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November 2015

Rehabilitation – at QBE and wider…..Adam Shelverton

Senior Rehabilitation Consultant, QBE

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Agenda

• QBE Rehabilitation

• Emerging Risks

IOSH Rail

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What does the industry expect?

Return to work ratio*

*Wadell and Burton (2003) “Is work good for you?”

6 months absence 12 months

absence

24 months

absence

50% 10%30%

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Early Intervention is…….

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QBE Return/QBE Return+

Supports Strategy for Early Notification

Early Capture

Standard QBE approach

All Policyholders Eligible

QBE Return

Making People and Business Healthy

Early Capture

Policyholder Review & Questionnaire

Bespoke Rehabilitation Services

QBE Return+

Making People and Business

Healthy

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QBE ReturnMaking People and Business Healthy

The Detail

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QBE Return

Easy as 1,2,3

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QBE Return

3 Easy Stages

MINOR MODERATE MAJOR CAT

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2

3

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• Reduced loss of earnings equals on average £1,107 per claim*

• 18% faster return to work**

• Proven policyholder hidden cost savings

• Claims Prevention or Claims Management

Benefits of Rehabilitation

* Based on policyholder and QBE analysis 2010/2015 data

** Based on QBE Data (2010/2015) against the Medical Disability

Advisor: MSD cases, Moderate Manual Labour category.

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Post claim rehabilitation services

MINOR

Services

include:

• Treatment

only

• Treatment

Scoping

• Telephonic

Triage

MODERATE

Services

include:

• Telephonic

Triage

Assessment

and

treatment

MAJOR

Services

include:

• Bespoke

triage and

case

management

CAT

Services

include:

• Bespoke

Face to face

assessment

and case

management

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Emerging Risks:

The Ageing Workforce

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Have we got our heads in the sand?

• According to the latest Office for national statistics report*, there are currently 1.13 million workers in the UK, aged 65 or over, compared to 874,000 in 2011 when the DRA was finally phased out.

*Office of National statistics: UK labour market, January 2015

• Average age of retirement predicted to be 67 for all in 2028.

• State pension??

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Pushing the limits of Longevity (World)

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Year Developments Life expectancy at birth

1925 • Changes in health such as clean water and

better sewage and waste disposal curb

outbreaks that were lethal to children

• 1948 – 13 year Old Sylvia Diggery treated

1955 • Vaccines for smallpox, diptheria, polio and other

contagious viruses

1985 • Public health campaigns on heart health and the

dangers of smoking reduce heart disease deaths

2015 • Improved drugs, diagnostic tests, surgeries,

disease treatments and other medical advances

2045 • Regenerative medicine may interrupt ageing?

If not conservative estimates put life expectancy at

81 (high obesity rates offsetting other gains)

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Population Pyramids

A move from this to this…….

But why?

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The realities of ageing

• Muscle power, lung function, eyesight and hearing loss occurs as we age

• Decline in Cognitive performance

• Bone mass reduces at a rate of 1% a year at 30.

• Heart – Starting at 20-30 peak aerobic capacity drops by about 10% per decade.

What’s being OLD?

• When your address book has mostly names that start with Dr

• When everything hurts and what doesn't hurt doesn't work.

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The realities of ageing - continued

• Little conclusive evidence that older workers have an increased risk of occupational accidents.

• Accidents involving older workers are more likely to result in serious injuries, permanent disabilities or death.

• Recuperation following an injury may take longer also if there are pre-existing / degenerative conditions.

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Accident prevention is the way forward.

Employers would do well to conduct health, safety and risk management

audits specific to older workers to ensure their working environment is as

safe as possible.

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QBE Research

QBE commissioned research amongst senior HR decision makers in November 2014.

The Results

• 60% of HR decision makers did not know the number of their company’s employees who were above the state pension age.

• 68% said their business did not monitor the cause and/or rate of absence specifically among older workers

• 62% of respondents did not conduct specific health and safety/risk management audits.

• 72% were not accessing the suitability of existing occupational health and rehabilitation programmes and 74% were not reviewing flexible working practices.

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What can employers do?

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1. Risk Management

2. Healthcare services

3. Prevailing Attitudes (Increased Diversity =

Increased productivity)

4. Training

5. Working Practices

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The future – Trading retirement?

Increased health and improved function in later life.

New models of working longer

• Parents spend more time with young children

• Sabbaticals

• Gap years

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Emerging Risks: Obesity“It’s the new smoking”

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Obesity – The Basics

BMI

• Body mass index (BMI) is used to calculate whether a person is underweight, a healthy weight, overweight or obese for their height.

• The calculation divides the adult's weight in kilograms by their height in metres squared.

• Obesity alone – defined as a body mass index (BMI) of 30 or more, while overweight is BMI of over 25

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Guess The BMI?

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BMI

Chris Robshaw

31.1

Usain Bolt

24.9

Chris Froome

19.5

Borderline Overweight

(0.1)

Obese

Borderline Underweight

(0.6)

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Obesity – A Cause for concern

• Growing problem with no signs of plateau.

• Obesity rates in the UK are the highest in Europe.

• 20% of the population are now obese.

• Costs to the UK economy exceed £5 billion per year

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Obesity and accidents

Accidents

• Obese workers are more likely to injure themselves.

• Obese males are 9% more likely to submit personal injuries

• Obese females are 9.7% more likely to submit personal injuries

• Falls account for 30% of personal injuries

Injuries

• Increased risk of fractures, trauma injuries, sprain and strains

• Increased risk of Type 2 diabetes

• Increased risk of heart disease / cancer / Osteoarthritis

• Increased recovery rates

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Obesity

Will it be a disability?

http://www.theguardian.com/society/2014/dec/18/obesity-can-be-disability-eu-court-rules

Employers fear obesity

• Many employers avoid acting, fearing that if they address obesity, workers will complain that their employers unfairly target people who are overweight.

• BUT…. Obesity costs!!!!

• Employers have to find a balanced, considerate way to address this issue.

• Currently, only 29% of employers offer advice to employees about healthy eating.

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Shift work – A new risk

There is early research to indicate there could be a correlation between shift work and the incidence of diabetes.

This research has indicated shift work resulted in a 9% increase risk of diabetes. 37% increase for men alone.

What do you think are the reasons behind this rise?

Could this be the new source of disease claims to overtake HAVS and deafness?

IOSH Rail

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What can employers do?

“The most effective way to approach weight problem in the workplace, is to include healthy eating and exercise as part of an overall workplace wellness initiative.”

- Beate O’Neill- Head of wellness consulting for Punter Southall Health & Protection Consulting

Workplace Initiatives

• Exercise initiatives. Cycle to work schemes, Gym discounts, Shower facilities

• Prevent shift working or remove rotating shifts.

• Encourage people to take a full lunch break.

• Employee challenges eg. Most steps in a week

• Out of work clubs eg. Sports teams

• As part of rounded wellbeing package eg advice health eating / exercise etc

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Questions and answers

Adam Shelverton,

Senior Rehabilitation Consultant, QBE

IOSH Rail