The Keep Britain Working Review, published on 5 November, proposes a fundamental shift in the way workplace health is managed. And with it recommending a larger role for employers in supporting employee health, there are opportunities for the group risk and health insurance sectors.
“It’s a really positive report,” says David Williams, head of group risk at Towergate Employee Benefits. “It recommends a shared responsibility approach, which will make a massive difference to workplace health.”
Under this recommendation, rather than leaving workplace health issues for the employee and the NHS to resolve, it would become a tripartite responsibility between employers, employees and health services. Bringing the employer to the table is a potential game changer according to Mark Till, chief executive officer at Unum UK. “Many employers are frightened to have a conversation with an employee who is off sick, but this will help to change this,” he says. “It makes sense: working together can make it easier for an employee to return or stay in work.”
Employer benefits
As well as more proactive employer involvement, the report recommends a much more structured approach to dealing with health issues. Rather than focusing on absence, employers will be encouraged to adopt a more joined up approach that runs from prevention and early intervention through to rehabilitation and return to work plans.
This mirrors the approach already taken by insurers. “It’s a strong endorsement of the valuable role the group protection industry plays in supporting workplace health,” says Chris Morgan, head of product and proposition strategy, protection at Canada Life. “Group protection supports preventative and rehabilitation healthcare in sickness management.”
Another major positive, especially for smaller employers, is the sharing of good practice. Sam Atwell, policy and research manager at the Health Foundation, says that employers can sometimes struggle to navigate the support that’s available. “An SME will often go out of its way to help a key employee return to work. This will help employers identify how to spend their money more effectively.”
Adopting a more proactive approach to employee health will also create more resilience across the workforce. “The recommendations restructure the contract between employee and employer,” says Peter Hamilton, head of market engagement, Zurich UK. “It’s very positive.”
Insurance opportunities
With the insurance sector already taking this joined up approach, there are plenty of opportunities to support more employers. “The group approach works,” says Hamilton, who believes there is an opportunity for insurers to work as an outsourced HR department to help get employees back to work. “We get economies of scale but there are also benefits from the alignment of interests. If someone gets back to work it’s good for them, their family, the employer, the insurer and the economy.”
Group medical insurers can also see opportunities within the report’s recommendations. Dr Subashini M, medical director at Aviva UK Health, says that prevention and early intervention are key aspects of group medical insurance. “When used effectively, they can help to reduce absence, improve productivity and contribute to a healthier, more resilient workforce.”
Advisers have a key role to play too. Roy McLoughlin, consultant at Omny Benefits, welcomes the report’s recommendations. “It’s great news for advisers in this space,” he says. “Some employers are already doing this but for others, it is a bit of a leap of faith. We can guide them to the most appropriate support.”
Implementing the report’s recommendations is also likely to trigger innovation across the insurance sector, according to Till. “It’s almost certain that we’ll see innovation to meet the brief,” he says. “Occupational health will extend but we could also see changes to products such as cash plans and income protection to support employers.”
And, while many believed tax relief was off the table for this review, financial incentives for employers who adopt good practice did get a mention in the report. These include recognition in public procurement; access to pooled funding, which would benefit smaller employers; and tax relief on benefits in kind that support workplace health.
Financial pressures
Cost is an issue. Although Sir Charlie Mayfield, who led the review, said that doing nothing wasn’t an option, the immediate response from many in the business sector was the financial implications of adopting a more proactive approach.
Williams is concerned that smaller employers won’t have the appetite – or funds – for investment. “It’s really difficult to ask small employers to do this when they’re already worried about finances,” he says. “Keeping employees healthy and working is a real benefit for employers, but it could be difficult to convince them to invest in this. It may be a good idea at a bad time.”
The leap of faith required to get smaller employers onboard is highlighted in a news story in The Guardian. Using the report’s figure of £5 to £15 per employee per month to provide additional occupational health support, it calculated it would cost employers £6bn a year. A chunky bill, but a decent return on investment if it delivers the trumpeted £85bn a year saving for employers.
Hamilton says it’s fair that employers might feel under financial pressure, given the recent rise in national insurance and the changes set out in the Employment Rights Bill. “It can’t be too much of a burden,” he says. “The focus will be on what we have and what works: it must be done with employers not to them.”
Personnel issues
Staffing could also be an issue for widespread adoption. Currently, one of the key barriers to early intervention is the availability of NHS support, especially around the two key areas of long-term absence, mental health and musculoskeletal issues. But shifting to an early intervention model may remove the need for so much medical input. “The medical and clinical side will still be important, but a lot of the solutions aren’t medical,” says Atwell. “A case worker can ensure the focus remains on what an employee can do and the possible changes that can help them stay or return to work.”
Advances in technology may also help to increase skills in this area. Till says that, while AI may reduce data-focused jobs, human-centric jobs, such as health professionals and case workers, will be less affected. “Through early intervention, there will also be a shift in the way support is delivered,” he adds. “A little bit more support upfront can save a lot later on.”
McLoughlin is also concerned that the report’s recommendations may be kicked in the long grass. “This needs to maintain a high profile. Smaller employers don’t know where to go for support.”
Next steps
While this is a risk, the activity proposed for the next few years should help keep workplace health on the agenda. Central to this is a three-year vanguard phase. “This will inform how government decides to drive wider adoption of the Workplace Health Provision model, including future employer incentives,” explains Dr M.
More than sixty employers, including Sainsbury’s, Google and Nandos, have signed up alongside insurers, such as Aviva, Axa Health, Unum and Zurich. Hamilton says more employers are likely to join. “This is a real opportunity to learn from others and share good practice. It is exactly what Sir Charlie Mayfield called it – a race to the top.”
