Long-term absence will worsen as missed treatments and lengthy waiting lists hit – analysis

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There is a bubble waiting to burst for employers in the form of increased long-term absence rates due to growing numbers of employees not accessing treatments during the pandemic.

Steve Herbert, head of benefits strategy at Howden Employee Benefits & Wellbeing, told Health & Protection he expects an increase in long-term absence from those employees who were unable to receive treatment or diagnosis during the pandemic, and whose medical conditions might well have worsened as a direct result.

Herbert added he also expects to see a spike in long Covid claims.

“NHS waiting lists are already at a record high of 4.7m – with more than 300,000 waiting more than a year for routine treatments,” he said.

“If anything this number is likely to increase before it starts to fall, and it will take a very long time for waiting lists to reach acceptable levels.

“Meanwhile there will be employees with relatively minor health conditions that – while not life threatening – are still debilitating or prevent them from working at full productivity, or indeed working at all in some cases.

“It’s vital for employers to return to full productivity just as quickly as they can post-pandemic – so providing employees with access to private treatments via private medical insurance, cash plans or healthcare trusts will become increasingly important so that each and every employee can contribute at their maximum level of output.”

This is being borne out in claims experience coming through from organisations.

Steve Ellis, head of employee benefit consulting at Properis, told Health & Protection that he is witnessing companies where there is a bubble waiting to burst of people who have not been putting in claims for treatment.

“I was talking to one of our cash plan clients and we did an analysis of the claims through 2018, 2019 and 2020 and the number of claims particularly for dental had reduced so there are people who are maybe delaying dental treatment,” he said.

“Because of that you’ve got your knock-on effect where people are not maybe enjoying as good as oral health as they would and they could be missing the early stages of mouth cancer because they have not had a dental treatment.

“Optical has probably not been affected as much because people may have still had eye tests, just not as many. But you may be missing the things the optician picks up regarding blood pressure and other ailments and at the more extreme end, potentially missing the early stages of brain tumours.”

 

Physiotherapy claims to come

But Ellis predicts there will also be a lot of physiotherapy claims in waiting with people not self-referring  for treatment for aches, pains.

“With people working from home and the knock-on impact of non-assessed workplaces, people like me sat on a couch in the conservatory with my laptop on the table, that is a musculoskeletal absence waiting to happen,” he continued.

“At this particular client, they’ve got 660 people on the cash plan and they had something like 80 physiotherapy actions a couple of years ago – there were four last year.

“From 80 down to less than 10 does say there is potential for an awful lot of musculoskeletal issues, which then have a knock-on effect where the condition could get much worse and may need treatment on the private medical cover, and it could even have a longer term effect which could lead to income protection claims.

“So what we’re seeing now could be a catalyst for what happens in the future.”

Dave Middleton, executive chair of the Association of Medical Insurers and Intermediaries (AMII), told Health & Protection that lengthening NHS waiting lists would inevitably lead to an increase in both short and long-term absence as a result of those who have not been able to be treated due to the pandemic.

“The provision of private medical insurance, trusts and cash plans have never been more important and those employers who currently provide these benefits for their employees will undoubtedly benefit from the investment they have made,” he said.

This was echoed by Towergate Health & Protection head of group risk David Williams.

He told Health & Protection that while there may be cases where employee illness might not be getting any worse, the length of NHS waiting lists means they simply are not being treated, so they remain absent from work far longer than they might have in previous years.

“This points to the benefits of private medical cover which can help bypass those queues and get the employee back into work more quickly,” he said.

“Those employees with income protection cover will be able to call on the early intervention services provided by the insurer and these will also help with recovery outside of the usual NHS timescales.”

 

Several years to recover

Christine Husbands, managing director at RedArc, anticipates that it will take several years for treatments to get back on track.

“Therefore, I agree that long-term absence is likely to increase over the next few years as people wait for non-emergency treatment and surgery,” she said.

“Good quality support services will be able to help individuals manage their symptoms as effectively as possible and potentially reduce the impact on absence from work.

“We’ve already seen increased need for wide and varied support, including for mental health, navigating the NHS and long Covid.”

Katharine Moxham, spokesperson for Group Risk Development (GRiD), told Health & Protection that the protection industry as a whole is anticipating a lag on income protection and critical illness claims, given the delays people have faced during the pandemic accessing diagnosis and treatment, especially during the first lockdown.

“Whether this impacts on long-term absence rates going forward remains to be seen, but because furlough and working from home have, in effect, masked long-term absence, we could see an increase in absence rates as businesses return their people to their normal place of work,” she said.

“Those employers with group risk already in place, will have been able to support people through this difficult time for them thanks to the raft of embedded services that come with group risk products.

“Fast access to employee assistance programmes, online GP services and second medical opinion services will have been particularly helpful for those people otherwise facing delays in accessing advice, support, diagnosis and treatment.”

But Claire Ginnelly, managing director at Premier Choice Group, is keen to point out that while physical issues can have debilitating impact on people, mental health will create a new pandemic due to the impact of Covid-19 and help is needed.

“As much as a lot of employers have done a really good job of staying connected to employees who are working remotely, it is not until we start to physically see each other again that some mental health issues will start to manifest and I really do worry about this. Feelings of anxiety could be heightened for a lot of people.

“For employers with health and protection policies there will be benefits in their plans which will help to support colleagues. For those who haven’t, it is worth looking at some sort of employee assistance programme to help employees.”

 

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