Facemasks, social distancing, and toilet paper fisticuffs may feel like distant and rather surreal memories of the pandemic. But, five years after the world went into lockdown, Covid-19 has left a lasting mark on workplace health.
“The Covid-19 effect has been seismic,” says Dr Katie Tryon, commercial director at Vitality. “It supercharged the trajectory of several health trends and it will leave a lasting legacy.”
Pandemic side-effects
Concerns over exactly what this legacy would be started to arise during the pandemic. With the NHS focused on treating those with Covid-19, normal activities including cancer screenings and health checks were suspended, while fears over contracting the virus, meant patients gave their GP surgeries a wide berth.
These missed and late diagnoses came through in the claims statistics as Nick Homer, head of market management – corporate risk at Zurich, explains: “It is back to normal levels now but we did see an uplift in cancer claims following the pandemic. It could be societal but it could also be due to not getting access to treatment.”
Long Covid claims are another unpleasant reminder of the pandemic. Homer says there are still active claims for the condition, although not at a concerning level. “Symptoms vary so it’s quite challenging to support claimants with long Covid,” he explains. “However, we’re not seeing a greater number of chronic fatigue syndrome claims and these ones might have been called ME in the past.”
Mental health claims have also surged since the pandemic. “It’s really difficult to say whether this increase is due to Covid-19 or not,” says Dr Suba M, medical & sustainability director at Aviva. “We went through a collective trauma, which raised awareness, but it could also be a generational shift as younger people are more comfortable talking about mental health.”
Whatever the cause, she adds that anxiety and depression remain the top two causes of mental health claims, followed by work- related stress and post traumatic stress disorder.
Shifting expectations
We may be over the feared cancer claims bump, but living through a pandemic has also had a profound effect on the public’s perception and expectations around health. “People are nervous about the NHS,” says Lucie McGrath, health, equity and wellbeing lead at WTW. “As well as the issues seen during the pandemic, media coverage makes people think it’s struggling so they look for alternatives. Subsequently, we’ve seen an explosion in the use of healthcare plans over the past 12 months, including more claims from younger people who might have used the NHS before the pandemic.”
Demand for healthcare services has also increased, especially around two areas – mental health and musculoskeletal conditions – where NHS support tends to be more patchy. Dr Tryon says she’s seen these two risk factors come to the fore over the past 10 years. “Mental health, musculoskeletal conditions and weight management have replaced smoking and alcohol as the main risk factors. Working from home has exacerbated musculoskeletal conditions and we’ve also seen an increase in mental health issues, especially among under 35-year- olds,” she explains.
Alongside this fear of having to wait for NHS treatment, individuals are increasingly seeing their employer as their health service. “Employees expect their employers
to provide health and wellbeing support,” says Tina Kennedy, product director at Simplyhealth. “Similarly, HR providers see it as their responsibility: nearly two thirds of employees say health benefits encourage them to stay with their employer.”
Insurer challenge
These post-pandemic shifts are creating a major challenge for medical insurers. “The medical insurance sector is facing a real challenge with claims, both in terms of numbers and costs,” says Dr Tryon. “Utilisation has never been so high.”
McGrath has seen this uptick too. As an example, she points to one well-established scheme which has seen a 50 per cent increase in healthcare spend in the past year, despite having a robust health and wellbeing programme in place. “These increases are down to a mix of things,” she adds. “We’re seeing more high-cost claims for cancer and more complex conditions, perhaps due to delayed diagnoses, but also more usage from younger employees who might have turned to the NHS in the past.”
The provision of more primary care services is also adding to the cost. Dr Tryon says claims for primary care now account for more than half of all medical insurance claims by volume at Vitality, with the vast majority of these for digital GP services.
Although virtual GPs are low-cost, it can trigger additional claims costs if members are referred for further consultation or diagnostic tests. Where someone would have seen their own GP in the past, most of these follow-on tests would have been picked up by the NHS: now they’re adding to claims costs on medical insurance.
Shift to early intervention
The increased use and cost of primary care services is often the focus for tricky renewal conversations between insurers and employers, but Dr Tryon believes it could hold the key to getting healthcare spend back under control. “It’s encouraging early intervention,” she says. “If we can manage more claims in primary care rather than only picking them up when they need secondary care this will help us manage costs.”
Savings are coming through in several different ways. There are lower treatment costs if conditions are caught early when easier to treat. Dr Tryon says when employees engage early they are much more likely to follow recommendations on where to receive treatment. “Investment in primary care services could be a gamechanger.” she adds. “It drives health improvements and helps us optimise the employee journey.”
Taking this more upfront approach to managing employee health is already leading to product development. As an example, Simplyhealth launched Simply Essentials earlier this year to deliver a whole of workforce solution that targets early intervention.
For as little as £3 per employee a month, this targets the main causes of workplace absence – mental health and musculoskeletal issues – through digital GP, physiotherapy, and counselling services. “It’s all included in one app so employees can get speedy access to services that will make a real difference to their health and wellbeing,” says Kennedy.
Prevention focus
Against the backdrop of increased demand for healthcare, greater focus on prevention and early intervention is also encouraged by Kazone Kozen, associate director (health and benefits) at WTW. “Shortening the clinical journey is the cheapest way to manage workforce health. It takes a long time for prevention strategies to reduce serious conditions, such as cancer and cardiovascular disease ,but providing education and encouraging healthy lifestyles can lead to improvement,” she explains, “Understanding what drives claims can make this approach even more targeted.”
But ironically the pandemic has made it harder to get this message out, about the importance of prevention and early intevention. As more of the population adopts hybrid and remote working, traditional workplace health promotion strategies such as posters and office-based awareness campaigns are rendered ineffective. “It’s a real challenge in the hybrid environment,” says Dr Tryon. “Employees do value hybrid working but it does make it more difficult to maintain their mental and physical wellbeing. Some employers are mandating more time in the office but whether or not that’s the right approach, it’s essential that health and wellbeing remains a workplace priority.”
