Employers can convey value on investment more effectively and create a business case for doing so by using an integrated approach that treats all members on a common platform, gathers key data points and interprets MI in simple yet succinct communications.
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Speaking at a Corporate Adviser round table last month, Centrica EM&T HR director, Vish Buldawoo and Pamela Gellatly, CEO of Healthcare RM, part of HCML Group, showcased Centrica’s employee health strategy, which involved partnering with HCML to update its offering and put in place an integrated strategy that worked for the entire organisation.
Several years ago Centrica implemented a fundamental change in the way it operated from an HR perspective. The new approach offered a chance to examine the way its vocational rehabilitation was working and try a more innovative approach.
Buldawoo said: “It was a great opportunity for a company to come in and look at the capability of our occupational health, see where they could upskill, and introduce the right capabilities to support the organisation.”
Prior to the reorganisation there were around 135 third-party bodies in Centrica’s overall benefits strategy. “We didn’t know the cost, we didn’t know the efficacy, or whether it was actually driving any value,” said Buldawoo.
Centrica has a complex patchwork of organisations presenting a wide range of workplace environments, each with their own HR and health challenges, including gas fitters, call centre workers, and traders operating in the wholesale gas market.
Centrica implemented an integrated health model for the entire organisation with the help of HCML, which also manages the organisation’s healthcare administration. The HCML integrated model offers remote case management services that cover occupational health and EAP functions. It also has what it refers to as a “functional health team,” which consists of physio, CBT, therapists, and nutritionists Gellatly noted: “The biggest advantage that we’ve had up to this point in terms of data is running everything through a single system. It doesn’t matter whether it’s first-day sickness, absence, whether it’s an EAP that we run or whether it’s the health care plan, all of that data gets captured on a single system. As we see and assess individuals, we start building a detailed picture.”
Centrica implemented a common platform across the UK Centrica Group to manage its occupational health sickness absence, targeting day-one sickness absence for its engineers and its contact centres tailoring its services to the needs of business units.
Buldawoo said: “Having a third party that can manage all our services, bring the data together, and help us understand what our data is telling us was vital for us as an organisation. We saved a bit of money and we started to see opportunities and benefits that we couldn’t see before because of the 135 providers that we had.”
Implementing the new strategy involved modifying terms and conditions for the entirety of the UK workforce. It now had streamlined terms and conditions and a universal core health care plan for all employees, whether they are traders in London, engineers, or contact centre staff Gellatly emphasised that the integrated approach of the company at the organisational level is mirrored at the individual level. She explained that HCML offers a universal healthcare plan, paid for by Centrica, but individuals can also choose to upgrade to higher levels of cover. For those organisations without health insurance, HCML also provides an extended EAP programme.
Integrated health at an organisational level covers risk management that goes beyond health and safety, such as rehabilitation after accidents and injuries, occupational health monitoring, and psychological risk assessment.
The model also includes health benefits that take into account clinical and biopsychosocial aspects, and covers group income protection management, PMI claims management, trust claims management, case management for health and injury, and other factors.
Wellbeing benefits within the Centrica arrangement offer opportunities to improve health and reduce claims and include EAP Plus– covering psychological, musculoskeletal, digestive health, and menopause as well as physiotherapy and nutrition.
HCML has found that since including wellness benefits in its healthcare plans, up to 54 per cent of participants in those plans have lost weight and as a result, cut their risk of injury by 64 per cent.
At the individual level, the integrated health model from HCML looks at the biological, the biomedical, and the biomechanical. George Engel first proposed the notion of the biopsychosocial model in 1977. It contends that in addition to biological aspects, psychological and social factors should also be taken into account to comprehend a person’s medical state.
According to this theory, pain is a psychophysiological behaviour pattern that cannot be solely attributed to biological, psychological, or social variables. It proposes that psychological counselling should be incorporated into physical therapy to address all facets of the experience of chronic pain. HCML’s approach considers social issues such as work hours, relationships with coworkers and managers, family, friends, hobbies, sports and ethnic or genetic predispositions, all with the aim of taking a holistic view of the individual to identify causes of conditions, rather than to simply be responsive with treatments.
Gellatly said: “We measure the management standards as part of our biopsychosocial assessment. We look at what the occupational stressors are and then we can feed that back to Centrica. Change was the biggest factor by far and we give them some data insight into that. When it was Covid, it was family health that was the biggest problem.
“Now we’re seeing personal stressors at home and it’s gone back to demands on the individual being the key issue at work, particularly for the engineers and the call centres where they are inundated and people being abusive to them.”
The HCML approach evaluates physical issues including psychological risks based on DNA and epigenetics, as well as personal stressors like relationships, finances, family, and social support, comorbidities, resilience and coping mechanisms, personality, and neurodiverse conditions.
It also examines physiological issues including age, gender, clinical conditions, and lifestyle factors like weight, exercise, nutrition, alcohol, drugs, smoking and sleep. Gellatly pointed out that when individuals are evaluated, their current health concerns as well as their underlying causes are also assessed.
She said: “Instead of it just being the traditional interventions that you get in a health care plan, we put in the ability for people to claim for weight loss, exercise advice, nutrition, advice, support on the menopause, support as they get older.
You’ve got age-related conditions happening and we can treat them even though they’re not ill. If when we assess those conditions are relevant, we will treat not only the presenting symptoms but the underlying cause.”
Gellatly also highlighted the clinical and psychosocial flag systems which can be used to help identify a serious health issue when specific symptoms are seen during a patient’s examination or in their medical history.
Clinical red flags are indications of potential significant pathology such as inflammatory or neurological illnesses, structural musculoskeletal damage or abnormalities, circulatory issues, suspected infections, tumours, or systemic disease.
Red flags for musculoskeletal disorders are an example of this. If present, these call for an immediate referral for surgery as well as additional research. Orange flags alert the clinicians to serious issues that may be psychiatric and require referral to a specialist instead of following the usual course of management for mild mental health conditions like anxiety. Yellow flags, on the other hand, represent views, evaluations, conclusions, emotional reactions, and pain-related behaviour. Blue flags represent beliefs about how work and health are related, such as the conviction that work is overly demanding and likely to aggravate an existing injury or the conviction that coworkers and the workplace supervisor are unsupportive.
Finally, black flags include legislation restricting options for return to work, conflict with insurance staff over injury claims, overly solicitous family and health care providers and heavy work, with little opportunity to modify duties.
According to Buldawoo, call centre employees experience a different type of stress compared to other workers, especially in light of the present energy crisis, which may cause them mental health-related issues.
He noted: “The impact on customer contact centres is incredible. We were able to pivot to giving them a service that supported all contact centre employees at a point where they were getting hassled by customers. We now have consistent support and an integrated model for that individual.”
HCML’s strategy for the next five years is to try and do more in the individual space.
When it comes to information, Centrica went from using information packs to scaling down to a one-page dashboard for each business unit from HCML.
Gellatly said: “We still have got a 60-page report that we do quarterly but now it’s an interactive dashboard so certain people can have access and drill down themselves.
“It was about how we get bite-sized chunks that people can digest and understand. We not only produce numbers, we then produce insights and recommendations to go with them.
“We normally give the managers three objectives of what they need to focus and work on, and that’s made a difference.”
HCML collected data on Centrica’s demographics, work-related cases, stress factors, outcome measures, risk factors, and colleague experiences as a means of demonstrating their accomplishments.
It found that there had been a shift toward more wellbeing interventions rather than only clinical treatments.
Costs associated with missed work due to illness have decreased by £35m over the last three years thanks in part to Centrica’s use of wellbeing-based case management. Physiotherapy and psychological costs have decreased by £5m, while senior management healthcare plan costs have decreased by £2.5m.
More examples of the return, or value on investment are that 70 per cent of people returned to work sooner than the clinical averages, 75 per cent of people who received psychological support experienced positive results after three sessions, and 70 per cent of people who received proactive musculoskeletal support did not miss any work for a year.
Gellatly also pointed out: “We’re measuring how quickly somebody returns to work compared to clinical norms and that’s where we see a lot of the sickness absence reductions and savings in that. We’re measuring the correlation between inactivity, excess weight and sleep.
“The media reports on the workrelatedness of conditions. There’s a lot of perception of work-relatedness but the amount of work-related ill health is actually very tiny.”
Both Gellatly and Buldawoo acknowledged that although there was initial scepticism, employees have now embraced the changes as evidenced by the feedback.
Buldawoo said: “We’ve heavily invested in culture change within British Gas and we’ve now got better insight into the health of our workers.
“There was a bit of rejection and apathy at the start but we have successfully realigned the organisation and the way it deals with workplace health.”
Centrica has had to overcome that apathy through consistency and the delivery of the integrated model and it’s noteworthy to also highlight that only 1,400 out of the about 19,500 participants in the two health insurance plans, according to Gellatly, have opted out.
“It’s the consistency of the approach that is helping deliver the cultural change throughout the organisation,” Buldawoo concluded.