Hannover Re, FibriCheck & Dialogue
Navigating the future of the NHS: how insurers & healthtech partners can drive change?
With rising healthcare demands, treatment backlogs, and delays in diagnosis placing a strain on the NHS, the Hannover Re UK Life Branch recently hosted a webinar to explore the impact on mortality and critical illness, and how insurers, collaborating with healthtech partners, can drive better health outcomes through digital tools and preventative care for both policyholders and society.
Sickness has led to approximately 900,000 workers missing from the workforce by the end of 2023, exceeding pre-pandemic expectations and costing nearly 5 billion GBP in lost tax receipts. Improving public health could save the NHS 18 billion GBP, delivering significant benefits for society, insurers, and the broader economy.[1]
The webinar hosted by Alastair Morris, Business Development Manager, featured insights from Vicky Webb, Head of Biometric Risk, and Maria Pelkonen Hall, Digital Innovation Manager at Hannover Re Life & Health. Jack Hanley joined them from FibriCheck, a global technology company helping to detect cardiovascular diseases early and optimise diagnostic pathways , and Ellie Janik from Dialogue, a wellness platform enhancing customer engagement and supporting preventative care for insurers and employers.
Watch the full webinar here, or keep reading to explore key insights from our article.
The NHS present and future: navigating healthcare challenges and opportunities
The NHS, launched in July 1948, was the world’s first healthcare system to provide free medical care at the point of need, funded by taxation. Over the decades, it has achieved remarkable milestones, pioneering medical innovations like the UK's first heart transplant in 1968, gene therapy in 2002, and advancements in digital healthcare, such as the NHS app.[2]
Originally designed to treat acute illnesses, the NHS has evolved to meet changing healthcare demands, including chronic disease management and preventative care. For example, the NHS Health Check, introduced in 2009, screens adults aged 40-74 for cardiovascular risk factors.[3]
Vicky Webb explained that despite these advancements, the NHS faces significant challenges. The ageing population has led to an increased prevalence of chronic conditions like diabetes and hypertension, alongside rising rates of depression.[4]
As of June 2024, 7.6 million people were waiting for NHS treatment, with delays in diagnosis and care impacting survival rates and life insurance claims.[5]
During the pandemic, the postponement of routine care resulted in a temporary drop in critical illness claims, highlighting the ripple effects of healthcare pressures.[6]
Lord Darzi Independent Investigation of the National Health Service in England, September 2024. Independent investigation of the NHS in England - GOV.UK Figure II.8.15.
Staffing challenges exacerbate these issues, with 121,000 NHS vacancies reported as of September 2023. Unsurprisingly, mental health conditions like stress and anxiety remain the leading causes of sickness among NHS staff, especially as mental health needs continue to rise.[7] Vicky explained that referrals for adult mental health services have been growing at 3.3% annually, and earlier this year it was reported that over 1 million people are waiting for treatment and 345,000 waiting more than a year for initial contact. For children and young people, referrals have been increasing at 11.7% annually, raising significant insurance considerations for the next generation and future customers.[8]
Vicky highlighted how cardiovascular health has also seen setbacks. While mortality rates from cardiovascular disease (CVD) have improved for decades, recent trends show stagnation and even reversal, driven by lifestyle factors, with reduced hypertension management during the pandemic, and delays in emergency response potentially also contributing.[9] Waiting times for cardiology services have also surged over the past decade.[10]
Lord Darzi Independent Investigation of the National Health Service in England, September 2024. Independent investigation of the NHS in England - GOV.UK Figure III.13.1: Directly standardised mortality rate from all circulatory disease, persons under 75s, England, 2001 to 2022
Data is now showing a reversal of previously improving CVD mortality trends.
In the last 10 years, waiting times for cardiology-planned hospital care have increased by
Looking ahead, the NHS is pivoting toward three key shifts announced by the Secretary of State for Health and Social Care [11]:
- Adopting digital innovations
- Transitioning care from hospitals to communities
- Focusing on prevention
Recent funding announcements include 22.6 billion GBP for resource spending in 2025-26 and 1.5 billion GBP for capital investments to expand capacity, though some experts caution these funds may only sustain existing services. In the long term, the government is working on a 10-year health plan for England, seeking input from stakeholders to shape the future of healthcare.[12]
FibriCheck: empowering early detection in cardiovascular health
Cardiovascular disease, especially arrhythmias like atrial fibrillation (AF), remains a critical health challenge. AF affects one in three people over the age of 45[13] and increases the risk of stroke and heart failure fivefold, making early detection essential. AF however, is often underdiagnosed due to intermittent symptoms or its absence during in clinic spot diagnostic tests. Symptoms like palpitations may indicate AF but are frequently linked to less serious conditions too, complicating diagnosis.[14]
Patients often face a "revolving door" of cardiac diagnostics, enduring repeated appointments, and tests with long waiting times. This inefficiency strains both patients and healthcare providers.
Adopting a digital-first, continuous monitoring approach with FibriCheck can enable longitudinal data collection enhancing diagnosis and treatment. Jack Hanley provided an overview of how FibriCheck monitors heart rhythms over time, providing a more accurate and comprehensive view of a patient’s health. For instance, while a patient with intermittent episodes may show normal rhythms during a GP visit, FibriCheck can identify episodes of arrhythmia that might otherwise go unnoticed. This enables clearer diagnoses and earlier interventions.
Early detection of AF - a leading cause of stroke - can significantly reduce stroke incidence and prevent progression.[15] In Europe, rising stroke rates are driven by poor metabolic health and ageing populations. In the UK alone, stroke care costs are projected to climb from 43 billion GBP to 75 billion GBP over the next decade. Early detection, particularly in high-risk individuals, could prevent up to 90% of strokes, underscoring the urgency of innovative solutions like FibriCheck.[16]
FibriCheck is a software-only medical device compatible with smartphones and wearables. Jack explained how the device uses photoplethysmography (PPG) technology, detecting 14 types of arrhythmias, including AF, with 98.3% sensitivity and 99.9% specificity.[17] Results are reviewed by cardiology experts and shared with patients and healthcare providers, facilitating timely follow-up.
Health insurers have embraced FibriCheck to empower members to self-assess and receive quick answers. Jack highlighted that one insurance partner has seen over 16,000 assessments conducted to date, achieving a 4.3% AF detection rate - four times higher than the NHS rate - while 95% of tests found no serious issues, reducing unnecessary GP visits and further testing. Interestingly, of those negative results, almost half of the users reported some symptoms, this indicates that FibriCheck has been an effective digital triage solution to rule out ‘harmless symptoms’ and prevent unnecessary GP appointments and diagnostic referrals.
In conclusion, FibriCheck’s digital-first approach improves diagnostic accuracy, reduces healthcare costs, and supports better management of rising stroke-related expenses. As stroke rates continue to climb, this innovative solution will become increasingly valuable, offering insurers opportunities to leverage digital tools for preventative healthcare and early intervention, ultimately improving health outcomes for both policyholders and society.
Dialogue: a holistic, preventative care model
Whilst it's clear that digital tools are essential for scaling preventative care, their impact extends far beyond cardiovascular health to address a broad range of chronic diseases, which contribute to rising healthcare costs.
In England, projections from the Health Foundation indicate that nearly 1 in 5 adults will be living with chronic conditions like dementia, cancer, and heart disease by 2040. These figures underscore the urgent need for a more holistic approach to preventative care.[18]
Ellie Janik provided an overview of Dialogue, a digital health engagement platform driving the shift to prevention-focused healthcare with personalised solutions that help insurers connect with customers while using behaviour change science to support physical, mental, social, and financial wellbeing.
Physical activity is central to both Dialogue’s platform as well as the NHS long-term plan, aimed at reducing the risks of chronic illnesses and mental health issues while lowering public health costs. Through fitness tracking, personalised activity goals, and physical activity challenges, Dialogue encourages users to meet and exceed the WHO’s 150-minute weekly physical activity guideline.[19] With preventable, long-term conditions accounting for about 50% of GP appointments and 70% of hospital days, promoting physical activity not only enhances individual health but also supports healthcare sustainability by easing the burden on public services.[20]
ABI Protection claims by reason 2023
This is especially relevant for insurers, as stroke and heart disease are among the major drivers of critical illness claims. Studies show that meeting the 150-minute activity guideline can reduce the risk of heart disease by 35% and stroke by 25%, underlining the impact of physical health on insurers and the broader public health system.[21]
Ellie shared positive data insights from Dialogue which show that 86% of its users meet or exceed the 150-minute activity guideline, compared to just 63% of the UK population.[22] Ellie explained how sedentary users also see a 75% increase in daily steps on average after joining Dialogue’s platform, demonstrating its effectiveness in improving health outcomes.
The link between physical and mental health extends beyond the positive impact of physical activity on mental wellbeing; conditions like depression also increase the risk of physical diseases, such as heart disease. This underscores the need for a holistic approach that views the mind and body as interconnected, rather than separate.
For mental health, Dialogue offers mindfulness tools, meditation, and self-guided cognitive behavioural therapy (CBT). Its content library also covers diet, nutrition, financial wellbeing, sexual reproductive health and many more wellbeing topics, addressing diverse needs and life stages. Collaboration with UCL’s behaviour change experts led to the development of Healthy Habit plans guiding long-term improvements in sleep, stress, substance use, physical activity, diet and mood.
Digital health tools like Dialogue provide insurers with valuable data to build personalised services and improve risk assessments, while promoting proactive health measures that mitigate claims risks. Furthermore, public health interventions like these can generate significant economic returns - up to 14:1 for general health measures and 24:1 for mental health initiatives in young people - benefiting individual wellbeing, as well as employers, insurers, and healthcare providers.[23]
The digital shift: how insurers can leverage technology for better health outcomes
During the panel discussion in the second half of the webinar, Maria Pelkonen Hall highlighted the urgent need for the insurance industry to embrace the shift towards digital technology and platforms. Consumer expectations, shaped by rapid advancements in sectors like retail and banking, are forcing insurers to adapt. Today’s customers demand personalised experiences, and the technological progress in other industries makes it clear that insurers must embrace digital tools to stay relevant.
Platforms like Dialogue, which focuses on proactive mental health care and holistic wellbeing support, illustrate this shift. These platforms are evolving beyond traditional wellness apps to become comprehensive health management tools, incorporating machine learning and predictive analytics to anticipate health risks and reduce claims frequency.
Digital technologies also offer opportunities to decrease claim severity. For example, precision medicine can target critical illnesses like cancer at early stages, while wearables like smart rings and watches enable continuous monitoring of cardiovascular health. These innovations can provide valuable insights for ongoing health management, benefiting insurers, customers, and healthcare systems like the NHS.
Maria went on to explain that the digital shift is not just a trend in more mature insurance markets but a global movement. Drawing from her insights in her role with the global Life and Health Digital Business Accelerator, she shared how many industries, including insurance, transitioned to digitally enabled distribution models during the pandemic.
In markets like the US, insurers use third-party data, such as drug prescriptions and vehicle datasets, to refine underwriting decisions. Additional 3rd party data like lab-test results are further reducing the need for medical tests, streamlining the process for both insurers and policyholders. Similarly, countries like Australia are integrating electronic health records into underwriting, while Nordic nations are exploring how to manage the influx of patients who seek care earlier due to digital health tools and genetic data.
This global digital transformation highlights how insurers can leverage technology to improve customer experience and reduce costs, all while driving better health outcomes.
Future outlook: the path forward for insurers, healthtech, and the NHS
"Embracing technology allows insurers to manage claims through proactive healthcare, benefiting the insured, insurers and the public health system like the NHS. These opportunities require strategic foresight, technological agility and a commitment to meet evolving customer needs. At Hannover Re, we have the right partnerships to support you in this transition.”
Maria Pelkonen Hall, Hannover Re
“There’s no getting away from the fact that the challenges facing the NHS will persist for some time, but we remain optimistic. There are a lot of promising developments in the pipeline, from technological advancements, including the use of AI within the NHS, to initiatives encouraging individuals to engage more with their health, as we’ve discussed today.”
Vicky Webb, Hannover Re UK
“We must live in a world where digital health services underpin both prevention and care access. The potential for these technologies is huge. Technologies like FibriCheck, which have achieved incredible accuracy and reliability within a software-only delivery model, are game changers. This represents a significant shift. We now have cost-effective scalable technologies that can be effectively deployed at the population level and provide efficient front-door access to healthcare without compromising on clinical accuracy."
Jack Hanley, FibriCheck
“We live in a rapidly changing world where people, from a healthcare perspective, expect services that cater to their individual needs on a very personal level. There's also a growing expectation that not only private providers but the NHS too will anticipate future health requirements. At Dialogue, we're investing heavily in AI, the technology of the moment, to deliver tailored health recommendations using real-time data. AI has huge potential for both insurers and the NHS, automating processes, diagnostics, self-management, and triaging - key for reducing NHS backlogs, as seen in dermatology. It's all about personalisation, automation, and balancing it with the human touch.”
Ellie Janik, Dialogue
References
[1] Our greatest asset: The final report of the IPPR Commission on Health and Prosperity
[2] NHS England » NHS History & The NHS App after the pandemic - NHS England Digital
[4] Lord Darzi Independent Investigation of the National Health Service in England, September 2024. Independent investigation of the NHS in England - GOV.UK Technical Annex, Figure I.5 & Section 1.5
[5] Lord Darzi Independent Investigation of the National Health Service in England, September 2024. Independent investigation of the NHS in England - GOV.UK Figure II.8.15.
[6] CMI Assurances Committee Working Paper 191.
[7] Staff Shortages | The King's Fund
[8] Lord Darzi Independent Investigation of the National Health Service in England, September 2024. Independent investigation of the NHS in England - GOV.UK Sections 1.6 & 2.4.
[9] Lord Darzi Independent Investigation of the National Health Service in England, September 2024. Independent investigation of the NHS in England - GOV.UK Figure III.13.1
[10] NHS hospital care: Who is waiting and what are they waiting for? | Nuffield Trust Figure 5.
[11] The Government's 10-Year Plan | Health And Care | The King's Fund
[12] What Does The Autumn Budget 2024 Mean For Health And Care | The King's Fund
[14] Why you should check your heart rhythm regularly - FibriCheck
[15] https://www.stroke.org.uk/professionals/atrial-fibrillation-information-and-resources
[16] Stroke has devastating impacts | Stroke Association
[18] Watt T, Raymond A, Rachet-Jacquet L, Head A, Kypridemos C, Kelly E, Charlesworth A. Health in 2040: projected patterns of illness in England. The Health Foundation; 2023 (https://doi.org/10.37829/HF-2023-RC03).
[19] World Health Organization Physical activity
[20] Valuing health: why prioritising population health is essential to prosperity
[21] World Stroke Organization: Stroke & Exercise
British Heart Foundation: Physical Inactivity
[22] Active Lives Adult Survey Report
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