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Occupational Health - UK - April 2016

“There are approximately 450,000 new cases of occupational ill health in the UK every year, but the costs of managing ill-health at an individual corporate level remain poorly measured and unclear. Active marketing of OH, coupled with evidence-based proposals for cost-effective interventions, will be required if the market is to make a serious impact in healthcare.”
– Lewis Cone, B2B Analyst

This report answers the following key questions:

  • What are the key determinants driving the occupational health industry?
  • Was the industry affected by the financial crisis and the slow recovery? If so, how has it developed and changed since?
  • How have government schemes influenced market demand and supply?
  • How has the provision of occupational health services changed over recent times?
  • What are the key issues the industry needs to address to expand its service?
  • What does the future hold for occupational health services?

This report covers the UK occupational health market. Occupational health is defined as healthcare provision provided in the workplace, and includes both specific health and safety care, and broader issues of health, fitness and preventative health care, often referred to as wellness. There remains much debate and confusion over the precise definition of occupational healthcare, and the boundaries of the sector remain vague. According to the joint International Labour Organisation/World Health Organisation Committee on Occupational Health, occupational healthcare is aimed at the following:

“The promotion and maintenance of the highest degree of physical, mental and social wellbeing of workers in all occupations; the prevention amongst workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; and the placing and maintenance of the worker in an occupational environment adapted to his/her physiological and psychological capabilities.”

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Table of contents

  1. Executive Summary

      • Market size
        • Figure 1: UK employment, 2015, (% of total)
        • Figure 2: UK market segmentation for occupational health provision at salary costs for non-commercial operators, by type of provider, 2011-2015, (£ million)
      • Market trends
        • Figure 3: How health condition affected work, by industry sector and level of extent, 2014, (%)
        • Figure 4: Percentage of respondents identifying most common cause of long-term absence, 2015, (%)
        • Figure 5: Average sickness absence rates, by region, 2014, (% working time lost per year)
        • Figure 6: Average annual cost of absence, 2011-2015, (per employee per year, by sector, in £)
        • Figure 7: Analysis of cost of workplace illness and injury, by cost bearer, 2006/07-2013/14, (£ billion)
      • Market factors
        • Employee demographic changes affecting OH service distribution
          • Longer working hours also take a toll on workplace health
            • Government plans to conduct a public sector sickness absence review
              • Industry structure
                • Forecast
                  • Figure 8: UK occupational health market segmentation forecast, by provider, 2016-2020, (£ million at 2015 prices)
                • Ageing working population will pose fresh challenges to, and require innovative measures from, OH service providers
                  • Changes to SEQOHS standards could help accredited members win business
                    • Technology advancements will affect OH trends, through types of ill-health and service provision alike
                      • What we think
                      • Key Insights

                          • Why is the continued development of occupational health perceived as important to economic performance?
                            • What is currently restricting market development?
                              • How can OH providers expand their service provision and convince businesses of the benefits of services?
                              • Introduction

                                  • Definitions
                                    • Methodology
                                      • Abbreviations
                                        • Market positioning
                                            • Figure 9: Sickness absence among UK employees, 2009-2013, (Million, % and days)
                                            • Figure 10: Sickness absence among UK employees, 2009-2013 (Millions)
                                            • Figure 11: Average level of employee absence, by sector, 2015, (Average working time lost (%) and average days lost per employee per year)
                                            • Figure 12: Average level of employee absence, by sector, 2015, (Average working time lost (%) and average days lost per employee per year)
                                          • Economic conditions
                                            • Ethical
                                            • UK Economy

                                              • Key points
                                                • Overview
                                                  • Figure 13: UK GDP quarterly development, 2005-2015, (£ billion)
                                                  • Figure 14: Quarters after GDP peak, 1979, 1990 and 2008, (Number of quarters and GDP as % of pre-downturn peak)
                                                • Inflation
                                                  • Interest rates
                                                    • House prices
                                                      • Consumer spending
                                                        • Manufacturing
                                                          • Figure 15: UK output, by industry, 2008-2015, (Index: Q1 2008 = 100)
                                                        • Business investment
                                                          • Figure 16: UK GFCF 2005-2015, (£ million)
                                                        • Imports
                                                          • Exports
                                                          • Market Factors

                                                            • Key points
                                                              • Health at Work Policy Unit aims to improve links between the evidence and the policies associated with health and wellbeing at work
                                                                • Employee demographic changes affecting OH service distribution...
                                                                  • ...with longer working hours per week also taking its toll on workplace health
                                                                    • NHS Health at Work set up to monitor and improve quality of services
                                                                      • Fit note data collection and feedback should ensure that improvements, where necessary, are made to the programme
                                                                        • Government plans to conduct a public sector sickness absence review
                                                                          • Managers and employers provided public health guidance by NICE to aid development of a more health-aware workplace
                                                                            • Fit for Work service rolled out nationwide, but still lacks complete employer recognition
                                                                              • Other factors
                                                                                • Legislation
                                                                                • Market Size

                                                                                  • Key points
                                                                                    • Introduction
                                                                                      • Workforce
                                                                                        • Figure 17: Working hours lost due to sickness absences, by gender, 2009-2013, (%)
                                                                                        • Figure 18: Working hours lost due to sickness absences, by gender, 2009-2013, (%)
                                                                                        • Figure 19: Working hours lost due to sickness absences, by age group, 2009-2013, (%)
                                                                                        • Figure 20: Working hours lost due to sickness absences, by age group, 2009-2013, (%)
                                                                                      • Public sector
                                                                                          • Figure 21: Analysis of employment in central and local government, by size of company, 2015, (000s)
                                                                                          • Figure 22: Analysis of employment in central and local government, by organisation size, 2015, (% of total employment)
                                                                                        • Private sector
                                                                                          • Figure 23: Analysis of employment in the private sector, by size of company, 2015, (000s)
                                                                                          • Figure 24: Analysis of employment in private sector, 2015, (Employees in 000s by size of company)
                                                                                        • Overall market
                                                                                          • Figure 25: Differences in absence and workforce Size, 2011- 2015, (Average days lost per employee)
                                                                                          • Figure 26: Differences in absence and workforce size, 2011-2015, (Average days lost per employee)
                                                                                          • Figure 27: Organisations with an absence target, by level of absence and size of company, 2015, (%)
                                                                                          • Figure 28: Organisations with an absence target, by level of absence and size of company, 2015, (%)
                                                                                          • Figure 29: Proportions of organisations monitoring the cost of employee absence, by type of organisation and by size of company, 2014 and 2015, (%)
                                                                                          • Figure 30: Average annual cost of absence, per employee per year, by sector, 2011-2015, (£ per year)
                                                                                          • Figure 31: Average annual cost of absence, 2011-2015, (per employee per year, by sector, in £)
                                                                                          • Figure 32: Segmentation of the cost of absence to the economy, 2010, (£ billion)
                                                                                          • Figure 33: Analysis of cost of workplace illness and injury, by cost bearer, 2006/07-2013/14, (£ billion)
                                                                                          • Figure 34: Analysis of cost of workplace illness and injury, by cost bearer, 2006/07-2013/14, (£ billion)
                                                                                        • Industry analysis
                                                                                          • Figure 35: Average sickness absence by sector, 2011-2015, (Days lost per employee per year)
                                                                                          • Figure 36: How Health Condition Affected Work, by Industry Sector and Level of Extent, 2014, (%)
                                                                                          • Figure 37: How health condition affected work, by industry sector and level of extent, 2014, (%)
                                                                                        • Reasons for absence
                                                                                            • Figure 38: Common causes of short term absence, 2013-2015, (% identifying most common cause)
                                                                                            • Figure 39: Percentage of respondents identifying most common cause of short-term absence, 2015, (%)
                                                                                            • Figure 40: Common Causes of Long-Term Absence, 2013-2015, (% Identifying Most Common Cause)
                                                                                            • Figure 41: Percentage of respondents identifying most common cause of long-term absence, 2015, (%)
                                                                                            • Figure 42: Number of days lost through sickness absence in the UK, by reason, 2009-2013, (Millions)
                                                                                            • Figure 43: Estimated working days lost due to work-related illness or injury, by illness or injury, 2010/11-2014/15, (000s)
                                                                                          • Stress
                                                                                            • Figure 44: Causes of work-related stress, by type of organisation, 2015, (% of respondents, top three causes)
                                                                                            • Figure 45: Methods being used to identify and reduce stress, by type of organisation, 2015, (% of respondents that take steps to manage stress)
                                                                                          • Regional analysis
                                                                                            • Figure 46: UK regional employment 2013, 2014 and 2015, (000s and % of total)
                                                                                            • Figure 47: Regional public sector employment in England, 2011-2015, (000)
                                                                                            • Figure 48: Average sickness absence by region, 2009-2014, (Average no. of days lost per employee per year)
                                                                                            • Figure 49: Regional sickness absence, 2009-2014, (Average no. of days lost per employee per year)
                                                                                            • Figure 50: Average sickness absence rates, by region, 2014, (% working time lost per year)
                                                                                            • Figure 51: Average sickness absence rates, by region, 2014, (% working time lost per year)
                                                                                          • Market development
                                                                                              • Figure 52: The UK market for occupational health provision at salary costs for non-commercial operators, 2011-2015, (£ million)
                                                                                              • Figure 53: UK market segmentation for occupational health provision at salary costs for non-commercial operators, by type of provider, 2011-2015, (£ million)
                                                                                              • Figure 54: UK market segmentation for occupational health provision at salary costs for non-commercial operators, by type of provider, 2011-2015, (£ million)
                                                                                          • Market Trends

                                                                                            • Key points
                                                                                              • Public and private sector attitudinal differences to OH still remain
                                                                                                • Outsourced OH services still preferred over in-house provision
                                                                                                  • Absenteeism still a problem in the workplace
                                                                                                    • Work/life balance under increasing pressure
                                                                                                      • Group risk schemes becoming more popular with employers
                                                                                                        • Initiatives launched to gain better insight of UK employee health
                                                                                                          • Best and worst initiatives that tackle absence identified
                                                                                                            • Mental health illness on the rise, but workplace remain sceptical on legitimacy of absence
                                                                                                            • Industry Structure

                                                                                                              • Key points
                                                                                                                • Industry development and structure
                                                                                                                  • Industry groups
                                                                                                                      • Figure 55: Structure of the UK occupational health industry, 2015, (£ million)
                                                                                                                      • Figure 56: Structure of the UK occupational health industry, 2015, (% of total market share)
                                                                                                                      • Figure 57: Analysis of the changes in the structure of the ‘other human health activities’ industry, 2011-2015, (Number of outlets and businesses)
                                                                                                                      • Figure 58: Analysis of the changes in the structure of the ‘other human health activities’ industry, 2011-2015, (Number of outlets and businesses)
                                                                                                                    • Structure by employment
                                                                                                                      • Figure 59: Analysis of the employment structure of the ‘other human health activities’ industry, 2014 and 2015, (Number of employees and outlets)
                                                                                                                      • Figure 60: Analysis of the employment structure of the ‘other human health activities’ industry, 2015, (% of total outlets)
                                                                                                                    • Structure by turnover
                                                                                                                      • Figure 61: Analysis of the financial structure of the ‘other human health activities’ industry, 2014 and 2015, (£000 and number of businesses)
                                                                                                                      • Figure 62: Analysis of the financial structure of the ‘other human health activities’ industry, 2015, (£000 and % of businesses)
                                                                                                                  • Company Profiles

                                                                                                                    • AXA Icas Healthcare Occupational Health Services

                                                                                                                          • Figure 63: Financial analysis of AXA Icas Occupational Health Services, 2010-2014, (£ 000)
                                                                                                                        • Company strategy
                                                                                                                        • Bupa Occupational Health

                                                                                                                              • Figure 64: Financial Analysis of Bupa Occupational Health, 2010-2014, (£ 000)
                                                                                                                            • Company strategy
                                                                                                                            • Cigna Healthcare Occupational Health

                                                                                                                              • COPE Occupational Health and Ergonomic Services

                                                                                                                                • Duradiamond Healthcare

                                                                                                                                      • Figure 65: Financial analysis of Duradiamond Healthcare, 2010-2014, (£ 000)
                                                                                                                                    • Company strategy
                                                                                                                                    • HCA International

                                                                                                                                          • Figure 66: Financial analysis of HCA International, 2010-2014, (£ 000)
                                                                                                                                        • Company strategy
                                                                                                                                            • Figure 67: Financial analysis of Roodlane Medical, 2010-2014, (£ 000)
                                                                                                                                          • Company strategy
                                                                                                                                          • Health Management

                                                                                                                                                • Figure 68: Financial analysis of Health Management, 2010-2014, (£ 000)
                                                                                                                                              • Company strategy
                                                                                                                                              • International SOS (formerly Abermed)

                                                                                                                                                    • Figure 69: Financial analysis of International SOS/Abermed, 2010-14, (£ 000)
                                                                                                                                                  • Company strategy
                                                                                                                                                  • Medigold

                                                                                                                                                        • Figure 70: Financial analysis of Medigold Health Consultancy, 2010-2014, (£ 000)
                                                                                                                                                      • Company strategy
                                                                                                                                                      • Occupational Health Care Limited

                                                                                                                                                            • Figure 71: Financial analysis of Occupational Health Care Limited, 2010-2014, (£ 000)
                                                                                                                                                          • Company strategy
                                                                                                                                                          • OH Assist (formerly Atos Healthcare)

                                                                                                                                                                • Figure 72: Financial analysis of OH Assist/Atos IT Services UK, 2010-2014, (£ 000)
                                                                                                                                                              • Company strategy
                                                                                                                                                              • People Asset Management (PAM) Group

                                                                                                                                                                • Syngentis

                                                                                                                                                                    • Company strategy
                                                                                                                                                                    • Working on Wellbeing Ltd (formerly Serco OH)

                                                                                                                                                                          • Figure 73: Financial analysis of Serco OH, 2008-2012, (£ 000)
                                                                                                                                                                          • Figure 74: Financial analysis of Working on Wellbeing Ltd, 2013-2014, (£ 000)
                                                                                                                                                                        • Company strategy
                                                                                                                                                                          • Figure 75: Analysis of profiled companies’ combined turnover, 2010-2014, (£ 000)
                                                                                                                                                                      • Forecast

                                                                                                                                                                        • Key points
                                                                                                                                                                            • Figure 76: UK occupational health market segmentation forecast, by provider, 2016-2020, (£ million at 2015 prices)
                                                                                                                                                                            • Figure 77: UK occupational health market segmentation forecast, by provider, 2016-2020, (£ million at 2015 prices)
                                                                                                                                                                            • Figure 78: Development of the UK occupational health market, 2010-2020, (£ million)
                                                                                                                                                                          • The increasing age of the working population will pose fresh challenges to, and require innovative measures from, OH service providers
                                                                                                                                                                              • Figure 79: Estimated long-term conditions in the UK working age population by 2030, by illness, (Number)
                                                                                                                                                                            • Changes to SEQOHS standards could help accredited members win business
                                                                                                                                                                              • Technology advancements will affect OH trends, through types of ill-health and service provision alike
                                                                                                                                                                                • OH professionals need more focused-based and suitable training to meet specific employee demands
                                                                                                                                                                                • Further Sources and Contacts

                                                                                                                                                                                  • Trade associations, regulatory authorities and independent professional bodies
                                                                                                                                                                                    • Trade magazines
                                                                                                                                                                                      • Trade exhibitions

                                                                                                                                                                                      Companies Covered

                                                                                                                                                                                      To learn more about the companies covered in this report please contact us.

                                                                                                                                                                                      Occupational Health - UK - April 2016

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