Britain faces an urgent economic inactivity crisis driven in large part by ill-health and the barriers to work faced by disabled people.
Over 1 in 5 working-age adults (2.8 million)are out of work and not looking for work and the most common cause is long-term health issues.
The disability employment rate is 52.8%, 29.5% below that of non-disabled people and early indications suggest this gap is widening.
Everyone loses in the current system:
- individuals face life-changing consequences – a 22-year-old leaving work due to ill health can lose over £1 million in lifetime earnings, plus the profound wellbeing impact of lost purpose and connection
- employers lose £120 per day per sick employee, face recruitment costs exceeding £11,000 per replacement, and are experiencing sickness absence at a 15-year high – totalling £85 billion annually
- the state faces unsustainable costs of £212 billion per year (equivalent to 7% of GDP or nearly 70% of all income tax collected) through lost output, additional welfare payments, and increased NHS burden
The Keep Britain Working (KBW) Review examined the underlying causes through engagement from employers, providers, representative bodies, employees and those with lived experience.
Three persistent problems to tackle:
- a culture of fear that is felt by employees and, differently, by employers, especially line managers – this creates distance between people and discourages safe and early disclosure, constructive conversations and support just when they are needed most
- a lack of an effective or consistent support system for employers and their employees in managing health and tackling barriers faced by disabled people – this lack of support is sometimes compounded by a Fit Note system that is not working as intended
- structural challenges for disabled people, creating barriers to starting and staying in work.
The solution
The key components of the solution set out in the review are to:
- establish, with employers and providers, a Healthy Working Lifecycle which defines the practices that drive the best outcomes in reduced sickness absence, improved return-to-work rates and better participation and retention of disabled people
- develop better workplace health provision with existing providers and practitioners, the support employers and employees need to deliver the Healthy Working Lifecycle, focusing initially on new stay-in-work and return-to-work plans within the lifecycle, and improving access to support
- build evidence of what works to underpin incentives for adoption – create a Workplace Health Intelligence Unit (WHIU) to aggregate and analyse data, consider incentives to drive uptake, guide continuous improvement and provide leadership, as a movement HQ, across the new system.
The Vanguard phase
The Vanguard phase is a 3 year programme seeking to develop solutions by working with employers, providers, regions and wider stakeholders to collaborate, learn, experiment, and prove what works to transform workplace health and inclusion in the UK.
In 2026:
- develop the Healthy Working Lifecycle into an employer facing standard
- develop a formalised framework for quality Workplace Health Provision
- create a WHIU to aggregate and analyse data, guide continuous improvement and provide leadership, as a movement HQ
- establish the data requirements to support the Healthy Working Lifecycle and Workplace Health Provision deliver the outcomes of reduced sickness absence, improved return to work rates and better participation and retention of disabled people
To read more about the plan and the next 3 years see:
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