Prevention is better than cure: the role of employers in improving worker health

On publishing its Get Britain Working white paper in November, the UK Government said that reforms aimed at reducing unemployment and tackling economic inactivity would focus on helping people with long-term health conditions to return to work, preventing health conditions from developing in the first place, and expanding access to mental health support.

Photograph: iStock/Chinnapong

In addition to boosting NHS capacity in areas of the country with the highest levels of economic inactivity and overhauling the health and disability benefits system, the Government’s plans called for an independent review into how employers could better support people with disabilities and health conditions to return to, and stay in, the workplace.

This mood music continued into the new year, with the chair of the Health and Safety Executive (HSE), Sarah Newton, telling attendees at the SHW Live show in Manchester in January that traditional safety risks had been prioritised over workers’ health for too long, and calling for a “fundamental shift” towards preventing employees from becoming ill through their work.

Recent HSE figures revealed that 1.7 million workers reported they were suffering from work-related ill health in 2023/24 – almost half of which related to stress, depression and anxiety – while 33.7 million working days were lost due to illness or injury.

A report published by the Institute for Employment Studies (IES) in January found that the UK’s ill health “employment gap” is one of the widest in Europe. Comparing the UK with 14 other European nations, the report found that at 21 per cent, the UK had one of the highest rates of workers reporting health limitations. The research also found that the likelihood of those aged between 16 and 64 with health limitations being out of work had more than doubled between 2018 and 2022 in the UK.

The report highlighted the importance of providing healthy workplaces, helping people to stay in work, and supporting people with health conditions to return to the labour market. This could be achieved, said the report, by making adaptations to workplaces and roles, and intervening early to ensure that job design and workplace conditions do not worsen health in the first place.

From HSE’s perspective, Newton said the shift to health would involve three actions from employers: carrying out risk assessments to control workers’ exposure to stress-causing activities; transforming the way in which mental health is approached in the workplace; and revolutionising the approach to health surveillance.

The Royal Society for Public Health (RSPH) has called for a universal right to a healthy workplace and the introduction of a minimum level of support that employers should provide to improve employees’ health and wellbeing.

In a report published in October, the RSPH said that almost half of UK workers lacked access to routine health checks at work. It recommended that the Government introduce a mandatory national ‘Health and Work Standard’ that would set a minimum level of health support to which employees should be entitled.

But what should that health support look like? RSPH head of policy and public affairs, Simon Dixon, tells Safety Management that the level and type of support provided should depend on the business and the specific needs of its workforce.

“The important thing to stress is that there is never going to be a one-size-fits-all model,” says Dixon. “It’s about making sure that every employer takes this seriously, talks to their workforce, and puts in place an action plan that will work for the specific circumstances they are facing.” He also emphasises that any workplace health monitoring and intervention measures must be optional, batting aside newspaper headlines warning about compulsory workplace weigh-ins.

“It’s not about making people do things. If someone looks at their life and says, ‘I’m perfectly happy with the choices I’m making, I’m fully aware of what the long-term implications might be, and I don’t care’, then that’s their prerogative,” says Dixon. “I don’t think it is for the employer at that stage to say they have to change. But very few people want to be unwell – we want to be happy and healthy, and we should be able to get the support that we need to do that.”

As things stand, he indicates that too many companies are doing the bare minimum when it comes to looking after the health of their workers, and employees face a “lottery” on whether they end up working for an employer that goes the extra mile.

“We have 10 million people who have absolutely no health support at work. That means they’re not getting things like the cardiovascular health checks that the Government is rolling out, and there’s no support around smoking cessation, or staying physically active. The employer is just meeting their legal health and safety duties,” says Dixon. “That’s fine in terms of meeting the current legal obligations, but it doesn’t recognise that the eight-plus hours a day that people spend in work can be really important for improving their health.”

He adds: “We have a lot of people now living with long-term health conditions, and that number is only projected to go up. Part of that is being driven by our lifestyles and the places where we’re spending our time. So, if we want to make sure that fewer people are acquiring health conditions that require interventions, we need to ensure the support that some people currently get through the workplace is the norm, rather than the exception.”

Reimagining the role of employers

The Institute for Public Policy Research (IPPR) has called for a “reimagining” of the role that businesses play in the health of the UK population. It wants to see the introduction of a tax incentive for companies that commit to “significant improvements in the health of their workforce”, as well as new compulsory reporting on worker health, aimed at helping investors “differentiate between health-orientated and health-harming businesses”.

Dr Jamie O'Halloran, IPPR: "Close to half of employees have a long-term condition." Photograph: IPPR

Part of this involves providing “indirect support” to workers by improving the quality of their jobs so they don’t become ill through their work, Dr Jamie O’Halloran, a senior research fellow at IPPR and co-author of a series of reports on the interaction between health and the economy, tells Safety Management. Another part is about adjusting workplaces and roles to support people with health conditions and disabilities to remain at work.

“It’s up to businesses themselves to see what they think their workforce needs. Our work is about trying to get businesses to see that their employees are a valuable asset that needs investing in, and part of that investment is in their health,” says Dr O’Halloran. “Close to half of employees have a long-term condition, so it’s about how we create environments which support these people to be as productive as they can be. It’s about trying to encourage businesses to be more supportive of these people.”

He adds that there will be “costs associated with doing this sort of work”, but businesses stand to gain “quite substantially” if they get it right.

In August 2024, the UK Department of Health and Social Care and NHS England announced a pilot programme through which 130,000 workers at selected sites around the country would be offered cardiovascular health checks that can be completed “quickly and easily” in the workplace.

Cardiovascular health checks are being offered to workers through a UK Government pilot programme. Photograph: iStock/katleho seisa

While more than 16 million people are already eligible for an NHS Health Check, only about 40 per cent of them take up the offer. The Government says the aim of offering these checks in the workplace is to “make it more convenient for people to understand and improve their cardiovascular health”. 

One company that is taking part in the pilot is Jaguar Land Rover (JLR). The car manufacturer is offering the health checks to 4,000 workers at its Solihull plant near Birmingham. Over a three-month period before the end of the current financial year, JLR says that 75 production line workers each day will be able to take part in the health checks, which include a blood pressure check, a cholesterol check, a height, weight and BMI check, and a lifestyle questionnaire.

“JLR is investing £15 million a year in its global health and wellbeing programmes because we know that healthy and happy colleagues help us to deliver high-quality products and ensure a positive future for our business,” said Jaguar Land Rover’s chief medical officer, Dr Steve Iley, on announcing the initiative last summer. “Health checks are a fundamental part of prevention and therefore feature in many of our programmes.”

He added that collaborating with Solihull Metropolitan Borough Council on the Workplace Cardiovascular Disease Checks pilot “presents a unique opportunity to work together on providing awareness and signposting for our employees”.

Healthy workers, healthy businesses

While the cost of investing in workplace health programmes may seem daunting – particularly to small and medium-sized businesses – it can reap great rewards, according to advocates.

The cost of worker illness to UK businesses increased by £30 billion between 2018 and 2023. Photograph: iStock/LaylaBird

In its final cross-party Commission on Health and Prosperity report, published last summer, the IPPR found that the cost of worker illness to businesses in the UK increased by £30 billion between 2018 and 2023 – £25 billion of which was the result of lower productivity by people who came to work while sick. The remaining £5 billion was the result of an increase in the number of sick days taken by employees.

There are steps that could be taken to ease the financial burden of investing in workplace health support. The Confederation of British Industry (CBI) last summer urged the Government to incentivise employers to support the health of their workers by removing the tax burden of occupational health provisions. The CBI argues that reforms to the health tax system would incentivise half of businesses to invest more in the health of their employees.

Analysis carried out by the CBI found that making Employee Assistance Programmes (EAPs) fully tax-free benefits could boost productivity and generate £10 for every £1 spent by the Government. The lobby group also suggests that relaxing rules on tax relief for employer-funded medical treatments recommended by occupational health specialists could generate £5 for every £1 spent.

In its Health, Safety and Wellbeing Manifesto 2024, British Safety Council called for the introduction of a tax offset for businesses that invest in new technologies that drive up health, safety and wellbeing standards in the workplace. As part of its push to see wellbeing placed at the heart of economic growth, British Safety Council has also called for the development of a National Wellbeing Strategy and the appointment of a dedicated Minister for Wellbeing.

IPPR’s Dr O’Halloran acknowledges that smaller employers “definitely have a challenge” when it comes to funding worker health support initiatives. He says there is “definitely a need” to help businesses initially, whether that be through financial support or “advice-type services”, but he does not foresee a long-term requirement for support once the rewards of a healthier workforce kick in.

“I don’t think these things should be in there for the long term,” he says. “I think once people realise how beneficial this sort of viewpoint is, it should pay for itself.”