Cutting through the noise: How to support employees with cancer

Cutting through the noise: How to support employees with cancer
Cutting through the noise: How to support employees with cancer

By Colin Hawes, Head of Group Income Protection Claims and Medical Underwriting at Generali Employee Benefits UK

It’s generally a given that employers should do all they can to support employees diagnosed with cancer. The reality, however, is that support can vary hugely from one company to another.

Although there’s a vast amount of generic guidance out there from charities, government and NHS sources, the experience of employers is that it’s fragmented and not always relevant to individual circumstances. Moreover, their role is ill-defined.

It seems the only certainty is that laid out in the Equality Act 2010 with regards to making ‘reasonable adjustments’ for disabled employees. Whilst individuals returning to work following cancer treatment might not consider themselves disabled, it’s likely that many would fall within the auspices of the Equality Act’s definition, namely: ‘You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities’.

According to statistics from Macmillan Cancer Support, around one in four (25%) of people in the UK face poor health or disability after treatment for cancer.

Employer role & responsibility

But even with the guidance of the Equality Act in place, it’s might be considered a potential minefield as to what’s ‘reasonable’? Exactly how far could / should employers go? And what are the cost / value implications?

“What’s ‘reasonable’ in this context is something that the employer can accommodate within their workplace,” says Dr Julie Denning, Partner at Working Towards Wellbeing, a specialist in providing support to employees with cancer and their employers, and one of Generali’s rehabilitation partners. “This varies from employer to employer and job to job."

"For example, it’s sometimes possible to offer alternative duties or flexible working hours, but this may not work for all jobs and all people.”

Against this backdrop, employers report a need for an online one-stop-shop source of information and practical tools: not only in relation to cancer, but for all people with a disability and / or long-term health condition. Additionally, they require more financial support for making adjustments. These represent findings from the CIPDs latest Health and Wellbeing At Work survey report, which used to be known as the annual Absence Management Survey.

Crucially though, the NHS strategy and implementation plan makes it clear that information and support must be tailored to both the employer’s needs and the needs of their employees in order to fulfill the individualised requirements of proven effective support for long-term health conditions.

The case for vocational rehabilitation

Enter the vocational rehabilitation specialist – the essential hub of personalised care pathways for working age people.

An independent review of the scientific evidence to support vocational rehabilitation was published some years ago, prior to NHS England’s national cancer strategy. It was commissioned by the Vocational Rehabilitation Task Group – a group of stakeholders representing the UK government, employers, unions and insurers – in association with the Industrial Injuries Advisory Council.

This substantive document backs up the effectiveness of vocational rehabilitation with a large amount of evidence. It concludes that there’s a strong business case for employers to take a positive approach to supporting health at work, the return to work process and vocational rehabilitation.

Although ‘work support and vocational rehabilitation’ represents a key component in NHS Englands Whole Person, Whole Pathwayapproach (the national implementation plan) to people affected by cancer, it represents a ‘consideration’ for healthcare commissioners as opposed to a mandatory requirement.

It’s perhaps understandable, therefore, that as the cash-strapped NHS strives to achieve its goal of achieving world-class cancer outcomes by 2020, the vocational rehabilitation aspect is being left largely to employers. Obviously, this isn’t explicitly stated anywhere, hence why many employers might be left feeling a little exposed and confused as to expectations.

Pubic & private sector support

The good news is that those employers with group income protection (IP) in place will already have ready-access to vocational rehabilitation specialists.

Cancer now represents the top cause of claim across all group risk products, according to recently published claims statistics from industry body GRiD. Just under a quarter (24.2%) of all group risk claims were related to cancer and many more individuals were helped back to work after a period of sick leave thanks to support funded by insurers.

The bad news is that still only a fifth (19%) of employers currently provide group IP to the entire workforce, with an additional 14% providing cover based on grade / seniority, according to the CIPD’s latest figures.

That’s not to say that public sector support hasn’t been made available.

The government put in place various support mechanisms for employers – not specific to cancer but relevant nonetheless – to help in its care pathway goals.

For example, Fit For Work, the government’s Occupational Health referral service targeted towards those off work for four weeks or more due to sickness. However, this never really got off the ground and from 31st March this year the assessment services were disbanded, although its website and helpline is still available for general information and advice.

Meanwhile, there’s also the Access to Work scheme: a potential government grant for those with a disability or health condition that makes it hard for them to do parts of their job or get to and from work.

Nearly a third of employer respondent’s to the CIPD’s survey, referenced earlier, said they’d used this scheme, although the majority of these were public sector organisations. Private sector companies were least likely to have heard of it: 19% of private sector companies have used it compared with 48% of non-profits and 59% of the public sector.

Fewer had heard of, or used, the Disability Confident scheme. This aims to support employers to make the most of the talents disabled people can bring to the workplace.

Vocational rehabilitation doesn’t explicitly appear in the CIPD survey’s list of strategies used to manage long-term absence but it’s likely to represent a key component for many in the top three approaches highlighted, namely: return to work interviews (75%); changes to working patterns or environment (69%); and case management approach (65%).

What is vocational rehabilitation?

It’s defined as a series of services that are deigned to facilitate the entrance into or return to work by people with disabilities or by people who have recently acquired an injury or disability.

Working Towards Wellbeing is a vocational rehabilitation expert. It specialises in the provision of support to both employees diagnosed with cancer and their employers. The organisation works primarily with the providers of group IP but also via HR or OH referral.

“Support should start from the point of diagnosis,” says Denning. “We help employees understand treatment plans, what it means for work and life, provide musculoskeletal and mental health expertise, signpost to family support, nutrition and diet expertise, anything really that they need.

“We also work closely with line managers, helping to equip them with the information and tools they need."

"From an employer perspective, the key is to retain strong connections with the employee and avoid making assumptions.

“Employers often assume that the employee would rather not be contacted once they go on sick leave, but it’s important to keep the channels of communication open. This could just be as simple as a monthly email to keep the employee up to speed on what’s happening at work. In this way, all parties will feel better prepared when the individual is ready to return to work.

“Prior to return, we also provide expertise around making reasonable adjustments.

“Alongside strong communication, early intervention is key. There’s plenty of evidence to show that by supporting individuals from the word ‘go’ the clinical outcomes are better. And that’s a win-win for everyone.”

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