Incentivising SME Uptake of Health and Wellbeing Support Schemes

This research aimed to provide new insight into how incentives might be used to encourage and support small and medium-sized enterprise (SME) employers to invest in more health and wellbeing schemes for employees. The report considers: What support are SMEs already providing in this space? What do SMEs say prevents them from doing more? What kind of interventions would SMEs like to invest in, should greater support to do so be available? What impact could a government intervention have in improving uptake? The mixed-methods approach centred around a discrete choice experiment (DCE) undertaken within a survey of 500 SMEs (with at least 10 employees) in Great Britain. This was supplemented with a series of 30 qualitative interviews to provide more detailed insight into some of the issues identified through the survey. The research finds that 70 per cent of SMEs surveyed reported they currently provide at least one type of proactive health promotion scheme for all employees, but smaller SMEs generally provide lower levels of support. Provision is often employee led and comes about as a result of requests from staff. SMEs have an appetite to do more but lack of resources--both money and/or time--are the top barriers to implementation, along with a lack of knowledge about what support to invest in. Support to address issues surrounding musculoskeletal conditions, common mental health problems and the way work is organised or managed were the top three areas in which employers wanted to do more. The discrete choice experiment, supported by qualitative evidence, suggests that both financial support and the provision of advice and support have a role to play in improving SME uptake of health and wellbeing schemes. With regards to financial support, a greater impact could be achieved by funding a larger group of SMEs at 50 per cent reimbursement than half as many SMEs at 100 per cent. Navigating the market for these services can be challenging for SMEs and many stated they would not know what health and wellbeing programmes to invest in even if there was financial support. Access to supplementary advice, in the form of a needs assessment and signposting to appropriate health and wellbeing schemes, was observed to have a significant impact on stated uptake in the experiment. Such assistance could help SMEs to deliver on their often-stated desire to help improve the health and wellbeing of their staff. The risk of "deadweight loss" from SMEs using any financial support to simply subsidise actions that they are currently taking appears low. Both the survey and interviews identified that employers had a desire to do more and intended to use any funding provided to either extend their current provision or move into new areas. The report concludes with some suggestions for further research to better inform future policy design.