Transformation and cultural change

Leading & Implementing a Healthy Universities Approach to Enhance Staff Experience & Performance


Key messages

Consideration of the Staff experience in the workplace has been an important aspect of the whole settings approach for many years. In particular Dame Carol Black’s Report in 2008 highlighted that good work was good for health.
This takes on particular significance in the higher education (HE) sector where the energy and vigour of staff is a primary component of the student experience.

With the introduction of student fees the relationships and experiences of those within the sector have taken on an ever-sharper focus. The healthy settings approach advocated by the English Healthy Universities network acknowledges the wider context of the workplace wellbeing and resilience agenda.

There are strong arguments in favour of a good return on investment for health and wellbeing initiatives in the workplace (from Price Waterhouse Coopers and others). There is also an increasing recognition of the Social Return on Investment as being of particular significance within HE – issues such as reputation and social capital having a large impact upon marketing, retention and growth.

A key message in this section is that universities increasingly need to be aware of how the health and wellbeing of the academic community is an important component of a wider strategic environment. Within a recessionary economic climate, and with graduates facing a very challenging route to employment, the staff in a university setting need more than ever to be able to stretch and inspire students – and they need to be healthy and energetic to be able to rise to the challenge.

This Guidance Package offers…

…a presentation by Ewart Wooldridge, Head, Leadership Foundation for Higher Education about how those involved in advocating or leading Healthy Universities work need to be equipped with specific skills
…a description of the key developments around which staff experience and performance should be viewed
…an outline of the key issues involved in engaging staff in the Healthy University approach

Action points

Indentify what data already exist and who integrates and monitors those data
Find out is your institution has a staff survey and who respond to issues raised
Map any current activities which address staff health issues and identify additional support that could be offered using internal and external partners

Quick win

Consider forming a complete-and-finish group to undertake the Healthy Universities self review tool for your institution, that includes key gatekeepers and strategic managers. Also, make use of the presentation from Dame Carol Black and statements from national organisations such as CIPD, NICE and the IoD to add credibility and sanction to the Healthy Universities approach.

Key Concepts and Terms

With any use of a ‘whole-system’ approach it is important to recognise that there is a process of synergy; with the sum of the whole being greater than the sum of the individual parts. As such, this section will consider staff health as a component of the holistic ‘healthy universities’ model. From the outset it is important to stress that the use of ‘staff health’ goes beyond a medicalised definition to share many characteristics with the concept of ‘wellbeing’; which has much contemporary currency. A useful operational definition is the one used by Dame Carol Black in ‘Working for a Healthier Tomorrow’ (Black, 2008):

‘The subjective state of being healthy, happy, contented and satisfied with one’s quality of life. It includes physical, material, social, emotional, development and activity dimensions.’(Waddell and Burton, 2006)

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Health and wellbeing are determined by a wide range of factors and the workplace represents an important setting where interactions occur and influences take place. As such, concern about staff health within the higher education sector forms part of a wider workplace health and wellbeing agenda which has been given greater focus in an environment of global recession and scarce resources.

There is growing consensus about the importance of addressing workplace health for the following reasons:

  • For individuals and their families, because it impacts on the quality and length of life people lead, affecting their capacity to work and provide for their family;
  • For employers, because a healthier workforce is a more productive workforce; having healthier workers also provides an incentive to invest in their training and development, and such investment will yield a higher return; and
  • For society as a whole, because the consequences of ill-health lead to social exclusion, lower output and reduced tax revenues. Higher costs in terms of healthcare and social security benefits add to the burden on the taxpayer.’ (Black, 2008, p.22-23)

Wider Context and Evidence Base

Key developments

There are a range of key publications and developments that have impacted upon the evolution of a staff health and wellbeing agenda for higher education.

  • In 1986, the Ottawa Charter articulated and energised a vision of public health, that advocated a whole system approach and highlighted the centrality of individuals within settings of everyday life:

‘Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources…Health is created and lived within the settings of everyday life; where people learn, work, play and love.’ (WHO, 1986, p.3)

  • In 2004, Wanless (2004) reported on Securing Good Health for the Whole Population, with a focus on prevention, the wider determinants of health and the cost-effectiveness of action to improve the health of the whole population and reduce health inequalities. In particular, he introduced the term ‘fully-engaged’, putting the individual at the centre of the health debate and leading logically to a consideration of the individual in the workplace setting as a key focus for securing health. He also made a strong argument for self-efficacy and education within health:

‘People need to be supported more actively to make better decisions about their own health and welfare because there are widespread, systematic failures that influence the decisions individuals currently make.’ (Wanless, 2004, p.4)

  • In 2006 the Institute of Directors (2006) published a Directors’ Guide to Wellbeing at Work, which presented a powerful argument for investing in workplace health:

‘All enterprises seek to be in a healthy state. If their employees are in a good state of health and wellbeing this must surely contribute to successful performance. The downside of that is that when time and effort is lost through sickness or other absence from work, or when employees are not getting or giving of their best.’ (IOD, 2006, p.5)

  • In response to growing demand from the sector, the Healthy Settings Development Unit at the University of Central Lancashire (UCLan) in 2006 established an informal English National Network of Healthy Universities with the aim of contributing to student, staff and community health. Building on this, UCLan and Manchester Metropolitan University submitted a successful funding proposal to HEFCE, Developing Leadership and Governance for Healthy Universities, to support and further develop this work, which suggested that:

‘By focusing on the introduction of whole system approaches to health and well-being within Higher Education, this project has the potential to achieve significant financial benefits for individual HEIs, for the Higher Education sector and for society as a whole. Through strengthening networking, sharing good practice and generating guidance tools, the project will seek to enable a fuller understanding and clearer articulation of these benefits:

    • Student and Staff Retention, Performance and Progression
    • Staff Productivity/Presenteeism
    • Future Shaping
    • Corporate Social Responsibility’
  • HEFCE funded a parallel project in 2006, Creating Success Through Wellbeing in HEIs, which, unlike the Healthy Universities project, focused exclusively on employee wellbeing. This one year project has led on to a two year project, Improving Performance through Wellbeing and Engagement, described in more detail in the ‘University Context’ section.
  • Both projects drew inspiration from the landmark report Working for a Healthier Tomorrow (Black, 2008), which articulates clearly how employers and health care professionals should recognise the opportunities offered by the workplace for the provision of facilities and dissemination of advice on how to improve and maintain health. Significantly, the report makes the telling point:

‘There is something of a self-sustaining cycle of good health and good wealth, just as there is a similar cycle of poor health and poor wealth.’ (Black, 2008, p.37)

  • In the changed, post-election landscape, Bupa, in partnership with the Work Foundation (2010) published a significant vision Healthy Work Challenges and Opportunities to 2030. This document projects this time-line forward and facilitates important future gazing. In particular it suggests:

‘The way in which work is organised affects physical and mental health. Employers looking to reduce absence and promote productivity need to consider aspects of organisational culture, working practices and job design that have been shown to play a role in employee health and wellbeing.’ (Vaughan-Jones and Barham, 2010, p.35)

Further information relating to workplace mental health and wellbeing is available in the Guidance Package on Developing an Holistic and Joined-Up Approach to Mental Wellbeing.

Evidence base

There are a number of financial and non-financial motivations for investing in staff health.

In the statistical annex to Working for Healthier Tomorrow (Black, 2008), Price Waterhouse Coopers present a compelling business-case on the return-on-investment that effective health and wellbeing interventions can bring to the workplace. They assert that for every £1 that a company invests on wellbeing (and health), the return is more than £4.

Alongside these financial motivations, there are non-financial arguments that apply to all sectors and may have particular resonance for Healthy Universities. A commitment to being a healthy setting will contribute to reputation-building and enhancement – and in what looks set to be an increasingly competitive market for universities (both in terms of attracting and retaining the best staff and being a destination-of-choice for students), the contribution of health and wellbeing cannot be over-emphasised.

Examples of Good Practice

Case 1
One of the ‘big-five’ high street banks has a call-centre on a green field site in Cheshire. The newly built enterprise was suffering very high levels of staff turn-over, employee satisfaction research showed the staff were very unhappy and had low levels of morale and satisfaction. The visionary Director of Human Resources took a whole system approach and conducted site research to drill down into the issues impacting the workforce. One of the key issues revealed by the research was that the green field nature of the site resulted in being isolated from key services. A pilot scheme was introduced whereby a concierge service was made available to support the workforce with such tasks as visits to the post office to renew car tax and simple shopping (the loaf of bread or the pint of milk needed on return home).
The service was a great success with the (mostly female) workforce. The second stage was to bring a visiting hairdresser on site, again with very good take-up from the workforce. Subsequently, health-screening events, lunch-and-learn and other activities have been successfully introduced. Through this, there was a major attitude shift within the workforce, the company became an employer of choice, the workforce turn-over dramatically reduced and employees reported feeling valued and a reciprocal sense of loyalty to the employer.

Case 2
The pharmaceutical giant Glaxo Smith Klein (GSK) conducted research across their 30,000 person workforce, revealing a significant cluster of employees who were very highly motivated and loyal to the company, but also close to ‘burn-out’. When investigated further, the shock result was that those in the cluster were predominantly senior managers with high levels of responsibility. The Human Resources team at GSK engaged with this challenge by developing an ‘energy-team’ to work with managers and offer support in relation to healthier lifestyles, better time management and personal development opportunities, thus facilitating them to draw back from the threat of burn-out.

There is a wealth of evidence relating specifically to mental wellbeing and the value of adopting a whole organisation response. Two key sources are Five Ways to Wellbeing  and NICE Public Health Guidance for Employers on Promoting Mental Wellbeing through Productive and Healthy Working Conditions. Further information on these is available in the Guidance Package Developing an Holistic and Joined-Up Approach to Mental Wellbeing.

The next section will look specifically at examples of best practice from the higher education sector.

University Context

In considering staff health and wellbeing within the specific context of universities, it is appropriate to draw on learning from the parallel project introduced earlier, Improving Performance through Wellbeing and Engagement, which is funded by HEFCE in partnership with the Scottish Funding Council and the Higher Education Funding Council for Wales. The project is led by the Universities of Leeds and Glasgow in partnership with the Universities of Birmingham, Bristol, Chester, Newcastle, Winchester and Queen Mary, London, and Grimsby Institute for Further and Higher Education.  This project aims to:

  • develop a higher education specific business case for employee wellbeing and engagement – showing what aspects make have the biggest impact on performance
  • support institutions to enhance their practice by developing a bank of practical case studies and toolkits
  • support learning and sharing across the sector by developing an employee wellbeing network, supported by regional meetings.

This work is focused specifically on staff and the website has an extensive range of case studies and toolkits that provide useful learning and can contribute to a whole-system approach.

A number of HEIs that are members of the English National Healthy University Network offer useful examples of projects that work with both staff and students to secure health and wellbeing outcomes. These include:

  • Leeds Metropolitan University’s award winning web-based project Wellbeing: You are on the Right Path
  • Leeds Trinity University College’s cross-institutional Health and Wellbeing Group, which has been in existence since the mid-1990s and is strengthened by representation from interested and committed individuals from across all the key areas: academic, student support, HR, catering, student union, health advisors, community development and sports centre.

Planning and Implementation

The critical success factors for staff health and wellbeing can be broadly divided into:

i) Commitment from the senior decision makers – the directorate, executive and/or senior management team. Key determinants here include:

  • business case for a cost-effective policy
  • reputation-building and ‘impact’ (as defined in the Research Excellence Framework)
  • becoming an employer of choice
  • retaining both staff and students
  • expression of corporate social responsibility.

ii) Wide-ranging staff engagement and endorsement of the Healthy University approach. Key issues here include:

  • effective communications; in particular staff (and student) voice having a viable forum
  • understanding of the proposition exchange, where all stakeholders see a benefit
  • staff feeling valued as a resource and stakeholders in a worthwhile enterprise.

In planning and implementing work in support of staff health and wellbeing, it will be important to secure both senior-level commitment and wider engagement. The concept of a ‘psychological contract’ has been discussed within the context of Healthy Universities by Ewart Wooldridge, Chief Executive of the Leadership Foundation for Higher Education (see Healthy Universities newsletter issue 2):

‘The psychological contract…represents that aggregate of reciprocal expectations between an institution and all its members. It is about such issues as a sense of fairness, dignity at work, the balance between collegial and corporate pressures and indeed the expectations and perceptions of leadership. Creating a sense of well-being and organisational health is at the heart of the concept.’

It will also be important for those advocating and leading Healthy Universities work to be equipped to develop the ability to influence beyond authority, nurturing a sense of shared enterprise and equity, supported by clear communications and mutual understanding. Some useful information relating to this thinking is provided in a presentation made by Ewart Wooldridge to the English National Healthy Universities Network.

Consultation and Partnerships

A commitment to consultation and partnership working should be integral to effective planning and implementation, as indicated in the section above. The creation and resourcing of an interest group may provide a useful way forward: this can help to identify pockets of good practice and give motivated individuals an opportunity to work together.   Depending upon individual institutions there may be a health and wellbeing group that generates smaller ‘complete-and-finish’ units for specific projects or interventions.

It will also be important to work with external partners. This will mean learning from and sharing experiences with other HEIs investing in staff health and wellbeing. It will also mean looking outside of the higher education sector to learn from good practice and identify opportunities to secure effective partnering.

Evaluation and Impact

It is also crucial to have evaluation built into the development and implementation of the whole system Healthy Universities approach. As discussed in the Evaluation Section of the main website, this is likely to involve outcome and process evaluation – and require a focus on two levels: the overall initiative and way of working, in order to capture the added value of the approach; and component interventions and projects.

In relation to workplace health, there are a number of possible data sources that can contribute to both process and outcome evaluation (as well as to research focused on efficiency in terms of cost-effectiveness or cost-benefit):

  • Routine data related to staff accidents, sickness, absence and performance: these provide a potentially rich source of information that will need to be interpreted and understood in the context of a university’s investment in workplace health
  • Staff perception or attitude questionnaire.

Effective arguments to support continued investment in and the long-term sustainability of staff health and wellbeing are strengthened if there is a ‘base-line’ data set that can identify changes over time and track the evolving themes and concerns highlighted by the perception survey. Best practice also suggests that institutions should consider a respondent validation exercise – where participants are invited to reflect their interpretation of the questions and motivations behind the questionnaire response. There will be resource implications to effective evaluation, but without it the health and wellbeing approach is vulnerable in the cold economic climate facing the higher education sector in the future.


Black, C. (2008) Working for a Healthier Tomorrow. London: TSO. [Internet accessed on 13 August 2014]

Institute of Directors (2006) Wellbeing at Work. London: Director Publications Ltd. [Internet accessed on 13 August 2014]

Vaughan-Jones, H. and Barham, L. (2010) Healthy Work: Challenges and Opportunities to 2030. London: Bupa. [Internet accessed on 13 August 2014]

Waddell, G. and Burton, K. (2006) Is Work Good for Your Health and Wellbeing. London: TSO.

Wanless, D. (2004) Securing Good Health for the Whole Population. London: HMSO. [Internet accessed 6 January 2015]

World Health Organisation (1986) Ottawa Charter for Health Promotion. Geneva, Switzerland: WHO. [Internet accessed on 13 August 2014]