Group risk products now offer a range of added-value features that are increasingly being used by policyholders. Many are virtual healthcare services, initially introduced during the Covid lockdown, but now aimed at homeworkers and employees who want to access mental health, physiotherapy or GP services without lengthy NHS queues.
This introduction and take-up of these services has been seen as a major success for the group risk industry. But concerns have more recently been voiced by some in the intermediary community, on whether increased demand for these services is affecting delivery in some cases. At the same time there has also been some negative coverage in the media of leading EAP provider Health Assured (see box below)
Potential issues
A limited number of intermediaries are concerned that a shift towards virtual services may exacerbate health issues by overlooking problems that would have been spotted during face-to-face appointments.
While most intermediaries contacted did not raise this as an issue, Kevin O’Neill, head of workplace health at Barnett Waddingham, voiced some reservations in this respect.
He says: “There have been some questions expressed around the level of clinical care a virtual GP consultation offers given the difficulty assessing some conditions without a physical examination and the consequences if the correct diagnosis is missed. Has this question been adequately addressed in provider due diligence?”
Additionally, Alan Richardson, head of business protection and group at LifeSearch, suggests that online physiotherapy may suffer from lack of physical contact. He says “The approach has garnered mixed reactions
from gym-goers. While some appreciate the convenience, many are left uncertain about its effectiveness, questioning how accurate a diagnosis can be without in-person contact.”
But insurers point out that statistical evidence suggests this is not an issue, and it can be a useful triaging tool. Zurich for example reports that around 10 per cent of its virtual GP service users are recommended to see a GP face-to-face, and around a further 2.5 per cent are encouraged to attend A&E urgently.
This is particularly true when it comes to mental health services. HealthHero, for example, points to research evaluating two London Improving Access to Psychological Therapies (IAPT) services which found that remote therapy (via telephone or video) produces comparable, if not better, outcomes than in-person therapy.
Some intermediaries also expressed concern about the quality of some embedded EAP services. Steve Ellis, head of employee benefits at Prosperis, laments that some don’t offer face-to-face counselling, and as a result he says he only recommends stand-alone EAP services to key clients.
Nadeem Farid, head of health and wellbeing benefits at Drewberry says that the embedded EAPs, particularly on group life schemes, can be “very basic”, and has come across people being turned away by triage for being “out of the remit”.
Demand increase
While there is clearly a range of lower-cost and more premium offerings, usage of added-value features is increasing.
HealthHero, for example, reports that between January and September 2024 its virtual GP services saw a 27 per cent increase in total GP consultations compared to the same period in 2023, and a 179 per cent increase since the same period of 2021.
This has led to what is seen as intermediaries biggest concern: higher usage leading to access delays, suggesting provider resourcing power has not always kept up with increases in policyholder demand, which has in part been driven by the ongoing NHS crisis.
Sean McSweeney, employee benefits team director at Mattioli Woods, says: “I am definitely hearing of cases of people not getting through to services as quickly as they should. Virtual GP services have traditionally claimed to offer a same day service but people can now wait two or three days for a slot. And with EAPs they can find the line is engaged or there are delays in accessing counselling.”
Of course, it is worth pointing out that this may still be quicker than arranging a GP appointment through primary healthcare services.
Provider response
Providers do not seem to recognise some of these concerns being expressed by intermediaries.
The Employee Assistance Professionals Association (EAPA) denies any downturn in standards on either embedded or stand-alone EAPs.
So does Health Assured, which reports that in over 95 per cent of instances it regularly manages to get people into structured counselling sessions within 48 hours of them contacting its services.
HealthHero quotes a 94 per cent average patient satisfaction rating for its virtual GP services for January to September this year, and an 87 per cent satisfaction rating for its mental health services during the same period.
Virtually all insurers – Zurich, Unum, Legal & General, Generali, Aviva and Canada Life – maintain that services standards and customers satisfaction levels remain high.
But while insurers provided a wealth of information none specifically addressed the issue of whether they have been switching third-party providers or putting pressure on them to improve their services as a result of increased demand.
Potential improvements
There is acknowledgement across the industry that there have been recruitment issues, although these appear to be easing, helping providers respond to increased demand for services, particularly virtual GP appointments.
Farid says: “Virtual GP providers have already increased their resources and EAP providers are stepping up and providing more manpower.”
Furthermore, the fact that all EAPA-accredited providers will have been audited by the body by the end of this year, when previously they were only required to self-certify, should help ensure services standards remain robust going forward.
BOX: Recent months have seen widespread media coverage of BBC allegations that Health Assured allowed strangers to eavesdrop on confidential calls. But these are strongly refuted by the provider. The matter is currently being investigated by the British Association for Counselling and Psychotherapy (BACP).
Bertrand Stern-Gillet, CEO at Health Assured, says: “We strongly dispute any suggestion that we have breached the confidentiality of our service users, and we don’t accept the position of the BBC reporting.
“We have been in communication with the BACP since the first contact from the BBC earlier this year, alerting them to the claims raised and expressing our desire and willingness for them to conduct a quality assurance visit at the earliest opportunity.”
Karl Bennett, chairman of EAPA, which is also looking into the issue, adds: “The stories in the newspapers have only been about one organisation and we have nothing to announce
as yet.”
