Inspire Q4

The latest health and wellbeing news from The Health Insurance Group

Welcome to the Q4 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 musculoskeletal health (MSK). The ageing population in the UK and rising levels of obesity and inactivity, has seen the number of individuals living in constant pain escalate over the past few decades. But many of the risk factors for these conditions can be reduced.

#MeToo: is your business protected?

Since the first news story about Harvey Weinstein surfaced in Autumn 2017 and the recent allegations against Sir Philip Green, sexual harassment in the workplace has been a hot topic.

From an ill-judged remark to full-blown assault, workplaces can be a breeding ground for sexual harassment.


The Equality Act 2010 defines sexual harassment as “unwanted conduct of a sexual nature” which has the purpose or effect of violating dignity or “creating an intimidating, hostile, degrading, humiliating or offensive environment”.1 A wide range of behaviour can come under this definition: sexual jokes or comments, remarks about someone’s body or appearance, displays of pornographic material, cat calls or wolf-whistling, flashing, sexual advances, groping, sexual assault, or rape. The common factors are the effect that the conduct has on the victim, and that it is unwanted.

Some forms of workplace sexual harassment can constitute a criminal offence, such as:

  • Harassment and stalking - Protection from Harassment Act 1997
  • Sexual assault and voyeurism - Sexual Offences Act 2003
  • ‘Revenge porn’ - Criminal Justice and Courts Act 2015

Despite many of the headlines focussing on women’s experience, a BBC survey in November 2017 found that 40 per cent of women and 18 per cent of men had experienced unwanted sexual behaviour in the workplace2.

Stamping out sexual harassment is a difficult job, especially as many victims may prefer to stay silent due to fear of it impacting their career.

A report by the Equality and Human Rights Commission (EHRC), published in March 20183, found that around half of the respondents hadn’t reported their experience of harassment to anyone in the workplace. According to the EHRC, obstacles to reporting included:

  1. "The view that raising the issue was useless as the organisation did not take the issue seriously.
  2. A belief that alleged perpetrators, particularly senior staff, would be protected.
  3. Fear of victimisation.
  4. A lack of appropriate reporting procedures.”

Employers need to consider how best to create a positive workplace culture. This means putting sexual harassment at the top of the agenda, to recognise the scale and impact of sexual harassment in the workplace, and to take steps to prevent it from happening in the first place – and deal with it swiftly when it does happen.

Establish the framework

Employers should establish a clear framework and have policies in place to cover any potential harassment or discrimination. These should include recruitment, training and promotion, and be written in plain English so they are more likely to be read and understood.

Clarity is key

Creating a clear complaints process and communicating it to all staff is key. Every employee should know who to speak to, and line managers should be trained and confident in implementing policy and addressing concerns.


Employers could consider training people on what the policy means in order to bring it to life. This can help build a company culture where people are expected to be respectful of each other.

Cultural shift

Recognise that certain workplace norms, such as heavy drinking cultures, can underpin many people’s experiences of harassment. If a company does have a culture that could lead to an increased chance of harassment, it should ensure that it has solutions in place to support any employee who has experienced such behaviour.

Support mechanisms

Employers should look at what benefit packages they offer, and how they can be used to support the harassment policy. For example, if you already have an employee assistance programme in place, consider adding a reference to their helpline as a support mechanism.

Offering a third-party whistleblowing helpline can help if employers are concerned about complaints going unreported. This can reassure employees that their concerns will be treated anonymously. Helplines will also steer victims toward other important resources.

The #MeToo movement has raised awareness of how prevalent sexual harassment is within the workplace, and allowed victims to be heard. It is up to employers to try and stamp out harassment once and for all.

1. Equality Act 2010, section 26
2. ComRes poll for the BBC
3. Turning Tables: Ending sexual harassment at work

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Managing musculoskeletal conditions at work

The cost of musculoskeletal conditions (MSK) to business and the UK economy is substantial. In 2016 over 30 million working days were lost due to MSK conditions alone (22.4 per cent of all sickness absence) costing the UK economy an estimated £7 billion per annum (PHE, 2017).

We know that MSK conditions are common and can cause disruption to people’s lives and work. These conditions will also increase the older the workforce becomes.


Employers need to ensure that they take a proactive approach to reducing the work-related risks that may cause a MSK problem, as well as supporting those who develop one whether it is short or long term.

By providing preventative action, intervening early and offering good rehabilitation and reasonable adjustments to help someone remain or return to work, employers can enable their workforce to lead full and active lives both in and out of work.

Employers do have some legislative responsibility to reduce the risk of harm to health at work and to identify those risks too as far as is reasonably practicable. To do this effectively employers need to gain a good understanding of:

  • The characteristics at work – such as any physical or mental demands, shift working or variable workloads
  • The workforce – the demographics of the workers, their gender, maybe the approximate fitness levels needed to do the job, their skills and expertise etc.
  • The prevalence of MSK problems – their sickness levels, from staff feedback etc.


There are several pieces of legislation that relate to the responsibilities of employers and employees, and the prevention of musculoskeletal conditions. The Health and Safety Executive website has a comprehensive list and guidance of all the legislation to be aware of.

Reasonable adjustments are also a requirement of employers under the Equality Act 2010. They need to provide adjusted working conditions to aid employees with a disability or long term medical condition as recommended by a health professional.

Assessing the risk

Employers have a legal obligation to assess the risk to health and safety of their employees whilst at work. In simple terms a risk assessment involves:

  • Looking for hazards
  • Deciding who might be harmed and how
  • Evaluating or scoring the risks and deciding whether more needs to be done to minimise or remove them
  • Producing a record of this work and your findings, and a record for employees to be aware of


Line managers need to be trained to be aware of the risk factors in their workplace that can put musculoskeletal health at risk, as well as being fully aware of their responsibilities regarding health and safety.

They need to be confident about having a conversation about health with their staff so that early interventions can be implemented, and an escalating condition can be identified quickly.

They need to consider the length of the working day, whether someone takes regular breaks and their holiday entitlement, and if equipment is safe too.

Training should be provided that enables employees to do their jobs in a safe manner and in a way that reduces any risks to their health. This is about helping people to understand how their environment can have an impact on their musculoskeletal health too. Specific types of work and roles, may need specific training, on manual handling or DSE training for example.

Absence management

Musculoskeletal conditions can lead to employees taking a period of absence. If this does happen, putting in place a planned return to work schedule, and clearly setting out what support is available and what they will do and when, and ensuring that any training and equipment needs are identified too will help someone ease back into work and regain their productivity levels sooner.

The employee may be able to access an Access to Work grant to help pay for any reasonable adjustments or specialist equipment that they may need to help return to work.

Seeking expert advice

If you have occupational health this should be the first port of call when an employee gets symptoms of an MSK condition. If you do not have an in-house occupational health service, you should seek external advice from an occupational health expert if the problem persists. They have the specific knowledge and training in work function and health to be able to advise both employer and employee of the modifications, treatments and adjustments that need to be made, and when a return to work is feasible and achievable.

Physiotherapists who work in occupational health are also trained to look at the issues that may affect a return to work process, taking into account biological, psychological and social issues as a means to diagnose and treat patients.

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How to protect your musculoskeletal health

In simple terms ‘musculoskeletal’ health (MSK) relates to your muscles, tendons, ligaments and joints functioning well and being pain free.

If everything is working well we don’t really notice our musculoskeletal health, but as soon as something goes wrong it can affect our lives significantly.


MSK problems are responsible for the largest proportion of years lived with a disability in the UK and can be very painful and debilitating. As we age our muscles and joints begin to show signs of wear and tear, and with an ageing population in the workplace, this has resulted in MSK being one of the leading causes of sickness absence and early retirement due to ill health.

But many of the risk factors for these conditions can be reduced through healthier lifestyles, and by taking some simple measures in the workplace to minimise the risk of injury, or accidents.

The main causes of MSK conditions:

1. Occupational hazards or repetitive work

Certain types of workplace activity can put you at greater risk of developing MSK problems, such as frequent bending, twisting or lifting heavy objects, as well as repetitive activities that can build up over time or sitting for long periods of time at a computer.

Prevention and minimising risk:

Early risk assessments of workstations and types of work are a good way of identifying any risks to health and modifying them before they become a problem.  

If you are office based make sure that you do a Display Screen Equipment assessment so that your chair and screen are the right height for you, and take regular breaks away from your desk, or from a repetitive task.

Also make sure that you undertake appropriate training if your job involves manual handling to learn how to lift objects properly and without injury. Take a break from bending or lifting at regular intervals.

If you notice any issues report them immediately so that you can get expert help as soon as possible, as early intervention is proven to minimise the impact of an MSK condition.

2. Obesity

Obesity substantially increases the risk of developing an MSK condition. You are over twice as likely to develop knee pain, with 2 in 3 knee replacements attributed to obesity due to the load placed on the joints. The risk increases as you get heavier and if you have been overweight from a younger age, so there is every reason to make adjustments early in life.

Prevention and minimising risk:

Maintaining a healthy weight is vital for the risk reduction of many conditions such as coronary heart disease, stroke, Type 2 diabetes, and cancers. But eating well, and from a wide range of fruit and vegetables, will help you to stay healthy and reduce the risk to your joints and ligaments at the same time.

3. Physical inactivity

Currently only a third of people in the UK are active enough to maintain good health. Indeed half of the population does no exercise at all.

Being active on a regular basis helps to mobilise and lubricate joints, build muscle and bone density and strength, and maintain flexibility and function. Being physically active can also help to improve our chances of remaining independent as we age in later life.

Prevention and minimising risk:

Engaging in regular physical activity can help to reduce the risk of an MSK condition developing, or getting worse.

Activity doesn’t have to mean going to a gym or running, it can also be achieved by walking or cycling to work, playing with children, gardening, and it can be broken down into short 10 minute bursts throughout the day if time is an issue. Don’t forget weight-bearing exercise too to help maintain upper body and bone strength.

4. Smoking

It is well known that smoking is not good for health. It has been proven to be one of the main causes of cancer, coronary heart disease and stroke. But it is also a risk factor for rheumatoid arthritis. Indeed smokers who develop this condition are more likely to have an aggressive form of it and respond less well to treatments.

Prevention and minimising risk:

There are well-established support services to help you quit smoking. Seek out help from your pharmacist, GP, or local stop-smoking service from the NHS. There are medicinal patches, medication and support groups that can help you stop.

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Avoiding injury during the festive season

The festive season can be an exceptionally enjoyable but stressful time of year. There are so many things to do, food and presents to buy, preparation for visitors. But many people get injured, cut, or burnt and need medical treatment every year during the Christmas period.

Here are some tips on how to stay injury-free during the Christmas period.



Wherever possible try to do your shopping in short spurts and pace yourself. If everything has to be done in one big shop, make multiple trips to the car during the day to drop off bags, take a break, and rehydrate and eat something healthy to keep energy levels up.

Wear shoes and clothes that are comfortable and layers that can be added to or removed to keep your body temperature regulated. Stretch out stiff necks, shoulders and hands to alleviate tension. Or better still take someone else with you to help!


Hot fat and oil, alcohol and sharp knives can turn the kitchen into a dangerous place. Save alcohol until after the cooking is over and mop up any spills immediately to prevent slips. Take care when using knives and always make sure that they are out of the way of small hands, and those pots and pan handles are turned away from the edge of the work surface.

Take breaks out of the kitchen and rehydrate with water regularly. Ask others to help and delegate work to others too.

Wrapping presents

Wrapping presents can be a long process that involves a lot of kneeling on the floor and twisting. Take care to have regular breaks from this and avoid crouching over for extended periods of time with bad posture. Change positions regularly and try to sit in a supportive chair.

If you already have a bad back make sure that you take extra care to adopt a good posture and spread out the wrapping amongst others in the family if possible.

Cutting yourself with scissors can also be a hazard, so take care when using them to wrap.

Decorating the tree

Every year people get injured decorating their tree by over-reaching for higher branches, lifting a heavy tree, or using a chair or stool to reach higher levels. Make sure that you use a proper stepladder to reach higher branches, or consider buying a smaller tree. Fall-related injuries peak during this time of year, so make sure that you are not one of them.

The tree lights can cause electric shocks and burns, so check the wiring and lights before putting them on the tree. Make sure that the electricity sockets are not overloaded and always turn lights off when you are not in the room.

Candles, hanging lights and home fires may create a lovely cosy feel but they are also a serious fire risk. Always take care with a naked flame and never leave them unattended.

Food poisoning and alcohol abuse

The reported numbers of people with food poisoning can be high during the festive period as we eat and drink more than usual. Make sure that any food is cooked and stored appropriately. If you aren’t sure about food that is prepared for you, don’t eat it!

Alcohol can be a major cause of Christmas accidents. Excessive drinking can make you careless and affect balance and your ability to make decisions. Try to drink sensibly and make sure that you intersperse alcoholic drinks with water to dilute the effect.

Travelling long distances

One of the great things about the holiday season is that we can all try to make time to get together with family and friends. But often this can involve long journeys that can have an impact on your neck, back and legs.

There are a number of lumbar supports available for driving and travelling. Explore whether they would make you more comfortable on a long journey.

Make sure you stop for regular breaks if you are driving, or get up, walk around and stretch during a plane or train journey.

Take care when lifting heavy bags and luggage. Use bags that have wheels and make sure that you use your hips and legs to lift heavy objects.

Car accidents also increase at Christmas. Weather conditions, tiredness and hangovers can affect your driving and make conditions treacherous. Ensure that your car is in good working order, and make sure that you drive when you are well rested and sober. If the weather is bad consider delaying your journey until it improves.

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Latest news from the insurers

Did you see the latest updates from the insurers?

Here's the latest from Aviva, AXA PPP, BHSF, Bupa, Health Shield, Simplyhealth, The Exeter, Vitality and Westfield Health.



25 October: UK adults missing out on 11 hours sleep each week
New research from Aviva shows the extent of the UK's sleep deprivation.

10 October: Aviva publishes new research for World Mental Health Day
A new study from Aviva has found that up to two in three (65%) UK adults have experienced a mental health condition.


03 October: AXA - Global Healthcare to provide virtual doctor service
AXA - Global Healthcare has announced that, following a pilot, its virtual doctor service, Global Care on Demand, will be available to all new and existing international individual and SME customers with outpatient cover as of 1 November.

19 September: AXA PPP names property workers as the least active workforce in the UK
They may be busy running around from property to property, however new research from AXA PPP shows estate agents are the least physically active workers in the UK.


Bupa offers Babylon Digital Healthcare app for SME

With effect from 1 January 2019 all new BUPA SME customers will have access to the Babylon Digital Healthcare app for their members. Existing BUPA SME customers renewing on or after 1 January 2019 will also enjoy access to the Babylon app for their members with effect from their next renewal date.

Babylon offers a range of health services and health information powered by artificial intelligence (AI). Part of this includes giving employees fast access to GP appointments directly from a phone or tablet.

Babylon is already available to BUPA corporate clients, who have the option to add this to their health insurance plan for an extra cost. For new and renewing BUPA SME customers, Babylon will be included in their cover as standard.

Babylon are regulated by the Care Quality Commission for their clinical services and their doctors are regulated by the General Medical Council.

04 October: Millions of women in the UK baffled on the ‘breast’ health advice
A study from Bupa Health Clinics has found that 80% of women are unclear on what impacts their risk of breast cancer. 

10 September: Bupa UK launches 30-minute ‘lunch break’ male health check
Bupa UK has launched a check specifically designed to provide assessment and advice for prostate and testicular cancer.


16 October: Vitality launches new Amazon partnership to keep members in prime health
Vitality has announced a new partnership with Amazon, evolving the way its members are incentivised to be healthier through the company’s Active Rewards programme.

08 August: VitalityHealth launches new partnership with Newcastle FC
Vitality has become the new Official Wellness Partner of Newcastle United Football Club.

Best of the rest

5 November:  More than a third of remote workers report new back pain since working from home
A new study from BHSF has found that UK home workers are being let down by their employers, who are failing to ensure their home workers are working in a way that supports a healthy posture. 

25 October: Simplyhealth research shows a rise in Insurance Premium Tax would deter employers from providing health benefits
Two thirds of HR decision-makers who currently offer health and wellbeing benefits and intend to next year anticipate their organisation would either reduce or remove the health and wellbeing benefits they currently offer, as a result of an increase in Insurance Premium Tax (IPT).

19 September: The Exeter launches app with Square Health
The HealthWise app gives Exeter customers access to on-demand virtual GP appointments, as well as a ‘second opinion’ medical advice service and online physiotherapy and mental health services.

20 August: Employees say mental health support would improve loyalty
A poll by Health Shield has found nearly three in five (57%) people say that if their employer proactively supported their mental wellbeing, it would help them to feel more loyal, be more productive and take less time off work.

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