Reducing the number of people not working due to ill health

Data published today by the Office for National Statistics shows that the number of people who are not working due to long term sickness has risen to a record high.

From previous research, we know that the most common medical problems that can prevent individuals from working include mental health issues such as depression, stress, and anxiety, as well as musculoskeletal disorders like back pain. In addition, cardiovascular diseases, respiratory conditions, cancer, and neurological disorders are among the many other medical conditions that can significantly impact a person’s ability to work.

We have also seen higher death rates than usual in recent years in the UK; which probably reflects an increase in the number of people with long-term medical problems and their severity. A parallel challenge is demographic change to an older population, given that the disability employment gap increases with age. Trying to reverse the trend in the number of people in the UK who are not working due to poor health will not be easy and requires a much more active approach and collaboration from employers, the NHS and government.

The recent increase in the number of people in the UK who are not working due to poor health is likely to be due to short-medium term changes rather than to longer term problems such as rising rates of obesity. There was a rise in the number of people with mental health problems during the COVID-19 pandemic and this will account for some of the increase. We also saw some reductions in physical activity which would affect the number of people with musculoskeletal problems. There are also many people waiting for specialist NHS care (e.g. joint replacement surgery) who may not be able to work until they receive their treatment. Some people are also suffering from the post-COVID problems (i.e. Long COVID).

Reducing the number of people in the UK who are not working due to ill-health requires a multi-faceted approach involving various stakeholders and this is a priority for government, the NHS and employers.

Improving healthcare accessibility should be a priority. Many individuals are unable to work because they are waiting for NHS treatment, such as patients waiting for joint replacement surgery. To address this issue, we must ensure that healthcare services are readily available and accessible to all. This means reducing waiting times for consultations, diagnostics, and treatments, as well as increasing the number of healthcare professionals.

Mental health support is another crucial aspect that needs enhancement. The prevalence of mental health conditions is on the rise, and it is essential to provide better access to counselling, therapy, and mental health resources. Additionally, we must work towards reducing the stigma associated with mental health issues, allowing individuals to seek the help they need without fear or judgment.

To promote overall health and prevent illnesses, comprehensive public health campaigns are necessary. These campaigns should focus on encouraging healthy lifestyles, raising awareness about common health issues, and providing information on preventive measures. Initiatives targeting physical activity, healthy eating, smoking cessation, and mental health can make a significant impact on improving public health.

It is also important to empower individuals with chronic health conditions to self-manage their health. By providing education, resources, and support networks, we can help them better understand their conditions, make informed decisions, and actively engage in their own care. For instance, individuals can monitor their blood pressure at home to self-manage hypertension.

Employers play a crucial role in supporting individuals with health conditions. Encouraging them to provide reasonable workplace adjustments is essential for enabling these individuals to continue working or return to work. This may involve implementing flexible work arrangements, modifying duties, making ergonomic adjustments, and ensuring access to necessary support services.

Occupational rehabilitation programs can be instrumental in helping individuals with health conditions transition back into the workforce. These programs should provide training, education, job placement assistance, and ongoing support to improve employability and facilitate a smooth return to work.

Creating awareness about the benefits of work is essential. Evidence shows that a healthy and safe work environment has positive impacts on physical and psychological health. By raising awareness through campaigns and information leaflets, we can highlight the advantages of work, such as increased social contact and a sense of purpose, motivating individuals to return to work after an illness.

Increasing access to occupational health services is crucial for supporting individuals in the workplace. Occupational health teams can assess and support individuals with health conditions to work, and they can devise and implement policies to maintain a healthy workforce. Investing in occupational health services for those who currently lack access can reduce inequalities, support individuals working with ill health, and contribute to healthier workplaces overall.

Improving workplace health and safety is another area which should be a priority for employers. By encouraging a positive workplace culture and management practices, providing access to healthy food and drink, encouraging exercise, and offering support for smoking cessation, employers can enhance the wellbeing and safety of their employees, creating a productive work environment.

Strengthening social safety nets is vital for individuals who are unable to work due to severe health conditions. This can include providing income support, disability benefits, and ensuring access to appropriate healthcare services. These measures can help individuals maintain financial stability and access the necessary resources for their wellbeing.

Investing in research and data collection efforts is crucial for understanding the causes and impact of ill-health-related work absence. By gathering comprehensive data and conducting research, we can inform evidence-based policies, interventions, and programs aimed at reducing the number of individuals affected and improving overall health outcomes.

Fostering collaboration among government agencies, healthcare providers, employers, and community organizations is key to developing comprehensive strategies for reducing ill-health-related work absence. By sharing best practices, data, and resources, we can create a coordinated and effective response that addresses the various factors contributing to this issue.

Finally, the National Institute for Health and Care Excellence (NICE) has developed a guideline called “Workplace Health: Long-Term Sickness Absence and Capability to Work.” This guideline provides evidence-based recommendations and tools, including a Cost Calculator, to assist employers in managing sickness absences and determining the cost effectiveness of workplace health interventions.

By implementing these strategies effectively, we can improve overall workforce participation and wellbeing. This will benefit individuals, businesses, the NHS and the economy.

Azeem Majeed, Professor of Primary Care and Public Health, Imperial College London

Lara Shemtob, Academic Clinical Fellow in General Practice and Occupational Health Physician, Imperial College London

Kaveh Asanati, Professor of Occupational Health, Imperial College London

This blog was first published by the Society of Occupational Medicine.

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