With the roll-out of Fit for Work (FFW) under way, employers and employees can start to benefit from work-related advice and support to help manage sickness absence. And, while there are concerns about the effectiveness of the service, industry professionals believe it should help to raise the profile of insurance-based solutions for tackling absence and health-related problems in the workplace.
The news that the service is finally up and running, albeit initially in a limited way, has been well received by the insurance industry.
Aviva group risk director Steve Bridger describes it as a step in the right direction. “It will be particularly useful for small and medium-sized companies that don’t have access to insurance or occupational health support,” he says.
“In addition, by demonstrating how an intervention can improve the outcome when someone is unable to work, it will also positively highlight to the Government and employers the work that insurers do in this area.”
Market response
But while the service has received a positive response – given the short time it has been in place – it has not resulted in a flurry of activity from the insurers’ product development departments. For many, it has been much more a question of ensuring that FFW is integrated within their own products and services.
For example, Axa PPP healthcare director of health consulting Elliott Hurst says his company has adapted its protocols across occupational health to ensure that the service is taken into account. “We haven’t yet come across an employee that has engaged with the service as well as with their employer’s own occupational health provision but we have started to ask whether they’ve used it,” he says. “Where they say yes, we’ll look to obtain their consent to speak to the service. A joined-up approach to helping them back to work is essential.”
Group income protection (GIP) insurers have also made sure they are part of the FFW discussions with employees. Bridger says: “Group Risk Development worked with the Department for Work and Pensions to make sure employees referred to FFW are asked whether they have GIP. Signposting it in this way will enable more people to take advantage of the support this product provides.”
Adviser action
Although insurers are unlikely to produce a raft of new products in the near future, the introduction of the FFW service could result in much more work for advisers. For example, Hurst believes it offers a great opportunity to start a conversation with an employer.
“Awareness is relatively low so if an adviser talks to them about it, it’ll show they have their finger on the pulse and will allow them to broaden the product conversation to absence management, occupational health, GIP and so on,” he explains. “Advisers will win clients as a result of this.”
Certainly, research has found that, even though FFW has been under development for several years, a worrying number of employers are still in the dark about what it does. As an example, a study conducted by the PMI Health Group in March found that, although the service had been in place by then for four months, 30 per cent of HR professionals were still unaware of it.
Jelf Employee Benefits head of benefits strategy Steve Herbert is not surprised by this finding.
“Employers don’t really understand what the service is yet,” he says. “The name’s been changed a couple of times and although we’re now back at the original one used for the pilot, the service isn’t as comprehensive as was originally intended. We need to help employers understand what it is and how it affects them.”
Employer support
As well as benefiting from the advice and support provided by the service, employers may need to make a number of changes to take full advantage of it. For example, absence policies should be adapted to incorporate FFW. Reassuringly, nearly 50 per cent of employers who attended one of Jelf’s employment seminars in February had this on their agenda.
Employers should also conduct their own awareness campaign, as Punter Southall Health & Protection Consulting head of wellness consulting Beate O’Neil explains: “Employers need to educate their line managers and employees about the service to ensure it’s used correctly. This should include what to do if an employee is absent and how FFW integrates with any existing services.”
This education process should also cover how to deal with the FFW reports and assessments. “These documents are confidential and their content is covered by the Data Protection Act so it is essential they’re handled correctly and not left hanging around on a desk,” adds O’Neil.
Some advisers are already looking at how they can support their employer clients. Seminars are common, with O’Neil saying this was the most popular topic for her clients in 2014.
Others have launched services to help their clients. For example, earlier this year Jelf set up an occupational health helpline service to enable clients to access advice quickly.
“This gives our clients access to advice on a full range of absence and employee wellbeing issues, including information on FFW and how to use it,” says Herbert.
Sales boost
As well as supporting employers and helping them to integrate the service into their own absence management framework, the introduction of FFW presents opportunities to increase sales of health insurance and group risk products.
Canada Life Group Insurance marketing director Paul Avis says that if the attention of employers is drawn to the differences between FFW and insurance, they will see the benefits of investing in the latter.
Insurers regard the four-week period before intervention as a shortcoming of the FFW service. Avis says: “A four-week intervention is a good starting point but it might not be quick enough. The pace of change in the workplace means you need to be off sick for only a couple of months and you’d be going back to a completely different working environment.
“A GIP insurer will look for notifi-cation at two weeks or earlier, wherever it can. Getting in this early enables you to provide case-specific focused rehabilitation and greatly improve the chances of the employee returning to work.”
This case management often goes beyond providing advice on the condition, taking in everything from workplace issues to problems in the home that might be affecting the employee’s health or mental wellbeing.
The other shortcoming of the FFW service is that there is no element of compulsion. GPs do not have to refer their patients for an assessment and, if the recommendation comes back that an employee needs a particular course of treatment, there is no obligation on the NHS or the employer to fund this.
“The Government’s looked at what insurance does and watered it down,” says Bridger. “FFW will work in some instances but it highlights how much more support insurance can provide.”
Promotion potential
Whether the industry gets the oppor-tunity to demonstrate that it offers a richer absence management solution will depend on how successfully FFW is promoted. While keeping it relatively low-profile may make sense as the service is rolled out, many feel it deserves greater fanfare.
“The ‘We’re all in’ campaign for pensions auto-enrolment was such a great success,” says Avis. “It would be foolish not to replicate this level of promotion for such an employer-oriented issue.”
Any promotional activity would also need to hit another key stakeholder – the GP. Already there are concerns that FFW will be regarded in the same way as the fit note.
“Fit notes were introduced in 2010 and there’s still no perceptible difference between what they include and the old-style sick notes,” says Herbert.
“I’m concerned the same level of apathy may affect FFW.”
While Herbert’s concerns are justified, the Government may find it easier to get buy-in from GPs for FFW. While the fit note required them to learn a new way to complete a sick note, referring a patient to the FFW service should in fact reduce their workload and remove the need to fill out a fit note.
With promotion and buy-in from all parties, there is huge potential for both FFW and the insurance market.
Bridger says: “Once results start to come out on FFW, I hope the Government will share them with the insurance industry.
“Comparing results with industry ones will help the Government refine the service or even lead to the realisation that incentivising employers to take out insurance may be a better way to tackle long-term absence.”
Fit for Work service – the roll-out
The first part of the Fit for Work service was launched last December, giving employers, employees and GPs in England and Wales access to health and work advice by phone or online chat, or through a library of resources accessible on
the internet.
The second part, the referral service, is subject to a phased roll-out. This kicked off in March, with GPs in two areas – Sheffield and Betsi Cadwaladr University Health Board – able to refer any patient who has been, or is likely to be, off work for four weeks or more for a free assessment from an occupational health professional.
This part of the service will continue to roll out across England and Wales, with the expectation that it will be nationwide by autumn 2015. Once this is in place, FFW will be broadened to include employer referrals.
