More than 2.5 million people are unable to work due to long-term sickness, with the Health Foundation forecasting that the number of working-age people living with major illness is set to grow to 3.7 million by
2040. As this has serious consequences for individuals, businesses and the economy, employers must do more to turn these figures around.
The CIPD’s Health and wellbeing at work 2023 report highlights the nature of the problem. It shows a marked increase in sickness absence, with an average 7.8 days per employee, up from 5.8 days in 2019.
While minor illnesses such as colds and stomach upsets are the leading cause of short-term absence the next two largest causes – musculoskeletal injuries and mental ill health – also account for the top two causes of long-term absence. “The strain on the NHS means that access to primary care is getting worse so employees are struggling to get the help they need for short-term illnesses,” says Mark Southern, sales and marketing director at WPA. “Unfortunately, if you don’t catch a short-term issue such as a bad back or depression early enough, it can turn into a long-term condition.”
The health insurance market has recognised this gap and developed a range of services to deliver the support employees need to treat conditions quickly and, in some cases, prevent them altogether.
Early intervention
Group income protection has long championed the benefits of early intervention. “Even if an employee is on a policy with a six-month deferred period, the insurer will encourage the employer to get in touch straight away so they can offer support to help the employee return to work as quickly as possible,” explains David Williams, head of group risk at Towergate Health & Protection. “This is so valuable.”
The value of this fast response has also been recognised by the medical insurance sector, with digital GP services added to cover. By giving employees access to a GP, often within 24 hours, it can provide considerable reassurance and fast-track them into treatment where necessary.
Digital extension
Insurers are also innovating in this space to ensure these benefits aren’t restricted to employees with medical insurance. For example, WPA launched its Digital Health app in February, providing access to services including a symptom checker, digital GP and physiotherapy, and mental health support. “It’s designed to deliver primary care services to employees without medical insurance,” says Southern. “This should help to reduce short-term illness and presenteeism while also preventing some conditions from becoming long-term.”
The price point – less than £50 a year per employee – also means it’s regarded as a trivial benefit by HMRC and therefore not subject to P11d taxation.
Sustainable delivery
It’s hugely positive to plug the primary care gap but it’s not without its challenges. Sarah Goodwin, head of strategy at Axa Health, explains: “Employees are so engaged with the digital GP services but it raises questions about sustainability. If usage continues to grow, it will have to become more expensive.”
As an example, while appointment levels were around 17,000 a month at Axa Health pre-pandemic, they now stand at 55,000. This popularity, and the real benefit it delivers to employees, means employers are open to solutions around controlling the cost. Goodwin adds: “Insurers may have to cap the number of appointments or charge a small excess for each appointment. There’s also room for more education and triage around these services to ensure they’re used in the right way.”
Positive prevention
Education is also playing a part in helping prevent employees develop long-term conditions. Dr Katie Tryon, director of health strategy at Vitality, says that engaging with healthy lifestyle programmes can be beneficial for all employees, including those with chronic conditions. “Our research found where people with diabetes followed an exercise programme, they had a 40 per cent lower all cause mortality rate,” she says.
While there’s some strong evidence for the benefits of these programmes, the usage statistics remain unhealthily low. “It’s so hard to change behaviours,” says Goodwin. “It takes six to nine months to make the lifestyle changes to prevent diabetes. Although few people are prepared for this commitment, we must
keep trying as it makes such a difference when employees do make changes.”
Cultural ambassador
A supportive culture can help. “There can be a real nervousness around letting an employer know you’re living with a chronic condition,” Dr Tryon explains. “Having wellbeing champions and providing employees with plenty of tools to help them look after their health will create a positive culture where everyone feels supported.”
Offering screenings can help too. As an example, Aviva’s wellbeing apps, DigiCare+ and DigiCare+ Workplace, provide wellbeing support including a health check to its protection customers. “We’ve seen a massive uptick in the numbers engaging with the support, including more than 51,000 ordering a health check,” says Sophie Mairs, insights and wellbeing manager at Aviva.
These tests have identified health concerns, including high cholesterol in 55 per cent of tests and abnormal liver markers in 32 per cent. “One woman’s results showed her white blood count was low. This helped her GP diagnose chronic fatigue syndrome and enabled her to access treatment,” adds Mairs.
Chronic care
As well as providing more health information, the medical insurance position on chronic conditions is also softening. While they have traditionally been excluded, Lucy Irvine, head of employee benefits at Advo, says that some cover towards the cost and management of chronic conditions is available on some UK schemes. “Employees looking for a richer level of benefit could consider a global healthcare scheme, although the impact of this wider claims experience should be considered if premiums are to remain sustainable,” she explains.
Even where chronic condition cover isn’t an option, services such as digital GP and health information can provide invaluable support to employees living with chronic conditions. Katie Brown, absence management lead at WTW, recommends training managers on what’s available. “This enables them to signpost employees to the right products and services,” she says. “It also helps to create a culture where employees living with a long-term condition feel supported.”
Adviser support
The ABI’s Growing Demand report shows the importance of workplace provision when it comes to accessing health services. Of the 1.8 million people who did this in 2022, 75 per cent used their employer’s scheme. They also made up 87 per cent of digital GP appointments and 94 per cent of mental health counselling and therapy appointments.
Advisers have a key role to play in supporting employers and their workforces. Stephanie Porton-Corr, wellbeing lead at WTW, says: “There are many benefits available so we work with organisations on gap and overlap analysis. This explores which services fit best and whether the organisation needs to implement pathways or triage services to ensure benefits are as effective as possible.”
Advisers are also helping employers deliver comprehensive communications programmes. Williams says he’s seen organisations implement health benefits then remove them if they’re not used and the finance director questions the investment. “Advisers need to make sure the message gets out to HR departments and employees.”
Data analysis can also make sure the most appropriate interventions are promoted. Brown says that looking at claims and usage data can help to identify any hotspots and inform an organisation’s wider health and wellbeing strategy.
Developing services to prevent long-term conditions, and to support those who are living with chronic illness, will help to reduce the number of people becoming economically inactive due to poor health. But, for these services to be truly effective, good communication and data analysis are essential.
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