Academy for Small Businesses I Bupa UK

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The Academy gives you leading health and wellbeing insights that will help support you in growing your business. Watch virtual events where our panel of experts discuss health and wellbeing issues – specifically for small businesses.

Events cover a range of key issues such as introducing a workplace mental health plan, reducing absence and building resilience as a small business owner to help your business thrive.

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In our latest series, founder of Holly & Co and Not On The High Street, Holly Tucker MBE, explores a range of key topics.

Hello and welcome to Bupa Academy for Small Businesses. I'm your host Holly Tucker.

Today, I'll be discussing how small businesses can play a vital role in creating inclusive

and supportive environments by supporting women's health in the workplace. We will be covering three different

areas, including menopause, supporting parents and female cancer.

I'm delighted to welcome our guests, Laura Williams, Head of Partnerships Legal Team

at WorkNest. WorkNest provide employers with HR expertise, employment law

and health and safety services. Laura is a qualified solicitor and has 15 years of experience in

the legal sector supporting SMEs. And Dr. Naveen Puri, Medical Director at Bupa.

Naveen has 20 years experience as a doctor working within both the NHS and Bupa.

Amongst his areas of clinical interest is health inequality and variation in healthcare,

including in women's health. Before I begin, I wanted to highlight

that although we refer to women throughout this session, we do recognise that members of

the transgender, non-binary and intersex community may also be

experiencing these issues too.

Part 1 – Menopause in the workplace

So, Naveen, could you start by explaining why it's so important for small businesses to support women's health?

Yeah, well, thank you for asking the question, Holly. The first thing I'd want to say is that women's health isn't just an issue that affects women.

The workplace is made up of women, of course, but also by men who are interacting with, related to and invested in healthcare and

wellbeing of women as well. So, it's really important that we consider that this is an issue for everyone to be aware of.

Women experience different life stages to men. And so, I think one thing that could be quite useful for us to consider is things like the

fact that they experience periods, pregnancy, issues of infertility and the menopause further in life.

And at various stages in life, they can be different needs that arise as well. And those can impact them in the workplace too.

They may also be barriers to women experiencing support around healthcare, both visible and invisible too.

A common invisible barrier is just a lack of understanding. But also, common visible barriers might be the lack of restroom

facilities or the ability to take a break when they're in the middle of a hot flush, for example, for menopausal women

So, it's really important that we recognise those are at play as well. We've got some statistics that show that one in four women

have indicated that they recognise that their health issues have led to a barrier to them being promoted.

And one in five women have potentially been impacted in terms of their desire to stay at work as well.

And so, I think when you consider that half of your workforce potentially, with all that resource, all that training, all that investment may want to

leave your firms because they haven't got that support or opportunity for onward progression, then this is really something

we need to make a priority in terms of us addressing. So, having outlined all of that then,

what can workplaces do to help women? And so, what I want to do is highlight some positives that workplaces and employers and

managers in particular can take forward to help their workforce. One thing is to start conversations and

create a culture around openness. If you've got a culture where people are joking about periods or joking about the menopause,

just think about those that are experiencing it. And I think some reframing there could be really, really helpful.

Maybe inquiring around Menopause Awareness Day, who's going through the menopause and what symptoms may be being experienced.

Remember by investing in these conversations and in starting to create a culture which may be more open, you're going to retain

your talent, you're going to retain a stronger and more effective workforce, you will potentially reduce absenteeism.

And I think it becomes a much more attractive place for people to work at as well. Work gets out and you may find your recruitment drive become

much more successful because you are a much more healthier place to work in. Wow, gosh, so many interesting points.

Another question, Naveen. Six in every 10 women feel their menopausal symptoms have had a negative

impact on their work. For those who don't know, can you tell us what are some of the key symptoms of the menopause and how they

might impact employees while they're actually at work? Absolutely Holly.

I think it's really important we consider symptoms because they are so variable and there's so many of them that people often don't have a true understanding of

what the menopause can do and how it can affect somebody. Let's start off by saying that symptoms don't affect everybody and they don't

often have a huge effect on many people. But for one in four, they can certainly have a significant impact and therefore

it's important that we are aware of these. Menopausal symptoms can go on from a few days to many months and certainly can

occur from years before the menopause and up to seven years afterwards as well. So it's not just a date like an anniversary or a birthday.

It's actually a whole period of your life that can be impacted by the menopause. So it's really important that we have

some awareness around this. So in terms of specific symptoms, then I think one that we're all aware of is changes to your period.

And by that, I mean things like irregular periods, periods becoming more heavier or more lighter. So it's really important

you recognise the impact of that. Women will sometimes be used to predicting their periods and therefore working around that in the workplace.

But if that regularity or pattern changes, it can really have an impact on their ability day to day.

Another common symptom, which I think has a lot of misunderstanding around it, is a hot flush. And so a hot flush essentially

is an intense sensation of heat which starts in the head and works its way downwards and can be

accompanied by things like anxiety or even palpitations as well. But palpitations mean an increasingly forceful heartbeat or

an awareness of your heartbeats as well. And so hot flushes again, you know, can have a real impact. They can last from seconds to hours

sometimes and can come on without any warning whatsoever. So if you're in the middle of a task or doing something particularly

important like a presentation and suddenly a hot flush comes on, you can only imagine the impact that would have on your ability to perform

your day to day functions. Other symptoms might include joint dysfunction, joint

pains, aches, stiffness, etc. and effects on mobility. We also find women can find their sleep

is disturbed as well. Insomnia is a really big issue. And in combination with that, hot flushes don't just occur during the day, they can

occur during the night as well and also impact sleep. So with insomnia and hot flushes as well, sleep quality can really be affected with

all the lifelong consequences that come with that. We also find that some people find their sex drive is affected as well.

There can be a real lack of libido and that can also therefore impact relationships as well. So consider the

wider impact of that. Things like urinary problems can also be an issue. We find that some women find they pee less

predictably or they are more prone to infections as well. So it's really important we consider the impacts there too.

I'm just I'm listening to you intently there because I've obviously been involved in small businesses all my life

and run one right now. And actually small businesses have small teams.

And so if you do have a vast majority of that small team going

through something like this, it's so important, as you said, to have this open dialogue.

And as you said, as well, to be sensitive to when you might bring it up. It's not something you might do in the team meeting, let's say,

unless everyone's being very open about it. But actually creating that ability for someone just to tell you

this is what they're going through. And as I have a team of all women of various ages,

quite a few of us going through perimenopausal symptoms or menopausal symptoms. And we've luckily got an open culture so

we can be quite open about this. And it just makes it normal and it makes it actually a supportive environment.

And I think then, as you said, it leads to employment, employee engagement, retention,

a safety feel, feeling that you belong, all of these things. And I think it's not to be

underestimated, is it? So a smaller team can be impacted much, much more. And to have that level of openness can

really impact you positively all the more as well. Correct. Laura, so as we've heard,

workplaces can be hard on women, especially when there are no clear or inclusive

policies to support them. What policies can small businesses introduce to better

support women experiencing the menopause? Yeah, well, I think to build on what you're both saying there,

there's been a real positive change in awareness of menopause and how it impacts women at work. A really good starting point and one I

would encourage businesses to do is to implement a menopause policy. And what that can do really to build on

what Naveem was saying is it can help to reaffirm your business culture, encourage open

conversation, inform, provide some information, provide the name of an individual who might be your menopause

champion, for example, someone you can go to for a bit of support or if you need any adjustments.

So if you are struggling with more severe symptoms than menopause, who to go to to have a conversation? And like you say, encourage the open

discussion about it. Certainly the SMEs that we advise, we've seen the positive impact of having more inclusive

policies can have both on culturally and also with employee engagement as well. Absolutely.

Naveen, back to you. What are some of the other practical ways businesses can help employees who might be

experiencing the menopause? So we've touched on a few things and certainly Laura's

suggestions, I think, are really pertinent in terms of having a formal menopause policy. But sometimes it's the softer things that

can also make a difference as well. And getting to know what your employees' individual needs are can be really, really fruitful.

So while I've mentioned things like instituting a desk fan or giving someone control of the air conditioning unit, I'd also encourage

you to recognise that your staff have a wealth of insights themselves and actually utilising them as an

expert resource can be really, really useful. And so starting conversations, I think, is a really good first step because you'll come up

with a whole host of solutions that perhaps you hadn't thought of yourself.

Practical solutions might also include flexibility. So when it comes to the menopause, it can

really have an impact on how somebody works day to day. Symptoms can be quite debilitating. And so giving individuals the flexibility

to excuse themselves from a meeting, perhaps work more flexibly in terms of environments or

working from home rather than the office or in a place that is more conducive to their wellbeing could also be helpful.

I'd also consider perhaps offering flexibility around hours as well. Some women may recognise that their symptoms are particularly bad

first thing in the morning or last thing in the evening. And so giving them that flexibility to undertake their work to the

best of their ability when they find they can be most productive can also be helpful. There is also, thankfully, some formal

support that Bupa can provide as well. So I'd like to speak to that if I may, because I think this can be really helpful for our listeners.

Bupa has a women's health hub online, which is available to anybody, whether you're a Bupa customer or not. And we're really proud of the content on

that because written by clinicians who have a really vested interest in providing the best outcomes and

information for our customers. I'd also share that the information is written to a standard which means it's accessible to

everyone. So doctors like me can be very guilty of speaking in jargon. But the good news is this content is really patient

friendly or customer friendly. And so please feel free to have a look at that. And it's for everyone, not just for women. I'd also direct you to our line manager

guides as well, because as Laura mentioned, while there are things such as policies we can put into place, actually sometimes managers just don't know

where to start. And so a good port of call might be one of our line manager guides, which are written specifically with a health

focus and lens at their core. And then looking at some of the paid services within Bupa, we

do have a number of health products and plans that could be really useful for a woman undergoing the menopause.

We have, as it says on the tin, a menopause plan, which is a specific appointment dedicated

to addressing any symptom and all symptoms of the menopause and coming up with an action plan for that.

And there's also a follow up appointment which is provided as part of that plan as well. We also, moving away from the menopause,

have women's health assessments as well. And these tend to focus more around women's cancers, so providing cervical screening and

breast screening, but also a woman can raise any other health issue she wants to. And so within the context of that,

anything can be discussed. And finally, if your plan with Bupa includes mental health cover, we recognise that the

menopause and other women's health issues can cause a mental health impact. And so the mental health cover will

provide you with access to a trained professional who can take a call from you, essentially ask you a few questions and

assess your needs and then refer you on to other services that may be useful for you. Sometimes this may also involve referral

to a mental health professional. And by accessing the mental health cover, you may find you can do

that without having to speak to a GP in the interim. Incredible, absolutely amazing service.

Laura, what are some of the business risks of not supporting menopause in the workplace?

So I think on a day to day level, that disengagement, people don't feel supported. It leads to increased absences from work.

Depending on how it's been handled, it might result in a grievance, which is then obviously there's a process to be followed then to investigate that and outcome it.

That again, just takes time and energy away from from growing your business and productivity generally. And as we've mentioned briefly

earlier, it might also have an impact on recruitment. People looking at if one can work for your business, they'll often look at

employee feedback and what they're saying about what kind of culture it's like to work there. And on the flip side from reputationally as well,

you know, it's the real open, positive way, real open conversation about menopause now across a range of business sectors. And I think being a positive

contributor to that conversation is only going to be good for your reputation as a business. And obviously, from

the legal side of things, there's obviously risks of claims for discrimination based on age, sex, disability,

depending on circumstances. Similarly, there was a very high profile case of unfair dismissal where a long serving

member of staff, they'd be going through a performance management process, or on a final written warning. They actually produced

evidence from their GP to say the impacts of the menopause they're experiencing were impacting on their

performance at work for various reasons. The employer chose to disregard that or thought they

knew better, moved to dismissal, then they resulted in a hefty unfair dismissal claim. So it can be costly

financially from that side of things as well. So there is inherent risk there. We're nearly at the

end of our first session. But before we move on, let's look at the top takeaways from our experts.

By addressing women's health and providing better support, businesses can play a vital

role in creating an inclusive and supportive environment. Introducing a menopause policy will

provide women with the support to regain control of their health and their wellbeing.

And left unsupported, the menopause can lead to disengagement, increased absent levels

and potential loss of talent. We are now moving on to our second part

of today's session, [Music]

Part 2 – Supporting parents in the workplace

Naveen, having children is a monumental event in someone's life.

What advice would you give to small business owners to ensure they're fully supporting

expectant mothers in the workplace? Well, the first thing I'd say is that it's really important you

encourage your employees to stay as healthy as possible. A healthy workforce needs to do great output and great positive

things for your business. But in particular, there needs to be a focus around the health of a pregnant woman as well.

Some pregnancies may have complications alongside them as well. While we recognise that pregnancy is a very natural part of a

human condition, sometimes there are complications that can occur from diabetes to high

blood pressure, the need to see a doctor more frequently for other checks. And so do be mindful of that too.

Now while stating that pregnancy is a very natural process, there are also some things that can go wrong or symptoms that can

start to occur for some women. So to be mindful of this, I think it can be very useful. And I'll share some of these with you now

because I think this could be helpful for our listeners. We know that bowel and bladder symptoms can be common in pregnancy

from things like constipation, developing piles because of their pregnancy, needing to go for

a wee more frequently because the pregnancy is pressing down the bladder and such like as well can be an issue.

Dental issues are also common, so bleeding gums are a common factor and that can affect taste, ability to hydrate and things of

that nature as well. Heartburn can be a big factor too. When you consider there is a pregnancy growing inside the abdomen which is pushing up on

the stomach, it can cause a real sensation of discomfort. It can also be swelling as well, from the hands to the feet, the legs, the arms and

so it's really important that you factor that that may impact people's ability to use their hands or to walk etc as well.

Mental health issues are also common. I think I'd be remiss if I didn't mention that some women can get quite anxious or feel

quite low during parts of their pregnancy and it's important that we recognise that. And finally, I think the one that most of

us are aware of is nausea, sickness and vomiting as well, so please be conscious of that too.

Now the good news is there's lots that businesses can do but you need to have an awareness of those symptoms to be able to respond to them.

So common things that we find helpful are offering frequent breaks as and when required and allowing your women to work flexibly

so that they can perform when they're feeling well and feeling good and perhaps take a time out when they need to address and tend to

their symptoms. Reducing numbers of hours worked, all the location of work can also be helpful as well,

allowing for example flexible working from home or to another environment which may be more conducive to a woman's

wellbeing can be helpful too. When it comes to swelling and the collection of fluid particularly down by the feet and

the legs, offering a stool can be a really simple solution for that. We also find that adjusting the task that

your employee may have to undertake could also be helpful as well. If there's heavy lifting for example, consider that perhaps that

isn't the most kindest thing for that employee to have to do or long distance travel, particularly at the later stages of

pregnancy. It may be more appropriate to find another person in your firm to do that and reallocate duties to your pregnant employee who no

doubt will take on whatever other responsibilities you might find could be helpful. And then the other one I'd mention is

providing adequate ventilation. Sometimes simple things like a desk fan providing access to a window can be really helpful because

you know, carry that extra weight, can generate lots more heat and therefore in a hot environment or in a hot day that can

be even more cumbersome. Yeah, I mean I'm recognising all of the things that you've been saying there.

As someone who has had many women fall pregnant, have their babies under my care or not like

you, not as a doctor, but it's so important that you have this open communication.

I think along with everything that they're worried about in terms of their symptoms and how they're feeling, they're also very

anxious that this is their job that they might really care about, well I hope they care about, and you're also looking to

make them feel supported. So I think again it's all about this open communication that they feel that they can

share how they're feeling, they're feeling anxious about maybe having maternity cover when they might be coming back, what's

going to happen without them. And the same with the employer as well, it's also anxious about losing this magnificent

person, how can they stay in contact. So I think these things are really important but it gets

back to that communication. Laura, what is the business's duty of care to pregnant

employees and how might it differ for those who are non-desk workers or

workers who have shift patterns? Well it leads into the suggestions for making those reasonable

adjustments to support them work really because there is that overriding duty to reduce workplace risk particularly.

And obviously it's a legal obligation to carry out a risk assessment to make sure those risks are reduced in work.

But you must also remember to carry out a specialist pregnancy related risk assessment when someone is full pregnant.

And to keep that updated because obviously the pregnancy will develop, as Naveen said, complications might arise.

So keeping that up to date is important and it will lead into that, like you say, that open communication with the employee and

they feel supported and will want to give as much as they can to work throughout their pregnancy.

And Laura, how should small businesses manage maternity leave? Well as we know, roles in small

businesses often are roles that wear many hats. So you might be taking that time out from

work to have their baby. You're losing quite a key person with the business potentially. You'll have all that customer knowledge, supplier contacts, all

of that kind of thing. So planning is definitely the best piece of advice there. So it's having a conversation.

So in addition to congratulating them, it's opening that conversation to start thinking about their plans for when they'd like to

take their maternity leave. The legal entitlement is to 52 weeks. Do they want to take that full period? Do they want to take part of it?

Have they got any thoughts about how they wish to use their accrued holiday as well? It just all helps with that for planning

and it can help actually reduce anxiety for the employee in doing so. But as an employer, it just enables you

to prepare for a long lead time for the handover before they go on maternity leave so you can manage in their absence.

It's surprising actually, the amount of businesses we speak to and they sort of ring us going, "Can I talk to them about it?

What can I say?" Well I was just going to ask you this. The nervousness about it. The nervousness about it. Tell me about that.

Well, they often feel like, you know, frustrated saying, "I don't know what's happening." Well, they're going to have a baby. It's all going to be fine.

But it's just having this, but it's absolutely fine. And actually, on a serious note, it is showing that support and demonstrates that actually the

employee will feel supported in doing so and having that conversation as well. And there's obviously, you know,

further legal entitlements, but he's been mindful of. So, pay time off for antenatal appointments. Again, if we've got

that dialogue going, we want as much notice as we can, please, of those appointments, it might mean a couple of hours out to go

to attend certain clinics of the business, and they're entitled to that paid time off. And also, the right to

return to the same job, once they return from maternity leave, or if they've taken the full period, it might

be they're returning to a suitable alternative role if there's business reasons for them not being able to return to the exact

same role as previously. And obviously, around that, the right not to be dismissed because of having a child,

of course, and not to suffer a detriment for having taken that time out. there's obviously a risk of discrimination claims arising off the

back of that if it's not handled properly. And there is scope for businesses to take advice, so Bupa Growth plus customers in particular,

do have access to an HR advisory service where they can seek advice and support should they need to do so.

Very, very helpful and useful there. Naveen, having children for the first

time is, as we said, monumental event in someone's life. How should small businesses support new

parents in the workplace? And why is it so important? It's a really big one, isn't it?

having starting a family and having children, or indeed expanding your family as well. And I think it's really important that businesses

recognize the very positive role they can play in that process. Now for people starting a family,

while it's a really wonderful thing to be doing, it can also be really fraught with feelings of

complete sort of overwhelm, feelings of loneliness, feelings of shame or guilt, because they don't know what to do

and don't know who to ask, et cetera. So perhaps being a supportive source of counsel

could be really helpful. And we've spoken a lot today about creating an open culture at work, and I'd certainly extend that to conversations

around starting a family and all the pressures and expectations that come with that.

There are certain things that we know new parents will experience that can really have an impact on them in the workplace.

And I think some understanding goes a long way in helping them adjust to that. Common things like sleep deprivation,

I think any... I was wondering if that was going to come up, yes. Absolutely. But sleep deprivation can have a real impact.

And remember, this isn't just a sleep deprivation that occurs over a particular day or a weekend. It occurs over a very

prolonged time frame and therefore can really have a knock-on effect on someone at work as well. So to recognize the impact

of that could be helpful. There are no easy solutions to this, but just recognizing that, I think, is a really helpful first step.

Another thing is that child care is really expensive. And all the associated costs with child care as well, particularly if you are

looking up salary reviews or bonuses or indeed making cuts, this could have a real impact

on your employees too. Sometimes, as Laura mentioned, there can be real concerns around job security as well.

Starting a family or indeed expanding your family comes with risks of leaving the workplace and potentially missing opportunities

for promotion or progression, particularly for women. And so perhaps some reassurance around that can be really, really helpful to remind

an individual of their value and how much you recognize their talent can be really positive.

And to ensure that when they come back to work, there's a real welcome and a recognition of what they're bringing back with them.

We recognize that pregnancy is a really positive process. But when a woman has her child, they

can, for some people, be a real period of feeling quite down and low after their pregnancy just because

of the sheer overwhelm of the task that befalls them. You have this young child in your presence 24-7

who depends on you for all of their needs. And that can be really overwhelming, particularly if you haven't got any support,

if you've never been given any guidance in terms of what to expect, or indeed, if you're doing everything right, it can still be something which is

a really fraught time. So recognizing that postnatal depression may affect your employee is also really important.

I'd also extend that to the partner as well. While they don't experience a postnatal depression, it can certainly have a mental health impact

on the partner of a pregnant individual too. So that recognition can be really helpful from an employer perspective.

And so moving on from that, then, if we consider what support your organization can offer,

there is not a one magic bullet that fits every pregnancy. But certainly, as mentioned, open culture can be a

really positive first step. And I think communicating regularly with your employee too,

just checking in with them, seeing how they're doing, because things change day to day. They may be okay one week and actually struggling another week.

And so for you to have regular conversations can be a really good source of support. We've spoken about flexible working,

and I think this is really useful for parents in particular. They can't predict when, for example, their child may have a

sleepless night or fall ill, and therefore they can't predict what other needs they may need to address, like taking their child to a doctor

or addressing full sleep and things of that nature. So to offer flexible working can be really helpful too.

And finally, on the point around people's concerns around their job security and career development,

perhaps be mindful that those are the individuals you really want to be targeting those conversations to. If there's a training

course being advertised or an opportunity for a secondment, perhaps bear those individuals in mind because they may feel

neglected or indeed be neglected because they've been off work for a while or weren't in your line of sight

when those things came about. And in terms of paid full services, you as an organization may consider subscribing

to an employee assistance program because that can be a real source of independent support for your employees.

Sometimes despite all the support you may provide and the open culture you may generate, it can be really difficult

to speak to your employee about certain things. So your employer about certain things I should say. And so investing in an

employee assistance program can be really helpful to give them independent and external advice, much

like seeing a therapist, for example, is also independent and free of any

judgments and such like as well. And as already mentioned by Laura, with Bupa Growth Plus, if

your teams are eligible, they can access that service too. - It is a real moment in

time when you come back to work and you've got a young one and you maybe have extended your family.

And I think one of the things that I've tried to do in my teams is make sure that there's no elephant

in the room. There's the sense that this person has come back, they're insecure, they might not have

slept all night long, they want to do a good job, they want to have their mark again in the workplace.

And I think it's for employees to try and if they can,

be as open as they can about what their experience is. But as an employer, to

make it an environment that you might talk about your own experiences,

you might ask the rest of the group to share, who else hasn't had a great night's sleep?

And just allow that to be an open conversation. And I too often have I witnessed people really fearful

about their career progression. And I think it's really a great point that you make to really take some time

to help them feel secure. And I think the more that they can feel secure, the more that they feel

that can be open with you, the longer that person hopefully will stay with you.

And also, but more than that, the more they'll enjoy their job, the more that they're going to contribute to the team

and the culture of the organization. And I've seen many, many times how that environment

has fostered fantastic employees and that I've worked with for many, many years

and many pregnancies actually as well. - Laura, what guidance should small businesses be offering to employees who are

returning to the workplace? - Well, it's surprising to start with the number of businesses that call us saying,

have an employee who's off on maternity leave saying, I haven't told them if they're coming back. Well, it's important to remember

they are still your employee, they do remain employed. So unless they actually choose to resign, they are coming back.

And I think in terms of advice, it's having the conversation, speaking to them, picking up the phone,

it's quite daunting return. They've been off for a number of months. They're probably very nervous and trying to sort of juggle everything to come back.

We talk about that, the work-life balance. And a lot of women think, I think it's got to be all one or the other.

And I think anything we can do as an employee to support that, like you said yourself, can get the best out of your staff team.

And they don't lose their work ethic. The other person's circumstances have changed. And I often think that new parents

are often amazing multitaskers. And I think it's a bit of a tough superpower. - I agree. - You know, so if you can actually make good--

good use of that and having those conversations, of course, is keeping in touch days as well. So there's up to 10 you can

take during maternity leave and they are days in which you can agree to come back into work. So say, for example,

you're having a business up to a meeting, don't forget about them and invite them to that. It's a paid day at work for that day

or even equally if you want to have some update training generally, have a meeting to have a conversation ahead of their return.

They might even want to do a couple of days here or there to ease themselves back into it and start to pick things up

and getting the feel for being in work again. It can all make that transition transition a lot easier.

And obviously if they do want to make a flexible working request to change their hours, there is a formality to that

where they write and make the application. As an employer, we can consider it. So we have to, there are

reasons where we can refuse it if we need to for commercial reasons that are there

or try and have that conversation to come to a compromise if you care. and it all ties into, as I say,

supporting that return to work for everyone's benefit, for the employer and the employee. Absolutely. Naveen, tragically though,

more than one in five pregnancies end in miscarriage in the UK each year. How can businesses

offer support in that circumstance? Yeah. We've spoken a lot about what businesses can do to

support a pregnancy, and I think all those things are really positive and really wonderful, but I think there's also a responsibility to recognise, as you say, that some

pregnancies don't go to full fruition, and indeed they can be the loss of a child at any point during that pregnancy.

The impact of that can be absolutely profound, and I think one thing I found very useful was to consider that the

loss of a child, whether the child was delivered or not, can be akin to a bereavement or an actual loss of somebody who was living,

and the impact on an individual is absolutely profound as a result of that. We recognise that people can

experience feelings of anger, of guilt, of failure, of shame, really

negative emotions that can be really deeply entrenched. And remember, it's not just the person who was pregnant who

experienced disease, but also their family and their partner as well, potentially. So it's really important to recognise

the wider impact there too. We also recognise that some of these short-term feelings can actually become more entrenched

longer-term thoughts as well, and lead to mental health conditions like depression or anxiety, which lead to formal

treatment medically as well. So there can be a real knock-on impact there. I think the

things that we just described in terms of creating an openness and an inclusive culture really come into their own here, because

to have those difficult conversations requires what we call psychological safety, and nobody is going to speak about these very deep

negative emotions if they don't feel safe to do so. They can sometimes within a workplace be

a sense of difficulty in starting the conversation, because you may have been sharing in the excitement of the person as they

progressed through their pregnancy or may have bought them a gift for their pregnancy, and suddenly they now happen to have a very different set of

conversations with you. But to provide the safety for them to have those difficult conversations can

be really helpful. There may be unpredictable feelings like tearfulness or bursts of anger, which I think are really

appropriate, because emotional ups and downs are part and parcel of this process. And allowing the space and

providing some understanding around that can be really, really helpful. I'd also suggest that you may want to consider how you

manage potential absences as well. Sometimes these feelings can be so overwhelming that actually taking time away

from work can be the more healthier and productive thing for your employer in the long run than insisting they come into

work despite those negative feelings and such like as well. And as a manager, I think it's important that you are equipped with the

support from your own management and leadership in dealing with these very difficult conversations, because they

can be quite impactful on anyone that has to have them. From the point of view of Bupa as an

organisation, we have online what's called a mental health hub, which provides a range of resources for

suffering available. And sometimes just recognising that actually these feelings could be depression or these, you know,

sensations could be anxiety, can be really empowering for an individual. So please feel free to either make use of that yourself

or direct employees if you feel that might be helpful. Similarly, if you have a Bupa health plan that has mental health

cover, you are entitled to pick up the phone and speak to an advisor who can talk through your symptoms,

ask you a few questions and then direct you to appropriate resources or indeed specialists as well. If your

cover extends to this, it can be the case that we can refer you on to a specialist without the need for you to see a GP

as well. So making use of that can be really helpful. What I'd also say is that make use of charities as well. There are some

fantastic organisations out there. I can think of one called Tommy's, for example, which is really helpful at sharing sort of

almost peer support around miscarriage and loss of pregnancy too. With the best will in the world as an

organisation, you may just not have the insights into what this individual is going through. And sometimes meeting other

people who have gone through similar can provide a level of comfort that perhaps you as a workplace weren't able to achieve. Thank you so

much. We're nearly at the end of our second session. But before we move on, let's look at the top

takeaways from our experts. Supporting parents will not only help them, but the business will benefit from

greater employee loyalty and retention. It's important business owners are aware of the full

range of employment rights that pregnant women, new mothers and new fathers have. Touch base with

parents before they return, consider flexible working and remember their personal circumstances may

have changed, but their work ethic won't. We are now moving on to the third part of today's

session, supporting female cancer in the workplace.

Part 3 – Supporting female cancer in the workplace

Naveen, for women in the UK, breast cancer is the most common cancer and one

in seven will develop the disease in their lifetime. What adjustments can businesses make if an

employee has chosen to stay in work whilst undergoing cancer treatment? Thank you for that figure of

one in seven, Holly, that's really quite stark, isn't it? And what I'd also show is that one in two people in the UK will

experience cancer at some point. And so actually, you know, broadening the conversation to all cancers, it's affecting many people at

some point in their life. What we know is that cancer can affect people very differently. And so it's really important that

you take your cue from your employee, but also consider what generic measures you can put in place in

anticipation of an employee having a cancer. I think it's important to recognise that many people don't want

to be defined by the illness, they are not a cancer, they are somebody who has a cancer and therefore recognising the

impact of the condition on them, but not defining them by it can be really important. Some may choose to work through part of all of their

treatment, in fact, and so don't make assumptions about what cancer means. For some people, cancer is just something they live

with, like diabetes or high blood pressure. And for others, it can be much more consequential.

So taking the cue from the individual can be really helpful. For those that work, we know that work can be really fulfilling

and really give you a sense of, you know, purpose and function. And so allowing your employee to continue to work and making adjustments

and providing support around that can really help give them a sense of self and a sense of purpose and start to

explore that with them if you can. I'd also say be mindful of some of the symptoms that occur around cancer and also some of the

inconveniences that may come about because of it as well. A common symptom is tiredness, for example,

which I know we can all experience sometimes the time with a cancer, it can be even more profound and really have an impact on how you do

your day to day duties, how you dispel your functions, etc. So do be conscious of that. And if

you can provide adjustments for that, such as working adjusted hours, working from home, even

providing rest breaks during the day, that could be really fruitful. In terms of the inconveniences that cancer can cause, as

well as the obvious things, you know, some individuals need to have regular blood tests or attend regular appointments or take

regular calls from their doctor and actually providing the space and the flexibility for that can be really helpful. It can be quite

difficult for an employee to lean on your kindness and say, oh gosh, I've got another thing to ask of my employer. Will they,

you know, when will I break the straw of that camel's back? Which is, you know. the kinds that you've given them so far.

So to recognise that there should be a culture around not feeling ashamed or not feeling guilty for asking for support can also be

really, really helpful. And for you to actively pre-empt that conversation by saying, "What can we do to help? Do you need some time

around appointments this week?" And having regular contacts can be really helpful as well.

I'd also recognise, rather ask employees to recognise the psychological impact of cancer as

well. You know, it's not just a physical condition as serious as it is, it also has psychological impacts as well. An

individual can really feel many things from feeling quite low to feeling depressed, feeling anxious, guilt,

shame, a complete, you know, sort of detachment from things, in fact, a denial of their cancer

and all the impact it's having. And so to be able to navigate that can be really helpful as well. I'm not expecting employers to

be experts in this, but to recognise that many people have many different emotional responses can be a

helpful first port of call. And Laura, what is a business's legal

responsibility to employees who are experiencing cancer?

So if you have a member of staff who has cancer, they're protected from the Equality Act of 2010 from the point of diagnosis. So it

doesn't have to be any sort of long-term prognosis or anything like that. It's from that point of diagnosis

they're automatically protected. And what that does is place an obligation on the employer to make reasonable adjustments.

Now that could be things like allowing more time off for appointments, being flexible around hours if they're feeling the effects of

any treatment they're going through. It might also mean if you have an absence trigger

system. So it might be a system whereby you might issue warnings for excessive absences. Obviously taking account of

any absences might be connected to their cancer and discounting that from your calculations.

They're not unfairly penalised for that. But similarly, if you have a member of staff who has a

partner, for example, they're caring for or even a child or another member of their family who is struggling themselves

whether it's mentally or otherwise in caring for them and supporting that, such a thing is associative discrimination. So it's

not the employee that has the disability per se, it's a member of their family. And if an

employer treats them less favoured because of that, because perhaps they're not quite with it, if they're kind of

feeling anxious about it, or their mind's elsewhere, or they might have more periods of absence due to it, it's

making sure they are in a protected position. So it's really important as a business to be aware of those things.

That's fascinating. Naveen, what are some of the most common myths that prevent women from going for their smear test or

mammogram? And how can small businesses promote more awareness around screening?

Screening is really important. And I think as a doctor, of course, I would say this, but please, please do attend for your screening appointments.

They are there for your own protection and to pick up cancers before they've developed and while we can do much for them.

The two kinds of screening available to women, as you mentioned, are cervical screening, where a woman has a smear test and breast

screening via a mammogram, a particular kind of x-ray. And let me speak about both of those if I may, just to dispel some of the myths

around them. So to your question around why women don't seek out screening, there can be many factors.

But one is embarrassment or a fear of the unknown. I think some people anticipate there'll

be a particularly invasive procedure or the pain of the procedure. Sometimes there can be a shame or a guilt

around having screening as well. What I'd invite women to consider is that doctors perform screening all the time.

For us, it's a really regular and routine part of our day. I know for a woman, building up the courage to have a screening

examination or process can be really fraught. But remember, for us, it's a day-to-day thing. And that's not to minimize the feelings

you're experiencing, because I take on board any woman and any man's feelings around any medical interventional process.

But remember, we do this all the time. We're used to making you feel comfortable. We're used to any concern or anxiety you have.

And we would welcome you to have your screening with us. From my perspective, I'd like to share that Bupa does offer screening to women

who would like to take screening up with us. As part of our offerings in Bupa Health Clinics, you can access a

women's health assessment, or indeed just seek out a cervical smear or a mammogram as a separate service as well.

We can offer these to women from the age of 25 for a cervical smear up to any age, and from 40 up to any age

for mammogram screening. But I should also add, these are available in the NHS and are completely free,

from the age of 25 for a cervical smear up to 70, and from the age of 50 up to 70 for a mammogram.

So please do take these up for free via the NHS if you would like to as well. Thank you so much.

How can businesses support employees returning to work after cancer?

So I think from my point of view, what I would say is that anyone that returns to work from cancer needs to have an open culture and an

opportunity to explore their feelings, should they so wish, and perhaps make you as their employer aware of some of their needs that have

arisen because of their cancer. Sometimes the needs will be very obvious, such as surgical sites or

other impacts that are physical, but sometimes they won't be, such as the psychological impacts or other things

that are not necessarily obvious to you, because people can be quite good at masking their symptoms and hiding things

from their employer, particularly if they don't feel safe in their workplace to share with you. So creating a culture around openness can

be really, really helpful, and encouraging an individual to perhaps be open about their feelings, should they so wish, can also be helpful too.

They may not take you up on that at the first offer, but it may be after a few prompts, they may finally have a conversation with you.

I'd also encourage you to consider formally as a line manager what one-to-one conversations you want to have with your employee.

As with any employer that's taking time off work for any sickness, you want to know whether there is anything you need to do as an organisation to help them

with their return to work. And the same applies to cancer as well. But perhaps when considered with cancer because of the psychological impacts that

we've already spoken of, it can be even more important to have that conversation and even more important to have it sensitively as well.

So things like discussing their desire to work flexible hours, for example, other adjustments they may need to make,

such as using restroom facilities, changing dressings, the need for hydration, fans, etc.

There can be many needs that we don't necessarily know of, obviously, but that the employee may well share with you. And remember, they've gone through their

conditions or they'll know what adjustments may help them. And I'd certainly invite you to invite those conversations as well.

Sometimes it's also important to recognise that cancer isn't just a one-off process. There isn't just one operation or one cycle of treatment.

It can be something which goes on over a protracted period of time. Indeed, we now have people who live with cancer as a chronic disease, just like

they live with diabetes or high blood pressure. So consider that your adjustments may need to be long term, not

just short term as well. Some people may also benefit from having a mini induction when they return to work

after a protracted period of absence. I know off-camera Laura and I were speaking about the concept of a mini

induction whereby when someone's been away from work for a period of time, they may have forgotten some of the more basic day-to-day things that they took

for granted, such as what passwords to use for what programs. And so just providing the time and the

space to do that can be really, really helpful. I'd end by saying that the key is to be empathic and just to be as supportive as

possible and as open as possible, understanding as possible. We're not expecting you to have all the answers to manage a very

complex medical condition, but certainly empathy and an openness around how you approach your employees

can be really helpful. I think empathy is that word, isn't it, here, in that anyone I've known that's

gone through cancer, there is a different frame of mind that they come out with, certainly, you know,

looking at mortality or their purpose and life and what they want to achieve and the love of their family.

And they've gone through something, you know, absolutely. It's been one of the scariest things that they've ever done.

And so I think that relationship, again, is so key that actually it could be that they want to look at how

they can maybe expand their job, maybe look at flexible work and they want to take up that hobby that they always wanted to do, but they

don't want to give up their job. So I think having that, again, we talk about this environment.

It's playing through, isn't it, with everything. Having the environment to be open and to support someone with empathy is just

absolutely key for a fantastic relationship. Laura, what advice would you give to

businesses on how to support employees who might be on long term sickness?

So long term sickness should be covered in your sickness absence policy within your employee handbook.

It's a useful tool for managers or as a business owner to understand the process to be followed through. But also for the employee to be aware of

how regularly they need to keep you updated with regard to their ongoing absence. So what we should be receiving is timely

sickness or fit notes, as they're called, to notify any further periods of absence.

I'd also encourage regular communication. We often get businesses feeling a bit apprehensive as to, well, they're unwell,

should I make contact with them? And I think there's definitely a balance. We don't want to be hounding them and keeping them all the time.

But similarly, we don't want to leave them at sea either. So having regularly timed welfare meetings, for example, that can be a

starting point, could be an invitation to the workplace if they're physically able to do so, depending on their condition or it could

be done by a video call or a telephone call just to have an update as to how they're feeling. What's been the update

from their GP or consultant? What is their prognosis? And that could then lead into a conversation around

supporting a return to work if and when that's possible. So can we encourage them back

with a phase return or support them in doing so? Can we give lighter duties for a temporary period of time

to help with that as well? And it might be actually that obtaining an occupational health or a GP's medical,

more in-depth medical report. Obviously, you'd need the employees consent to do that first. And it may be actually we reach the point

of, well, there aren't any recent adjustments we can make to their current role they're employed under.

There aren't any suitable terms and roles we can offer. We've had someone offer, you know, a number of months. And it may be we're looking at possible

termination of employment for medical capability grounds. Now, that does need to be handled carefully.

And I would urge businesses thinking about that to take advice before doing so. Obviously, mentioned before, those Bupa

Growth Plus customers do have access to the HR advisory service if they want some additional support with that.

But also in terms of how you handle that, obviously, there's the unfed dismissal risk that could be exposed if it's handled poorly.

But just generally in terms of the longer absence, if the employee feels aggrieved

or upset about how it's been managed, we do see quite a number of grievances. And again, what that will do is elongate

the period, perhaps they're absent from the business. It will potentially start relationships. So it's really important to handle it in

the right way from the outset. It's not just that person, isn't it? It's the culture of the organization,

those colleagues that might be supporting. It's such an important thing to deal with correctly.

Naveen, what are some of the services small businesses can use or promote that will help support

employees experiencing cancer? So reassuringly, from Bupa's point of

view, we have a couple of things that I'd like to highlight, and these are available to individuals who are eligible for these particular

services if their cover permits. The first is mental health cover, which we've already spoken of.

But just to remind our listeners, what that is is a service helpline rather, where they can call in and speak to an

adviser who will take some details from them and will be able to direct the member to an appropriate mental health service or provision.

Sometimes if they need to see a specialist, that can be done by this service as well. And therefore, that can remove the need

to see a GP beforehand. Secondly, I'd also mention Bupa's full cancer cover, which is where a member

will be covered for any treatments and costs that can be incurred because of their cancer. We also have

Bupa direct access for cancer cover as well, whereby an individual can call one of our cancer specialists

and speak to them on the phone and be seen by a specialist in person rather than having to go by their GP for

symptoms that may be suggestive of a cancer as well. And then finally, in terms of paid full services, within our clinics, we do offer

women's health checks and also breast and cervical health checks as well as a focus around cancer screening as well.

And so if a woman wants to see a GP for generic symptoms and discuss those, she can do so as part of a health check.

Or if she wants to undertake a cervical smear or a mammogram, she can do that as part of those cancer checks as well.

Thank you. We have reached the end of our session today. Thank you to Laura and

Naveen for joining me. We hope you found it useful. See you next time.