Why a tax break for employers is the smart way to improve mental health | Norman Lamb

Twenty-two billion pounds: that’s the estimated annual cost to employers and taxpayers of sickness absence. Much of that relates to mental ill-health – which, along with musculoskeletal complaints, causes about 80% of sickness absence – and sick leave seems to be on the rise.

A recent survey by the Engineers Employers Federation found that 41% of companies had witnessed an increase in long-term absences over the past two years.

On top of that, there is the cost of presenteeism – people turning up for work despite being unwell and underperforming as a result. The impact on productivity is massive. Many end up losing their job as a result of ill-health.

That’s the cold economics. But the human cost is dreadful. Lost earnings and the awful loss of self-worth that comes with the unemployment. Those with severe and enduring mental ill-health lose out the most, with an employment rate of just 7%.

Simon Stevens, the chief executive of NHS England, highlighted this miserable state of affairs in his Five Year Forward View for the NHS back in 2014. He focused on the role of employers, arguing that incentives should be offered to those “who provide effective Nice-recommended workplace health programmes for employees”. Enlightened thinking for an NHS boss: put more effort into prevention and everyone could benefit.

Now we have an opportunity to test this idea. This week the West Midlands became the first city region to publish an ambitious Action Plan for Mental Health. It is the culmination of more than a year’s work by the mental health commission I chaired on behalf of the West Midlands Combined Authority. At its heart is a focus on prevention and early intervention.

We were asked to look at the total cost of mental ill-health to the region, and to consider how we could make more effective use of resources in order to achieve better results for people and to have a positive impact on the regional economy. One of our key ideas is a trial of what we have called a wellbeing premium – a discount on an employer’s business rates in return for that employer committing to key evidence-based actions to improve the wellbeing of people at work.

We know, for example, that the training of line managers can have a positive impact on how people are treated at work, the culture in the workplace, and the support people receive when struggling with ill-health. We know that it is important to have someone at board level taking responsibility for wellbeing. There is also emerging evidence of the value of training people in mental health first aid.

Provided we can secure the funding to pursue this trial, our aim is to evaluate the impact over a two-year period. We hope to work with 100 employers, from businesses employing just a handful of staff up to large organisations. Our aim is to build the evidence of what works over that period.

We believe we will be able to demonstrate that, once companies have been encouraged to act through the receipt of the wellbeing premium, they will see the potential positive impact on their bottom line. For this reason, we believe that the wellbeing premium should be time-limited. Once a company sees the value, then there will be no need for any continued public subsidy.

This is a win-win situation. For employees, better support at work, reduced distress from sickness absence, and reduced loss of earnings. For employers, improved productivity, reduced sickness absence and fewer people leaving work unnecessarily at enormous cost to the business. For government, improved productivity – needed now more than ever. And supporting people more effectively to stop deterioration of health means a reduced burden on the NHS and savings on the benefits bill.

This proposal sits alongside other exciting initiatives. We are working with the government’s Health and Work Unit to deliver a multimillion-pound trial of individual placement and support. This is an approach, with a strong evidence base, that aims to get those with mental ill-health back into work. The trial will work in both primary and secondary care.

We will also use public procurement to encourage companies tendering for contracts to take action to improve the wellbeing of their workforce. Surely it’s not too much to ask for such companies to demonstrate that they are good employers.

These are just a few aspects of a new approach that aims to focus on preventing ill-health rather than repairing the damage once it’s done. Our health and care system is under unsustainable pressure. It will need more resources in the years ahead, but we can also be smarter at acting to prevent ill-health.

Why a tax break for employers is the smart way to improve mental health | Norman Lamb

Archie Norman obituary

My father, Archie Norman, who has died aged 104, was an eminent paediatrician who pioneered research into cystic fibrosis and asthma at Great Ormond Street hospital, in London, and neonatal care at Queen Charlotte’s.

The son of George Norman, a radiologist, and his wife, Mary (nee MacCallum), a nurse, he was born in Oban, Argyll and Bute, and watched his father march off to the first world war. He grew up in the soot-covered mill town of Shaw in Lancashire (now part of Greater Manchester), and remembered the “waker” coming down the street and the sirens summoning workers to the morning shift.

After attending Charterhouse school, in Godalming, Surrey, he studied medicine at Cambridge University, taking psychology as a postgraduate and then went to the Middlesex hospital. He served as a house registrar at Great Ormond Street before the second world war when there were few antibiotics and no NHS. At his weekly whooping cough clinic distressed mothers with children queued around the block to be given coloured pills depending on their ability to pay.

During the war he was assigned as medical officer to the 4th battalion of the Northumberland Fusiliers, a reconnaissance unit sent to North Africa in early 1942. At the battle of Knightsbridge he was left behind in the retreat tending the wounded and sending away his last vehicle to safety. He served in PoW camps in Italy and Silesia before being liberated by the Russians. He led 150 troops to freedom, marching on foot for weeks through Russian lines and then by train to the Black Sea. On their commendation he was appointed MBE in 1945. “They had an exaggerated idea of what I did,” he said.

Returning to Great Ormond Street, he arrived in an extraordinary new era for paediatrics. He founded the hospital’s respiratory clinic to pioneer research and treatment of cystic fibrosis and asthma. He undertook the first UK life tables for cystic fibrosis, which showed that in the early 1950s few children reached teenage years. Asthma was a significant cause of child mortality in smog-filled London and he raised money to pay for new lung function tests and pioneered the use of steroids to treat children.

As the numbers of patients grew, he organised the founding of the Cystic Fibrosis Research Trust, cajoling parents and benefactors into getting it off the ground. Later he was a driving force behind the founding of the Children’s Trust at Tadworth, Surrey, as a centre for helping children with brain injury.

In 1953 he became consultant paediatrician at Queen Charlotte’s, where he worked on groundbreaking care of premature babies. He looked after the first quintuplets born in the UK, in 1969. At night he would dash up to London from the family home in Kingswood, Surrey, to do an emergency transfusion, driving home afterwards “feeling that I had done something worthwhile”.

He worked long hours and lived for his patients until he retired to spend more time with his wife, Betty, a GP. He never sought recognition and disdained bombast. He always wore a clean white coat on the ward and walked up the stairs even if the lift was available. He drank little and settled for a cheese sandwich for lunch.

He is survived by Betty and their five sons, Duncan, Thomas, Sandy, Donald and me, and by seven grandchildren.

Archie Norman obituary

We need mental health support at work – and every employer should commit to it | Norman Lamb

We all have mental health, just as we all have physical health, and in both cases we are on a continuum, where our health can vary day to day. It is estimated that one in four people experience a mental health issue in any given year, and that one in six employees is depressed, anxious or suffering from stress-related problems at any time. However, many of us know little about mental health. We often don’t spot the signs that a colleague, employee, or we ourselves are struggling, and this delays help and recovery.

Last week Business in the Community (BiTC) released the most comprehensive report of its kind, called Mental Health at Work. Worryingly, the report uncovered the fact that over three-quarters of employees have experienced poor mental health, and almost half of workers would not talk to their manager about a mental health issue. And while employers are talking more about it, words are not translating into action.

There is a disconnect between the ideals of company bosses and the reality of employees when it comes to mental health. Most board members believe their organisation is supportive on the issue, but 56% of people who have disclosed a mental health issue at work said their employer took no mitigating actions, found BiTC. How can we close this gap between perception and reality? A vital and practical step employers can take, and a key recommendation of the BiTC report, is investment in first-aid training in mental health for staff.

Mental health first-aid is the mental health equivalent of a physical first-aid course. It teaches people the skills and confidence to recognise the signs and symptoms of common mental health issues, listen empathetically and effectively guide a person towards the right support.

Recently, I became a mental health first-aider myself, and now have the tools to start a meaningful conversation on the issue, something most of us would struggle to do. Could you think of the right words to say to someone who may be feeling suicidal? Having experienced loss in my family the training allowed me to reflect on what I might have done differently.

We spend a considerable amount of our lives at work and with more of us working longer hours, under more pressure, having mental health first-aid support in the workplace is critical not just for employees, but for businesses too. As it stands, mental health issues (stress, depression or anxiety) account for almost 70m days off sick per year, the most of any health condition.

Today, on World Mental Health Day, with support from Mental Health First Aid (MHFA) England and Mind, I am calling on the government to act and bring parity to mental and physical health in the workplace. I’m submitting an early day motion on the issue as the first step towards amending the current legislation, which requires employers to train staff in physical first aid, to in future include mental health first aid.

How can we possibly justify leaving the law as it is? So far as the NHS is concerned the government has committed to the principle of “parity of esteem” between physical and mental illness. Surely they must apply the same logic to the workplace.

Put simply, this is a call for every workplace to have trained mental health first-aiders just like they have physical first-aiders. A number of employers are taking action. WHSmith has committed to match the number of staff that are physical first-aiders with mental health first-aiders over the next 12 months.

There’s a growing momentum for change, and hundreds more businesses across a range of sectors are implementing mental health training for staff from Unilever and Crossrail to Channel 4. Employers have a duty of care to their workforce, and with the scale of mental issues in this country much more needs to be done. The government must act now to ensure every employee has access to mental health support at work.

We need mental health support at work – and every employer should commit to it | Norman Lamb

We need to have protected, compassionate psychological well being care | Norman Lamb

A group fishing session for patients. The Constructive and Safe programme aims to generate constructive therapeutic environments. Photograph: Christopher Thomond

If you had been becoming taken care of for a physical sickness or injury – like a broken leg or a heart problem – you would never picture that as element of that treatment method you could be tied to your hospital bed to avert you from moving or restrained encounter-down by the wellness professionals caring for you.

But for many folks who have a psychological illness, a finding out disability or autism, this is a probability.

The problem of restraint in health and care is some thing that has been grappled with for numerous many years. The overuse of restraint and restrictive interventions is component of a absolutely outdated culture in wellness and care providers but they are even now currently being employed too often in today’s system. Last year’s report from Thoughts demonstrated that very powerfully.

Final month, I was proud to oversee the launch of Optimistic and Protected, a two-year programme to end the deliberate use of encounter-down restraint in all well being and care settings. It aims to generate more positive, therapeutic environments in which restrictive interventions such as physical, chemical or mechanical restraint and seclusion are in no way the norm.

To obtain this, we have worked with the Royal College of Nursing, Expertise for Health and Capabilities for Care to create new guidance for pros as well as workforce instruction tips in two key documents: Good and Proactive Care and A Good and Proactive Workforce.

Creating these has concerned a genuine work to get it right so that service customers and employees, outdoors groups and charities representing sufferers, and companies all truly feel capable to assistance the approach. Even so, what’s grow to be obvious is that everybody needs the very same thing: protected, compassionate, humane care. This has been stored at the heart of our work and we’ve acquired overwhelmingly good suggestions from a assortment of men and women across the method.

I have heard some of the extremely distressing stories of individuals who have been restrained. Becoming held face-down for a prolonged time period in a way that may be unpleasant or make it difficult to breathe is something we would all hope never to knowledge. I have also heard from personnel who have struggled with this concern, who are following protocol but who locate the use of restraint as frightening and potentially unsafe as individuals do.

The situation for alter is absolutely clear.

We want to promote a culture exactly where the use of forcible interventions is radically decreased, in which personnel and sufferers are secure and where dignity and respect are paramount. Nevertheless, we require to make confident that the advice forming the basis of Positive and Secure is useful and workable. I recognise that there are a good deal of men and women working in really challenging situations with individuals who do display challenging behaviour. Where a person has behaved in a way that poses a danger to themselves or others, it’s completely proper that action is taken but the priority need to usually be to maintain folks safe.

Which is why the advice suggests different approaches, such as constructive behaviour help, that target on enhancing top quality of life as well as meeting demands and minimizing distress. It functions by encouraging good behaviour alternatively of restricting unfavorable behaviour. Caring for individuals in this way indicates that restrictive interventions are considerably much less most likely to be required.

Between the extremely optimistic responses to this programme, the question has been raised: will this really make any difference?  A essential part of Optimistic and Risk-free is that the guidance will kind portion of the Care Quality Commission’s rigorous inspections. This is not just a document that will sit on a shelf. It is backed by a programme of instruction and advice and it has teeth attached since if organisations flout the principles and carry on with enterprise as typical, then there are consequences, which could be as severe as a criminal conviction.

But this is only a start, change isn’t going to occur overnight. Very good practice requirements to become standard practice.

Many overall health and care suppliers and staff have presently committed to championing this programme and guaranteeing it works in practice and I strongly urge anyone functioning in health and care to do the exact same.

There are presently some outstanding examples across the method. When I visited Oxleas psychological well being hospital not too long ago to launch our Crisis Care Concordat, employees demonstrated how they are taking action to decrease the use of restraint and provide much more supportive, compassionate crisis care. Such examples present that it is achievable.

That’s why I want to see progress on this and why we have committed £1.2m for 2014-15 to assistance Positive and Protected, like building an modern programme of instruction across overall health and social care.

This is complex and there is a prolonged way to go. Nonetheless, this hugely critical programme has been constructed on a powerful consensus across the method that modify is essential and it really is by doing work collectively that we’ll drive the adjust that we all want to see.

Are you a member of our online neighborhood? Join the Guardian healthcare network to acquire typical emails and unique gives.

We need to have protected, compassionate psychological well being care | Norman Lamb

Dementia, loneliness and how we can help | Norman Lamb

Many elderly people are lonely and dementia makes that worse. Photograph: John Stillwell/PA

It is four o’clock in the morning. A man has been roused from an already fitful sleep by his wife. She is upset and confused. And she has wet the bed. He has to comfort her and change the sheets at the same time. Eventually he is able to return to bed and get a little bit of rest before his wife wakes up again. Then he will face a day of enormous challenges, before the night cycle repeats itself.

He does it because he loves her – and because she still counts. Theirs is not a life devoid of any joy or pleasure. But dementia can be a cruel condition, both for those who have it and for the people who love and care for them.

Yet these two are comparatively lucky, because they have each other. Dementia combined with loneliness is truly devastating. Tragically, it is a situation in which many more people are due to find themselves.

The Campaign to End Loneliness calculates that some 800,000 people in England are chronically lonely. Forty-six per cent of people aged 80 or over report feeling lonely at least some of the time. Meanwhile, one in three people aged over 65 will go on to develop dementia.

And dementia and loneliness already meet all too frequently. The Alzheimer’s Society has found that a third of people with dementia have lost friends. Nearly two-thirds of those with dementia who live by themselves feel lonely. Some 5% of people with the condition have not told friends about their diagnosis. All of this is deeply distressing.

So we need an assault on the twin epidemics of dementia and loneliness. Of course we have to find new ways to manage dementia – and ultimately to cure it. But in the meantime, we must do more to help people cope with it.

Helping people live well with dementia is a big priority for this government and an essential step in creating a fairer society.

But responsibility does not just rest on the shoulders of politicians and health and care professionals. Compassion for others is a moral imperative that none of us should ignore.

That’s why the Alzheimer’s Society’s Dementia Friends programme is so important. It supports people who want better to understand all the implications of the condition. I have gone through the programme and become a Dementia Friend, and it is hugely worthwhile and informative.

Last week saw celebrities and people living with dementia teaming up with the Dementia Friends Campaign to encourage even more of us to sign up. One million are expected to be recruited by 2015.

We are championing dementia-friendly communities, where more of us can learn about dementia – and where people with it are encouraged and helped to lead fulfilling lives. More than 50 cities, towns and villages are already taking local action to become dementia friendly.

All of this should be just the start, the beginning of a massive social movement. If just a fraction of the many millions of Guardian and Observer readers signed up to be a Dementia Friend by visiting www.dementiafriends.org.uk it could have a major and enduring impact. And it would be a fantastic way of helping to overcome our loneliness epidemic.

Just as good neighbours are concerned about crime, so they should be concerned that the people who live in their community are properly looked after.

We all matter, we all need to be loved, and we should all do all we can to look out for others – remembering just how vulnerable and unhappy we would be if we were lonely ourselves.

Norman Lamb is Minister of State for Care and Support

Dementia, loneliness and how we can help | Norman Lamb

Dementia, loneliness and how we can support | Norman Lamb

Many elderly people are lonely and dementia makes that worse. Photograph: John Stillwell/PA

It is four o’clock in the morning. A man has been roused from an already fitful sleep by his wife. She is upset and confused. And she has wet the bed. He has to comfort her and change the sheets at the same time. Eventually he is able to return to bed and get a little bit of rest before his wife wakes up again. Then he will face a day of enormous challenges, before the night cycle repeats itself.

He does it because he loves her – and because she still counts. Theirs is not a life devoid of any joy or pleasure. But dementia can be a cruel condition, both for those who have it and for the people who love and care for them.

Yet these two are comparatively lucky, because they have each other. Dementia combined with loneliness is truly devastating. Tragically, it is a situation in which many more people are due to find themselves.

The Campaign to End Loneliness calculates that some 800,000 people in England are chronically lonely. Forty-six per cent of people aged 80 or over report feeling lonely at least some of the time. Meanwhile, one in three people aged over 65 will go on to develop dementia.

And dementia and loneliness already meet all too frequently. The Alzheimer’s Society has found that a third of people with dementia have lost friends. Nearly two-thirds of those with dementia who live by themselves feel lonely. Some 5% of people with the condition have not told friends about their diagnosis. All of this is deeply distressing.

So we need an assault on the twin epidemics of dementia and loneliness. Of course we have to find new ways to manage dementia – and ultimately to cure it. But in the meantime, we must do more to help people cope with it.

Helping people live well with dementia is a big priority for this government and an essential step in creating a fairer society.

But responsibility does not just rest on the shoulders of politicians and health and care professionals. Compassion for others is a moral imperative that none of us should ignore.

That’s why the Alzheimer’s Society’s Dementia Friends programme is so important. It supports people who want better to understand all the implications of the condition. I have gone through the programme and become a Dementia Friend, and it is hugely worthwhile and informative.

Last week saw celebrities and people living with dementia teaming up with the Dementia Friends Campaign to encourage even more of us to sign up. One million are expected to be recruited by 2015.

We are championing dementia-friendly communities, where more of us can learn about dementia – and where people with it are encouraged and helped to lead fulfilling lives. More than 50 cities, towns and villages are already taking local action to become dementia friendly.

All of this should be just the start, the beginning of a massive social movement. If just a fraction of the many millions of Guardian and Observer readers signed up to be a Dementia Friend by visiting www.dementiafriends.org.uk it could have a major and enduring impact. And it would be a fantastic way of helping to overcome our loneliness epidemic.

Just as good neighbours are concerned about crime, so they should be concerned that the people who live in their community are properly looked after.

We all matter, we all need to be loved, and we should all do all we can to look out for others – remembering just how vulnerable and unhappy we would be if we were lonely ourselves.

Norman Lamb is Minister of State for Care and Support

Dementia, loneliness and how we can support | Norman Lamb