A call for more employer action in group IP

Last month, I gave a call for action on individual IP. This month, it is the turn of group IP. Dame Carol Black, the expert adviser on health and work to the Department of Health and Public Health England, launched the report Investing in a Workforce Fit for the Future from the Work Foundation's Health at Work Policy Unit in September. This is the first of four reports.

This issue is now a priority for the NHS. By avoiding ill health at work and providing good rehabilitation, people can live healthier lives, the economy is more productive, and the NHS and DWP can save money. The purpose of the initiative is to develop sound evidence-based advice for policy makers.

A key part of the report concerns incentivising employers to take action and that improving the health of the UK workforce is not a challenge that the government can solve on its own.

Successful and effective action is dependent on the engagement of key stakeholders: employers, employees and healthcare professionals. And I would add IFAs to this list.

Many employers do recognise the role that they can play and work hard to have a positive influence.

Many more do not or do not do it effectively. Organisations that implement workplace health and wellbeing programmes often find there are financial benefits in doing so: by reducing days lost through sickness absence and improvements in staff turnover and employee satisfaction.

This also has significant implications for the economy. It is estimated that improving workplace health could generate government cost savings of more than £60bn (the equivalent of nearly two-thirds of the NHS budget for England). So there appears to be a strong policy case to encourage more employers to invest in their employees.

Despite this, those rising to this challenge are the exception rather than the rule. In many cases, employers feel the costs are too high, the benefits too low or they don't know where to start. For smaller employers, everyday pressures of running the business leave little time or resources for such a programme.

The report recommends that the government assesses the feasibility of fiscal incentives to encourage employers. They should be targeted both to encourage employers already doing something to do more, and to entice those employers not doing anything to start.

In particular, they suggest reviewing current taxation of employer-sponsored health interventions; testing different fiscal incentives; and investigating the current and potential role of IP.

They also suggest the development of an evidence base around IP (particularly its role in rehabilitation and back-to-work support for employees who are not usually covered by IP) and exploring incentivising more employers, of all sizes, to offer IP to employees.

In my view, the point about an evidence base for IP-funded rehabilitation interventions is absolutely crucial to any progress being made. We have been here many times before. Everything seems to go well until we hit the brick wall of HMT.

They always say ‘where is your evidence?' Case studies are important, but the gold standard is reasonably large-scale randomised controlled trials. An option would be to look at interventions vs outcomes and costs for the group IP population of a large insurance provider against a similar cohort of people who rely on the NHS. It would require collaboration between Public Health England and that provider. Any takers?

If we could get this evidence, it would be very powerful in advancing our case. £60bn looks impressive, but how much would incentives actually cost and save?

Richard Walsh is a fellow at SAMI Consulting