The £85bn Crisis | How Workplace Ill-Health Is Crippling Businesses, the NHS, and the Economy

After nearly four decades in health and safety enforcement, management, and consultancy, I've seen countless workplace challenges. But nothing quite matches the scale of what Sir Charlie Mayfield's Keep Britain Working Review has laid bare. A £85 billion annual haemorrhage that's quietly devastating British business.

The Hidden Epidemic | 2.8 Million Workers Lost to Ill-Health

Economic inactivity due to ill-health has reached crisis levels, with 2.8 million working-age adults now completely outside the workforce. This represents an economic catastrophe equivalent to losing Scotland's entire working population.

Let me put this in perspective. We're not talking about occasional sick days or minor productivity dips. During my years establishing and growing Astutis in my consultancy, I've witnessed this crisis evolve from isolated cases to an epidemic.

The impact cascades through four critical areas:

• Business losses: £85 billion annually in lost productivity and increased costs.
• NHS pressure: Preventable conditions are overwhelming an already-stretched health service.
• Benefits burden: System pushed beyond sustainable capacity.
• Human cost: Careers derailed, potential unrealised, expertise lost.

Three Persistent Problems Creating Perfect Storm Conditions

The Mayfield Review identifies three interconnected failures that trap workers and employers in a destructive cycle. These systemic issues require coordinated action across government, business, and health services to resolve.

1. The Culture of Fear

Fear operates on multiple levels, creating distance when support is needed most:

• Employee fears: Job security concerns, stigma, being seen as liability.
• Manager anxieties: Lack of training, legal worries, saying the wrong thing.
• Organisational paralysis: Risk aversion preventing early intervention.

Real-world impact: For example, let’s say a skilled engineer hid deteriorating arthritis for three years, fearing redundancy. By disclosure, simple adjustments become extensive rehabilitation – a company could lose months of productivity and nearly decades of expertise.

2. The Support System Vacuum

The current fit note system fails to capture modern work realities:

This creates lose-lose scenarios where talented people exit unnecessarily while businesses haemorrhage recruitment costs.

3. Structural Barriers for Disabled Workers

The UK lacks systematic mechanisms compared to international best practice:

• Germany: Mandatory quota systems with financial incentives.
• Netherlands: Embedded disability coordinators in large employers.
• Denmark: State-funded workplace modifications.
• UK: Ad-hoc arrangements relying on goodwill.

The Vanguard Solution | From Reactive to Proactive

The Government's Vanguard programme marks a fundamental shift from treating workplace health as an individual problem to establishing it as a shared responsibility. This pilot approach allows organisations to test innovations while building the evidence base for national rollout.

Having implemented similar programmes throughout my career, I can attest to their transformative potential. Vanguards will focus on three critical implementation areas:

The Three Pillars of Vanguard Action

1. Embracing the Healthy Working Lifecycle Prevention-first thinking that delivers measurable returns:

• Ergonomic assessments reducing MSDs by 40%.
• Stress management programmes cut absence by 25%.
• Early intervention showing 3:1 ROI within 18 months.

2. Providing Workplace Health Provision Non-clinical case management bridging critical gaps:

• Trained coordinators linking occupational health, HR, and operations.
• Personalised return-to-work plans.
• Manager confidence building through structured support.

3. Building the Evidence Base Data-driven insights through the Workplace Health Intelligence Unit:

• Sector-specific intervention effectiveness.
• Cost-benefit analysis of prevention strategies.
• Scalable best practice models.

IOSH's Endorsement of the Report

IOSH's backing of the Mayfield Review signals professional consensus on the need for systematic workplace health reform. This endorsement provides safety professionals with institutional support to drive transformational change.

As a Chartered Member of IOSH, I find Ruth Wilkinson's response deeply resonant. The review's emphasis on prevention aligns with what our profession has advocated for decades:

• Person-centred approaches recognising individual needs
• Early intervention over reactive treatment
• Integration with NHS systems through technology
• Evidence-based decision making

This is how smart business is conducted and backed by our leading professional body.

Actionable Steps for Health and Safety Professionals

Implementation requires systematic action starting immediately. Based on my experience, this five-step framework positions organisations to capitalise on the Vanguard opportunity while addressing current crises.

Your Implementation Roadmap

Step 1: Audit Current Provision

• Map existing health support against review recommendations.
• Identify gaps in mental health, disability, and rehabilitation support.
• Calculate current absence costs and productivity losses.

Step 2: Build Your Business Case

• Contextualise the £85 billion figure for your organisation.
• Project ROI using 3:1 prevention investment ratio.
• Align proposals with strategic business objectives.

Step 3: Engage Leadership

• Present findings to board/senior management.
• Secure champion at executive level.
• Establish working group with HR, Operations, and Finance.

Step 4: Design Pilot Programme

• Select high-impact department for initial rollout.
• Develop metrics framework for evaluation.
• Create a communication strategy addressing the fear culture.

Step 5: Launch and Monitor

• Implement early intervention protocols.
• Begin manager training on health conversations.
• Establish feedback loops for continuous improvement.

The Bottom Line | Act Now or Pay Later

Organisations face a binary choice: embrace proactive health management now or continue haemorrhaging talent and money. With political will crystallising and competitive advantage at stake, delayed action means accelerating losses.

The organisations embracing this shift will secure:

• Retained talent through supportive cultures.
• Reduced costs via prevention over cure.
• Enhanced productivity from engaged, healthy workforces.
• Competitive advantage as early adopters.

Those that don't? They'll continue contributing to that £85 billion black hole while watching competitors race ahead.

Ready to transform your workplace health approach? Subscribe to the Astutis Quarterly Newsletter for expert insights and practical guidance on implementing these revolutionary changes. For weekly updates on critical developments like the Keep Britain Working Review, explore our This Week in Health and Safety series below – because in our rapidly evolving field, staying ahead of the curve isn't just our tagline, it's your competitive necessity.