry specific modules within existing degree and education programmes (influencing future professionals) 5 All stakeholders (including individual inc. individual responsibility; Education of workforce to understand how they can deal with work related health issues.; Move away from responsibilities) agree benefits and understand roles blaming individuals to understanding management confrontation. in making positive changes. 6 Translate proven health activities from other industries into rail Sharing of best practice from other industries 7 Improved understanding of OH issues in rail by OH practitioners Proactive OCC health, not prescriptive 8 Industry-level strategy for Engagement Clear industry wellbeing strategy that engages staff and manages based on key industry risks 9 Trade Union support Top level and TU commitment and involvement; Getting trade union reps better engaged on health risk (+) assessments 10 Behaviour and culture change activities. National programme, Education (local), Action plan, Lead for centre 11 Increase employee say in what is happening Culture of "TALK" employees have to take responsibility - it isn't company responsibility. Company can help/support. 50:50 awareness industry; Ensure engagement so employees share problems and are involved in wellbeing activities 12 Appendix C. Responses & Enablers Detailed Comments Prevention funding (switch from reactive to proactive) Look to transfer investment from OH spend to prevention; Preventative measures ensure focus is not just on resolving issue but reducing and preventing health issues occurring; Building prevention into work practice; Diabetic management strategy; Industry wide standard matrix. Recognised industry-wide matrix based on key issues i.e. obesity, mental health, managing ageing workforce. Create a "bandwagon."; Sleep apnoea/sleep disorders strategy needed. Why are driver passing medicals when raised incidence of sleep disorders in the industry. 13 KISS (Keep It Simple) KISS: Keep it simple and sweet - messages 14 Better awareness of H&W initiatives across dispersed Raise awareness of H&W issues. Encourage lifestyle changes; Benefit of social wellbeing/engagement - Expand awareness/understanding workforce across group 15 Awareness of, reporting & training for stress issues Reporting mental health; More education on mental health issues for managers and staff 16 Collaborative industry approach to common issues 17 Health data collection supports reasoned decisions to What information do we need to collect to asses that we are achieving our vision?; Develop clear understanding of key driver for info drive change. needs are understood and communicated - answers the way 18 Intended use of data outputs is understood during the planning stage for collection. 19 Clinical leadership provides direction for Clinical leadership - OH needs to be in driving seat; Change the railway doctor's arrangement from transactional to development of industry s health capabilities embedded/oh/informing business on risk 20 Organisational roles take a holistic approach to health rather than functional Manage role conflict; Role and conflict of managing for attendance and H&W policy Copyright Institute for Manufacturing Page 45 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

46 Appendix C. Responses & Enablers Detailed Comments Rank Responses Comments 21 Need for data that is more leading Data collection and analysis i.e. makes sue return to works done; What bothers me is the unknown unknowns; Need for data that is leading, reliable, robust 22 Competency frameholders for health and wellbeing line managers Rail OHP/OHA 'certificate' of rail knowledge/understanding 23 Engage ageing workforce Skills - capitalise on experience of the older generation; Ageing workforce should not seen as a problem 24 Companies publish improved health data indicating Ensure that data collection/reporting is done consistently across the industry enabling easy aggregation to identify industry issues, trends the progress of the rail industry etc. 25 Informing policy / standards development for OH 26 Success is measured and reviewed before wider industry roll-out. 27 Industry educational and competence requirements are mapped 28 Job roles altered to become more engaging Redesign workplace, access and work tasks to include physical activity 29 Action based upon sound evidence Achieve a better understanding of data 30 More effective communication between OH service providers and line managers 31 All trained on health at work as the norm 32 Health professionals improve health decisions within organisations 33 Guidance is developed to assist railway physicians Guidance on health reporting good practice 34 Baseline health assessment of all high risk workers Guidelines for fitness assessment for older workers and what to do with fails; European standard for health exams. 35 Improved occupational health reports 36 Improved OH guidance (eg managing return to work) Provide a solid consistent and high quality OCC health service; Creator defined rail specific OH advice to manage absence 37 Health and wellbeing monitoring technology 38 Diet & Nutrition advice (engage food services) Active lifestyles; Health and wellbeing actions i.e. Fruity Friday, Stop Smoking 39 Communication leads to access to information for all Ensure proper feedback on policies developed 40 Improved cost benefit analyses and tools Copyright Institute for Manufacturing Page 46 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

47 Appendix C. Responses & Enablers Detailed Comments Rank Responses Comments Job Risks roles are proactively altered to become addressed more engaging Clinical Industry leadership productivity provides is enhanced direction to improve for development successful outcomes of industry s for all. health capabilities 43 More Opportunity effective for communication health/safety by between design OH service providers Companies and re-evaluate line managers health policies Good communication within diverse organisations i.e. internet, intranet, written, visual Clinical effectiveness is managed within industry Hazard specific working groups tackle difficult health hazards Work/life Day seminar balance with heritage (shift management) factor on asbestos management Guidance Rehabilitation is developed plans reduce to assist absence railway costs physicians Better use and understanding of phased returns and adjusted work patterns Better cooperation between medical professionals Create cross-discipline (e.g. OH and FLEET) datasets to enable empirical thinking and understanding; Assess effectiveness of interventions Improved occupational health reports Link to NHS; Strategy for better link with NH/their initiative and resources eg OHS and GPs to determine impact and success Better Employee cooperation health and between wellbeing medical issues professionals also impact Poor GP and OCC health judgements. Too much detail of what can't be done rather than what can. Guidance issued; Shift work that ensures eg passengers OHS and GPs that BSG assessments are carried ut on shift patterns with involvement of the workers Logistics of remote working Measure absenteeism and link with travel to work mode. Active travel = less absenteeism 49 Link reward (or salary sacrifice) to health wellbeing 51 Link reward (or salary sacrifice) to health & wellbeing 50 Diet & Nutrition advice (engage food services) 52 Embrace diversity of workforce 53 Send signal through franchise programme for H&W 54 Implement all 10 recommendations in briefing 55 Link with cancer screen OH where feasible link with cancer screening programmes at work Copyright Institute for Manufacturing Page 47 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

48 Appendix C. Responses & Enablers Detailed Comments Rank Enablers Comments 1 Rail based medical standards are reviewed and Medical standards: Less complex, risk based, evidence based, clinical guidance for workforce physicians; Medical standards on recruit and improved for better outcomes retention by each health. Conclusion - standards for medical practitioners. 2 Best practice knowledge transfer Understand/define and share industry best practice on provision of workplace health facilities; Better sharing of good practice in the industry; Employ a public health expert (not an occupational health expert) to embed healthy work practices; Need best practice on fatigue management. 3 Occupational Health and Wellbeing expertise 4 Improved equipment / reduced emissions 5 Resources (Numbers of professionals) Increasing mechanisation to eliminate hazardous 6 tasks There is an increase in health skills purchased by the 7 organisation 8 Funding 9 IIP 10 Real-time data collection (eg via tablet technology) Incentives and penalties? - H&W as a contract criterion Railway conferences allow cross-fertilisation and promotion of best practice Guidance enables better contracts developed with OH providers Supply chain standards ensure health is integrated into design Smart cards enable the health of employees to be tracked through their working life Increase use of 3rd party OH and absence management to support managers Rigorously use the development in tablet technology to capture real time data. Also real time support. Consider new "SOS" type apps, linking to health professional. 16 Data processing system / shared databases 17 Supply chain provides tools to reduce harm 18 Regional OH provider centres based at railway premises 19 Voluntary standards improve organisational 20 Voluntary standards result in the scope of health Have a "tool" information session for those involved in procurement; Consistency when in rail no matter what company or role. Can "expect" same standard treatment approach - geographical factors. Copyright Institute for Manufacturing Page 48 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

49 Appendix D. Workshop Process Copyright Institute for Manufacturing Page 49 Rail Health & Wellbeing Workshop 3 15 Nov DRAFT 1.0 Nov 2013 Dominic Oughton do251@cam.ac.uk

50 Workshop agenda Morning 9:15 Registration & Coffee 9:45 Introduction, agenda and process 10:00 Participants share perspectives Vision; Key Challenges & Actions needed 11:00 Prioritise Vision elements; Drivers and Challenges 11:15 Break 11:30 Identify leading Actions Needed 12:30 Lunch Afternoon 13:15 Identify breakout groups for Afternoon Session 13:30 Characterise priority Actions for Impact / Effectiveness 14:15 Develop Action Plan 15:00 Break 15:15 Present Elevator Pitch & Carousel Review 16:15 Review 16:30 Close Copyright Institute for Manufacturing Health & Wellbeing Roadmap Dominic Oughton do251@cam.ac.uk

51 Background and Aims of Workshop Purpose of the roadmap: We are looking for a roadmap to bring about commitment and understanding for a series of well-planned, effective and prioritised tasks that a diverse range of stakeholders believe will improve health and wellbeing management within the railway and therefore the health and wellbeing of the Rail Workforce and the efficiency of the sector. Commitment: Individual managers, companies aware and prepared, Managing Directors engaged, customer willing to act or request RSSB to act Understanding: What tasks, costs, impacts? The organisations role? Role for RSSB/ industry? Well planned: Timed well, those participating are able to act, coordinates with and benefits the customer, yearly costs align with industry s capacity to meet them, meets new control period timeframe, customer has time to implement Effective tasks: tasks are needed, cost effective, generate company action, generate industry action Prioritised: By industry or organisational level of importance?, By sector? By Cost? By Stage? Improve: industry level? Organisational /customer level? Both? At low cost? At high cost with high return? Evolutionary? Planned? Copyright Institute for Manufacturing Health & Wellbeing Roadmap Dominic Oughton do251@cam.ac.uk

52 Workshop Definitions Occupationa l Health Wellbeing Contemporary thinking and government policy on workforce health recognise that health has three fundamental elements. The effect of work on health (eg airborne contaminants, asbestos, musculoskeletal disorders, mental health) Fitness for work (eg safety critical tasks, drugs and alcohol testing, health assessments) General wellbeing (eg obesity, smoking, sickness absence management, rehabilitation) Industry consensus, including the Industry Safety Meeting (ISM), now supports rail employers actively embracing these three elements. The three components of employee wellbeing, taken from Wellbeing, Productivity and Happiness at Work (Ivan Robertson and Cary Cooper, 2011), are said to be: 1. Psychological wellbeing for example, the ability to handle the stresses of everyday life and maintain a positive attitude and sense of purpose 2. Physical wellbeing for example, the amount of exercise, sleeping habits, alcohol 3. Social wellbeing for example, a positive and supportive social network Engagement Employee engagement is a measure of how motivated an employee is to give their best to their job. It shows how well motivated, energised and inspired they are to go the extra mile. Engagement is uniformly measured via staff surveys and typically asks questions about pride in their company, would they recommend as a great place to work, belief in company vision and goals, a willingness to go beyond their job requirements and whether they are considering leaving at the present time. Companies with high levels of employee engagement experience greater profitability, reduced absence and greater levels of employee wellbeing, amongst many other benefits. See for more information. This is about how we create the conditions in which employees offer more of their capability and potential. David Macleod author of UK Govt s Engage For Success report. Employee engagement should not be confused with how we communicate and interact with our people. Presenteeis m The term presenteeism is often interpreted in different ways. Robertson and Cooper (2011) suggest three attributes to the term: 1. Attending work when unwell 2. Putting in long hours but not working all of the time (often known as face time ) 3. Working at a reduced level because of distractions (for example, going online) Additional attribute added: People who have a health risk factor that inhibits their ability to do their job (for example, obesity and manual work). Copyright Institute for Manufacturing Health & Wellbeing Roadmap Dominic Oughton do251@cam.ac.uk

53 How? What? Why? Roadmapping- Linking future to present Time Trends & Drivers Markets Opportunities Technologies & Capabilities Enablers Where are D 1 D 2 D 2 M 1 M 2 M 3 O 1 we now? O 2 O 3 O 4 O 1 O 2 T 1 T 2 T 4 C 6 T 1 How can we get there? M 2 C 3 T 5 Where do M 4 we want to go? Funding Infrastructure Staff / skills Copyright Institute for Manufacturing Health & Wellbeing Roadmap Dominic Oughton do251@cam.ac.uk

54 VISION Social Templates Technological Trends & Drivers Stakeholder Perspectives Health & Wellbeing Challenges Environmental Economic Political & Legal inc DfT/ORR Workforce On-board Trackside Station & TOCs & FOCs Network Rail Suppliers InfraCos inc Health Professionals Work-related Non work-related Lifestyle Opportunity & Access Responses Industry leadership Stakeholder Clinical leadership Actions Evidence based action (eg for TOCs & FOCs; Network Rail; ORR, Reporting and metrics RSSB, ISLG & Employee engagement Contractors & Education & Training Suppliers, OH, Tus; Workforce & s Behavioural change Enablers Knowledge People & Skills Facilities & Infrastructure Standards & Regulation Supply Chain Past 2014 Short Medium Long 2025 Vision CP4 CP5 CP6 CP7+ Trends & Drivers What is shaping the future context and environment for H&W Stakeholder Perspectives What are the needs of the different stakeholder groups H&W Challenges: Current and Future Challenges (and Opportunities to improve) H&W Responses that could be put in place to deliver improved H&W outcomes and performance...and associated Actions by Rail Stakeholders Enablers and other resources also necessary for success Copyright Institute for Manufacturing Health & Wellbeing Roadmap Dominic Oughton do251@cam.ac.uk

55 2-Step Workshop process Step 1: Scan ( Landscape ) - Large group activity - Broad scope - Share and capture perspectives - Link, focus and prioritise Step 2: Probe ( Landmark ) - Small group activity - Focused scope - Share and capture expertise - Organise, plan and action Google Earth Copyright Institute for Manufacturing UK Robotics & Autonomous Systems Roadmap January 2013 Dominic Oughton do251@cam.ac.uk