One in five UK adults of working age are currently out of the workforce due to health reasons. That stark headline statistic from the Keep Britain Working review which was released in November 2025 underlines the challenge facing individuals, employers, and the country.

The review, headed by Sir Charlie Mayfield, could not be clearer in setting out the challenges and consequences which arise from long term sickness. With unemployment due to ill health up by 800,000 since 2019, the impact is felt across society. For example:

• A 22 year old individual who falls out of work due to ill health could lose up to £1million over their lifetime, impacting not only their health but also their mental wellbeing.
• UK employers lose £85billion each year due to employee sickness impacting turnover and lost productivity.
• For the country as a whole the cost of ill health that prevents work equates to 7% of GDP or the equivalent of nearly 70% of income-tax receipts.

The rate of long term sickness seen in the UK is higher than comparable countries. So much so that an additional two million individuals would need to be returned to long term work just to bring the UK in line with the OECD average. Why is this? Well, partly the review’s authors identified three key barriers to managing health and disability in the workplace. They are:

• A culture of fear which prevents employees and line managers from feeling that they are able to discuss and address challenges at an early stage.
• A lack of effective or consistent support, compounded by a ‘fit note’ system which the report’s authors believe is not working as intended.
• Structural challenges for disabled individuals which leave them disproportionately excluded from the workplace.

In the light of the report, Sir Charlie Mayfield has been asked to lead a three-year initiative which is designed to identify changes within the workplace which could both prevent those with health issues from falling out of work and to help those already out of the workplace to return to employment. The Vanguard Taskforce will bring together employers, the disabled, work representatives and health experts. Commenting on the initiative Sir Charlie Mayfield said: “Employers are uniquely placed to make a difference, preventing health issues where possible, supporting people when they arise, and helping them return to work. If we keep Britain working, everyone wins – people, employers, and the state.”

More than sixty employers ranging from global brands such as British Airways to smaller SME organisations have already signed up to the initiative. Organisations across the health sector have also signalled their support. For example, the Chartered Society of Physiotherapy, which itself contributed, to the report commented: “This is a huge opportunity for employers and healthcare systems to recognise the power of rehabilitation in keeping people well and working. A significant part of that success depends on employers playing their part by harnessing the full expertise, experience and capacity of the independent physiotherapy sector, alongside NHS services, to create healthier, more supportive workplaces.”