“Sick-note culture” is a misdiagnosis of the UK’s ill-health workforce crisis

"The workplace is fast becoming the latest battleground in the culture wars," said the Royal Society for Public Health's CEO

Earlier this month, Rishi Sunak claimed that the UK is in the grips of a “sick-note culture,” resulting in a significant rise in people being unnecessarily signed off work.

While we don’t share the prime minister’s diagnosis of the problem, the growing numbers of people leaving the workforce presents significant challenges for employers and the economy alike. Promoting better workplace health has never been more important.

There are currently 2.8 million people whose ill-health is limiting their ability to participate in work. We lose around 185 million working days to ill-health every year. A report released earlier this year by the Times Health Commission found that ill-health is costing the economy dearly, to the tune of £150 billion a year.  

Read more: Is Sunak right about "sick-note culture"?

What’s causing the UK’s crisis of working age ill-health?

The reasons behind the crisis are complex and varied. Several studies have shown that across the workforce, preventable and manageable conditions remain the most common form of work-limiting health conditions.

Mental ill-health is now the most common cause of work-limiting conditions among younger people, and musculoskeletal conditions continue to be an issue. The causes of this are varied.

We are still feeling the effects of the Covid-19 pandemic. Levels of loneliness are rising, impacting young and old alike. Societal pressures such as the cost of living crisis are placing a huge toll on mental health, and long-term conditions continue to limit people's ability to work.

The pressure on the health service and growing waiting lists means that people are waiting longer to access care, which is making treatable conditions worse and therefore increasing the time people spend out of work.

What can employers and HR teams do about it?

The picture painted by the evidence is a bleak one. However, employers are perfectly placed to have a positive impact on the health of their staff. After all, a healthy workforce is a productive workforce.

Read more: Sick leave hits 10-year high in cost of living crisis

In any organisation, culture is key. HR teams are pivotal in cultivating the workplace policies and a culture that promotes better health and wellbeing. Healthy working environments have a zero-tolerance approach to bullying and reduce stress for employees ,which helps alleviate mental ill-health. They also actively facilitate healthier habits such as regular exercise and healthy eating.

The most important principle in public health is prevention. In the context of a workplace this means making sure that staff are supported to make healthier choices and have access to a healthy environment, screening and wellbeing support.

The right education and training around managing and spotting the signs of ill-health are particularly important for line managers. Being able to offer practical and self-management support for both mental and physical health issues can be the difference in preventing a long absence and can help manage an employee's return to work.

When staff become unwell, rapid access to occupational health and ensuring that they receive the necessary care to prevent their condition from worsening, along with occupational sick pay terms that support the lowest-paid staff in getting their conditions diagnosed and managed, are key.

The health of the workforce isn’t a culture war issue

The workplace is fast becoming the latest battleground in the culture wars. The amount of time that employees spend working from home and individual flexible working arrangements have attracted much media attention in recent years. There is a real danger of the issue becoming ideological and the overwhelming body of evidence on how to improve health in the workforce being ignored by policymakers and employers.

Read more: Fit notes for sick employees hit record high

We need government to incentivise employers to support workplace wellbeing, to ensure that there is access to occupational health and to ensure that occupational sick pay is used as a lever to keep people well, not ill.

Employers and their HR teams can play a pivotal in reversing the trend of growing ill-health in working age people. Many of the best organisations will already do much of this, but ensuring that the lowest-paid workers have access to the right support is critical to tackling ill-health at work.

Creating the right culture and embedding the principles of better health promotion in practice will pay off for both employer and employee. After all, everyone stands to benefit from healthier and more productive workforce.

By William Roberts FRSPH, CEO of the Royal Society for Public Health