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Despite the fact that half of all people born after 1960 in the UK will be diagnosed with cancer in their lifetime, it remains an intensely personal matter, different for everyone who experiences it. Some people will openly share their new situation, others will need some time to get to grips with what it means for them before telling anyone else, others may feel guilty or ashamed or want to avoid “making a fuss”. There may or may not be apparent symptoms of illness, depending on how early the cancer is caught, where it is primarily located and so on. The important thing is that nobody is obliged to make details about their health known.
Living with many forms of cancer will have an effect on a person’s ability to work. The last thing a cancer patient needs is the added stress of losing their income. We believe it is better for everyone when employees can rely on their employer to support them through a difficult time rather than keeping important information to themselves out of fear for their livelihood. Creating a culture of empathy and security starts at the top with senior management empowering their team leaders and supervisors to listen to the people they work with and be supportive, sympathetic advocates for them. We aren’t suggesting team leaders should be everyone’s best friend – that would compromise their ability to manage – but their relationship with their teams should be one of mutual respect and collaboration, not surveillance and antagonism.
One way in which employers can demonstrate their commitment to encouraging such a culture is to have employee benefits in place which provide help to employees in exactly these circumstances. Group Income Protection (GIP) started life as a simple salary replacement for injured or disabled workers but, over the last ten years, has evolved into a comprehensive suite of absence management and wellbeing support tools for employees and employers alike. Typical policies may now include, rolled into the policy premium and free at the point of use, an Employee Assistance Programme (EAP), second medical opinion service, early intervention service (EIS) and rehabilitation support. Group Critical Illness (GCI) has likewise been enhanced in recent years and, as well as providing a lump sum payment on diagnosis, could allow for a personal nurse adviser to contact the employee and offer practical and emotional support. That support is available for as long as the employee needs it – we partner with RedArc to provide this support service, and there are people still receiving help ten or more years after their claim was made.
As the name implies, an EAP is designed to be there to help employees with anything at all that might be troubling them. The breadth of this service cannot be underestimated for someone living with cancer. There will be obvious ways to make use of the helpline to address the impact on mental health through counselling, which may be delivered over the telephone or face-to-face depending on what is most comfortable and convenient for the individual. The headline benefit is not the only way it can help, though.
There may be less obvious consequences of a cancer diagnosis, and for many of these the experts on the other end of the EAP helpline can still offer guidance and support. Perhaps an employee needs extended or irregular periods of leave to attend hospital appointments or recover from treatment. The EAP can advise on employment rights, adjustments to the workplace or flexible working options. Reduced earnings or care costs could be weighing on the cost of living, in which case the EAP can offer help with budgeting or debt management. Signposting this benefit early and often can take a huge weight of an employee’s shoulders, giving them access to someone they can discuss any concerns they are having, in complete confidence, any time of day or night.
Cancer is a complex set of illnesses – over 200 separate varieties – and treatment is a fast-moving area of research. It is important to be absolutely certain the diagnosis is accurate and the treatment plan is the best possible based on the specific circumstances of the individual. There can be a reluctance to get a second opinion, but when something as important as your health is on the line it should be seen as prudent and considered perfectly normal. Best Doctors, a leading provider of second medical opinion services, recommends changes in treatment 34% of the time, and a change in the diagnosis in 12% of cases. This can have far-reaching consequences in a cancer case.
Best Doctors, as the name implies, work with leading consultants and specialists around the world, as nominated by their peers in the medical community. At no cost to the patient, they can have their entire case reviewed which, for cancer, includes a retesting of the pathology – a vital step in ensuring clinical certainty. Simply reviewing the existing file will more than likely lead to the original opinion being corroborated, so to get the most value out of the service the experts leave no stone unturned.
EIS is typically best suited to complex or subjective absences but can still be useful in clearer-cut clinical cases. The objective is generally to identify issues before they become serious and return employees to work safely, before they become more serious and a cause for long-term absence. This is less relevant if somebody has been diagnosed with cancer – often they will be unwell and in treatment for a considerable period of time. In such circumstances, EIS becomes more about easing the progression into a GIP claim, if appropriate. With the help of an EIS Nurse, the employer and employee can complete the claim submission process in plenty of time so that by the end of the deferred period, there is a smooth transition from Occupational Sick Pay to the Group Income Protection claim payment. Income should be the last thing an employee with cancer needs to be worrying about.
At its core, the GIP product is designed to help people who are unable to work due to illness. While access to a variety of support services is a huge benefit and an increasingly important part of discussions, the value provided by the core product should never be overlooked. After being absent from work for more than a set amount of time, often 26 weeks, a proportion of salary will be paid to the employee. On top of paying salary continuance, pension and National Insurance contributions can be maintained, and membership of other workplace benefits such as a private medical insurance policy will be protected too.
There will be costs arising as a result of living with cancer. Hospital parking, adjustments at home and other expenses all add up. The financial safety net provided by GIP can help mitigate those incidental costs of living while unable to attend work. Even when a return is being managed, proportionate benefit payments mean that employees can be returned safely and sustainably, focusing on their health and wellbeing, without their income suddenly dropping as their GIP claim will taper as their earnings increase.
Many GIP providers have access to rehabilitation consultants, either in-house or outsourced, and claims managers. From the moment a claim is accepted (or possibly even before, if EIS has been engaged with), dedicated specialists take responsibility for a person’s case. These people will work closely with the employee, employer, any medical specialists involved in the case, perhaps Occupational Health professionals and other stakeholders in the ongoing absence. Their purpose is to understand the complete circumstances of the employee’s absence and, if possible, return them to work in a safe and sustainable way.
Cancer is a complex illness. Employees may need debilitating treatments in multiple stages over the course of years, and their ability to work will wax and wane. An independent, objective case management team can monitor the situation from both a medical and professional perspective, centralise communication between all parties and manage expectations realistically for all sides. This takes a lot of the burden off managers and creates a healthy distance for decision-making and planning, while ensuring the employee is considered at all times.
Cancer in various forms accounts for almost two-thirds of Group Critical Illness (GCI) claims, which is not surprising when you consider that half of people born after 1960 will be diagnosed with cancer at some point in their lives. This product pays a lump sum, tax-free, directly to the employee. This money can be used for whatever the employee needs, such as covering costs of adjustments that need to be made at home, hospital appointments, travel and so on.
One accusation often levelled at GCI is that the product terms are overly technical and difficult to understand. Many cancer diagnoses are fairly clear-cut whether they meet the definition covered for a claim to be paid or not, and processing times for cancer claims tend to be shorter than for conditions which may require more investigation.
The product may also come with support services such as Second Medical Opinion or Personal Nurse Services, broadening the support available from just the spend on the insurance product.
Personal Nurse Services give GCI claimants telephone access to a dedicated nurse for as long as they need their help and support. The purpose of this service is to provide practical and emotional support. The nurses can signpost patients to relevant resources and groups and even help frame discussions with GPs and specialists by suggesting questions to cover and talking through any responses away from the stress of an appointment slot.
Given that the majority of GCI claims are for cancer, the teams have a wealth of knowledge and experience when it comes to the day-to-day impact of living with cancer. While it is a gross understatement to call them a shoulder to cry on, or a safe space to vent, that emotional aspect alongside practical suggestions is a huge part of the success of this support service. Particularly considering the reciprocal effect of cancer on mental ill health, services such as these can add a strong pillar to a person’s support network.
There is a vast amount of help available to employees who have been diagnosed with cancer, provided the right benefit policies are in place to support them. These services take much of the slack for managing the personal, even private, aspects of living with cancer, allowing supervisors and managers to focus on the workplace. Many of these services can even be used by supervisors in turn, helping them understand their responsibilities to their employee. With effective communication and tailored support, many employees living with cancer can remain productive members of a team and Group Risk providers are here to help make sure that happens.