Small, Healthy and Wise - By Mike Robinson, chief executive, British Safety Council

Despite this, only 13 per cent of UK small and medium-size enterprises (SME) employ a HR professional with responsibility for employee health (Bupa). This doesn't mean that SMEs don't believe in looking after the health of their workers, but it is a reflection of their distinctive nature and the challenges they face. By Mike Robinson, chief executive, British Safety Council

‘Organisations with fewer than 50 employees lose to sickness absence on average 4.2 days per employee annually. This increase to 6.7 days for medium-sized organisations (CIPD, 2015)'

‘Efforts aimed at securing greater SME participation in health and wellbeing programmes should begin by engaging SME owners in a conversation about workplace health, allowing them to state their needs and business challenges'

Small and medium-size enterprises account for 47 per cent of private sector turnover and 60 per cent of the sector's workforce. SMEs are a very diverse group of businesses, including sole traders and those with up to 249 staff, operating across all industries. 

Almost 82 per cent of SMEs are micro businesses (with under 10 employees) and only 2.4 per cent are medium sized companies (50-245 employees). The highest proportion of SME employees work in the construction sector, while the greatest proportion of SME businesses operate in wholesale and retail trade. These figures demonstrate the complexity of the sector and the inherent challenges it faces in terms of workplace health provisions. An SME's ability to support its employees' health and wellbeing is determined by its size, the nature of its business and its resources. The role and influence of an owner-manager is far greater than in a large corporate organisation. Their understanding of workplace health issues, their attitude to health and wellbeing and the culture they create in the company are key factors in shaping workplace health and wellbeing provisions.

The UK health statistics show that one in every three employees have at least one mental or physical health condition. Minor illnesses, such as colds and coughs, are the number one cause of short-term sickness absence (CIPD, 2015). However, the greatest number of days lost to absence as a result of illness is attributed to musculoskeletal disorders (MSDs), stress, depression and anxiety, considered to be causes of both short and long-term sickness absences across all industries. Most SMEs don't collect sickness and absence information, but there is some evidence that SME employees experience stress differently than the workforce of larger companies. This is often related to a high volume of work, unsatisfactory career progression and poor communications.

Presenteeism (attending work while sick), often resulting in long-term sick leave at a later date, is also a result of workplace stress. In an SME, and particularly in a family-run enterprise, presenteeism can stem from concerns about the business's ability to continue everyday operations and meet deadlines, covering absent employees' work and placing an additional burden on work colleagues. Consequently, absence levels are lower in SMEs, although the prevalence of health conditions is no different to the rest of the market.

SME-specific challenges

Shortage of time is often a defining feature of an SME. The everyday pressures of running a company leave SME owners with little time and capacity to consider employee health in a strategic and pro-active way, especially if health interventions are infrequent. However, their financial implications are likely to be greater than expected. Organisations with fewer than 50 employees lose to sickness absence on average 4.2 days per employee annually. This increase to 6.7 days for medium-sized organisations (CIPD, 2015). HSE estimated that the average direct cost to business of a seven-day ill health absence is £8,000. The cost for SMEs could be greater if the absence results in lost business and productivity. Research indicates that the costs of presenteeism are even greater than the cost of absence.

A lack of health provisions in SMEs is often explained by company owners as an inevitable result of limited financial resources and the fact that SMEs are unable to benefit from the economies of scale in service. Some also argue that they don't know what is available and how to access existing provisions. The last two factors are closely related to the leadership values and the company culture.

Existing research suggests that low engagement might be a result of their distrust of the quality and relevance of public services. A significant amount of government communication relating to health and wellbeing is directed at employees, not at business owners. This may be reinforcing the perception that this is a personal issue and not one relating to the economic prosperity of the business.

The lack of awareness and the poor uptake of existing services also stems from a general lack of knowledge and understanding of workforce health and wellbeing and the long-term benefits of investing in them.

The government is often criticised by SMEs for not "speaking their language", which would reflect the regulator's lack of understanding of the challenges that SMEs face. Sometimes, this is related to the fact that the available workplace health provisions and support don't reflect the needs and operating context of SMEs that are limited by time, capacity, resources and economies of scale. A poor fit between services and needs is seen as key a barrier to their uptake.

Bureaucratic burdens, such as a requirement to implement formal policies related to employee health and wellbeing, which are perceived to be time-consuming and confusing, also discourage many SMEs that may wish to engage with the health and wellbeing agenda.

Potential solutions

Efforts aimed at securing greater SME participation in health and wellbeing programmes should begin by engaging SME owners in a conversation about workplace health, allowing them to state their needs and business challenges. The next step would be the development of services and support which reflect the particular requirements of their businesses. These health and wellbeing programmes and services should be cost-effective for both service providers and for SMEs and be delivered in a flexible way, so that owner-managers and their employees don't need to take time off from work to participate in training.

Finally, to facilitate SME access to health and wellbeing, the industry and the regulator should make a concerted effort to develop a dedicated one-stop portal that would host all workplace health and wellbeing information. It would act as a signpost for the 1.3 million SMEs which, by improving the health of their employees, would enhance their business prospects.

Statistical information about the SME sector in Britain, as well as many of the arguments and recommendations for health and wellbeing provisions for SMEs presented in this article, come from The Work Foundation's report, This won't hurt a bit. Supporting small businesses to be healthy, wealthy and wise, published in 2015.

For more information visit www.britsafe.org