Health screening can have great pre-emptive impact on staff and their families, but streamlining spending can be a real challenge, says Jamin Robertson

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Health screening provides a comprehensive medical check-up for staff and typically costs between £200 and £600 per employee.

Many employers limit access by targeting certain groups of employees or offering screening as a voluntary benefit.

Providers have introduced web-based surveys and alternative funding with the aim of making health screening more affordable.

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Regular health screening allows staff access to a rigorous medical examination, so is a tangible and attractive healthcare benefit. But how is the benefit best deployed?

Faced with a limited healthcare spend, employers must schedule screening to ensure it is effective. In most organisations that offer the benefit, health screening takes place at least every two years.

For older employees, and workers in highly physical or repetitive fields, employers may offer testing on an annual basis. Paul Nash, product manager at Cigna Healthcare, says those groups should be offered more comprehensive testing to flag up diseases prevalent in these sectors.

"There's testing for testicular cancer, blood tests for bowel cancer, and tests for prostate cancer, reflecting the increased prevalence of disease among the over 50 age group. It is not really cost effective to carry out those tests on populations below that age."

The cost of health screening can present a barrier. The general corporate bandwidth for conventional health screening is between £200 and £600.

As a result, some employers target provision by employee group or pass on some of the cost to staff. According to Employee Benefits/HSA Healthcare Research 2005, 23% provide screening as core healthcare benefit, while 11% offer it is as a voluntary benefit and 5% offer it through flex.

But Mike Owen, director of provider Wellness Technology, advocates the retention of fully-funded provision for all staff through a detailed online survey, which is often the first stage of a conventional health screening. This weeds out fit and healthy staff so only at-risk employees move on to the following stages of testing, clinical consultation, and comprehensive feedback, thus cutting costs.

This is aligned to the concept of demand management, a US theory now gaining ground in the UK. Dr Mark Simpson, managing director of Axa PPP Occupational Health Services, says: "By targeting the low, medium, and high risk categories it encourages employers to spend more intelligently. It's moving away from a mindless but well-intentioned screening policy to look at the actual impact on absence management, and productivity and performance."

But will employees who habitually under-rate their vices slip through the cracks?

"You find that given the anonymity of the web survey, people are a lot more candid," adds Simpson.

Raman Sankaran, director of strategy and development at provider HealthSure, says employers may alternatively insure health screening in a similar way to a healthcare cash plan. For a fixed monthly fee, employees receive a set screening entitlement, the employer is billed and submits a claim to the provider. "In the last six to 12 months, we've seen more take up of that," he says.

Uptake of these options may spiral in the light of upcoming age discrimination legislation that employers fear may prevent them from funding screening based on age. At LogicaCMG, all employees aged over 40 are entitled to health screening, a policy the company hopes won't be affected come October 1. "The restrictions based on age are absolutely relevant as long as they are clinically based on the prevalence of disease and relevance to that age group," says Nash.