Inspire Q3

Health and wellbeing news from The Health Insurance Group

Welcome to the Q3 edition of Inspire, our quarterly newsletter, designed to keep you informed about the issues that could be relevant to your business.

In this edition we look at the importance of knowing your numbers for heart health. With sleep being an essential component of maintaining good physical and mental health, we also give you tips on how to sleep better. 

Presenteeism and leavism in focus

We often talk about absenteeism being an issue for businesses, but are presenteeism (people working when unwell) and leaveism (people working outside contracted hours or during their annual leave) the new areas we should be focussing on to avoid reduced productivity? Recent reports certainly suggest so.

Year on year, survey findings are showing a rising culture of presenteeism in UK workplaces. This means more people coming into work when they are unwell, which is not a sign of a healthy workplace.


Presenteeism can actually be more harmful than absenteeism. The findings in the Britain’s Healthiest Workplace report indicate UK employees lost 11.7% of their working hours due to absence (0.8%) and presenteeism (10.9%).  

The issue in focus 1

  • 86% have observed presenteeism in their organisation over the previous 12 months
  • 57% report employees work outside contracted hours to get work done
  • 37% report employees use allocated time off (such as holiday) when unwell
  • 33% report employees use allocated time off to work

These figures raise concerns that many employees feel under excessive pressure. Work-related stress (commonly caused by high volumes of work) and mental health issues are on the increase. Advances in technology can also mean that the boundaries between work and home life are becoming even more blurred, resulting in an inability to switch off during out of work hours. External sources of stress, such as caring responsibilities and financial concerns, may put employees under additional pressure.

Just a quarter of those who have observed presenteeism or leaveism within their organisation report that steps have been taken to discourage it. So what can you do to help your business?

Tips for avoiding presenteeism and leaveism in your business:

1. Update your absence policy

Feeling pressure to come to work when ill (whether real or imagined) reduces employee morale. Make it clear that your company expects sick employees to stay home and recover. Likewise, make it clear that employees are not expected to work during their annual leave.

2. Be aware of the causes

Excessive hours can be a sign that people are struggling. A 24/7, ‘always on’ working culture can mean that employees feel they rarely get a break from work. And high workload demands can cause employees to avoid taking time off when they need it because they’re worried about deadlines or overburdening colleagues in their absence. A good work/life balance is vital to ensuring staff wellbeing and boosting productivity. Make sure this happens by insisting staff take their lunch break, or provide a break-out area in the office to ensure people can eat their lunch away from the desk.

3. Recognise the symptoms

Managers need to be able to notice the signals associated with employees experiencing high levels of stress or mental health problems, and feel equipped to have open and supportive conversations with them about their health. Workplace training of common mental and physical health issues will help reduce stigma and provide people with a better understanding of workplace wellbeing.

4. Create a supportive, open culture

Encourage regular open and honest dialogue to pre-empt presenteeism and leaveism threats. This is particularly helpful for identifying the early signs of stress, which untreated, can become a chronic condition with long-term health issues.

5. Examine your company’s health and wellbeing policy

A health and wellbeing policy that recognises that employees could be impacted by social, physical, financial and mental stresses and offers them appropriate support should help mitigate the impact of presenteeism on your business.

Programmes promoting healthy eating, encouraging staff to be active during lunch breaks (such as going out for a 15 minute walk) and providing counselling or training/support on financial management can help reduce the impact of long-term conditions, and improve productivity within your organisation.

1. Health and wellbeing at work, CIPD, May 2018

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Know your numbers 

Knowing and understanding what your own body's vital numbers are as well as how to keep them within a healthy range, can save your life and dramatically reduce your risks of developing serious health conditions.

Using this information you can take a number steps to reduce your health risk by making some easy lifestyle changes if these numbers are outside the healthy range.


(Remember many of the conditions listed below will not present with any symptoms so it is important to get them checked with your GP or pharmacist on a regular basis, especially as we get older.)

 The key numbers to be aware of include:

  • Waist measurement
  • Body mass index
  • Blood pressure
  • Cholesterol and triglycerides
  • Blood sugars

1. Waist measurement

Carrying too much weight around the middle increases your risk of heart disease, stroke and Type 2 diabetes.

How do I measure it?

This is easy to do at home by simply wrapping a tape measure around your middle about belly button height, and remembering to breathe out naturally. It is useful to compare the size of your waist with your hips too, as excessive weight around the middle is a key risk.

What is healthy?

  • Less than 37 inches (94cm) for men
  • Less than 31.5 inches (80cm) for women
  • If your waist is significantly more than this you should visit your GP

How do I bring it into a healthy range?

For most people adapting their diet to include a balanced healthy range of foods and smaller portion sizes, whilst increasing your physical activity levels, should help to get this back within a normal range.

2. Body mass index (BMI)

BMI is a measure of your weight in proportion to your height. Being overweight or obese puts additional strain on your heart and increases the risk of heart disease, Type 2 diabetes, sleep apnoea, as well as a range of other health conditions.

How do I measure it?

The calculation is a little complex so the easiest way is to use one of the many calculator tools available online. You will need to know your height and weight to get an accurate BMI reading.

Some BMI calculators will also adjust for your waist measurement to provide a more accurate measurement.

What is healthy?

A healthy BMI range is between 18.5 and 24.9. If you have a BMI of 30 and over, you are considered obese.

How do I bring it into a healthy range?

This is the same as the advice to reduce your waist measurement – you improve it by eating healthily and moving more to help to bring your weight down.

3. Blood pressure

High blood pressure (or hypertension) forces your heart to work harder. Your heart pumps blood around the body through the arteries by relaxing and contracting.

Blood pressure can be high without you knowing anything about it so it is important to get it tested regularly.

How do I measure it?

Blood pressure is measured with two numbers – for example 120/80mmHg. The first is the ‘systolic’ pressure – this is the highest level your blood reaches, when your heart contracts and blood is forced through the arteries, and ‘diastolic’ pressure which is the lowest level your blood pressure goes to when your heart relaxes. Your GP, pharmacist, or Occupational Health nurse can easily check your blood pressure and there are many machines available to buy which enable you to monitor it yourself at home too.

What is healthy?

The recommended target for blood pressure for people aged between 17-79 is somewhere below 140/90mmHg (clinically measured). If you are 80 or older it should be below 150/90mmHg.

How do I bring it into a healthy range?

It is essential to control blood pressure. By reducing it you can lower your risk now and in the future. Your GP may prescribe medication to help you control this but adaptations to your lifestyle will also help too. Be more active, eat well, reduce salt and cut down on alcohol. Try to avoid stressful situations too if possible.

4. Cholesterol and triglycerides

Cholesterol is the fatty substance found in blood and mainly produced by your liver. It plays an essential part in how the body’s cells work.

There are 2 main types of cholesterol:

  • LDL (low density lipoproteins) – the harmful type
  • HDL (high density lipoproteins) – the protective type

Having too many LDL’s in your blood increases your risk of heart disease, especially if the HDL level is low.

Triglycerides are another type of fatty substance and are generally found in foods such as meat and dairy products. People who are overweight or have a diet rich in these foods, or drink too much, are more likely to have high levels of this in their blood.

How do I measure it?

Your GP or nurse will measure this by taking a blood test and measuring your total cholesterol, and LDL, HDL and Triglyceride levels. This can be done as part of a health check and you will need to starve yourself for 12 hours prior to the test being done. The measurement is in units called millimoles per litre of blood (mmol/L).

What is healthy?

Healthy adults should have a total cholesterol level below 5 mmol/L. This will include both the LDL and HDL levels. Your HDL should be the higher number and LDL lower, producing a healthier average.

How do I bring it into a healthy range?

Again, maintaining a healthy diet and being more active is the key to a healthy cholesterol level. Cut down on fatty and sugary foods and eat foods that are known to lower cholesterol such as oats, nuts, vegetable oils, and fish such as salmon or mackerel. Sometimes your GP will prescribe medication to lower your levels too.

5. Blood sugar

High blood sugar is an indicator that your body is not making enough insulin, a hormone that moves sugar from the blood into your cells. High blood sugar can damage blood vessels, nerves, organs such as your kidneys and your eyes, and can ultimately lead to Type 2 diabetes.

How do I measure it?

Your GP or nurse can check your fasting glucose level with a simple test. Again this is measured by millimoles per litre of blood (mmol/L).

What is healthy?

The majority of healthy individuals are expected to have blood sugar levels between 4.0 to 5.4 mmol/L when fasting, and up to 7.8 mmol/L about 2 hours after eating.

How do I bring it into a healthy range?

Cut right back on sugary foods and eat a healthy diet. Keep a food journal to identify what you are eating and make adjustments if necessary. Exercise more and include some strength training.

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Facts about cardiovascular disease 

Cardiovascular disease (CVD) is a term that covers all the diseases associated with the heart and circulatory system, from those diagnosed at birth or inherited through our genes, to conditions that we develop such as heart failure, strokes,and coronary heart disease.

In the UK CVD causes about a quarter of all deaths; approximately 150,000 per year, or 420 people every day.


Typically around 42,000 people under the age of 75 die of CVD in the UK each year. The good news is that this alarming statistic has declined in the last few decades because many people are living longer lives. But that does not mean that the risk of developing a condition like CVD is not significant.

Currently there are 7 million people living with cardiovascular disease in the UK. It may surprise you to learn that women have become a higher risk for developing the disease in recent times, so that they are now on a par with men.

Region also plays a part at determining risk of premature death from CVD related conditions. For example: people living in Northern England and parts of Scotland are at a higher risk than people in Southern England.

Some of these conditions can be passed through families and affect people of any age and can be life threatening. Unfortunately about 620,000 people in the UK carry a faulty genetic makeup which puts them at a very high risk of developing heart disease, or dying very suddenly at a young age. Charities such as Cardiac Risk in the Young are doing some amazing research to try to identify early those at risk, and also support families who have been through this terrible experience.

The most common types of CVD

Coronary heart disease (CHD) is the most common type of cardiovascular disease. It occurs when our coronary arteries narrow due to the build up of fatty deposits on the artery walls, preventing adequate blood flow and supply to the heart. Angina is the pain and discomfort people experience when the walls are narrowing, but the result is a heart attack if they narrow so much that a blockage occurs.

Unfortunately CHD is still one of the leading causes of death in the UK and globally. 1 in 7 men and 1 in 12 women die from this disease in the UK every year, most caused by a fatal heart attack.

Alarmingly deaths for women from CHD are twice that of those from breast cancer.

The risk factors for this disease are mainly lifestyle related with smoking, high blood pressure, physical inactivity and being overweight amongst the main causes. The more risk factors you have, the more likely you are to develop the disease.

Atrial fibrillation (AF) is one of the most common forms of an abnormal heart rhythm and is the major cause of strokes. This disease causes irregular, and sometimes abnormally fast, heart rates. A normal heart rate should beat regularly and between 60 – 100 beats per minute when you are resting. AF can mean the heart rate is considerably higher than this 100 beat threshold.

It can cause dizziness, shortness of breath and tiredness. Palpitations are a common factor, where the heart feels like it is pounding, fluttering or beating irregularly, usually for a few seconds and sometimes for a few minutes.

There is still some debate about what causes AF but it tends to affect certain groups of people and may be triggered by drinking too much alcohol and smoking.

Heart failure occurs when the heart is not pumping blood around the body as well as it should, for example when the heart muscle has been damaged. This sometimes occurs after a heart attack, or due to high blood pressure, or even a disease of the heart muscle itself. It is sometimes caused by viruses but is also often hereditary.

Approximately half a million people have been diagnosed with heart failure in the UK.

The main symptoms are: shortness of breath when active and at rest, swollen feet, ankles, stomach and the back area, and unusual feelings of tiredness or weakness. Because the heart is not beating efficiently fluid can build up in the lungs, and other areas of the body. This can lead to swelling, causing oxygen levels to drop. This results in the feeling of tiredness many experience.

Heart failure is a long term condition that often gets worse over a period of time. It cannot be cured but changes to lifestyle and proper diagnosis and treatment can help people with this condition maintain a good quality of life.

A stroke occurs when the blood supply to the brain is restricted or cut off. This causes damage to the brain cells and a stroke occurs which can be fatal. A temporary disruption to the blood supply causes ‘mini strokes’.

Strokes are responsible for 38,000 deaths in the UK every year. About 1.2 million people in the UK have survived a stroke, and almost half are under the age of 75.

A stroke is a life threatening emergency so it is important to seek help fast if you, or someone you know experiences the symptoms. The F.A.S.T. campaign is well recognised:

  • F – facial weakness – can they/you smile? Has their mouth or eye dropped?
  • A – arm weakness – can they/you raise both arms?
  • S – speech problems – can they/you speak clearly and understand what is being said?
  • T – time to call 999 immediately

Strokes affect speech, the way you move and the way you think. The risk factors are usually made up of several contributing factors: smoking, uncontrolled diabetes, high blood pressure or high cholesterol.

The good news

The risk factors for all the heart diseases are similar and you are able to reduce your risk of developing them by moderating your lifestyle: eat well, maintain a healthy weight, exercise more, limit alcohol consumption and stop smoking.

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The importance of sleep 

About a third of our lives are spent sleeping. Sleep is an essential element of life and is just as vital as breathing, drinking and eating for helping us sustain good mental and physical health.

It is vital that we have enough sleep to be able to perform well at work. Lack of sleep is known to affect memory, cognitive skills and our ability to collect and store information. 


A lack of sleep can also result in extra sick days and can contribute to a number of health conditions such as heart disease, obesity, diabetes and depression, as well as leading to mood swings and anxiety.

If people are impacted by lack of sleep it is more likely that accidents, injuries and poor decisions could be made in safety critical situations.

The cost of sleep deprivation

It is estimated that sleep deprivation costs the UK economy £40 billion per annum in lost productivity (RAND, 2016). By encouraging their workers to adopt good sleep hygiene practices, and putting in place some simple measures, employers can help to reduce this figure and improve productivity and performance.

If people at work nod off during meetings, or are yawning at their workstation, it is clear that they are not getting enough sleep.

How much is enough sleep?

Sleep experts generally agree that a healthy adult requires between 7-9 hours of good quality sleep a day. Recent studies by RAND Europe (2016) have found that people who sleep less than 6 hours a night on average are 2.4% less productive than their well rested colleagues, and have a 13% higher risk of dying prematurely than them too.

What affects our sleep and what can help to improve it?

Mental health

Poor sleep, and disturbed sleep are one of the first signs of mental distress, and common mental health conditions like anxiety, stress and depression can all impact on the way we sleep.

It is important to address any underlying concerns that may be preventing people from sleep.

Physical health

People who are overweight or obese often report poorer sleep than those who are a healthy weight. Sleep apnea is more common when someone is overweight, and the resulting lack of oxygen causes people to wake repeatedly throughout the night. Someone who is managing chronic pain, smokers, and people who consume too much alcohol or food before bed will also notice the toll on their sleeping patterns.

Adopting healthier lifestyles by eating well, maintaining a healthy weight, quitting smoking and reducing alcohol consumption will all help.

The commute to work

This is one of the other highest-rated factors associated with sleep deprivation for working people. People who have to travel more than 60 minutes each way to get to work tend to sleep less. This sleep deprivation can accumulate over a week.

For people who have a long daily commute, consider flexible working options or occasional home working. Make sure you take time to relax on your journey: read a book, listen to podcasts or an audio book so that the long commute is not as stressful.

The environment

Trying to sleep when it is noisy, or too light, or hot in the room affects sleep too. Where you sleep is important. Electronic devices such as TV screens, laptops and smartphones all emit ‘blue’ light that can disturb sleep patterns. Make sure the bedroom is cool, calm and dark to encourage the brain to switch off.

The right attitude

Sleep is easier when someone is relaxed and has a good routine to prepare for sleep. Dealing with emails, playing electronic games, and stimulating the brain are all ways to rob you of sleep.


What we eat and drink affects our sleep. Caffeine, too much alcohol, and eating a large meal in the evening, are nearly always going to affect the quality of sleep.

Steps for a good night’s sleep

  1. Get into a routine – go to bed and get up the same time every day
  2. Keep your bedroom cool (no more than 18 degrees centigrade ideally) and dark or with low lighting – use blackout curtains if you can
  3. Avoid caffeine and too much alcohol in the evenings
  4. Eat your last meal several hours before bed
  5. Make time for moderate exercise during the day
  6. Read something before turning off the light but nothing too stimulating for the brain
  7. Turn off all electronic devices 1-2 hours before you go to bed
  8. Have a notebook and pen beside the bed so you can jot down any ideas or worries to deal with in the morning
  9. If sleep eludes you don’t just lie there awake. Get up and make a hot drink, or read, until you feel sleepy again
  10. Get any physical or mental health concerns checked out early
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Latest news from the insurers

Did you see the latest updates from the insurers?

Here's the latest from April UK, Aviva, AXA PPP, Bupa, Healix Health Services, SimplyHealth, Vitality and Westfield Health.


Breaking news: April UK to withdraw from the UK PMI market with effect from 1 September 2018

Customers whose renewal date is July or August 2018 will still be able to renew their policy for another year (however customers need to be aware that if they renew their policy and their health changes during the policy year they may not then be able to switch insurance provider).

Customers with a renewal date after 1 September 2018 will not have the option to renew their April UK policy. AXA PPP healthcare has offered to provide all April UK policyholders with access to an AXA PPP Healthcare policy with no new personal medical exclusions being applied.

We have written to all our business and consumer clients currently insured by April UK, with more details of the insurer’s decision and how this may impact them.

The letter also explains their cancellation rights and we will be contacting them directly soon to offer a review of alternative insurance plans.

Clients who remain with April UK for a further year will not be able to add any additional members or dependents to their policies. However they will be allowed to remove members and dependents.  

We encourage all our April UK customers to consider transferring their cover as soon as possible. A delay could result in new medical conditions arising, which could impact the price of any new policy.

We will attempt to contact all of our affected customers to provide more details of the options available and arrange alternative cover should it be required. If any affected customers have any questions or concerns in the meantime, or if you would like us to obtain quotes for an alternative policy, please do not hesitate to contact us.


27 April: Aviva and Now Healthcare Group to offer digital GP service
Aviva is giving large corporate health insurance customers swift, convenient access to more than 1,000 GPs, through a new collaboration with digital health company, Now Healthcare Group (NHG).

13 July: Aviva UK claim reports shows 96% of all claims were accepted in 2017
Following careful consideration, Aviva is withdrawing from the IPMI market to focus more of its health insurance resources on the UK PMI market.


24 April: AXA - Global Healthcare launches upgrade for SME clients
AXA – Global Healthcare has introduced an optional upgrade for small- to medium-sized enterprises (SMEs) providing international private medical insurance (iPMI) for their employees based overseas.

13 July:  AXA PPP launches campaign to promote exercise among employees

AXA PPP healthcare has launched a campaign that aims to encourage employees to be more physically active. Called Flying Start, it forms part of ukactive’s National Fitness Day campaign on 26 September.


4 June: Bupa Health Clinics’ experts advise how to future-proof your health
Bupa Health Clinics and Waitrose have launched an exclusive partnership offering shoppers a range of health services and activities

26 June: Bupa and Babylon extends its digital health service to UK businesses
Leading healthcare provider, Bupa and Babylon, Britain’s pioneering digital healthcare provider have extended their agreement to offer a range of AI-powered health services to all corporate businesses. This includes access to doctors within minutes, directly from any phone or computer.

17 July: New data from Bupa Dental Care reveals the UK's best and worst dental habits
New research from Bupa Dental Care has found 2 million adults in the UK haven’t been to the dentist in more than 10 years.


Changes to Vitality reward partners

Please note that as Eurostar has decided to withdraw from all partnerships, the Vitality member discount on Eurostar bookings will be ending soon. All existing bookings are still valid, but you won’t be able to make any new bookings from 31 August 2018.

If you do want to take advantage of the offer before it ends, you can get up to 50% off* the cost of the retail rate on fixed adult or child Standard Class and Standard Premier return tickets. Please refer to the Vitality Member Zone for details on how to book.

*50% off if you have platinum status

11 June: Vitality launches new investment solutions to prepare people for the retirement of tomorrow
To address the challenges of an ageing population in poorer health and concerns around the ability to fund retirement, Vitality has entered the long-term savings market with the launch of VitalityInvest.

9 July: VitalityHealth launches new partnership with Chelsea FC
Vitality has announced it will become the Official Health Insurance Partner of Chelsea Football Club. The insurer, which rewards its members for healthy lifestyle choices, will sponsor both women and men’s teams, as well as the Academy squads.

Best of the rest

6 April: SimplyHealth asks, “Is education more effective than taxation?”, as sugar tax comes into force
Simplyhealth research has revealed that nearly seven in ten (67%) UK adults think education is more effective than taxation when encouraging healthy life choices

17 April: Employers could do more to help the wellbeing of their employees
86% of respondents do not feel employees are doing enough to help employees deal with work-related stress and support their health and wellbeing, research by Westfield Health has found.

24 July: Healix offer Healthcare Trust clients a unique new EAP service
Healix Health Services has partnered with Vita Health Group to offer its Healthcare Trust clients a unique new EAP service.

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