Delivering health and wellbeing services (HWS) to small and medium sized enterprises (SMEs) in the manufacturing industry 

Aims To detail current and past initiatives to embed HWS into SMEs and understand the barriers and facilitators for developing HWS for SMEs delivered from their large enterprise partner (Jaguar Land Rover). We will test the feasibility of delivering such services and subsequently evaluate its clinical and cost-effectiveness in a follow-up research collaboration call. This study comprises a scoping review, and survey and qualitative work.  

What the research will involve:

Project plan (WP: work package) 

WP 1 – Scoping review of existing models of delivering health and wellbeing services to SMEs in the UK with an embedded policy review 

WP 2 – Qualitative study to explore opportunities, obstacles, and facilitators of providing health and wellbeing services from a large enterprise to supply chain SMEs 

WP 3 – Preparation for a ‘proof-of-concept’ feasibility and effectiveness study  

What has the study found so far and impact? (key updates) 

• Study is currently being implemented. Results will be available late 2024. 

• Evidence obtained from a Government study ‘New Occupational Health Taskforce to tackle in-work sickness and drive down inactivity’ is being directly fed into the Government’s Taskforce on Occupational Health

• Our NIHR Development Award set out to explore what health and wellbeing services (HWS) are provided in SMEs, what services are needed and what obstacles and opportunities exist for providing services in partnership with a LEO. Based on the planned work, the following highlights the main finding:

  1. A scoping review of the literature of HWS delivery models developed and implemented across SMEs in the UK since 2000, revealed that information on effectiveness of interventions promoting health and preventing ill health in SMEs is scarce (only six studies identified). Moreover, there was considerable methodological heterogeneity, and in health and wellbeing and work outcomes used. Nevertheless, interventions in SMEs in the UK were effective in improving health behaviours and health outcomes, and raising awareness about healthy living. The limited, yet

  positive evidence indicates the potential for such initiatives to yield improvement in work and health outcomes.

  2. Supported by a large enterprise organisation (LEO) (Jaguar Land Rover), we recruited three SMEs within their supply chain to collaborate in research. We undertook focus groups and interviews with 27 SME line managers and employees to explore HWS needs and the

  feasibility of implementing HWS from a LEO to their supply chain SMEs. We also explored employees’ willingness to participate in research. Our research showed:

  • SME leaders were committed to looking after the health and wellbeing of their staff but lacked clarity on necessary provisions and have limited resource capacity. They did not know what to measure or how to measure it, keen for simple external guidance.

  • SME employees highlighted inconsistent ill-health prevention measures, emphasing physical safety prioritisation. Limited trust and awareness of existing Employee Assistance Provision hindered service uptake. They expressed interest in earlier external support (particularly off-site services), health promotion, social activities and financial wellbeing.

  • Delivery of HWS via their LEO was an attractive proposition. Implementation recommendations included the need for support, clear communication of how the services can be accessed, articulation of what was in it for the LEO, and remote and on-site provision.

  • SME employees were receptive to research participation, even as a ‘control’ group. Obstacles included the owner/director’s decision regarding time and access, reliance on word-of-mouth communications, and concerns about anonymity in small, familial environments.

  3. We established an Expert Stakeholder and Public Group to provide feedback on methods and approach throughout the Development Award and on a follow-up research proposal.

  4. Meetings with JLR and their health provider, Health Partners, highlighted logistical, commercial, and regulatory considerations for adapting HWS interventions delivered by LEOs. Beyond commercial considerations (i.e. who pays for what and how), service provisions are carefully contracted to consider the legal, clinical and ethical responsibilities of OH professionals, ensuring liability protection for all parties.

Study Team: Dr Georgia Ntani, Prof Ira Madan, Prof Jo Yarker, Dr Vaughan Parsons and others.   

Further information: vaughan.parsons@gstt.nhs.uk 

Funder: National Institute of Health Research (Work and Health Development award) 

Publications - none