Here’s a question most C-suite leaders may not have asked themselves: when did we become healthcare providers?
Independent research conducted by Howden found that 43% of UK employees now use company provided private healthcare as their main route into diagnosis and treatment for serious conditions. Just 24% rely solely on the NHS. But this shift has happened quickly, which means that most businesses are still operating as if they’re running employee benefits schemes, when actually they’re running healthcare systems.
How we got here – and why it matters now
Increasing pressure on the NHS has accelerated a fundamental change in how people access care. Diagnostic use has been growing at double-digit rates. Privately funded procedures outside insurance have almost doubled since 2019. Employer plans are absorbing demand that would previously have been met by the public system.
The financial reality is stark: UK medical costs are rising at 12%, according to Howden Employee Benefits’ Global Employee Health Report 2026. That is nearly six times faster than general inflation. After accounting for baseline inflation, UK healthcare costs are rising 40% faster than the global average.
Most boards have not yet recognised the scale of what’s happening
It is not just volume driving costs, it’s complexity. The biggest cost drivers are musculoskeletal (MSK) conditions, cardiovascular disease and cancer. But increasingly, employees are presenting with multiple chronic conditions simultaneously – cardiovascular disease alongside diabetes and obesity-related issues, for example. When conditions overlap, costs rise sharply.
Diagnostic delays driven by NHS capacity pressures compound the problem. By the time employees reach private care, they often need more intensive and expensive treatment. For instance, our research shows that a third (33%) of UK employees have had a condition worsen as a direct result of long wait times. Add in the rising demand for expensive new therapies, such as GLP-1 drugs, and employers are facing claims their plans were never designed for.
This is where governance matters. With rapid advances in AI diagnostics, drug developments, mRNA technology and genetic engineering, employer understanding is crucial. Employers need frameworks to ensure that coverage is not only up to date, but sustainable over the long term.
They need to assess the pros and cons against clear criteria: proven outcomes, long-term sustainability, fairness and safety. The goal is to make the most of these advancements for the benefit of employees to ensure they receive the best possible care when and where appropriate.
The hidden cost: when employees can’t navigate what you’ve built
There’s an additional issue which comes down to employee understanding. More than a quarter (28%) have paid for treatment out of their own pocket this year, despite having insurance. Some wanted specific consultants or hospitals outside their plan. Others hit benefit restrictions they did not fully understand. Many simply did not know what their policy covered or how to access it.
Employees delay seeking care because they assume they’re not covered
When employers limit hospital networks, restrict certain treatments or require clinical pathways, they’re making rational decisions to keep plans affordable and accessible. But without a clear explanation, employees can see these as barriers, not guardrails.
It can mean employees delay seeking care because they assume they’re not covered or pay privately for treatment their insurance would have funded. They may become frustrated with benefits they see as inadequate, when the real issue is communication and navigation.
From a business perspective, this is a key issue. You’re investing in healthcare provision, but the return – employee wellbeing, productivity and retention – is being lost to confusion and poor access design.
What is the answer?
Organisations must recognise that having insurance isn’t the same as having access, and that complex benefits require active guidance.
This starts with clear clinical pathways. Employees need to know: if I have this symptom, where do I go? Who decides what happens next? What’s covered and what isn’t? They need to understand the reasons for coverage rules and restrictions, and that it’s not because the company doesn’t care about their health.
Smart employers are also recognising that early intervention saves money and lives. Fast-track diagnostics, virtual triage and targeted support for high-risk conditions, such as MSK and cardiovascular disease, improve outcomes and prevent expensive late-stage claims.
Time for strategic clarity
Most boards have not yet recognised the scale of what’s happening. They’re still treating employer healthcare as an HR issue, when it’s become a major operational and financial commitment.
Companies are now making decisions about who gets access to which treatments, how quickly people can see specialists and what level of care is sustainable across the workforce. These are healthcare provision decisions. They require the same strategic thinking, data analysis and governance that you’d apply to any other major business function. They need board oversight, not just benefits team management.
The good news is that the opportunity here is significant. Employees who can access healthcare quickly and confidently are more productive, more loyal, and less likely to leave. Organisations that design for both sustainability and usability will attract better talent and retain them longer. But only if people can actually use what you’re providing.
The question isn’t whether you’re in healthcare – you already are. The question is whether you’re doing it well enough to attract and retain staff, justify the investment, and whether your board knows that’s what they’re funding.
Cheryl Brennan is UK managing director of Howden Employee Benefits & Wellbeing, an employee benefit consultancy.
Here's a question most C-suite leaders may not have asked themselves: when did we become healthcare providers?
Independent research conducted by Howden found that 43% of UK employees now use company provided private healthcare as their main route into diagnosis and treatment for serious conditions. Just 24% rely solely on the NHS. But this shift has happened quickly, which means that most businesses are still operating as if they're running employee benefits schemes, when actually they're running healthcare systems.
