The recently published Mayfield Review paints a stark picture of economic inactivity driven by long term illness and disability. For a 22-year-old, exiting the workforce for health reasons can mean a lifetime loss in earnings exceeding £1m. The wider costs to the state and economy are harder to quantify but no less real. Being in work clearly benefits people, employers and the economy - so it's time to stop diagnosing the problem and start delivering solutions.
The numbers are stark. Since 2019 the UK has seen an additional 800,000 people out of work due to ill health – now roughly 2.8m. Unemployment is also rising: in July-September 2025, the rate reached 5.0%. With no sign of easing, the UK is facing a structural workforce challenge. That said, Sir Charlie's review sets out a practical route forward: clinically governed care, earlier intervention and shared accountability across employers, providers such as HealthHero and Government.
At its heart, this is about a joined-up pathway that prevents avoidable absence and accelerates safe, sustainable returns to work. That means faster access to mental health and physiotherapy support, clear steps for both employees and employers and a shared commitment to keep people connected to work wherever possible.
Without that integration, absence will continue to drift, confidence will erode and the UK will miss its chance to unlock the full potential of its workforce.
Reforming the fit note system
One practical step the Government can take is to reform the ‘fit note' – turning it from a passive certificate into a proactive recovery plan.
A dynamic, shared document, the fit note should focus on what an employee can do -not just what they can't - and set out reasonable adjustments to keep people connected to work, including review dates to track progress and other phased return-to-work options aligned with clinical advice.
With consent, sharing this plan between clinicians, HR teams and line managers will keep everyone aligned, reduce confusion and enable earlier, supportive interventions.
Digital health: a low-barrier route to better occupational health
Digital access is reshaping how people get care and manage their health. The same model can support workforce wellbeing. It lowers friction, removing the need for physical appointments and travel, bringing clinically governed support within faster reach.
Digital triage and virtual clinics route people quickly to the services behind most workplace absence, notably mental health and physiotherapy care. These conditions are leading causes of long-term sickness in the UK, yet access to support is often delayed by months.
Digital platforms such as HealthHero are changing that by providing early assessment, evidence-based treatment and ongoing engagement through virtual check-ins, progress tracking, workshops and reminders. For example, through our work with the Royal College of Nursing, 88% of staff said the mental health support they had received prevented them going off sick.
This continuity improves adherence to treatment and accelerates recovery - particularly for SMEs and dispersed workforces, where access to occupational health support is limited. We know first-hand that these models work; the next step is to scale them.
AI as the engine for faster recovery
Rapid advances in AI will play a critical role in the next phase of occupational health. Used safely and under clinical governance, AI reduces bottlenecks, accelerates assessments and improves decision-making processes.
In a recent Great Ormond Street Hospital study, clinicians reported a 35% reduction in feeling overwhelmed by notetaking and qualitative feedback. Applied to occupational health, the same principles can speed up triage, shorten the time from first contact to treatment, and route patients to the right care sooner.
AI can also power predictive recovery models, helping clinicians and employers estimate return-to-work timelines, identify reasonable adjustments and manage risk. That shifts us from a reactive model, where support begins only after long-term absence, to a proactive, data-driven approach that maintains health and confidence throughout the employee journey.
A new partnership to Keep Britain Working
The Mayfield Review has set the challenge to Keep Britain Working and by-proxy – growing. Tackling ill-health-related inactivity requires a systemic shift, embedding occupational health into the fabric of employment policy and business strategy.
This isn't only about reducing absence. It's about building a culture that puts health and productivity at the centre, where care and work are seen as mutually beneficial not competing priorities. This change can only happen if government, employers and healthcare providers act together and make returning to work a national priority.
If we truly want to reverse the long-term inactivity trends, and build a healthier, more resilient workforce to power the UK's economic renewal, the Mayfield Review to Keep Britain Working should be the start of a collective effort to expand access to occupational health across the UK, not be a footnote in history.
