As the cost of healthcare benefits needs to be aligned to effectiveness, Stephanie Spicer asks which perks are most apt at reducing sickness absence levels for employers

It might seem obvious to state that the best healthcare benefits for staff are the ones that are most effective at reducing sickness absence. While there are a range of options employers can put in place such as private medical insurance (PMI), health screening, employee assistance programmes (EAPs), flu vaccinations or gym membership, for example, the trick is in applying the right benefits in the right way.

In coming to a decision as to which benefits to select employers should also consider the cost of these in relation to their effectiveness. Stephen Smythe, risk and healthcare consultant at Jardine Lloyd Thompson Benefit Solutions, explains: "How do we define 'best'? All of the features and benefits available to employers through employee benefits are not effective if they do not tackle the problem. Through feedback, an employer can make an informed decision as to whether their benefit provision is hitting the mark. EAPs often provide management information that an employer can utilise."

That said, arguably the most effective benefit for tackling staff sickness is PMI. Providing the means by which employees can be fast-tracked to a consultant for an opinion on what ails them and to receive treatment within weeks has to be a major help in ensuring a short-term illness or physical complaint doesn't progress to a period of long-term absence.

Similarly, healthcare cash plans which help fund employees' trips to the dentist or optician and a range of complementary treatments such as physiotherapy, can also keep staff focused on maintaining their health and tackling physical niggles before they get any worse.

Health screening also helps identifies potential health problems. Stephen Flanagan, commercial director at Bupa, says: "Pre-employment screening is quite important to make sure you understand what potential risks you may be taking on. Obviously you can't discriminate but you can be aware of any issues and help manage them."

Providing a pleasant workplace and demonstrating a care for the welfare of employees, even in the simplest of ways, will go a long way towards keeping short-term and long-term sickness absence at bay.

Julie Waddington, healthcare consultant at Punter Southall, says: "Employees value an employer that cares about them and assists them to make positive changes that may affect their working and their personal life.

"Access to water and fruit, promoting exercise and health awareness, [providing] duvet days,or even something like having the right type of strip lighting within the office, can all make a positive enhancement to an employee's working environment and therefore physical and mental wellbeing," says Waddington.

It would be easy for employers to put as many of these benefits as possible in place and assume employees will reap the benefits. But it takes a bit more than that. At whatever level, whether dealing with short or long-term sickness absence, employers should have an absence management strategy in place to help identify the action that is needed.

Early stage management
Preventing a short-term absence from becoming a long-term one is crucial. This is a useful objective to bear in mind when managing absent employees.

"While a degree of long-term absence is inevitable, employers can usually reduce the long-term liability through effective management at the early stages. This ideally encompasses the effective use of a structured absence management programme," says JLT's Smythe.

For example, Bupa's 360 Health Risk Management is an early intervention product, under which the healthcare provider will step in and manage an employee back to work.

Bupa's Flanagan explains: "We would put a sickness absence monitoring system in place and work with employers in logging and monitoring sickness absence so we can get early interventions wherever possible.

"It might not involve PMI, it might be rehab for something or occupational health intervention, the whole point being to stop the absence becoming a claim and driving the longer-term costs upwards."

JLT's Smythe says group income protection insurers have also responded to employers' need to take a holistic approach in tackling absence by introducing a degree of flexibility and vocational rehabilitation into their products.

He points to Unum's Capital Option product which helps employers protect the income of staff with long-term illness or injury, while limiting their own long-term absence costs, and Pay Direct scheme which is designed to help absent staff to return to work where possible or to continue to receive benefits, even if they can't go back to work and end up leaving the employer.

"Canada Life has also been innovative at the smaller end of provision with the introduction of Business Care, which provides employers with Canada Life group income protection access to an information and support service covering key operational issues employers face, and Best Doctors (which provides access to a second opinion for people diagnosed with a serious medical illness or injury) as complimentary added value services," says JLT's Smythe.

Therefore, it is key that employers select both the right benefits, and the right mix within an overall strategy that is suited to both employer and employee.

Abby Bowman, PR Manager at HSA, says: "Companies used to offer one type of health benefit, for example, PMI or occupational health benefits for long-term absence, then healthcare cash plans, health screening or EAPs to help prevent sickness absence or to deal with short-term absence.

"Increasingly, employers are looking at their workforce as a whole and are introducing a health benefit that tackles a number of health issues - long and short term."

To this end, HSA offers integrated packages of benefits aimed at prevention as well as cure. Its WorkWell product, for example, includes occupational health and health screening, on top of the everyday health benefits, eye tests for VDU users, an EAP and consultation and diagnosis services, therefore addressing a range of health issues. It is designed to help prevent absence from happening in the first place and to help HR managers deal with it once it has occurred.

Once employers have devised sickness absence management strategies and selected appropriate products they should remember to communicate the healthcare they are providing to staff in order to capitalise on its effectiveness. As Bowman says: "Benefits are important, but communication and education are also key."†

Why offer benefits?

Why exercise?
Regular exercise can help burn fat, promote healthy blood sugar levels, improve bone density, boost the immune system and help guard against dips in mood levels. It also helps increase high-density lipoproteins (HDL) or "good" cholesterol levels. A high level of HDL is thought to protect against heart attacks.

Why vaccinations?
According to research conducted on behalf of the Consumer Health Information Centre in 2000, 5% of people take more than five days off work when they have colds or flu.

Why health screening?
This detects ailments at an early stage, including serious conditions such as cancer and heart disease, and means that employees can receive treatment earlier than they would otherwise have, perhaps enabling them to continue to work or to return more quickly.

Why employee assistance programmes?
Self-reported work-related stress, anxiety and depression accounts for 10.5 million working days lost each year, according to the Health and Safety Executive.

Why health habits?
Failing to drink enough water and other fluids can result in dehydration. The daily minimum requirement is often quoted as 8-10 cups a day. Dehydration can result in tiredness, poor concentration levels, reduced alertness, headaches and mood changes. It can also lead to constipation, kidney stones, and even a blood clot, heart attack or stroke, as it causes blood to thicken.

Case study - Construct zero sickness absence

Sickness absence is almost non-existent in the London-based construction industry recruitment company Consensus.

All 12 employees are offered private medical insurance (PMI) after they have been with the firm for six months.

Martin Tyrrell, managing director, says: "If someone has a niggling injury with all the hoops you have to go through in the NHS there is the risk they will defer treatment unless it is critical. But PMI motivates staff to get things sorted because they know they will be able to see a consultant once they have seen their GP."†

Through provider Standard Life, staff can also access online health and wellbeing service Vielife. "Staff can do health assessments or get information on nutrition, and so on. A lot of our employees have done that and moderated their lifestyle accordingly," says Tyrrell.

Consensus provides fresh fruit for staff every week and gym membership. A masseuse also visits the company every month to give back massages. "We think this is beneficial and everybody uses it," he says. 3

Staff are allowed to take time off for things like dental appointments without having to use up their holiday entitlement and on a good sales week they can go home at 4pm on a Friday.†

"I honestly believe that is why we have low sickness, people don't find work a chore and we don't lose people," says Tyrrell.

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