Health screening: A wider view of wellness

If you read nothing else, read this …

• Many employers now monitor employee wellness regularly rather than waiting for staff to become ill.

• How frequently health screening is offered, and to whom, depends on what the employer wants to achieve.

• Screening can identify issues within an organisation’s wellness strategy that need to be rectified.


Employers are realising the advantages of adopting a comprehensive approach to employee wellness

According to the Confederation of British Industry/Pfizer Absence and workplace health survey, published in May 2011, absence costs the UK economy more than £17 billion a year, with the average employee taking 6.5 days off work through illness in 2010. And that is before the impact of low productivity due to stressed or rundown staff is taken into account.

The economic benefit of having a healthy workforce is just one of the reasons organisations are continuing to invest in employee wellness programmes, despite the current economic climate. Mercer’s 2010 pan-European survey of employer health benefits, published in February 2011, found the main motivation behind such plans was actually the ability to attract and retain new talent, followed by managing health risks such as the cost of absence, and finally the need to increase productivity.

How an organisation approaches the issue of wellness will depend on what it is trying to achieve and its culture, says Chris Coyne, group head of reward at City and Guilds. However, in general, he believes employers are starting to view wellness as an integrated whole, rather than a series of packages.

“Rather than talking about private medical insurance or income protection, employers are thinking about wellness as a concept,” he says. “The struggle is defining that, working out how we integrate that and communicating that as a joined-up whole rather than as little insurance packages on their own jotted across the board.”

Joined-up approach

Louise Aston, director, Workwell campaign at Business in the Community, believes such a joined-up approach is vital if employers are to realise the full benefits of a healthier workforce. “We have spent three years developing our Workwell model, which looks at the whole person in terms of their psychological, physical and social wellness,” she says. “We know that physical activity obviously has an impact on emotional wellbeing, but we should look at this agenda in terms of sustained performance and wellness underpinning engagement and interacting with business success.”

This shift towards looking at employees’ overall health has led to more of a bottom-up approach, with organisations monitoring the health of staff regularly rather than waiting for them to become ill, says Dorian Dugmore, director of Wellness International, part of Adidas UK. “There is a really strong focus now on prevention, risk identification and intervention before issues present themselves as problems needing treatment,” he says. “That is the way that corporate wellness has to move and that is a real continuum for the future.”

Against this backdrop, health screening has a vital role to play. Valerie Phillips, head of business at clinical testing services firm Randox Health Checks, says this allows both employees and employers to learn about their current situation and devise ways to help those already in good health to stay well.

“Our approach would be to look at what is going on in your body now when you are healthy before conditions even occur,” says Phillips. “A lot of health screening is about identifying conditions that are already there, such as blocking of the arteries, but what we try to do is to look at very early markers in your body so that when you are in your 20s and 30s, you are able to maintain that level of health going forward. It is an approach to avoid absenteeism, rather than to treat it once it has occurred.”

Regular health screening also enables employers to identify conditions that may not be detected in a one-off event. Dugmore cites the example of a senior executive who took regular prostate-specific antigen (PSA) tests an early indicator of possible prostate cancer over a period of four years. The company was able to intervene early on to make sure the condition was treated at an early stage. “Had those screenings not been offered serially, that would not have happened,” he says.

Screening can also identify existing conditions that have yet to be diagnosed, allowing employees to get early, possibly life-saving, treatment. “The beauty of technology today is that [employers] can actually tailor a screen to their workforce,” says Phillips. “There are things everyone should have done, such as body mass index and blood pressure, but if [they] have a younger workforce, [they] could test for A, B and C and if they have a mainly female workforce, they would test for one, two and three.”

Paul Ashcroft, a principal at Mercer, says employers either tend to test for everything, offering a full lifestyle suite, or opt for more basic packages with specific extras included. “Specialist cancer screens such as breast screening have been available for years, but now there are tests available for diseases such as skin and prostate cancer, which are now probably included in most screenings,” he explains. “If you are picking up those types of diseases and intervening at an early stage, there is a strong case for saying that screenings can head off serious illness, as well as saving on long-term absence.”

Staff absences

When employers are faced with the prospect of staff absences, taking a active approach towards healthcare using effective treatment, rehabilitation and medical assessments can help to keep this time to a minimum. “If people do go off sick, it is about absence management rather than letting them fester there on their own,” says Aston.

“Otherwise, with someone who is off absent for three weeks it can go to six weeks, then three months and six months and then you have got a real issue. It is about proactive intervention making reasonable adjustments to what people can do rather than looking at what they cannot do, then rehabilitation, a phased intervention and being very proactive.”

Taking an active interest in an employee’s ailments can, on its own, lead to a reduction in the amount of time they are absent from work. Dugmore recalls when he was at a healthcare provider in Canada, and the most common reason for extended periods away from the workplace was road traffic accidents.

“As soon as someone said ‘whiplash’, it was automatically eight weeks off work,” he says. “But when we started sending [staff] to centres where they got their shoulders and necks massaged, it cut the return-to-work times by 50%. The more cynical approach to that is that it saves a lot of money as well.”

Coyne adds: “It is in [an employer’s] interest to get that rehabilitation specialist out early because it weeds out the genuine cases from those who, for whatever reason, are choosing to be absent. It is almost in the employee’s interests, too. They might be going back to work reluctantly as a result, but the fact [the employer] has expressed an interest and care for them is a step towards mending a broken relationship. Early intervention is absolutely critical and this is one area where it is easier to track and where they can get a return on investment.”

Complicated process

However, debate continues over the extent to which screening and other forms of health benefit should be offered by an organisation. Dugmore points out that screening can be a complicated process, which may mean it is impractical to make it a universal benefit. “You have to look at more intensive markers as people reach their fourth or fifth decade, compared with somebody in their 20s,” he says. “There are also issues around females versus males and around health issues that already exist. It is quite complicated, so to test everybody for everything just does not make sense.”

This decision will depend on a number of factors, including what the organisation is trying to achieve. Eleanor Smith, rewards and mobility manager at law firm Linklaters, says: “Are [employers] positioning it as a perk or from a risk perspective? Are they trying to make themselves more market-competitive within the area they are working in? Is it a differentiator or is it something that is expected?

“From our perspective, everyone gets everything, but that is an expectation at a magic circle law firm. It is very different to my previous job in retail, where [employers] do not want to offer benefits to an entire workforce because [they may] have tens of thousands of employees.”

The traditional health screening model, whereby executives on high salaries tend to be screened for, and insured against, all conditions and other members of staff get more basic packages, means that those least able to afford protection are the ones who are excluded, says Coyne. “In terms of the impact of long-term absence, yes, it would be a loss to lose a senior executive, but actually quite a lot of people would miss the post-room function as well,” he says. “It is very hard to break down traditional hierarchies and there is obviously a commercial imperative in terms of how much [employers] want to spend, but I would certainly put myself behind a full, flat offering. I think we should be offering the same to everyone.”

Ability to upgrade

In some organisations, there are already moves afoot to offer a basic level of provision to everyone, but also to offer employees the ability to upgrade, says Ashcroft. “We find a number of organisations are offering quite a good insurance plan, but then they are allowing employees to flex up if they want to by putting in a real top-hat type of plan, maybe with a specialist provider, which might include the ability to claim maternity cover, chronic conditions and private GP costs, which are normally outside the traditional benefits arena,” he says.

“You do see, particularly in the City, that employers want to be able to offer some sort of flexibility to employees who want the Rolls-Royce-type of package.”

Read more from the health screening roundtable discussion