I left the NHS just over 20 years ago with the vision of changing the heath of the nation or nations. Having trained as an Obstetrician and Gynaecologist, by the time I was considering leaving I had recognized that most of the issues we were seeing in our clinics were being compounded by patients’ lifestyles. We were using medicines and interventional therapies to effectively close the door after the horse had bolted.
I left to develop and deliver what we now call coached behavioural change wellness and performance programmes, and in developing these services have effectively done this in three areas. Initially in a private practice in Harley Street, as at the time, this was the only way we knew how to deliver services. From there I spent a decade delivering in elite sport, as part of Sir Clive Woodward’s 2003 World Cup winning team, with England Cricket supporting their reclaiming of the Ashes in 2005, with Chelsea for their Premiership titles under Mourinho and with the Welsh Rugby Union under Warren Gatland for two of their three recent Grand Slams. Subsequently, we supported the British Olympic Association in the run up to the 2012 Games. These two initial clinical steps taught us how to deliver one patient at a time and then in groups, one team at a time for sustained periods like the four-year World Cup or Olympic cycles.
A business shift to focus on people:
In 2005 I met Lord Hastings who was recently appointed to the board of KPMG with the responsibility of Corporate Social Responsibility. We recognized that if businesses were making appointments like Lord Hasting to their boards with a mandate to look after their people, there just might be an opportunity to deliver something new.
This is when we started to deliver a personal wellness coaching consultancy, delivering to the boards and senior management teams of some of the country’s biggest businesses, like Ineos, BP, RBS and St James’s Place Partnership.
After huge success with senior executives, we realized our offering needed to not only help the high achievers but deliver an impact their entire workforce.
This came about after a conversation with the group HR director at RBS who made it very clear to me, she had problem with how successful we’ve been with her senior leaders. She explained we were delivering to the top 300 people at RBS, and they loved it. She said: “I’m responsible for 95,000 employees and they were asking her “what about me?” The top 300 get paid the most and receive a huge number of benefits and now they were looking better, behaving differently, where happier and healthier and vocal about it. We were being asked to democratize Wellbeing; make the service affordable for businesses to roll out for everyone.
This was a pivotal moment for us. Technology has enabled us to combine our unique behavioural change coaching techniques with data through wearables and biometrics alongside medically guided education and achieve positive health outcomes to entire workforces. CorLife’s mission was to change the health of a nation one business at a time, by delivering coached behavioural change programmes to improve the mental and physical health, wellbeing and performance for everybody.
A deep-rooted reliance on the NHS
The NHS is an amazing institution that enables our society to offer treatment without remorse, but as a consequence there is no obvious corporate cost or accountability either personally or corporately. The loss of productivity, sickness and absence, and staff turnover are often not well measured or reported. EY have recently reported that this costs them over £3,000 per employee per year or in excess of £50m pa and growing at 1.5% year on year. What gets measured gets done, so currently for many nothing is getting done.
At a personal level most individuals in the UK take their health for granted. The NHS has been our insurance blanket. I would argue that people only really consider their health in the light of their ill health or someone they love.
A champion for change
In 2009 I met Steve Hilton, who was at the time David Cameron’s advisor, to talk about the Health of the Nation and what the Government might do to encourage change. He recognized that the NHS had been set up as an acute illness service and was not funded to support or encourage wellness, in the young or old, which might avoid illness and the incumbent costs. What he told me was there was no new money to invest in Wellness. One of the suggestions I made was that since Wellness and Performance were key to UK PLC’s corporate financial performance and that the Government might look to encourage this as this would be in line with their objectives, shareholder value and individual outcomes. They did this with Dame Carol Black’s initiative, Working for a Healthier Tomorrow. Here she advocated Occupational Health teams focus not just on traditional Health and Safety but also on the Wellbeing and Performance of their staff. Notwithstanding this recognition, take up has been slow. They did not incentivize this with tax breaks. Businesses do not like to spend money unless they don’t have to. As we have seen they will support their leaders, suggesting that with good leadership the employees would follow, but it is a little more complicated than follow my leader. Behavioural change needs to be individualized, set against a framework of your genetics, your past medical history, your likes and dislikes and where you are trying to go in life’s journey. We all have different directions of travel and one size does not fit all.
Post-Covid: Why businesses can no longer rely on the NHS
The Covid pandemic has had a significant impact. Individuals are much more aware of their own health and mortality. It seems to have become important. We have clearly seen from the pandemic results that those who were not healthy and got a Covid infection did significantly worse and have had a much greater chance of dying. Also, as Generation Z come into the work force, they want different things. They want to work for more than just money. They want to work with someone or for someone who cares about them and is seen to do so. They care about their planet, and they will act on this. The vegan movement is, in part, fueled by this. They want more, and so they should as they are going to inherit this mess.
Smart businesses have recognized that Covid has bent their people out of shape. Whilst there have definitely been financial wins for many businesses and the future of work may offer a more blended approach with greater flexibility, which should definitely help workers with young families or other caring duties, the People Officers and HR Directors have also seen the reported stress and mental health issues in their business dramatically increase. Stress was already the number one cause of absence from the workplace. This has now been fuelled by an increase in alcohol intake, weight gain and for many a massive drop in physical activity with no commute or lunch to find. These smart businesses are seeing their people as a risk. A risk for which the usual solution is currently and is predicted for the foreseeable future, to be overwhelmed. Waiting lists for normal workflows within the NHS have exploded. The NHS can’t cope. In truth, when it came to Wellness, it never could. It was not designed to deliver these services. We are seeing an extension in this issue within the management of our Social Care crisis. This is wellbeing for the elderly. The NHS was not designed to deliver against this agenda. So, what can we do differently?
Where do we go from here?
I believe we need to think about health and wellbeing differently. As societies we need to learn how to value and invest in our health when we are young, so we have more of it as we age. I think of life in three phases; historically called childhood, adulthood and old age.
I think that childhood stretches until mid or late 20’s for many. At this time people take on adult responsibilities, like jobs that become careers, places to live in that develop mortgages and relationships that often result in children. We then spend the next 30 years of our lives doing our best to discharge these responsibilities. At 60 years of age, historically we enter “old age”. This is typically characterized by the gradual decline in quality of life. “I used to love do this or that, but I don’t do them anymore”. This loss of function results in people becoming more fragile, infirmed and miserable and subsequently needing to be looked after – our social care crisis. We do not believe this needs to be the case. People who are supported to look after themselves well through their adult working life get less disease, and are happier and more productive in the workplace. They also enter “old age” in a much better place and are able to sustain this, hopefully resulting in a flat quality of life curve, where you fall off a cliff at the end of life, rather than seeing many years of gradual deterioration and mounting support needs and costs. If we can get this right, these three phases of life might be called, Happy, Happier and Happiest.
What if we lived in a world, or at least a country, that does care? Where we worked for an employer who invested in not just training you for the function of your job, but how you turned up at work to do your job and how you run your life, so that you and your business are more successful. With an enlightened Government that supports businesses doing the right thing with positive tax incentives. Where the insured healthcare market works as a support to the NHS and these Wellness agendas and does not just compete with it. Where there is a better work life balance for all, with happier, healthier people, who take responsibility and care about themselves, those around them and their environment. This needs leadership, education and support. This is not just a John Lennon song; it is a movement. It is about doing the right thing, starting with the person in the mirror. CorLife will be part of the debate and the solution.
Dr Adam Carey is the Founder and CEO of CorLife and CorPerformance, and Chair of the European Specialist Sports Nutrition Association.