Occupational Health – Prevention is better than Cure

As a consultant occupational health doctor, people are often referred to me when an employee seeks advice from their line manager with a problem. The line manager then speaks to HR who refers that employee to me. However, this reactive approach is only set in motion when a problem has reached such a point that the employee in question is forced to act.


Poor employee mental health – a modern problem

As our economy shifted away from manufacturing jobs and into the service and knowledge industries, the health problems suffered by employees changed. A manufacturing accident or repetitive strain injury is clear for all to see – an affected employee needs rest, rehabilitation and may potentially need adjustments to help them return to their jobs.

But the mental health problems experienced by employees in service and knowledge-based industries are less visible. So much so that the CIPD found mental ill health to be the single largest cause of long-term absence and experienced by 59% of organisations.


Suffering in silence

Diagnosed or recognised mental ill health is a clear issue. However, what can we do about the problems that don’t get noticed? Consider those employees who carry on despite not being at their best. Whether they’re afraid of the stigma associated with poor mental health, concerned about losing their jobs or simply don’t recognise their own symptoms, these employees represent a challenge for organisations.


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Presenteeism, where individuals come to work despite feeling unwell and are therefore unproductive in the work they do, is worrying. It’s estimated that presenteeism costs the UK economy nearly £30bn per year.

Presenteeism not only affects an individual’s productivity but impacts the team they work with. Their team inevitably has to pick up incomplete work or fix problems. This can rapidly affect the team bond and start to impact on the wellbeing of other employees.

Presenteeism also reduces an individual’s chances of addressing their problem and potentially makes it worse. Mental ill health is often only acted on when it becomes such a problem that individuals can no longer cope. By that stage, the employer has more to contend with than sick pay and the associated investment in that employee’s return to work. The employee is likely to have been working at a less productive level for some time and will have impacted their team-mates’ productivity as well.

It’s no wonder then that Deloitte estimates poor mental health costing UK employers as much as £45bn per year. The actual figure could be higher because this figure excludes the indirect costs that a business will experience as a result of poor mental health such as the impact on creativity, innovation and also on other employees.


Using a preventative approach for employee mental health and wellbeing.

By taking earlier action and intervening at an earlier stage, HR and line managers can take a preventative approach to employee mental health and the associated impacts. To paraphrase one of the founding fathers of the United States, Benjamin Franklin, this approach focuses on finding the horseshoe when the nail is lost – not waiting until the kingdom is lost:


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“For the want of a nail the shoe was lost,

For the want of a shoe the horse was lost,

For the want of a horse the rider was lost, 

For the want of a rider the battle was lost,

For the want of a battle the kingdom was lost,

All for the want of a horseshoe nail”



How can HR and line managers take a preventative approach to people’s health?

Taking a preventative approach to employee health requires a system that enables the root cause of these problems to be found. A preventative approach asks “why?”. To build on the earlier metaphor, this approach investigates why the nail fell from the horseshoe in the first place.

The view that mental ill health relates to the resilience levels of an individual is unhelpful and inaccurate. Too often, mental ill health is considered a result of an individual being unable to deal with the stresses and strains of ‘normal’ workplace pressure.

The evidence suggests otherwise.

The central theme in much of my work has been to question the symptoms of an individual’s condition and then understand the root cause of that symptom. Frequently, these root causes are not what might be expected. Finding and crucially addressing the root cause of the problem is essential.

In many cases, I have found the root cause to be within the business. By using a structured system, I can give HR professionals the tools they need to identify problems and prevent them from developing further.


Introducing R-O-P-E ®

I created the R-O-P-E system® as a unique way of finding the root cause of difficult and challenging situations. It is a shift from the conventional belief that the issue always lies with the employee.

The R-O-P-E system® helps HR professionals to find the unhealthy parts of the business and make them healthy. This not only improves employee health but business health as well.

R-O-P-E represents the four pillars of a healthy business and If any of these pillars are damaged, it affects the health of your employees and your business.

Taking this more proactive approach and intervening may result in a problem being identified at an earlier stage.

In addition, this proactive approach contains the direct cost and prevents indirect costs. For example, team members who cover for an absent or underperforming co-worker are less productive and may go on to develop problems themselves. A preventative approach limits this potential.


A root cause approach to poor employee mental health

Miller Health, DoreenThe R-O-P-E system® provides a stepping stone for human resources professionals to find the root cause of employee ill health. Often, these can be linked back to business health.

My new book, The Healthy Business Bridge – how employee health creates business wealth, describes the R-O-P-E System® in detail. Case studies demonstrate how R-O-P-E® works, giving HR professionals a way to identify with their own experiences. The book is coming out shortly so look out for it.

Would you like to learn more about creating healthier and more productive employees in a healthier and more productive business, if so please do contact me.



Thank you,



Please get in touch if I can help you or your team…

Doreen Miller

Tel: +44 (0)333 900 9280

Email: [email protected]


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Dr Doreen Miller

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