A sharp rise in long-term sickness is pushing more working-age adults out of the labour market and putting pressure on employers, the NHS and public finances, according to an independent government-commissioned review led by former John Lewis chair Sir Charlie Mayfield.
The review warns that ill health has become a major brake on growth and said businesses will face rising costs without earlier intervention and better workplace support.
The analysis said there are now around 800,000 more people out of work for health reasons than before the pandemic. It projected that the figure could climb further by the end of the decade unless prevention, support and return-to-work practices improve across organisations.
Sir Charlie said work and health were mutually reinforcing, and urged employers to see workplace health as part of their core strategy. “Work is generally good for health and health is good for work,” he said. “Britain is sliding into an avoidable crisis. Ill-health has become one of the biggest brakes on growth and opportunity. But this is not inevitable.”
Employers Put on the Front Line
Under the government response, more than 60 organisations will join a three-year partnership to trial prevention, early support and stay-in-work approaches, with findings intended to inform a voluntary workplace health standard by 2029. The plan places employers at the centre of change, with a focus on better data, manager capability and practical adjustments to keep people in jobs.
Professional bodies said early intervention would be vital. The Chartered Institute of Personnel and Development, which represents HR professionals, said the recommendations would only work if adopted widely and backed by policy.
Chief executive Peter Cheese said the plan’s success would depend on how well business understood the recommendations and whether national and regional policymakers supported them.
What’s Driving People Out of Work?
The review pointed to two dominant causes of health-related exits: younger workers were more likely to report mental health conditions while older workers were more affected by musculoskeletal problems.
The current fit note system often produced a binary outcome that left GPs without sufficient information about roles or adjustments, the report said, and this limited the use of phased returns or modified duties.
Disabled employment continued to lag other economies, the review said, and the UK’s growing inactivity rate among working-age adults risked lower productivity and rising welfare costs. It called for shared responsibility between employers, employees and health services, rather than expecting the state or individuals to carry the burden alone.
Industry Weighs Practicalities, Cost
Business groups offered a cautious welcome, saying firms would engage if support proved workable and affordable. The Confederation of British Industry, a business lobby group, has previously said companies need clear evidence of what delivers results and warned that rising employment costs could dampen hiring if reforms are not designed well.
Insurance and rehabilitation providers said the emphasis on early intervention aligned with established practice in vocational rehabilitation and group income protection.
Group Risk Development, which represents insurers providing employer-sponsored life, disability and income protection, said its sector had long focused on helping people stay in or return to work. The organisation backed a model that used case management, early intervention and clear plans for staying in and returning to work, delivered by existing providers and funded by employers.
Expert View: Make Wellbeing Systemic, Not Nice-To-Have
Workplace wellbeing expert Dave Capper, chief executive of Westfield Health, a UK health and wellbeing provider, said employers needed clear rules and consistent guidance so that good practice became standard across workplaces, not dependent on individual champions or budgets. He said a regulated framework would help organisations act sooner and more confidently.
“Workplace health and wellbeing must be at the centre of any response to the UK’s long-term sickness crisis,” he said. “Research consistently shows that creating a wellbeing culture helps people to thrive and leads to happier, healthier and more productive teams. Failure to recognise this means ignoring the root cause, leading to lower economic growth, wasted potential and a higher benefits bill.”
He argued for clear, legally backed guidance and simpler access routes for employees. “It’s vital that employers have clear guidance on how to support their employees’ physical and mental health. Ideally, this should take the form of a legally binding and regulated framework, alongside clearer routes to access for employees.”
Capper said policies should be supported by practical benefits and services that help people access prevention and treatment, and he urged companies to lift line manager capability.
“Wellbeing training for managers is another key area for investment. No matter the size of the business, line managers should be able to identify and support team members through health challenges to reduce long-term impact.”
What Employers Can Do Now
Experts say employers can take action by:
Auditing Absence And Adjustment Pathways: Map how employees move from first symptoms to time off, adjustments and return to work, and close gaps that delay help.
Strengthening Manager Training: Equip line managers to have timely, confident conversations about health, job design and adjustments, and to use phased returns where suitable.
Adopting Early Intervention Services: Build links with occupational health, physiotherapy and mental health providers so referrals happen early, not after long absences.
Using Data Responsibly: Track leading indicators such as referral times, uptake of adjustments and time to return, not only days lost.
Clarifying Roles And Responsibilities: Make it clear how HR, managers, employees and providers work together so support is consistent across teams.
The Policy Road Ahead
The review lands alongside wider employment reforms moving through Parliament. Employers will want clarity on how new standards and pilots interact with existing responsibilities under equality and health and safety law, and what support will be available for smaller firms.
With inactivity concentrated among people with fluctuating or complex conditions, the test will be whether trials produce scalable, affordable models that work in different sectors and sizes of business.