title: Health and well-being in small and medium-sized enterprises (SMEs). What public health support do SMEs really need?
abstract: OBJECTIVE
  Health and well-being in the workplace is a concept that is understood as a fundamental business case for a productive, happy and healthy workforce. The workplace is also a setting by which knowledge and skills about health can be disseminated to assist people, in improving their health and well-being. Public health professionals are in a position to develop workplace health and well-being interventions, which support those in jobs and those seeking employment. They can also influence the extent to which work and the workplace affects health and well-being outcomes. This article aims to identify the main health and well-being needs of a sample of small and medium-sized enterprises (SMEs) across Greater Manchester and the support that public health professionals can offer.
  
  
  METHODS
  The research adopted a Health Needs Assessment (HNA) approach using convenience and opportunistic sampling methods, from the list of SMEs in Greater Manchester. The SMEs varied in size and type of business, and 91 telephone interviews, using semi-structured questions, were used to collect data which identified the health and well-being needs of a sample of SMEs in Greater Manchester. This research resulted in qualitative data using thematic analysis.
  
  
  RESULTS
  Two key themes emerged from the study. Acute seasonal sickness was the most pressing reason for employee absence from work (viruses, flu, seasonal disorders) for the SMEs in this research. This accumulated to the theme of sickness presenteeism. This research highlighted that employees will present at work with acute illness that requires rest, is easily transmitted to other employees and most likely will take a longer time to recover from as cross infection and re-infection occur. A subsidiary theme was that of authenticity and the reporting of sickness, contributing further to sickness presenteeism as employees seek to legitimise their illness.
  
  
  CONCLUSIONS
  This article provides issues which are specific to SMEs in Greater Manchester. In particular, the pressing problem of sickness absence and sickness presenteeism is related to seasonal illness and the effects these have on SMEs in Greater Manchester. Public health preventative services such as the provision of flu vaccines may be one way of supporting SMEs with acute seasonal episodes of illness.
authors.affiliation: The Centre for Public Health, Manchester Metropolitan University, Elisabeth Gaskell Campus, Hathersage Road, Manchester M13 OJA, UK m.holt@mmu.ac.uk.
authors.forename: Maxine
authors.initials: M
authors.lastname: Holt
authors.affiliation: Centre for Innovation and Knowledge Exchange, Manchester Metropolitan University, Elisabeth Gaskell Campus, Hathersage Road, Manchester M13 OJA, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Powell
mesh_terms: D000328:Adult; D003625:Data Collection / Q000379:methods; D004739:England; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008297:Male; D016272:Occupational Health; D015980:Public Health Practice; D018582:Sick Leave / Q000706:statistics & numerical data*; D017132:Workplace
keywords: health and well-being; public health support for SMEs; seasonal and acute illness; small and medium-sized enterprises (SMEs)