đWork, health and the Autumn Statement
The Autumn Statement has been published. The Chancellor has attempted to present measures aimed at achieving sustainable economic growth, essential for balancing the books in the UK economy.
Work and health: What was included?
Amongst 120 pages is a seven point section on work and health, primarily outlining initiatives geared at helping people who are economically inactive due to ill health back into work. This includes the following changes to public sector services.Â
Expanding employment support services for people living with long term ill health and disability. The Office of Budget Responsibility predicts expansion of these schemes will result in 25 000 more people in employment by 2028-2029. The cost of expanding the programmes is predicted to outweigh the potential welfare saving by ÂŁ0.6 billion.
Reform to the work capability assessment process from 2025 to support more people back to work (a late stage gateway to longer term economic inactivity triggered after several months of sickness absence). The Office of Budget Responsibility predicts these changes will raise employment by around 10 000 by 2028-2029.
Reform to the fit note process to bring in support earlier on in the sickness absence journey. This will include the roll out of trials similar to research currently being undertaken on early intervention and joined up work and health support. The The Office of Budget Responsibility has been unable to forecast the impact of this on labour supply.
Of these measures, fit note reform and a focus on early intervention may be the most promising. Evidence suggests the earlier work and health issues are addressed the better the outcomes. Yet, bearing in mind the number of people who are economically inactive due to ill health is currently over 2.5 million, the predicted impact of these combined changes is limited - in total only increasing labour supply by around 50 000. This means just 2% of that 2.5 million cohort are predicted to flow from economic inactivity into employment as a result of the policy changes outlined in the Statement.
The government will also work towards developing a voluntary minimum framework to help guide employers on implementing occupational health services. While this is unlikely to be a game changer in catalysing uptake, it could be useful to employers, helping ensure they invest in evidence-based interventions when navigating the provider landscape and corporate wellbeing space.
Work and health: What was missing?
The work and health agenda is presented as niche and siloed. While the plans do represent some progress, the impact on numbers is predicted to be limited. Perhaps more importantly, the government have missed an opportunity to unify the narrative on work and health and its relevance to the current economic climate, specifically:
to communicate to stakeholders why the work and health agenda is essential to achieve sustainable economic growth and balance the booksÂ
to communicate to stakeholders how wider measures in this Statement can be best used to advance the work and health agenda and why this is importantÂ
Promoting the work and health agenda lies beyond any of the measures targeting long term economic inactivity due to ill health outlined above, described in a small section of the Statement. Many of the other larger points of focus, from business and National Insurance tax cuts, to welfare reform incentivising people on Jobseekerâs Allowance to keep up their search for work, hold potential for the work and health agenda. Getting this across to stakeholders means supporting businesses to understand how to invest the money saved through changes to the tax landscape into keeping their workforce healthy and why this makes financial sense for them. In addition, public communications around the health benefits of work are essential to wider welfare reform policies to minimise the risk that these changes will be perceived exclusively as punitive such that any platform to reach stakeholders on the relationship between work and health will be lost.Â
The work and health agenda strikes at the core of the economic challenges faced by this and any future UK government. As the health of the nation deteriorates, numbers depending on state support, including the NHS and welfare services are increasing. Meanwhile, growth in the number of people of working age well enough to work and contribute to government funds are not keeping up. This is amplified by demographic change as the population ages. This combination of forces will have serious consequences across public services in the coming decades. A joined up narrative around this is still missing from political leaders and the Autumn Statement is another lost opportunity to communicate with all stakeholders on the importance of unified policy change in this direction.
This may reflect political priorities, driving emphasis on other headlines. It may reflect a lack of joined up thinking. Most disturbingly of all it may reflect a fear of articulating where we are with the health and function of the population, and the potential pervasive consequences of this across society, with no clear solution ahead.Â