The need for occupational health provision has never been greater, so why are only 28 per cent of employers providing it, asks Becky Spencer.

If less than a third of all employers were implementing suitable safety requirements to protect their staff from injury at work, there would be outrage, and rightly so. But the statistics appear to show there is a general underlying acceptance that occupational health provision is a ‘nice to have’ add-on to a business rather than a ‘need to have’ provision that will protect employees at work and enable them to remain in work if they become ill.

And, sadly, the Government’s findings that only 28 per cent of employers provide OH services, meaning just 45 per cent of workers have access to them, doesn’t really come as a surprise – the lack of adequate OH provision is a long-term problem.

Back in 2008, Dame Carol Black published her review of the health of Britain's working age population, in which she called for a shift in attitudes to ensure that “employers and employees recognise not only the importance of preventing ill health, but also the key role the workplace can play in promoting health and wellbeing”.

Fast-forward to 2024 and Dame Carol Black has been announced as the Government’s new Occupational Health Tsar and is leading a new OH taskforce as part of the Government’s drive to tackle the problem of in-work ill health.

The scale of ill health

And what a big problem it is. Over 10 million working age people (aged 16 to 64) in Great Britain are currently living with a long-term health condition. Of those in work, around 1.8 million report suffering from a health condition which they believe is caused or made worse by their job. This equates to 5,250 cases of work-related ill health per 100,000 workers.

Stress, depression or anxiety account for around half of the self-reported cases of work-related ill health, followed by musculoskeletal disorders (MSDs). Together, these conditions resulted in 23.7 million lost working days in 2022/23. Overall, work-related ill health resulted in 31.5 million lost working days which is almost nine times higher than the number of working days lost due to non-fatal work-related injury during the same period.

HSE estimates the annual cost of new cases of work-related ill health is £13.1 billion. This compares to the £7.7 billion estimated annual cost of workplace injuries. The cost burden of ill health is split between individual workers, employers and the Government. The major costs to employers arise from productivity costs, occupational/statutory sick pay, ‘production disturbance’ costs and insurance premiums.

Taking all this into account, it’s clear to see why the new OH taskforce has been set up and it’s also clear that it has significant work to do if it is to achieve its aim of increasing employee access to occupational health support, whether that support is provided in-house or by an external provider.

The future

This summer, the OH taskforce will publish a framework for employers of all sizes which will set out how they can better support employees’ health at work. It will provide advice on the minimum level of occupational health support needed to stop sickness-related job losses and to better support employees returning to work after a period of ill health. Actions set out in the framework will be voluntary – it is not expected to introduce any new statutory occupational health duties.

To achieve results the framework will need to address the barriers that are currently putting businesses off spending on OH services, particularly smaller firms. Large employers are around five times more likely to provide OH services than small employers and yet the business impact of an employee being off due to long-term sickness, for example, will be felt much greater in a smaller firm where there isn’t as much, if any, staff cover.

Cost is regularly cited as the main barrier for smaller businesses not buying in OH support. Other barriers stated in a recent survey of employers include lack of demand for an OH service and a lack of knowledge about what OH involves and the value it can bring. Some employers said they prefer an informal approach to supporting employees with health issues and six per cent said their organisation was too small to need OH.

The UK Government, through the OH taskforce and other measures it is currently considering (including changes to tax incentives and the fit note system), is trying to address the challenges small firms face. Of course, it has a vested interest in getting it right this time. The welfare bill for people out of work due to a health condition or disability is growing year on year.  Currently, over 2.5 million people of working age are out of the labour market due to long-term ill health. Getting as many of these people back into suitable work is key to economic growth, as is preventing more people having to leave their job because of ill health.

To be successful in its efforts to increase OH provision, the Government will not only have to ensure the cost to businesses is affordable, it also needs to get employers engaged with, and committed to, the idea of providing OH support because of the benefits it can bring to their business.  

Occupational health services can help employers maintain and promote employee health and wellbeing; support staff with health conditions to remain in-work (including through reasonable workplace adjustments); and support the management of sickness absence and employees’ return to work.  Having the right OH support in place can save employers time and money (through less sick pay, less recruitment costs and less production downtime). It is also something that employees value, particularly at this time when NHS waiting lists are so long.