UK is trapped in reactive cycle of sickness and inactivity, warn wellbeing experts

Business leaders, policymakers and workplace experts have warned that the UK’s fragmented approach to work, wellbeing and welfare is undermining economic resilience, with comparisons to Denmark highlighting the pressure placed on the NHS and benefits system in Britain. The warning came during a Westminster roundtable  for the Policy Liaison Group on Workplace Wellbeing chaired by Dame Carol Black on 13 May. The discussion followed shortly after the King’s Speech opened the new parliamentary session with a renewed emphasis on “economic security”. Participants argued that Britain’s rising levels of long-term sickness and economic inactivity will require a more coordinated approach involving employers, government departments, healthcare systems and insurers.

The discussion focused on the findings of the government’s Keep Britain Working Review, which called for a shift away from a reactive system that intervenes only after people have already left employment because of ill health. The review, led by former John Lewis chairman Sir Charlie Mayfield, described the UK as facing a “quiet but urgent crisis”, with more than one in five working-age adults now economically inactive.

The review found that the UK now has significantly higher inactivity rates than comparable countries including Denmark, Sweden and the Netherlands, and estimated that increasing employment participation to 80 percent would bring around two million more people into the workforce. It also warned that economic inactivity linked to ill health costs the UK around £212 billion each year through lost productivity, welfare spending and additional strain on public services including the NHS.

Participants at the roundtable repeatedly contrasted the UK with Denmark’s more integrated approach to employment and welfare. Tobias Wermuth Simonsen of Denmark Coop said Denmark had sought to align government, employers, schools and wider society around a shared goal of improving wellbeing and helping more people into work.

“In Denmark, we have tried to bring government, employers, schools, and wider society together around a shared objective of helping more young people into work and improving wellbeing at the same time,” he said. “The key lesson is that if you want to solve problems affecting young people, you have to involve them directly and build systems that are flexible enough to meet people where they are.”

Wrong emphasis

Contributors suggested that Britain’s system places too much responsibility on the NHS and welfare state once people have already disengaged from work, rather than focusing on prevention and early intervention. Several argued that countries such as Denmark have been more successful because employers, welfare agencies and insurers work together to maintain people’s connection to employment wherever possible.

The Keep Britain Working Review similarly concluded that the UK lacks “systemic levers” to support disabled people and those with long-term health conditions to remain in employment. It called for a “fundamental shift” towards a model where responsibility for workplace health is shared between employers, employees and public services.

Dame Carol Black, who authored the influential 2008 review Working for a Healthier Tomorrow, told the event that Britain has waited too long before intervening.

“For too long, our system has intervened only after people have already fallen out of work,” she said. “We need a far more preventative approach that supports people throughout the whole working life cycle, particularly during periods of ill health, instability, or vulnerability.”

The roundtable also examined how management capability has been weakened by years of efficiency-driven restructuring. Contributors argued that line managers are increasingly expected to deliver higher productivity without sufficient training, support or time to manage employee wellbeing effectively.

A recurring theme was that disengagement often begins well before sickness absence, with employees feeling unsupported or invisible within organisations. Participants warned that the growing adoption of AI and automation could intensify those pressures if expectations around productivity continue to rise without corresponding investment in management capability and workplace culture.

Mental wellbeing

Christian van Stolk of RAND Europe described mental health as the “major outlier” driving economic inactivity, particularly among younger people. “There is something of a ‘British disease’ in the UK’s failure to reverse these post-pandemic trends while comparable countries have made greater progress,” he said. “We are confronted by a systemic problem, which must be treated as such.”

The Keep Britain Working Review identified mental ill health among younger workers as a growing contributor to long-term sickness and inactivity, while also highlighting shortcomings in the current fit note system, which it said often discourages phased returns to work or early intervention.

The review proposed the creation of a new Workplace Health Provision system designed to support employees and managers through rehabilitation, workplace adjustments and return-to-work planning. It also envisaged closer collaboration between employers, the NHS and insurers, including the development of “stay in work” and “return to work” plans linked to healthcare provision.

Gethin Nadin, chair of the Policy Liaison Group on Workplace Wellbeing, warned that previous attempts at reform had often lost momentum once political priorities changed. “One of the biggest risks with reviews like this is that momentum fades,” he said. “Governments change, priorities shift, and recommendations quietly disappear.”

The roundtable took place shortly after the King’s Speech outlined the government’s intention to continue welfare reform as part of its wider “economic security” agenda. The speech referenced both the Milburn and Timms reviews and pledged continued support for measures designed to help disabled and younger people remain in work.

Participants said that without stronger coordination between the Department for Work and Pensions, the Department of Health and Social Care, HM Treasury and employers, Britain risked remaining trapped in a reactive system that responds to economic inactivity only after individuals have already left the workforce.