As Labour sets about transforming the NHS, mental health services and access to GPs, can the planned changes really reduce sickness absence? Dr Bernard Yew shares his thoughts.
Top of the newly elected government’s policies to change Britain are ambitious plans to reduce the cost of economic inactivity due to sickness absence.
Sickness absence
Three-quarters worked while unwell in past year
Rachel Reeves, the new chancellor of the exchequer, said: “If people can work, they should be in work, but when you’ve got a backlog of more than 7 million on NHS waiting lists, it’s hardly surprising people are not able to work.”
It is therefore unsurprising that clearing the backlog, with an extra 2 million appointments a year, is now a priority, along with increasing access to GPs and mental health services.
But what exactly does the new government have planned, what are the implications for employers, and can the new measures really reduce sickness absence?
Reducing the NHS backlog
For every 13 people currently working, one person is on long-term sick leave, making the UK the only G7 country not to have returned to its pre-pandemic employment rate. As well as generating skills shortages, the problem is costing the economy £138bn a year.
In response, the government has pledged to deliver another 2 million NHS appointments a year, by paying NHS staff extra to work evenings and weekends. However, the likelihood of an already exhausted and burned-out NHS workforce being able to deliver another 40,000 appointments a week is questionable. Not least while junior doctors, already working more than 50-hours a week, are striking over pay and conditions.
This means utilising spare capacity in the private sector will become almost inevitable if the new government is really going to get the NHS back on its feet. Critical to this will be calling on all available resource, including mental health counselling and physiotherapy capacity within occupational health providers. Plus, modernising booking systems so that individuals needing appointments can be put into a pool for private providers to easily fish them out.
Overall, this will not be a quick fix. Even if the new government can deliver the extra appointments, it will take until early 2029 to clear the current backlog.
Employers who do not want employees to be affected by delays will need to continue to invest in private benefits, such as occupational health services and private health insurance, that allow employees to be seen within days, as opposed to months.
Recruiting 8,500 mental health staff
Despite the importance of early intervention for preventing acute issues, such as stress and anxiety, from turning into chronic conditions, parliamentary data shows individuals typically wait three weeks for a first appointment, then two months for a second.
This will not be a quick fix. Even if the new government can deliver the extra appointments, it will take until early 2029 to clear the current backlog.”
The result is that people who most likely already waited until they could no longer cope before seeking support are not getting the help needed to nip mental health issues in the bud. This is leading to mental health becoming the biggest cause of sickness absence and the biggest driver of economic inactivity among younger workers.
The government’s plans to recruit a further 8,500 NHS mental health staff is to be welcomed; however, as an organisation that’s already actively recruiting and training people in this area, the scale of the challenge is not to be underestimated. It takes 3-5 years to become a licensed counsellor, raising questions about the level of qualification for these staff.
For example, just as nurses and individuals with bioscience degrees are now allowed to take on GP work, following a two-year course to become a ‘physician associate’ (PA), the training bar might similarly be lowered to plug the mental health staffing gap.
It could be argued that having some resource is better than none, but just as 13,000 doctors raised concerns that patient care was being put a risk by PAs, questions remain over just how skilled the new mental health staff will be. This means employers who want to continue to provide access to fully qualified professionals may need to invest in employee assistance programmes, which typically generate a ROI of £10-£11 per employee.
Ensuring early cancer diagnosis
Doctors have warned that a third of cancer patients are facing potentially deadly delays, with just two-thirds of those with an urgent cancer referral being seen within the target 62 days. This is contributing to someone in the UK dying from cancer every four minutes, despite most cancers being very treatable if detected early enough.
Labour’s election manifesto also criticised the lack of scanners and the age of machines, many of which are being left in operation for longer than they should be. In response, the new government has pledged to double the number of state-of-the-art CT and MRI scanners, with embedded AI, believed to be faster and more effective at finding smaller tumours.
A key part of the mission-driven industrial strategy will be a plan for procurement to get products into the NHS, coupled with structured incentives to drive innovation and obtain faster regulatory approval for new technology and medicines.
This is to be welcomed, a caveat being that the NHS is not an agile organisation and transforming it will be akin to turning a tanker. This means employers would be wise to continue to invest in health screening as part of their employee benefits packages for now, if they don’t want undetected cancer cases to continue to drive up insurance premiums.
Ending the ‘8am scramble’ for GP appointments
A particular challenge for working parents, and employees in general, is the need to call their GP at 8am on the dot to secure an appointment, the outcome of which is that 9.8m people struggle to get an appointment and those who do rarely get to see their own GP.
Employers would be wise to continue to invest in health screening as part of their employee benefits packages for now, if they don’t want undetected cancer cases to continue to drive up insurance premiums.”
In response, the new government has pledged to deliver a modern booking system and ensure patients can see the same GP at each appointment if they choose to. Neighbourhood health centres will also be trialled, bringing family doctors, healthcare workers, physiotherapists and mental health specialists under one roof.
The aim is to recognise that GPs are the front door to the health service for most people, with excellent primary care the key to earlier diagnosis. Being able to see the same GP each time is anticipated to ensure ongoing complex conditions can be dealt with more effectively.
All of which is to be commended, as it has long been recognised that joined-up ‘whole person’ care that treats the person in their entirety is the key to successful outcomes. The challenge is ending the postcode lottery, where some areas have excellent primary care, while others fall short. Critical to this is increasing patient choice and helping employees navigate the system.
Employers and occupational health providers will be keeping a close eye on whether these election pledges bear fruit.
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