The United Kingdom is facing a significant challenge with a growing number of people unable to work due to long-term sickness. This issue has sparked a crucial conversation about the health and well-being of the nation's workforce.
A Personal Story of Transformation
Roni Jones, a former NHS manager and self-proclaimed workaholic, shares a powerful story of transformation. After collapsing in her garden in 2021, she was diagnosed with a debilitating neurological condition, joining the ranks of 2.8 million people who are currently off work due to long-term sickness.
"I can't even imagine being able to get up, shower, and leave the house regularly, let alone go to work," Jones, 63, says. Her condition, multisystem dysautonomia, causes her immense pain and fatigue, a stark contrast to her previous perception of those on long-term sick leave.
The Numbers Don't Lie
The statistics paint a concerning picture. There are now 800,000 more people of working age off work due to long-term sickness compared to 2019, a 40% increase. Additionally, the number of working people reporting work-limiting disabilities has risen by 30% to 4.1 million in the same period. If this trend continues, it could cost the economy a staggering £66.3 billion annually by 2030 in lost productivity, according to forecasts.
Health Issues: A Pincer Movement
Health issues are impacting the workforce in a two-pronged attack. Mental health problems are affecting individuals at the start of their careers, while musculoskeletal issues are taking their toll on those nearing retirement.
Let's delve into the conditions that limit work capacity but don't entirely prevent it. Since 2015, the number of affected staff aged 16-34 has risen the fastest, with almost half of them reporting mental health problems as their primary condition. Meanwhile, workers aged 50-64 have also seen a significant rise, with musculoskeletal issues accounting for a large portion of these cases.
When it comes to conditions that have forced 2.8 million people to stop working altogether, the picture becomes more complex but follows a similar pattern. Mental health is the leading cause, with 28% citing it as their main condition last year. This affects people across all age groups, with the youngest workers being the most vulnerable.
The Role of Mental Health and Money Worries
Mark Rowland, chief executive at the Mental Health Foundation, identifies four "mega trends" behind the rise in long-term sickness due to mental health issues. The first is a positive shift towards less stigma, encouraging more people to seek help. However, rising economic insecurity and inequality are also significant factors, with research linking income to poor mental health.
In 2022, during the peak of the cost-of-living crisis, 21% of people without a previously diagnosed mental health condition reported that worrying about money was making them feel depressed. This has been reflected in GP practices, with patients experiencing finance-related stress and those working for small companies feeling the pressure from their bosses.
The Impact of the Online World and Work Intensification
The ever-growing influence of the online world and the increasing digitalisation of work are also contributing factors. Ben Willmott, head of public policy at the Chartered Institute of Personnel and Development (CIPD), explains that while short bursts of stress can enhance performance, prolonged exposure is linked to anxiety, depression, and heart disease.
The UK stands out among its European peers in this regard. Half of British workers often work more hours than expected, the highest rate in Europe. Only a third of British workers have control over how they work, the lowest rate in Europe. Heavy workloads are the top cause of stress-related absences in the UK, according to the CIPD.
Musculoskeletal Issues: An Ageing Workforce
The ageing workforce is a significant driver of the worsening musculoskeletal problems. With the "baby boomers" approaching retirement and the average number of children born per woman in England and Wales dropping below the population-sustaining level of 2.1 since 1973, the median age in the UK has risen from 33 to 40.
Huge NHS waiting lists have only exacerbated the issue, with patients experiencing pain and its impact on their physical and mental health while waiting for treatment.
The Role of Employers and Line Managers
Clare McNeil, chief executive of Timewise, a non-profit consultancy on flexible working, raises important questions about the quality of work and its impact on sickness rates. She asks why employers aren't offering the flexibility needed by young people managing mental health conditions.
There is a moral responsibility to ensure the post-COVID generation entering the workplace receives good-quality employment, she argues. The Health and Safety Executive reports that 1.77 million workers suffered from work-related ill health in 2022-23, resulting in 31.5 million lost working days.
Inadequate line management and a lack of training for managers to manage people properly are partly to blame, according to the CIPD. A study by the University of Nottingham and Queen's University Belfast found a strong association between mental health training for line managers and lower levels of long-term mental health sickness absence. However, only 29% of organisations provide this training.
The Need for Reform and Prevention
Rowland argues that the entire system needs reform, with a focus on investing in prevention and support at the early stage. Other countries, such as the Netherlands, Australia, and Japan, have implemented initiatives to promote health and well-being, prevent ill health, and support the reintegration of sick employees.
The government's plan includes spending £1 billion over the course of the parliament to embed job advisers in GP surgeries through its Connect to Work programme. However, McNeil warns that the country will be in a "no man's land" unless the government provides clear expectations, incentives, guidance, and enforcement mechanisms for employers.
The BCC's Gratton adds that the government should also support businesses in offering preventative and rehabilitative health care, such as reducing insurance premium tax for private work health schemes.
A Call for Change
For people like Roni Jones, the need for change is urgent. She wants to see a shift in attitudes and an understanding of the challenges faced by those on long-term sick leave.
"What do you do to us when you think all of us are malingerers? Come live my life for a week. You would break your heart, because I have," Jones says.
This story and the statistics highlight the importance of addressing the health and well-being of the UK's workforce, and the need for a comprehensive approach to support those facing long-term sickness.
