Keep Britain Working Report: What HR and Wellbeing Teams Need to Know

The Scale of the Challenge

The numbers tell a tough story. Over one in five working-age adults are now economically inactive, with ill-health driving much of this increase. Perhaps most concerning is the 76% rise since 2019 in young people with mental health conditions becoming economically inactive. For organisations, sickness absence rates have reached a 15-year high, costing an average of £120 per day in lost profit per absence.

But there’s more behind those numbers. From our work with organisations across sectors, we recognise the human dimension: managers struggling with how to support team members, and HR teams navigating increasingly complex situations.

The Fear Factor

One of the report’s most significant findings centres on what it terms a “culture of fear” affecting both employees and managers. The report found that line managers consistently express anxiety about “doing the wrong thing” – whether that’s causing offence, triggering grievances, or ending up in tribunals.

This is compounded by role ambiguity. Managers understand they have a duty of care, but they lack clarity on where their responsibility begins and ends, what questions they can ask, and how to balance compassion with operational needs. The report notes that managers must navigate at least seven pieces of complex legislation related to health and disability, often with fragmented guidance.

The consequence? A workforce where health issues go unaddressed until they become critical, and opportunities for early intervention are systematically missed.

The Gap in Support

The report identifies a significant disparity in workplace health provision. While 86% of large employers offer some form of occupational health support, only 30% of SMEs do. Even where support exists, employees and managers frequently describe it as disconnected, generic, or difficult to access when needed.

Perhaps most problematic is the current “fit note” system. The report found that 93% of fit notes in England deem patients “not fit for work,” often extended without further consultation. GPs themselves highlighted the challenges: they often lack detailed knowledge of workplace environments, most don’t have occupational health training, and long-term certification drains their capacity. As one GP representative put it in the report, GPs should provide facts about a patient’s condition, but what’s actually needed is a detailed assessment of function and capacity in the workplace context.

The Disability Employment Gap: A Structural Challenge

The report highlights that disabled people face particularly stark barriers, with only 53% in work compared to much higher rates for non-disabled people. They’re more than twice as likely to be unemployed and nearly three times as likely to be economically inactive.

This isn’t just about individual circumstances – it represents a structural failure that the report identifies as one of the UK’s most pressing workforce challenges. What’s particularly striking is disabled employees’ consistent feedback about the exhausting burden of constant self-advocacy for adjustments. As one participant stated in the report, “We are having to constantly self-advocate. We are fighting against the system.”

The report is clear: addressing disability employment isn’t a side issue – it’s central to tackling the UK’s economic inactivity crisis and building truly inclusive, high-performing workplaces.

From Reactive to Preventative: The Healthy Working Lifecycle

The report’s central recommendation is the adoption of a “Healthy Working Lifecycle” – a framework that moves organisations from reactive crisis management to proactive prevention and support. This lifecycle encompasses five distinct phases: (1) recruitment and onboarding, (2) healthy in work, (3) unwell in work, (4) absence and return to work, and (5) exit and re-employment.

This framework recognises that health and wellbeing at work isn’t binary. People don’t simply flip from “healthy” to “absent.” There’s a critical middle phase – “unwell in work” – where early intervention can prevent escalation. This is where presenteeism occurs, where individuals continue working despite health challenges, often at reduced productivity.

The Role of Line Managers

Because the support that does exist is often perceived as generic, disconnected or difficult to access, line managers often end up being the first people employees turn to with wellbeing concerns. Yet most receive minimal training in this area. In our work with organisations, managers consistently tell us that while they feel confident handling performance conversations, they feel far less comfortable navigating wellbeing-related discussions.

The report’s proposed solution – Workplace Health Provision (WHP) – would provide case management support for both employees and managers, including “Stay-in-Work Plans” and “Return-to-Work Plans.” From our perspective, this external support is crucial, but it must be complemented by building internal capability. Managers need foundational skills to recognise early warning signs, initiate supportive conversations, and know when and how to escalate to specialist support.

The Evidence for Intervention: Strong Returns on Investment

One compelling aspect of the report is its synthesis of return on investment data for workplace health interventions. Employee Assistance Programmes show an average £8 return for every £1 invested. Mental health and wellbeing investments return £4.70 per £1 spent. Some musculoskeletal interventions show returns ranging from £11 to £99 per £1 invested. These figures should matter to finance directors and boards, but they also underscore the reality that investment in wellbeing isn’t a soft option – it’s a performance strategy.

However, the report correctly identifies that despite this evidence, adoption of workplace health interventions remains patchy due to poor data quality and limited understanding of what works in specific contexts. This is where the proposed Workplace Health Intelligence Unit could prove transformative – building a robust evidence- base that allows organisations to benchmark, learn, and continuously improve.

What This Means for HR and Wellbeing Leaders

The Keep Britain Working report arrives at a pivotal moment. The proposed reforms will unfold over three phases: a three-year vanguard phase (starting now), an expansion phase, and eventual general adoption over the next 3-7 years. For organisational leaders, several strategic priorities emerge:

1. Build Manager Capability Now

Don’t wait for national infrastructure to be in place. The report is clear that line managers are uniquely positioned to spot problems early, prevent escalation, and create psychologically safe environments. Investing in manager training isn’t just best practice – it’s foundational to the whole system working effectively.

2. Audit Your Current Approach Through the Lifecycle Lens

Map your existing policies and practices against the five phases of the Healthy Working Lifecycle. Where are the gaps? Most organisations have recruitment processes and return-to-work procedures, but what about the “unwell in work” phase? Do you have mechanisms for employees to signal they’re struggling before reaching the point of absence? Are managers equipped to have these conversations?

Consider also your approach to disability inclusion. The report highlights that disabled employees face an exhausting burden of constant self-advocacy for adjustments. Rather than operating on a case-by-case “reasonable adjustments for disabilities” model, ask: are we systematically building workplace adjustments that are inclusive from the outset? This means auditing whether flexibility is built into all roles as standard, whether communication and work processes assume a single “normal” way of working, and whether accessibility is proactive rather than reactive. The report frames this as universal design – focusing on enabling excellence rather than managing limitations.

3. Create Cultures Where It’s “Safe to Share”

The report emphasises that early disclosure depends on trust and safety. This requires more than policies; it demands cultural change that enables employees to raise concerns with their line managers before issues escalate.

Consider what signals your organisation sends about health and disability. Are senior leaders open about their own challenges, modelling that disclosure doesn’t damage careers? Do team norms permit conversations about struggling without it being seen as weakness? Are line managers equipped and confident to respond supportively when someone does disclose, or does their visible discomfort discourage openness?

The goal is to create an environment where the first conversation happens early and with the person best placed to make adjustments – the line manager – rather than waiting until a formal HR process or crisis point.

4. Integrate, Don’t Add

The report notes that many employers describe their wellbeing initiatives as “a random set of explosions” with no clarity on what works. The Healthy Working Lifecycle provides a coherent framework to integrate disparate initiatives. Rather than adding another programme, consider how existing resources – EAPs, occupational health, mental health first aiders, flexible working policies – connect across the employee journey.

5. Measure What Matters

The report’s emphasis on data and outcomes is crucial. Track not just sickness absence rates, but also return-to-work success rates, and leading indicators like manager confidence in handling wellbeing conversations or employee perception of psychological safety.

This is where workforce resilience assessment becomes invaluable. Understanding the specific resilience profile of your workforce – identifying where individuals and teams are thriving and where they’re at risk – enables targeted, evidence-based intervention rather than scattergun approaches. When organisations can pinpoint areas of vulnerability before they escalate into absence or attrition, they shift from reactive to genuinely preventative practice.

Looking Ahead: Positioning Your Organisation

The Keep Britain Working reforms will reshape the landscape of workplace health and disability inclusion over the coming years. The question for organisational leaders isn’t whether to engage, but how quickly and how strategically.

Early adopters – the “vanguards” in the report’s terminology – will shape what good looks like, build competitive advantage in talent attraction and retention, and be better positioned when incentives and standards roll out in later phases.

But beyond strategic positioning, there’s a simpler truth: people are your organisation’s most valuable asset, and they’re facing unprecedented health challenges. The gap between the support they need and what most organisations currently provide is substantial. Closing that gap isn’t just good for the bottom line – it’s essential for sustaining a healthy, high-performing workforce.

Final Thoughts

The Keep Britain Working report represents a rare convergence: a policy moment backed by compelling evidence, genuine employer appetite for change, and clarity about what needs to happen. For those of us who work in organisational wellbeing, it validates much of what we know from research and practice – that prevention beats cure, that manager capability is foundational, that psychological safety enables disclosure, and that inclusion requires systematic design, not just individual adjustments.

The report’s message is ultimately one of possibility. The current trajectory – rising inactivity, escalating costs, missed opportunities – isn’t inevitable. With the right approach, we can build workplaces where health, disability, and meaningful work coexist. Where managers feel confident rather than fearful. Where employees feel supported rather than isolated. Where organisations thrive because their people can thrive.

The work begins now.

Reference: Keep Britain Working: Final Report

Author Bio: Sandra Ordel is a Senior Business Psychologist at The Wellbeing Project, specialising in workforce resilience and neuropsychology. She works with organisations worldwide to measure and strengthen resilience, helping leaders build high-performing teams and cultures of healthy performance.