Working for health.

The Business HealthCheck

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Two men looking at a computer FAQs: all you need to know about the tool Sign up to pilot and download for free

An evaluation tool for organisations investing in health and wellbeing

About the tool

In partnership with PricewaterhouseCoopers and Business in the Community, Health Work Wellbeing is very pleased to be piloting an evaluation tool to help employers assess the cost of ill-health to their business and the impact of wellness programmes on these costs.

We are also grateful to National Grid, Nottingham University Hospitals NHS Trust and Marshalls for their involvement in pre-pilot work and to Boots, Bupa and the Business in the Community’s Business Action on Health Leadership Team for their support in helping to promote this initiative.

Workplace Wellness makes sense

A healthy workforce is a sustainable workforce; it makes common sense to ensure that, wherever possible, the people who make up our organisations are in good health and feel good about themselves and their work environment.

Adaptable to the size and sector of your organisation, The Business Healthcheck helps turn health and well-being into management information on which businesses can act, and shows that wellness really can have an impact on your bottom line.

Assistance

Please click on the link below to download the User Guide

Sign up for the Pilot and download for free

The evaluation tool is free to download and use, simply fill in your details below and click submit. We would like to retain your details and contact you in the future to gain feedback regarding the employer evaluation tool and to update you on relevant information regarding the initiative.



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We are working in partnership with Business in the Community* to provide additional help to use the tool and to collect some early feedback on the tool itself.

 

To view details about data protection, please view our privacy policy

* Business in the Community is one of the Prince's Trust's Charities. They engage, support and challenge companies on responsible business, working in four areas: Community, Environment, Marketplace and Workplace.

FAQs

To help you get started with the Business HealthCheck Tool we have set out some general responses to typical questions that people will have when using the tool.

Q1: What is the Business HealthCheck Tool?
A: The Business HealthCheck tool is a form of ready reckoner that businesses can use to:
  • assess and appraise the financial benefits associated with wellness programmes and develop the business case for the investment leading to better, informed decision-making.
  • calculate the up-front business costs of ill health in a given year.
  • generate possible scenarios for the projected business cost of ill health in the future
  • monitor progress and report to company board members and in company accounts.
  • evaluate the financial benefits of wellness programmes after they have been implemented following a thorough evaluation to determine the overall success of initiatives.
Q2. Why was the Business HealthCheck tool introduced?
Dame Carol Black published a review of the health of Britain’s working age population, ‘Working for a healthier tomorrow’ in March 2008. Amongst a number of conclusions, the review found lack of information to use in a business case as is a barrier to employers investing in the health and well-being of their workforce. The Business HealthCheck tool is a step towards this process helping employers to measure and report on the benefits of such an investment.
Q3: What software do I need to run the Business HealthCheck tool?
A: The Business HealthCheck tool is currently a standalone Microsoft Excel file. Each worksheet contains different steps in the calculation process and the worksheets are interlinked, so that information inputted in one sheet is available for use in a calculation on a later worksheet. It can be used on most systems which have Microsoft Excel software installed.
Q4: Why do I need to register to download the tool?
A: We ask people to register their details before downloading the tool to help us better understand the kinds of businesses, organisations, and individuals who are interested in looking at and testing the tool and listen to their feedback.
Q5: Is there guidance on how to use the tool?
A: The tool comes with instructions on each page and detailed guidance is available on the second last worksheet which you can access when you click on individual (linked) words in the worksheets. Clicking again on the individual (linked) words in the guidance note will return you to the place you were before. There is also additional guidance in the form of a pdf file which is available on the website. If you have specific queries which are not addressed in the guidance or by the tool, there is a telephone helpline (details of which are available at the end of these FAQs) that you can call.
Q6: How do I navigate around the tool?
You can navigate the model using the Business HealthCheck Toolbar. This appears automatically when the tool is opened. If you have closed the toolbar down or cannot see it, go to Excel's drop-down View menu bar, select Toolbars and then select Business HealthCheck Toolbar. You can also navigate the model using the worksheet tabs (found at the bottom of the screen) or the Map worksheet (second tab). The Map worksheet shows the key pages of the model and how pages link to each other.
Q7: What information do I need to use the tool?
A: The tool requests information about (i) the workforce and the workplace including:
  • Workforce size
  • Numbers of working days
  • Average gross salary
(ii) Business well-being metrics such as:
  • Sickness absence levels
  • Staff turnover
  • Numbers of accidents in a year
And (iii) the health and well-being programme that you are planning to introduce or have already implemented:
  • Numbers of people who were/will be included in the health/well-being programme
  • (Estimated) Cost of programme
  • (Estimated) Changes in business well-being metrics associated with the health and well-being programme.
You do not need to complete all the information. The information requested is dependent on what your business wants to use the tool for.
Q8: What can I do if I do not have the information requested as it is not collected by my business?
A: You can use national/sector averages to estimate up-front business costs of ill health to your business in a given year (see ‘guide’ worksheet for benchmark data) then begin to put into place the appropriate systems and processes to measure ill health in your business.
Q9: Where do I need to insert information in the tool?
A: The tool requires you to insert information on two worksheets: the first called ‘base data’ and the second called ‘projections’. In both of these worksheets, you are asked to insert information in boxes shaded in white. The grey-coloured cells are cells where you can breakdown your staff into different groups or sub-sets. For instance, you may want to input information for staff by grade or by location if wages or well-being metrics such as sickness absence differ greatly. The boxes shaded in blue do not need to be completed as they will automatically be updated by the tool.
Q10: What kinds of reports are produced from the tool?
A: The Business HealthCheck tool provides different reports:
  • ‘Base business cost’ report is available once you have completed the ‘base data’ worksheet. This provides a summary of your business’ total ill health costs in the base year prior to the introduction of any health/well-being programmes.
  • ‘Summary’ and ‘business case’ reports are available once you have completed the ‘projections’ worksheet. These include summaries of current and actual/estimated costs and benefits of introducing a health/well-being programme as well as financial/investment appraisal data such as net present value, internal rate of return and benefit to cost ratio.
Q11: Is it possible to update/modify the reports and calculations at any point?
A: Yes, the tool allows you to input updated information as and when this becomes available. This gives you the scope to present actual versus estimated information on the impacts of your organisation’s intervention.
Q12: How can I use the Business HealthCheck tool to calculate the up-front costs of ill-health in a given year to my organisation?
A: You need to simply complete the ‘base data’ worksheet entering the total number of employees in your organisation as the target population and 100% for participation rate. Then enter the different business metrics described above and unit costs as requested. Click on ‘view base costs’ and this will calculate the up-front costs of ill health to your organisation split by absenteeism, presenteeism, staff turnover, accident/injury, insurance premium and other.
Q13: How can I use the Business HealthCheck tool to develop a business case for introducing a health/well-being programme?
A: You need to complete the ‘base data’ and ‘projections’ worksheets. On the ‘projections’ worksheet, you are required to consider and estimate what impact you think a health/well-being programme will have on the various business metrics such as sickness absenteeism and labour turnover for your organisation. Then view the ‘summary’ and ‘business case’ reports. These include summaries of current and estimated costs and benefits of introducing a health/well-being programme as well as financial/investment appraisal data such as net present value, internal rate of return and benefit to cost ratio to help you decide if the investment is worthwhile. If you want to develop different sets of assumptions or scenarios of the impact of a health/well-being programme, for example, best and worst cases and compared these, use the scenario section at the bottom of the ‘projections’ worksheet. Then view the ‘summary’ report.
Q14: I want to use the Business HealthCheck tool to assess/appraise the benefits associated with health/well-being programmes. What assumptions should I use for potential improvements in the business metrics such as sickness absence?
A: To develop assumptions, you should review the existing research and case studies to determine which of these are most similar to your situation and the health/well-being programme that you want to introduce. Alternatively, you could use averages. A review of wellness programmes was carried out by PricewaterhouseCoopers as part of the Dame Carol Black review (‘Building the Case for Wellness’). This included a detailed literature review of published evidence and a systematic case study review of relevant UK case studies to assess the impact of wellness programmes (further information can be found on www.workingforhealth.gov.uk). This found improvements in business metrics varied substantially. This is to be expected as the success of the wellbeing programmes are likely to be dependent on a number of factors including size and type of organisation, type of wellness programme that was introduced and the nature of the issues being tackled, target population, length of intervention and planning, execution and management of the programme. A list of wellness literature can also be found on the ‘reference’ worksheet of the tool.
Q15: How can I use the Business HealthCheck tool to evaluate the financial benefits of a health/well-being programme?
A: After a robust evaluation has been carried out on the impact of the health/well-being programme, you can use the Business HealthCheck tool to evaluate the financial benefits of a health/well-being programme. You need to complete the ‘base data’ and ‘projections’ worksheets. On the ‘projections’ worksheet, you are required to enter the actual impact the health/well-being programme had on the different business metrics such as sickness absenteeism and labour turnover for your organisation. Then view the ‘summary’ and ‘business case’ reports. These include summaries of base costs and actual costs and benefits of the health/well-being programme for your organisation as well as financial/investment appraisal data such as net present value, internal rate of return and benefit to cost ratio to help you evaluate if the investment you made was financially beneficial. If you want to compare forecasts/estimates of the impact of the health/well-being programme that you made prior to commencement of the initiative with actual impact, enter actual impact on the ‘projections’ worksheet and your forecasts/estimates in the scenario section at the bottom of the ‘projections’ worksheet. Then view the ‘summary’ report for a comparison.
Q16: What is meant by target population, participation rate and active population?
A: Target population ‘Base date’ worksheet: To examine the total upfront costs of ill health to your business in the base year, enter the total number of employees in your business as the target population. Alternatively, if you want to examine the upfront costs of ill health to your business in the base year for a subset of employees (for example, because you want to target the health/well-being programme at this subset and want to examine the upfront costs of ill health for this specific target group), enter the number of employees in this subset as the target population. ‘Projections’ worksheet: Enter the number of employees you want to or have targeted with a specific health/well-being programme. Participation rate ‘Base data’ worksheet: Enter 100%. ‘Projections’ worksheet: Enter the percentage of the target population that you expect to participate or have actually participated in the health/well-being programme. For example, a business may subsidise flu vaccinations for all employees but only half choose to take this up so the participation rate is 50%. Active population This is simply target population multiplied by the participation rate.
Q17: How is the 228 working days calculated?
A: The 228 working days is based on 5 working days a week for 52 weeks in the year less 32 days for paid leave and public holidays. This is the standard number of working days used by the CIPD. If you feel that this is too high or too low for your organisation, you can enter a different number.
Q18: What is adjusted absenteeism?
A: Absenteeism is generally felt to understate the true cost of absenteeism for an organisation. This could be due to (i) under-reporting of sickness absence and/or (ii) the indirect costs of absenteeism e.g. absence of staff can have implications on customer satisfaction, or there maybe spillover effects because a key team member is away at a critical time thus reducing output of other team members. To account for this, absenteeism is ‘adjusted’ by a multiplier. 1.5 is a central estimate from the wellness literature [see The Sainsbury Centre for Mental Health (2007) Mental Health at Work: Developing the business case, Policy Paper 8]. This has the effect of making the effective days of sickness absenteeism greater than the actual number of days of sickness absenteeism. If you feel that you have accurate absenteeism data and there is no under-reporting or indirect costs then set the multiplier to 1.
Q19: What is presenteeism?
A: Presenteeism is defined as ‘the loss in productivity that occurs when employees come to work but function at less than full capacity because of ill health’ (The Sainsbury Centre for Mental Health, 2007). It is likely to be more common among higher-paid staff thus is more costly. Evidence suggests that costs due to presenteeism can be several times higher than costs due to absenteeism. Estimates mainly come from the US and they range from around 1.9 – 6.8 times the costs of absenteeism. Sainsbury Centre for Mental Health estimated the costs of presenteeism attributable to mental health problems in the UK to be 1.8 times those of absenteeism. This is used as the central estimate in the tool. This is believed to be a conservative estimate for mental health problems. Counterbalancing this, however, is the fact that mental ill health is more likely to be manifested in the form of presenteeism than absenteeism compared with other ill-health problems. So for all health problems, the multiplier of 1.8 appears to be reasonable. The estimate is just below the range of estimates from international studies. This is justified by the fact that the international evidence base relies heavily on studies from the US where coverage of occupational sick pay is significantly lower than in the UK. So there is a greater financial incentive for individuals to go to work even if they don’t feel 100%. Thus US presenteeism figures are likely to overstate the scale of presenteeism in the UK. [For further information see: The Sainsbury Centre for Mental Health (2007) Mental Health at Work: Developing the business case, Policy Paper 8]. The multiplier of 1.8 is applied to adjusted absenteeism. If you feel you have more accurate information on presenteeism, you can alter the central estimate.
Q20: How do I calculate the staff turnover rate?
A: The staff turnover rate can be calculated by taking the average numbers of leavers in a set period divided by the average numbers of people employed over the same period.
Q21: What are staff labour turnover costs?
A: Staff turnover cost measures the total cost of turnover to your company on a per employee basis. Total costs would include more than simply the cost of an advert for a replacement. It would include other recruitment and selection costs, training costs, separation costs and loss of productivity. According to one US report, “a rule of thumb sometimes used is that it costs half a year’s salary to hire a replacement” (The Sainsbury Centre for Mental Health, 2007). If you feel you have more accurate information on staff labour turnover costs, you can use these in the tool.
Q22: What accidents and injuries should I record in the Business HealthCheck tool?
A: This is a health and safety metric to record the number of accidents and injuries that occur each year in the firm. It is assumed that any lost days due to the incident are captured in sickness absence days. All employers must report specific workplace injuries to the Health and Safety Executive under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995. If your organisation collects data on minor injuries, these can also be recorded in the tool. The purpose of reporting on this metric is to estimate/monitor changes to this metric associated with any health/well-being programme.
Q23: What is the net present value?
A: The net present value is the difference between the discounted costs and discounted benefits. A net present value of greater than zero indicates the health/well-being programme is worth implementing/generates positive financial benefits.
Q24: What is discounting?
A: Discounting is a method used to convert future costs and benefits to present value using a discount rate. This is based on the principle that, generally, people prefer to receive goods and services now rather than later (time preference).
Q25: What is the discount rate?
A: Discount rate is the annual percentage rate at which the present value of a future pound is assumed to decline as the number of years increase. Your Chief Finance Officer or accountant will know the appropriate discount rate. As a default, 7% is assumed in the tool.
Q26: What is the internal rate of return?
A: The IRR is the discount rate that gives a proposal a present value of zero. It is often used by firms to determine whether they should make an investment. It can be used rank proposals. An investment should be undertaken if the IRR is greater than the rate of return that could be earned by alternative investments of equivalent risk (i.e. bonds, bank accounts, other projects etc.).
Q27: What is the pay-back period?
A: The amount of time it takes for benefits (cash inflows) to equal costs (cash outflows), resulting in the break even point. Typically, holistic wellness programmes can be expected to show a positive financial return over a period of 2 to 3 years. However, targeted interventions may show a pay-back period in a short period of time (see ‘Building the Case for Wellness’, PricewaterhouseCoopers www.workingforhealth.gov.uk).
Q28: What benefit-to-cost ratio should I expect?
A: To determine what benefit-to-cost ratio or the range of ratios to expect, you should review the existing research and case studies to assess which of these are most similar to your situation and the health/well-being programme that you want to introduce. A review of wellness programmes was carried out by PricewaterhouseCoopers as part of the Dame Carol Black review (‘Building the Case for Wellness’). This included a detailed literature review of published evidence and a systematic case study review of relevant UK case studies to assess the impact of wellness programmes (further information can be found on www.workingforhealth.gov.uk). This found benefit-to-cost ratios varied substantially. This is to be expected as benefit-to-cost ratios are likely to be dependent on a number of factors including size and type of organisation, type of wellness programme that was introduced and the nature of the issues being tackled, target population, length of intervention and planning, execution and management of the programme. The review did, however, find that the benefits of wellness programmes can significantly outweigh the costs. A meta-evaluation carried out by Chapman found the average benefit-to-cost ratio of worksite health promotion programmes to be around 5.81 [Chapman (2003) ‘Meta-evaluation of Worksite Health Promotion Economic Return Studies’, Art of Health Promotion Newsletter Vol.6 No. 6 January/February 2003]. A list of wellness literature can be found on the ‘reference’ worksheet of the tool.
Q29: I have looked through all the guidance and the frequently asked questions but have been unable to find the answer to my question. Is additional support available?
We are currently redesigning the tool and additional assistance will soon be available. Please do not contact BITC for further assistance.
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