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Sam Atwell @swjatwell.bsky.social · 1d

With the Keep Britain Working review expected soon, the government has an opportunity to rebalance work and health support towards retention and rehabilitation.

A better integrated Access to Work scheme should be at the heart of this.

Sam Atwell @swjatwell.bsky.social · 1d

With growing pressures on economic activity and welfare, the only sustainable approach to reduce long-term costs is to help people stay healthy and in work in the first place.

This is what AtW aims to do, any reforms should aim at making the scheme more user friendly and efficient

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Sam Atwell @swjatwell.bsky.social · 1d

Despite higher spend it’s important to remember that AtW still reaches only a small fraction of disabled people.

For those that get it, it can be transformative but there are ongoing admin issues that limit effectiveness.

The govt announced plans for reform in the green paper earlier this year.

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Sam Atwell @swjatwell.bsky.social · 1d

Latest Access to Work stats are out today

They show continued growth in the number of awards and spend, about 70% increase in both since 2019.

This is not hugely surprising: there's now 4.1m workers with a work-limiting health condition, up from 2.4m a decade ago

www.gov.uk/government/s...

Access to Work statistics: April 2007 to March 2025

www.gov.uk

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Sam Atwell @swjatwell.bsky.social · May 8

New analysis from the @healthfoundation.bsky.social today.

Statutory sick pay is being tweaked in the Employment Rights Bill, but these (welcome) reforms won't go far enough to protect workers financially

The below sets out the context and some ideas for change.

www.health.org.uk/reports-and-...

Making statutory sick pay work

This analysis explains why current satutory sick pay reforms, though significant, do not go far enough and outlines a path to a better system.

www.health.org.uk

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Reposted by Sam Atwell

Gavin Kelly @gavin-kelly.bsky.social · Mar 20

‘Mayfield’s report argued that action to stop people leaving work when they first fell sick would make much more difference than reforms to the welfare system aimed at long-term benefits claimants.’

on.ft.com/4hoqxSu UK employers ‘find it cheaper to replace sick staff than retain them’

UK employers ‘find it cheaper to replace sick staff than retain them’

Report by former John Lewis boss calls for stronger incentives for employers to invest in workforce health

on.ft.com

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Sam Atwell @swjatwell.bsky.social · Mar 20

As I say, we discussed these challenges in the final report of the Commission for Healthier Working Lives, which came out last week.

And more importantly, the report makes some recommendations for what we can do about them!

www.health.org.uk/reports-and-...

Action for healthier working lives

The Commission for Healthier Working Lives’ final report sets out the need for a new approach to work and health, outlining seven key recommendations to lay the foundation for long-term change.

www.health.org.uk

Sam Atwell @swjatwell.bsky.social · Mar 20

The annex on international comparisons is also useful.

This chart/table highlights one of the issues that has got a bit lost in the employment rights bill debates - just how low our statutory sick pay is!

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Sam Atwell @swjatwell.bsky.social · Mar 20

In a week where a lot of attention has rightly been focused on steep health-related benefit cuts, it provides a helpful corrective to the narrative - focusing on the critical role of worker retention and making workplaces accessible for disabled people to begin with.

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Sam Atwell @swjatwell.bsky.social · Mar 20

The first report from Sir Charlie Mayfield's "Keep Britain Working" review has landed this morning.

A very busy week in the health and employment space.

A first scan through sees it echoes a lot from the recent @healthfoundation.bsky.social Commission.

www.gov.uk/government/p...

Keep Britain Working Review: Discovery

www.gov.uk

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Sam Atwell @swjatwell.bsky.social · Mar 19

But on to the main issue...

We await next weeks OBR publication to find out the depth of cuts to PIP/UC, but initial estimates of 1+ million people affected are deeply concerning.

To echo the point made elsewhere, its simply not clear how this will help people into work, or promote health.

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Sam Atwell @swjatwell.bsky.social · Mar 19

I am minded here of the work done by @benbgeiger.bsky.social and others highlighting the impact of conditionality on people with mental health conditions - which obviously reflect a growing share of the caseload.

inequalities.substack.com/p/conditiona...

Conditionality and mental health: new evidence

A new study of Danish RCTs shows how the impact of conditionality depends on people's pre-existing mental health

inequalities.substack.com

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Sam Atwell @swjatwell.bsky.social · Mar 19

Again, this reflects a recommendation from the Commission for Healthier Working Lives for a caseworker support model for people experiencing work and health challenges (see below)

But for this to work, people need to feel that the 'help' will actually help, and not be forced through the door.

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Sam Atwell @swjatwell.bsky.social · Mar 19

There will be lots to work out with regards to the £1bn of new funding for employment support.

The green paper sets out some principles:

- Individualised 1-1 support
- Signposting to wider services
- Building around people's aspirations

But also suggestions this will be compliance driven

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Sam Atwell @swjatwell.bsky.social · Mar 19

We were also pleased to see a 'right to try' guarantee, that was called for by the Commission, and others (including @jrf-uk.bsky.social and @neweconomics.bsky.social )

The Commission called for 18 months 👇 it sounds like the current proposals could potentially be more radical (devil in detail etc)

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Sam Atwell @swjatwell.bsky.social · Mar 19

The time-limited 'Unemployment Insurance' benefit is potentially transformative, moving us closer to a model found in many similar countries.

It reflects a recommendation from the @healthfoundation.bsky.social Commission for Healthier Working lives last week

www.health.org.uk/reports-and-...

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Sam Atwell @swjatwell.bsky.social · Mar 19

There was a lot to chew over in yesterday's green paper.

There are real signs that the government wants to move towards an 'early intervention' approach for supporting people with health conditions into work

But the bit cuts to PIP/UC eclipse these positives

www.health.org.uk/press-office...

The Health Foundation responds to the Pathways to Work Green Paper

David Finch, Assistant Director at the Health Foundation, responds to the Pathways to Work Green Paper published by the Department for Work and Pensions.

www.health.org.uk

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Sam Atwell @swjatwell.bsky.social · Mar 18

Not a full answer, but colleagues at the Learning and Work Institute looked into this as part of an evidence review for the Commission for Healthier Working Lives

learningandwork.org.uk/resources/re...

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Reposted by Sam Atwell

Dr Lucy Foulkes @lucyfoulkes.bsky.social · Mar 18

I'd really encourage you to read this short article if you are remotely interested in the rise of mental-health related work inactivity - very thoughtful from @annieirvine.bsky.social

www.health.org.uk/features-and...

(cont)

Unravelling the rise in mental health-related inactivity

Dr Annie Irvine on why we need a much more holistic approach to understanding capacity in order to tackle mental health-related inactivity.

www.health.org.uk

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Reposted by Sam Atwell

Jo Bibby @jobibby.bsky.social · Mar 16

Want to understand what has been happening to working age mental health?

Read @healthfoundation.bsky.social analysis below.

Across multiple data sources, rates have nearly doubled in 10 years for the 16-34 age group.

Lower qualifications associated with ⬆️ rates

www.health.org.uk/reports-and-...

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Reposted by Sam Atwell

Christopher Rocks @christopher-rocks.bsky.social · Mar 17

Good to see this - it reflects one of seven recommendations from the @healthfoundation.bsky.social's Commission for #HealthierWorkingLives. The government must move beyond short-term fixes and invest in long-term support for work and health. More in the Commission’s final report:

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Reposted by Sam Atwell

The Health Foundation @healthfoundation.bsky.social · Mar 10

📣 NEW: Final report by our Commission for #HealthierWorkingLives.

The Commissioners say government and employers must act early when health issues arise – not wait until people have already left work ⬇️

buff.ly/EfkpBQu

Action for healthier working lives

The Commission for Healthier Working Lives’ final report sets out the need for a new approach to work and health, outlining seven key recommendations to lay the foundation for sustained long-term…

buff.ly

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Sam Atwell @swjatwell.bsky.social · Mar 10

The report has 7 recommendations

Key among them is expanding caseworker support to people at risk of falling out of work, and getting financial support to people faster through better sick pay and a reforms to benefits.

Better practical support alone is projected to save £1bn+ over 5 years

Sam Atwell @swjatwell.bsky.social · Mar 10

Why is this needed?

📈 20% of working-age people (8.2mn) now report a work-limiting health condition.

📤 300,000 people leave the workforce each year and report a work-limiting health condition.

This is putting significant pressures on employers, public spending and, critically, individuals too.

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Sam Atwell @swjatwell.bsky.social · Mar 10

Out today: The final report of the Commission for Healthier Working Lives.

Ahead of the forthcoming DWP green paper, the report calls for a radical shift from late-stage intervention to early support, before poor health forces people out of work

www.health.org.uk/reports-and-...

Action for healthier working lives

The Commission for Healthier Working Lives’ final report sets out the need for a new approach to work and health, outlining seven key recommendations to lay the foundation for sustained long-term chan...

www.health.org.uk

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