Just over 9.2m people are economically inactive in the UK, according to the Office for National Statistics, of which 2.8m are unable to work due to long-term sickness. Left unchecked, the Institute of Public Policy Research (IPPR) predicts in its cross-party Commission on Health and Prosperity that the number of people unable to work due to sickness will increase to 4.3m by the end of this parliament. “The challenge we’re facing is that while other countries have got back to the position they were in before the pandemic for long-term sickness, the UK hasn’t,” says Dr Jamie O’Halloran, senior research fellow at the IPPR. “The government has a role to play in helping people back to work but employers also have an opportunity to stop them falling out of work in the first place.”
To illustrate how significant a role employers have, O’Halloran points to the findings of the Pathways to Work Commission, which looked at how people in Barnsley and South Yorkshire could be helped back into employment. Of the 750 people who were interviewed, 51 per cent said their employer could have helped them stay in work. “Changes such as greater flexibility or a different role can prevent someone leaving an organisation,” he adds. “Employers have an important role to play.”
Group risk lessons
With its focus on helping people return to work, the experience of the group risk sector could help to shape government strategy. The latest claims survey from Group Risk Development (Grid) highlights the success of group income protection (GIP) insurers’ early intervention support. During 2023, 6,299 people who had a period of sick leave starting that year were helped to return to work by their insurer.
“The interventions insurers provide are effective and help people return to work in a sustainable way,” says Katharine Moxham, spokesperson at Grid. “The earlier an insurer can support someone the better. It’s positive that the government is taking this on board.”
As an example, of the employees supported in 2023, 4,691 were able to return to work before a claim was made following interventions provided by the insurer. “It’s a win win win situation for employers, employees and insurers,” says Ed Watling, head of health and wellbeing at Mattioli Woods. “Early intervention and prevention work particularly well for almost all conditions, including musculoskeletal and mental health issues.”
The value of early interventions is also supported by data from the Barnsley study. It found that while 91 per cent of those who had been off work for less than a year were interested in taking a suitable job, this fell to 60 per cent among those who had been out of work for five years or more.
Nationwide rollout
Mandating GIP may be a bit of a pipedream for the group risk sector but there are elements of the product proposition that the government should consider in its return to work strategy. “It has to be a holistic approach,” says Christine Husbands, commercial director at RedArc. “The physical side can be fixed but, after being off work long-term, an employee might not have the confidence to return.”
In the workplace, this multifaceted support could be delivered through a range of tools including medical insurance, virtual physiotherapy, and occupational health services as well as through the NHS. Moxham says it’s essential to have access to experts rather than more generalist support. “Specialists, whether in a specific condition or in vocational rehabilitation, will have a better feel for how to do this effectively,” she explains.
While using specialists can improve outcomes, there is a risk of confusion. Even if someone has a good understanding of their condition and the interventions that could benefit them, they might be influenced by previous experiences or opinions of friends and family. “There are so many different touchpoints where an employee might get stuck,” says Laura Matthews, senior wellbeing and benefits consultant at Barnett Waddingham. “We work with organisations to develop pathways to ensure the most appropriate support is delivered.”
Triage services can also help employees access the right support quickly. These can provide case management services to help employees navigate what’s available. “People don’t know what they need,” says Husbands. “There’s a risk that employers introduce a broad range of services and employees don’t know where to start.”
Culture shift
Culture in the workplace may also need to evolve. Matthews says there can still be stigma associated with saying you’re struggling. “Some employees worry HR will march them out the door if they ask for help. This isn’t productive: we need to change this mindset,” she says.
This may happen automatically as the government rolls out its workplace health initiatives, especially if it becomes easier to access support and treatment. However, there are already ways for an organisation to foster a more supportive culture.
Initiatives such as health and wellbeing assessments; line manager training to give them the confidence to identify and support employees who are struggling; and health benefit promotions and awareness days can all help. “We work with organisations to make it OK to talk about health,” says Paula Coffey, director of claims, rehabilitation and medical services at Unum. “Once an organisation starts using these services and employees feel supported, we find that GIP referrals ramp up.”
Prevention potential
Adopting more preventative health strategies can also help to create a healthier workplace. Watling believes more work will be done on prevention this parliament. “Individuals need to be given the tools and education on topics such as exercise and diet to help them adopt healthier lifestyles,” he says. “This will help with both minor and major health issues.”
This shift is also recognised by the IPPR. One of its five foundational pillars calls for a shift from reactive health services to preventative, primary care-led healthcare. With employees increasingly looking to their employers for health support, the workplace is an ideal place to deliver education and support around prevention.
The right measures also need to be in place in the state benefits space if the government is to encourage more people to return to work. For this, the IPPR is calling for a ‘right to try’ for people on health or disability benefits. “People on benefits should be offered a right to try work and, if it’s not right, be able to go back to the same level of benefits,” explains O’Halloran. “We’d also like to see some commitment from employers to improve job quality: there is a cost to paying the national living wage and abolishing zero hour contracts but if employees are treated well, they’re more productive.”
Technology is also likely to offset some of the additional costs that may be faced as the UK adopts a more robust approach to employee health and rehabilitation. Artificial intelligence is already transforming healthcare with technology being used to detect health issues including bone fractures, cancer and heart problems. Coffey says it’s an exciting time in healthcare. “AI and technology can leverage what we do with workplace health,” she says. “We’re constantly reviewing and evaluating what’s available: the right interventions have the potential to cut delays and achieve better outcomes.”
Creating healthier workplaces and encouraging people back to work may seem a simple objective but getting it right requires a broad range of inputs, from appropriate health support and triage through to the right working conditions. Recognising the importance of this joined up, multidisciplinary approach is key to any government health strategy.
