United Kingdom

Meeting your health and wellbeing responsibilities overseas

A university’s duty of care extends to the health and wellbeing of its staff and students overseas. Janet Penny, Client Manager at Aon, explains how universities and other organisations can protect the wellbeing of staff and students, wherever they’re based.

Demand for overseas placements is increasing among UK students, who want to experience a different culture, language and education. But while universities are keen to support students seeking these opportunities, there are also health and wellbeing risks that must be taken into consideration.

Under the Health and Safety at Work Act, universities have a duty of care to ensure the health and wellbeing of students and staff. This responsibility includes both physical and mental health and extends beyond the borders of the UK.

Health and wellbeing responsibilities

These responsibilities were brought into sharp focus during the pandemic, with students complaining that their physical and mental wellbeing was being overlooked.

But awareness of the need to safeguard students’ mental health was growing long before the pandemic. A report by the Institute for Public Policy Research found that between 2006 and 2016 the number of first-year students disclosing mental health conditions increased from around 3,000 to more than 15,000 (1).

Suicide is also a concern in higher education. The most recent figures from the Office for National Statistics show that the rate of suicide was 4.7 deaths per 100,000 students in the 12 months ending July 2017 - 95 suicides in total (2). Although this is lower than across the general population of similar ages, it is higher than in previous years.

Placement protection

These health and wellbeing concerns can be even more pertinent on overseas placements. Being thousands of miles from home, in a country where cultural differences are intensified by language barriers, can exacerbate mental health issues. This can have tragic consequences, with the incidence of suicide while on placement becoming more common in the last couple of years.

As well as being tragic for all concerned, the fallout for universities from these health events can be very damaging if they are found lacking in their duty of care. Reputational damage, legal liability claims and loss of income are potential repercussions.

This being the case, universities need to ensure they have the right risk management and controls around overseas placements. An agreed protocol with triaged pre-travel mental health checks is recommended to identify students and staff who might experience difficulties overseas.

Mental health assessment

As an example, Aon can provide a pre-travel mental health service, where students complete a questionnaire ahead of a placement. The responses to this, coupled with further input from psychologists where necessary, determine whether a placement is an option and, where it is, whether further support may be required when they’re away.

There are legal and governance issues associated with this. As well as requiring a student’s consent to share their details, universities must also consider their position as far as disability discrimination legislation is concerned. Preventing a student from going on an overseas placement because of their mental health could be regarded as discriminatory so any advice must be framed as a recommendation based on the information from the pre-travel service.

Universities should also make sure that all overseas placements, whether for students or staff, are subject to the same protocols.

International health cover

Another consideration when arranging overseas placements is how any existing mental and physical health issues are handled on the student’s health cover.

Personal accident and travel insurance covers the cost of emergency treatment when someone is overseas but these policies aren’t designed for pre-existing or recurring illnesses. Neither does it pick up on-going counselling for chronic Mental health conditions.

Where a pre-existing condition is identified that may require treatment during a placement, medical insurance can be arranged. This can be more costly but is more comprehensive and can give the reassurance that it will pick up the cost of treatment for pre-existing conditions, including on-going medication requirements for conditions such as asthma or diabetes. International health cover also offers additional features as part of the cover, with access to services such as telemedicine or employee assistance programmes.

Overseas staff

Issues can also arise around a university’s responsibilities to safeguard health and wellbeing when staff are based overseas. This has become more common during the pandemic, with online teaching enabling some members of staff to return to their home or adopted countries.

This raises questions around liability and what an employer needs to do to meet their health and wellbeing responsibilities, especially where staff aren’t under traditional contracts of employment. The Employers’ Liability (Compulsory Insurance) Act 1969 was originally intended to cover UK employees and temporary trips overseas. As work patterns have changed significantly since the sixties, some insurers are also covering long-term, yet still designated ‘temporary’, trips overseas, under the jurisdiction and territorial limits by their liability policies.

We would advise universities to assess the employers’ liability or workers’ compensation that’s available to an employee based overseas, and top it up to UK levels where possible with cover such as income protection. A reputable organisation may also want to undertake a similar exercise with healthcare, using a medical insurance scheme to replicate the level of healthcare available through the NHS. 

For staff overseas, there is often limited or no access to the local state healthcare system, which consequently creates a gap in cover if staff fall ill, and the potential to incur huge costs for treatment. International medical insurance policies also offer cover in the home and host country which may suit staff if they have a regular consultant in their home country that they prefer to see.

Experiencing other cultures can be a great opportunity for students and staff alike but it’s not without its health and wellbeing risks. Having a robust approach to managing these risks will ensure that all parties benefit from these overseas opportunities whilst boosting the reputation of the university.

More information

For more information about how your organisation can manage its health and wellbeing risks and responsibilities, both in the UK and overseas, please contact Janet Penny at Aon at [email protected]

(1) not-by-degrees-summary-sept-2017-1-.pdf (ippr.org)
(2) Estimating suicide among higher education students, England and Wales: Experimental Statistics - Office for National Statistics