People without any flexibility in their jobs are four times more likely to leave work following a decline in their health, according to research.
Following last month’s unveiling of the government’s plans to Get Britain Working, the Work Foundation at Lancaster University has published a report tracking the employment journeys of more than 9,000 UK workers between 2017 and 2022, focusing on those who became ill in the first two years of the study.
Researchers found that 9% of employees who had experienced a decline in health had left the labour market by the end of the four-year study period. Almost half of those employees had left work within the first year.
The Work Foundation said the data shows accessing flexibility at work is key for those with health conditions to be able to remain in work. Employees without any flexibility in their job roles were four times more likely to leave work after a health decline, while those with low levels of control over their work were 3.7 times more likely to leave.
The study period included the outbreak of the Covid-19 pandemic – an exceptional period of disruption to the UK labour market. But the Work Foundation found that, despite the extraordinary circumstances, people’s employment outcomes following a health decline were at similar levels to those observed in preceding years.
This, it says, suggests that poor workforce retention following the onset of ill health is a persistent labour market problem and was not caused by the challenges of the pandemic.
Ill health and flexibility
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The report, Stemming the tide: Healthier jobs to tackle economic inactivity, highlights what researchers call an ‘awareness to action gap’ among UK employers when it comes to addressing ill health at work.
From a survey of more than 1,000 senior business leaders, 64% said poor employee health had a detrimental effect on their organisation’s economic performance but only 48% of employers offered flexible working arrangements to their employees.
Ben Harrison, director of the Work Foundation, said: “The UK government’s Get Britain Working agenda focuses on supporting those who have fallen out of the labour market to return – but if we do not consider the factors that drive people to leave in the first place, we risk treating the symptoms rather than the cause.
“The evidence is clear that once someone leaves work due to ill health, it becomes increasingly more challenging to help them back into employment. To achieve the government’s ambition to boost the employment rate to 80%, we must take action to stem the flow of those leaving work due to sickness, and find new ways to ensure they remain connected to the labour market.”
Despite a legal obligation for employers to proactively manage work-related risks to mental health, only around a third of businesses surveyed said they were introducing other measures to prevent ill health, such as assessing workplace mental health risks (36%) and implementing adjustments to manage workload, work pace and role clarity (37%).
Employer support
Professor Stavroula Leka from Lancaster University, a co-author of the research, said: “Unlike other nations such as Germany, Denmark and the Netherlands, the UK government does not provide adequate support to employers by coordinating the provision of preventative occupational health services.
“From the business leaders we surveyed, 65% acknowledge the importance of occupational health – yet only 37% provide these services to their employees.
“With the number of working-age people living with major illnesses projected to grow, it’s clear the UK’s current systems need work. There is not enough focus on prevention and early intervention to support ill workers to stay in employment.”
The research found that people affected by multiple health conditions were significantly more likely to leave employment. Those with a single disability or health condition were 1.5 times more likely to leave work following a negative health transition than those without.
The likelihood of leaving work increases to 2.4 times for those with two disabilities or health conditions and escalates to 5.6 times for those with three or more conditions.
Recommendations
Last week, work and pensions secretary Liz Kendall announced a new independent “Keep Britain Working” review: looking at the role of employers and government in tackling health-related inactivity and creating healthy workplaces. It will be led by Sir Charlie Mayfield, former chair of John Lewis, and will report in Autumn 2025.
Harrison added: “We find workers with multiple health conditions – including mental health issues – are especially vulnerable to the risk of early exit from work. But crucially the evidence also suggests that early action from employers to support workers who experience ill health can make a big difference to retaining them in the workplace. It’s vital that the Keep Britain Working review identifies new ways for the government and employers to work together to provide this early intervention.”
Among its recommendations, the Work Foundation is calling on the government to:
- Ensure the Employment Rights Bill enshrines secure and flexible working from day one of employment
- Revise the Health and Safety at Work Act 1974 to reflect current modern workforce challenges, including psychosocial risks and mental health issues, and enhance enforcement of mental health risk assessments and preventive measures
- Lead a strategic transformation of OH services focused on improved and extended coverage for all workers, with mandatory provision by large employers
- Establish a UK-wide network of one-stop workforce health hubs, offering funded SME services and integrated with public health initiatives
- Strengthen and increase statutory sick pay to promote retention and enable phased returns to work
- Examine the practicalities of extending the duty of care for employers, subsidising the cost of long-term sickness absence, and incentivising vocational rehabilitation.
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