“If someone is referred to OH, they can sometimes feel they have misbehaved in some way,” she says. “We have altered the way we position it to be a health and wellbeing benefit. We use communications through the intranet to explain that it is less about what is wrong with an employee, and more about improving their ability to work. It is about helping the employee.”

Turner says the employer can help with various interventions, such as allowing someone who has had an injury to travel outside the rush hour so they do not get jostled on the Tube, and allowing more flexible working so staff can work at home more.

“Or it could be by referring them to one of our partner services, such as Axa PPP Healthcare, which will report on what to do next,” she says. “If you don’t do these things, it is a cost to the business and it is no good for the individual just to be left sitting at home.”

KPMG switched to Axa as its OH partner in April 2012. Turner adds: “If an employee hits a trigger, they get referred to Axa. We don’t have self-referrals because the line manager has to do it, although an individual can approach their manager about being referred.”

If an employee has musculoskeletal problems, for example, KPMG might call in a third party to assess the employee’s needs at work, or if there is a clinical need, the company might turn to private medical insurance (PMI).

KPMG used to self-insure for GIP, but, in January 2013, began a scheme with Unum working in partnership with Axa. Turner says: “For the first year, we will use our broker Aon Hewitt to manage claims. So we have three organisations providing a holistic approach. We want a good OH service so that we don’t get the claims. We want them to work together and collaborate, rather than operate in the dark.”