The Keep Britain Working review is seeking to learn lessons from Europe to explore the possibility of creating insurance schemes that pool risk to enable SMEs to access health and wellbeing benefits as part of plans to deliver Britain’s first Workplace Health System.
In an update on his review, which seeks to reverse an increase in labour market inactivity, released this morning, Sir Charlie Mayfield (pictured) set out the work being done with employers, providers and those with lived experience to deliver this new system.
It will be built on three practical components including creating better, more inclusive workplaces, better workplace health provision and better intelligence on workplace health and inclusion.
These components are held together by a concept of shared responsibility and, over time, by incentives increasingly aligned with measurable outcomes.
New plan
The new plan aims to build better, more inclusive workplaces and better workplace health provision to prevent ill health conditions from escalating and to support people in work with health conditions or disabilities, to achieve more successful returns after absences from work.
It brings together employers, the NHS, local authorities and other support services to ensure people don’t fall out of work unnecessarily and companies have better data on workplace health and inclusion to drive change.
Eleven regional Vanguards, including nine Mayoral Strategic Authorities, Cornwall Council, Hull City Council and Worcestershire City Council, and more than 200 Vanguard organisations are already building and testing the new system with employers, unions and disabled people across all four nations of the UK.
Draft model of workplace health provision
The update reveals that the draft model of workplace health provision has been developed through conversations and roundtables with employers, providers, occupational health and other employment support practitioners, GPs and insurers.
However, it also noted the critical test is whether the model is affordable and accessible for all employers, including SMEs and microbusinesses.
It adds that given what already exists in the market, and the interest received from providers, there is ground to believe that this test can be met. But it requires further exploration through two interdependent steps – settling the minimum specification for the draft workplace health provision model, and exploring potential access routes for SMEs and microbusinesses.
Testing potential of pooled purchasing
The report reveals that the talks that have already taken place indicate there is opportunity to test the potential for pooled purchasing of a workplace health provision on behalf of small employers in a place, for example via Mayoral or strategic authorities, devolved administrations or through sector bodies.
It added the model could also be pooled in this way through the supply chain of large employers, making services available to their partner companies.
The report cites the examples of the Hull’s Resilience Hub, which is testing whether a buyer’s pool can give SMEs affordable access to workplace health support, Working Health Services Scotland, which provides an established example of case-managed support for SME employees and the self-employed, focused on return-to-work planning, and South Yorkshire Mayoral Combined Authority, which is planning to trial independent, shared case managers sitting within businesses part-time to support employees with stay-in-work planning among others.
Pooling risk
However, as proposed in November’s Keep Britain Working review report, the update also suggests an alternative route for small businesses may be through insurance schemes that pool risks and support across small employers, so that premiums are priced lower across a larger group of employees.
This would draw on learning from approaches in some European countries and would build on insurance approaches that also already exist, such as group income protection, where workplace health support is already a prominent benefit.
But the report concedes this would need to address pricing, adverse risk selection and appropriate brokerage.
It further notes that developing the minimum specification for workplace health provision and exploring the routes for making it affordable and accessible for all employers therefore need to go hand in hand. Price depends on access, and vice versa.
Though it adds that participants in the review are keen to partner further, particularly regionally, to further test aspects of its draft workplace health provision model, and approaches that enable affordable access for SMEs and microbusinesses, whether through the market or public provision like WorkWell centres.
Employer standard
The review is also working on an employer standard which is being developed with the British Standards Institution (BSI).
Partnering with the review, the BSI has appointed an expert drafting panel to develop a new employer-facing standard, informed by insight and evidence, including from the vanguard partners.
It is expected to set out clear, outcome-focused expectations, including the importance of stay-in-work and return-to-work plans, rather than prescribing a single operating model.
The report adds this should help employers understand where they are, what good looks like and what practical steps to take next.
Generating better data
But the report also notes the need to create better data and intelligence to enable systematic improvement, with the emerging model therefore is likely to require two complementary forms of intelligence: performance data from employers, and trusted insight from individuals while there is still time to act.
Consequently, the review is now exploring the case for both of these types of intelligence and how they could be generated.
Not a welfare problem
Sir Charlie Mayfield, author of the Keep Britain Working review and co-chairman of the Keep Britain Working programme, (pictured) said: “Britain has spent too long treating economic inactivity as a welfare problem. It is not.
“Instead, it’s one of the largest and most attainable growth opportunities this country has.
We’ve had a National Health Service for almost 80 years. We’ve never had a Workplace Health System. That is why the same people appear on the welfare bill, on NHS waiting lists and in the productivity figures without anyone being able to join them up.
“It’s also why we are missing the best moments to help people. The new Workplace Health System would change that.
“Ten months of building and testing with employers, mayors, providers, unions and disabled people have made us even clearer about what needs to change and more confident that a new system that helps to drive economic growth is within reach.
“The task now is to build it.”