The Future of Work: Adapting to Fluctuating Health Conditions
The Get Britain Working White Paper has added momentum to the evolving conversation about the critical link between work and health. With rising levels of economic inactivity due to ill health in the UK, this topic has become more pressing than ever. For individuals, employers, policymakers, and taxpayers, the key challenge lies in understanding how health conditions impact work capacity and identifying ways to make work more inclusive and sustainable.
In this blog, I’ll explore the importance of flexibility in the workplace, how fluctuating health conditions may influence employability, and the steps needed to create more adaptable and inclusive routes to work.
Why flexibility has value in health and work
Health conditions are rarely static—they fluctuate, often unpredictably. This variability poses challenges for both individuals and employers. Static assessments of work capacity may provide a snapshot of someone’s ability at that time, but they fail to account for future fluctuations. In occupational health practice, timely reassessments are important to delivering useful advice. However, even assessments that anticipate fluctuations can offer critical insights—especially if they help map these variations to job responsibilities or work patterns.
Consider short-term sickness absence, a common experience for most employees. For example, symptoms from viral upper respiratory tract infection may result in a day when work is unsustainable. For individuals with long-term or chronic health conditions, these disruptions are more frequent, more significant and begin from a lower baseline of functionality. Traditional models of employment often lack the flexibility needed to accommodate variability when it is significant and frequent, leaving many individuals excluded from economic participation.
How can workplaces be flexible for fluctuating health?
In situations where significant fluctuations in health, symptoms and functioning occur very regularly, frequent expert reassessments are impractical. Instead, one approach involves empowering individuals to develop and utilise insight into how their health affects their functionality. This insight enables them to request support or take sickness absence when necessary. This works best where backstops are in place to offer expert support when sickness absence is ongoing beyond what is typical for them. The thresholds for this are most efficient when they are tailored to the course of an individual’s health.
However, insight is not ubiquitous. For instance, in some cases, mental ill health can impair someone’s ability to recognise when or the extent to which they are unwell. In such cases, more robust mechanisms—such as regular health monitoring and safety nets—are needed to ensure that individuals receive the support they require. The nature of the role also matters: higher-risk jobs require a greater degree of oversight where insight is an issue, to protect the individual and those around them.
Dynamic work plans for fluctuating health
For people experiencing frequent health fluctuations, dynamic work plans can offer sustainable solutions. These plans might include adjustments to align with periods of higher or lower functionality, for example
Remote work options on days when mobility is poor
Flexible start and end times after a night of severe sleep disruption
However, flexibility isn’t always accessible to everyone. High-skilled roles tend to offer greater autonomy and adaptability, while lower-skilled jobs often lack these options. This disparity became particularly evident during the COVID-19 pandemic, where remote work was disproportionately available to higher-income professionals. This disparity correlated with a disproportionate death toll in some societal groups.
Bridging the skills and flexibility gap
The ability to access flexible work often depends on skills and the nature of the role. Bridging this divide is essential to creating a more equitable workforce. Investments in upskilling, innovative work solutions, and technology can help make flexibility accessible across industries. For example:
Technology can enable remote or hybrid work for traditionally in-person roles
Programmes can prepare lower-skilled workers for roles that offer greater autonomy- such as through increasing technical literacy
Creative job design can make flexibility possible even in industries that have historically resisted change
This is not just about fairness—it’s about unlocking innovation, driving growth, and fostering an inclusive economy that delivers productivity.
What about severe health fluctuations?
For some individuals, health variability is so extreme that working on certain days becomes impossible. These challenges are especially pronounced in roles that lack flexibility.
Under the Equality Act 2010, employers must make reasonable adjustments for employees with disabilities, and in some cases this could include accommodating frequent absences. However, for some individuals, significant fluctuations in health and functioning can be a barrier to traditional employment.
Should we think outside the box?
Maybe, we need to think more deeply about all routes to economic participation for all. Some of the most flexible forms of economic activity are not carried out through typical employment structures. For example, there are ways to leverage flexibility through alternatives such as self employment, part time casual paid work and asynchronous work as a contractor.
The downside of working outside of secure employment structures is a lack of benefits such as sick pay. Flexibility can very easily become one sided at the disadvantage of those lower down the socioeconomic ladder, as has been revealed with some examples of zero hours contracts. A responsive social security system is therefore essential to support people with long term ill health exploring alternative economic participation. Yet, a more dynamic social security system will come with increased complexity that translates to operational costs.
Steps to build a flexible workforce
Creating a society where work and health better align requires collective effort, creativity in policies, and policies that ignite and cultivate creativity in individuals in turn. Five steps that would help lay the ground work:
Leverage technology: Use digital tools and automation to democratise flexible work options and close skills gaps
High yield upskilling: Offer training programs to prepare workers for roles that offer more flexibility and adaptability, particularly around improving technical literacy
Promote empowerment: Equip individuals with the knowledge and confidence to manage their health in relation to work, including incentivising finding creative ways to make work work for them
Advocate for flexible work policies: Support employers to use expertise in designing flexible practices that help improve their business productivity
Reform social security: Create a responsive system that supports individuals who cannot fully participate in traditional employment to explore all options when it comes to economic activity
Lara’s take
We need to make a compelling case for embracing diverse forms of economic activity for all. While secure employment offers significant advantages—such as sick pay and contractual protections against exploitation—rigidity in employment models can limit opportunities for both individuals and society.
This is a difficult balance to strike. However, there is definitely untapped potential in enabling individuals to realise their productivity and earning capacity outside traditional employment structures. Pushing everyone toward rigid models of work may not always serve the best interests of all stakeholders. Greater opportunities for flexibility in economic activity could be leveraged by others who are not currently economically active at all - not just those economically inactive due to ill health. By adopting a more flexible approach and outlook, we can unlock innovation, foster growth, and create a more inclusive and dynamic economy. But getting people to believe in themselves, be creative and build opportunities is challenging, particularly when there are barriers to progress. It requires a mindset shift on how we go about things and what is possible.
