Correspondence

Keep Britain Working: the story so far (June 2026)

Published 3 July 2026

Introduction

Six months into Keep Britain Working (KBW), our mission remains clear: to drive a fundamental rebalancing in how health and disability are supported in the workplace. Progress is encouraging. Working directly with over 250 employers, providers and other organisations, through workshops and sprints across the UK, we have confirmed both the scale of the challenge but also the opportunity.

The challenge is well established. Economic inactivity linked to ill-health costs an estimated £212 billion a year through lost productivity, higher welfare spending and increased pressure on the NHS.

The opportunity is also significant. There are almost 33 million people of working age in employment across the UK. Nearly 3 million are not in work for reasons of ill health. Retaining just 1% more of the working population (330,000) in work would add the equivalent of a large city like Cardiff in terms of economic capacity… without building a single house, without opening a new line of immigration, without waiting for a whole cohort of young people to leave school or university.

Our work so far has convinced us that significant improvement is attainable. Most of the building blocks already exist. When the right people come together, practical solutions emerge quickly. Our task, with the growing coalition we are assembling, is to design, build and deliver the conditions that make this opportunity realisable as soon as possible and on a national scale.

Two themes have emerged that are central to that ambition.

Shared responsibility. Employers, employees, providers and government each have a distinct role to play. For too long, the system has been organised around supporting people after they get ill or face barriers. We need to shift the emphasis: earlier action, better integration, and a genuine, shared commitment to keeping people healthy and in work.

Better data. The current system is fragmented and data-poor. We want to make performance visible, build a stronger evidence base, and unlock the potential for earlier intervention and prevention. Data is not a technical add-on, it is the engine that will drive accountability, market quality and long-term system improvement.

It’s rare to find an opportunity that benefits employers, improves life chances, reduces government spending and doesn’t require large up-front investment. This is growth hiding in plain sight.

This document sets out what we have learned and how we are building towards unlocking that.

What we have learned since March

Since the March Story so Far update, we have deepened our engagement across three workstreams, each contributing to our emerging model of a new workplace health system. In what follows we are being deliberately bold, to invite views and provoke a robust conversation around key parts of the system.

Developing the standard: sprints and regional work

We have worked directly with over 250 organisations to explore the Healthy Working Lifecycle in depth, including:

• Employer-led sprints with 30 Vanguard organisations, focusing on prevention, stay-in-work, return-to-work and performance data.
• Broader feedback groups with 70 further Vanguards, testing sprint findings and providing wider input.
• Ten regional workshops across Strategic and Mayoral Combined Authorities and the devolved nations, each involving around 20 to 30 small and medium sized enterprises (SMEs) to ensure local labour market realities were reflected.

The depth of that engagement generated a clear and consistent message: any standard must avoid being overly prescriptive. To be accessible across the diversity of UK employers, it must focus on outcomes and a small number of core fundamentals:

• Accountability: we need employers to recognise their responsibility for workforce health and inclusion, with a commitment to robust outcome measurement to make performance visible.
• Signal actions: we need employers to take a small number of specific actions, including stay-in-work and return-to-work plans and to set contractual expectations on health, that demonstrate organisational commitment.
• Aligned incentives: we need to ensure a positive return on investment from improving outcomes, with active encouragement of positive employer and employee behaviour.
• Shared responsibility: this isn’t just about employers doing more. Employees have responsibility too. We need active engagement from both.

Disability inclusion

Improving disability participation is not a separate objective of Keep Britain Working. It is central to it. We took a focused look at disability inclusion, working with Vanguard organisations supported by the Business Disability Forum, and drawing on early input from the DWP Independent Disability Advisory Panel and the Disability Charities Consortium.

Employers face a range of genuine challenges: data compliance tensions, cultural and trust issues, inconsistent terminology and limited line manager capability. The consistent conclusion, mirroring the broader sprint findings, is that progress depends on creating clearer accountability for outcomes.

We are therefore exploring how better measurement of participation and retention of disabled people in work could be achieved.  This will require us to address understandable concerns around confidentiality and the complexities of self declaration. However, our view is this has the potential to open much more ambition and the opportunity for a level of change that is commensurate with the poor performance we see today.

Workplace health provision

Through targeted engagement with providers and the NHS, we explored what high-quality case management looks like, how early support pathways can be strengthened, and where prevention can have the greatest impact.

The engagement highlighted that the current market is fragmented. Employees frequently fall into gaps between HR, Employee Assistance Programmes, occupational health and other services. What is needed instead is coordinated case management: a coordinated conversation between employer and employee, with access to specialist or clinical input when needed, and clear pathways for early intervention before issues escalate.

Better data about individual and workforce health risks is also central, enabling more targeted, earlier support rather than intervention only when problems have already become acute.

Summary

What has been striking throughout is not just the quality of insight, but the level of shared ambition and the enthusiasm and engagement in regions and across a wide range of employers. There is a genuine once-in-a-generation opportunity to reshape outcomes in this space.

This document begins to set out what that future looks like. Over the summer we will test our assumptions more widely, invite challenge and identify where further development is needed.

Building the future system

Based on the engagement we have had to date, we are now starting the process to confirm and frame what shared responsibility means in practice – what it means for employers to be ‘on the pitch’; what responsibilities fall on employees; what’s required from providers to improve workplace health provision. The table below summarises these expectations for each party. This is intentionally brief but indicates succinctly our direction of travel.   

Table 1: Summary of roles

Who	Why	Responsibilities	How
Employers…	…because they have a unique role in prevention and delivering better outcomes	Take accountability for workforce health and inclusion. Act early to prevent issues arising or escalating. Support staff to stay in or return to work. Measure and improve outcomes, not just inputs.	Provide workplace health provision including work and health checks. Embed stay-in-work plans. Implement return-to-work plans. Track and share outcome data with WHIU.
Employees…	…because creating shared responsibility gives agency and control of their own health journey	Play an active role in shared responsibility for work and health. Recognise the long-term value of work for health and wellbeing. Engage constructively with support to remain in or return to work.	Clarity of expectations, entitlements and responsibilities. Engagement with workplace health provision. Participation in health checks and stay/return-to-work plans. Accountability through clear contractual arrangements.
Workplace Health Providers…	…because employers and employees need support in delivering better outcomes	Deliver high-quality support to employers and employees. Collect and share performance data to create a transparent marketplace. Improve quality, accessibility, integration and consistency of services.	Advice on workplace adjustments and health promotion. Prevention through monitoring employee’s health, needs and barriers affecting their abilities to work. Case management for stay/return-to-work planning, including clinical and GP liaison. Targeted support for key conditions: musculoskeletal, mental health and wider needs.

We are progressing various work streams to test, confirm and articulate these expectations, including with BSI, with whom we have now formed the drafting panel to work on the ‘standard’.  We are also working to explore how risk pooling could play a key role in making better provision affordable and accessible to more employers.

Data: the engine for transformation

Across all our work, one theme recurs: the current system is data-poor. Performance on workplace health is largely invisible. Sickness absence measurement is inconsistent; return-to-work outcomes are rarely tracked; disability inclusion is poorly understood. This limits accountability, inhibits improvement and makes it impossible to know what is working.

We are focused on two types of data, each playing a distinct role.

Performance data

To improve performance, employers will need to collect more consistent data on sickness absence, return-to-work outcomes and disability inclusion. Aggregating this data confidentially with the Workplace Health Intelligence Unit (WHIU) would then offer a number of benefits, including:

• Making performance visible, highlighting trends and areas for improvement that are currently obscured.
• Building the evidence base, enabling more effective targeting of interventions and spending.
• Driving benchmarking and improvement, giving employers comparative insight and government a stronger evidence base to target support.

An outcome-focus also avoids overprescription: organisations can determine for themselves how best to improve within their own context. This will be key to keeping the ‘standard’ proportionate for different sizes and types of employers and ensuring accessibility for SMEs.

Health and work-ability data

Beyond performance data, there is a critical gap in understanding workforce health and work-ability. Current data tells us what happens when people leave the labour market, but very little about the health, support and adjustment needs that shape outcomes while people are still in work.

We are exploring a consistent approach to collecting this data through Work and Health checks, learning from approaches used in countries like Finland and Japan, introduced at key points across the employment lifecycle, covering core aspects of employee health, needs or barriers that may impact their ability to work. The potential benefits apply to employee, employer and beyond, and are threefold:

• Visibility: a clearer picture of workforce health and needs, and disability inclusion.
• Understanding: the ability to track trends and target support over time.
• Earlier intervention: identifying emerging risks before they lead to prolonged absence or labour market exit.

Checks could be introduced initially at onboarding and at trigger points such as periods of absence, potentially delivered digitally by an independent entity with assurance that no individual data will be shared with employers (or healthcare providers without express permission). A phased rollout, starting with larger employers or specific regions, is likely to be needed to test and build the model effectively. The roles of key actors would be:

• Employees complete checks and engage with outputs, with strong safeguards over personal data.
• Employers receive aggregated organisational or sectoral (not individually identifiable) insights to encourage proactive engagement in workforce health and needs.
• Government could commission and oversee the system, with data aggregated through the WHIU.

Managing risk and building trust

We are very conscious of the challenges surrounding the collection of health and work-ability data. Confidentiality, consent and trust, particularly around sensitive health data, will be central concerns. There is a strong case for a trusted intermediary to collect this data, rather than expecting employers to deliver this.

Building public confidence, including through demonstrable benefits for employees, will be critical. We are exploring deliberative approaches such as citizen assemblies to co-design the system with those who might use it, for both what data should be collected, and how. If these challenges can be addressed the potential is significant: a powerful national data asset capable of driving a step change in system performance, and outcome-based policymaking.

The role of government

While the changes described will be driven primarily by employers, employees and providers, government, including devolved administrations, mayoral strategic authorities and city regions, has a central role in creating the conditions for success, setting frameworks, holding the data infrastructure and aligning incentives.

Infrastructure and market frameworks

We see two clear areas where government has a role to play:

• Setting market frameworks: international examples show government can ensure coverage and affordability of services, particularly for smaller employers, and simplify the offer for employers navigating a fragmented market.
• Data stewardship: government is potentially best placed to act as a trusted guardian of the data infrastructure, establishing common standards, appropriate safeguards and enabling effective use across the system.

The Workplace Health Intelligence Unit (WHIU) will be central to this function:

WHIU Function	Description
Standard setting	Define standardised approaches to measuring and collecting performance data, and health and work-ability data.
Collection	Gather data from employers and providers across the UK.
Guardianship	Hold individual health and work-ability profile data securely and manage onward sharing only where consent is given.
Aggregation	Consolidate data on performance, outcomes and health and work-ability profiles by organisation, sector and region.
Benchmarking	Provide confidential intelligence back to employers and providers to drive continuous improvement.
Impact evaluation	Measure the effectiveness of interventions and establish the value-for-money case for new approaches, including digital and AI.
Evidence-based policy	Translate data insights into proposals and recommendations for government on policy and interventions.

Aligning incentives

Many organisations are motivated to engage in better work and health practices, but not all will do so without the right incentives. Government must:

• Support employers to adopt the standard.
• Reward continuous improvement and positive employer behaviour.
• Enable and encourage employee engagement, including considering how we can build greater clarity around expectations with respect to work and heath into contractual arrangements.
• Support the creation a vibrant, high-quality and affordable market for workplace health provision, especially for small businesses.

Further work is needed to identify the most effective levers. Proposals will be developed as evidence accumulates on what works.

Next steps

The next phase of the programme will turn this emerging model into a deliverable and scalable system. The open, participative approach that has characterised Keep Britain Working to date will continue - engaging employers, providers, unions, regional partners and those with lived experience throughout.

We are committed to early communication of our emerging conclusions precisely to encourage engagement, discussion and reaction from the many stakeholders we are engaging with. There will inevitably be issues and elements of the model for which we don’t yet have clear answers. Through this engagement approach our conviction is we will develop better quality outcomes. Our future work across the key Keep Britain Working workstreams are discussed below:

Healthy Working Lifecycle Standard

• Establish the BSI drafting panel, chaired by Valerie Todd, to begin developing the formal standard, drawing on consolidated sprint findings on prevention, stay-in-work and return-to-work, and developing the concept of redeployment and better-supported exits. We will ensure that any standard developed is feasible, accessible and proportionate for all employers, particularly including SMEs.
• Development of the Employee Voice to ensure that employee lived experience is central in shaping our approach alongside employers, providers and other stakeholders. This will include working with Unions and other employee representative bodies as well as directly with employees themselves.
• We will also need to look beyond traditional employment models so that we maximise the number of those in the UK who can benefit from the new system and approach.
• We will pay attention to different perspectives to ensure that the proposed system works for some of the key drivers of leaving work for health reasons while avoiding being overly prescriptive (for example Women’s/Men’s Health, Mental Health, MSK, Cancer)

Workplace health provision

• Develop the concepts of quality case management, early support and treatment pathways, and the role of work and health checks in supporting prevention.
• Build understanding of risk pooling and insurance approaches to make provision accessible and affordable for small businesses.
• Consider the supply side of the Workplace Health Provision so that the workforce and provider capacity does not constrain the market
• Articulate the role of Primary Care and GPs so that our resulting system is a more integrated and cohesive approach across work and the NHS, and incorporates ongoing reforms of the fit note process.

Disability inclusion

• Work with Vanguard organisations and academic partners to improve measurement of disability participation, creating the outcome-focused foundations for more inclusive practices across UK employers.
• Further develop the input from those with lived experience into the work of the review to ensure that disabled people have a voice throughout and are actively involved in the design of the system.

Data

• Begin shaping the Workplace Health Intelligence Unit and building the data requirements and strategies to underpin the system.
• Begin to develop and establish the data architecture required so that data confidentiality and privacy for employees and businesses is preserved, including compliance with GDPR.
• Exploring with Liverpool University the concept of work and health checks and how these could be tested via citizen assemblies
• Working with Rail Safety and Standards Board and other organisations already running health checks to explore what works and what data is most useful.

Incentives

• As we become clear on what the system looks like, we will need to ensure that incentives are aligned in the system, encouraging engagement, participation and shared responsibility across employers, employees and providers.

Join up with the Young People NEETs work

• Our work is complementary with the Milburn Review, as the Keep Britain Working programme can ensure we are improving the receiving environment for young people moving into the workplace and thus keeping them there more successfully. We will collaborate closely to explore the connections between the two programmes of work, and particularly where data can add value for both.

Through continuing our iterative, collaborative process with employers, employees and their representatives, providers, regional partners and wider stakeholders, we will resolve the many outstanding questions and build consensus on what is possible. The opportunity to deliver a genuine step change in work and health outcomes across the UK is real. We are determined to seize it.

Annex

The latest list of organisations who have expressed an interest in working with us in the Vanguard:

3-1-5 Health Club
A&M EDM
Acas
ARKIVE by Adam Reed
Ascenti Health Group
Association of British Insurers
Aviva
AXA Health
Barts Health NHS Trust
BP
British Airways
British Beer & Pub Association
BT Group
Bupa UK
Burger King
Business in The Community
ByteDance
Calderdale & Huddersfield NHS Foundation Trust
Canada Life
Canary Wharf Group
Capita
Career Returners
Carolina House Trust
Cartrefi Cymru Co-operative
CBI
Centrica
Change Grow Live
Channel 4
Chrysalis Courses
Coca-Cola Europacific Partners
COOK Food
Cora Health
Cosy Direct
Crown Estate
Currys
Dene Healthcare
Department for Business & Trade
Department for Energy Security and Net Zero
Department for Health & Social Care
Department for Work and Pensions
Disability Action (Northern Ireland)
East Midlands Railway (EMR)
EDF Energy
Endometriosis UK
Enginuity
Epilepsy Action
Evenbreak
EY UK
Fedcap
Ford UK
Future Fit
Genius Within
Goodshape
Google UK
Grayling UK
Haleon
HCA Healthcare
HCML
Health 2 Employment
Health Partners Group
Health Shield
HealthHero
Holland & Barrett
Home Office
Hospitality Action
HR Support 4u Ltd
Hussle
Independent Healthcare Providers Network
Ingeus
Inspired Ergonomics
Insurance at Heart
J Sainsburys
Jaguar Land Rover
John Lewis Partnership
Journey Enterprises
Kore Sandwell
Latus Group
Legal & General Group
Lloyds Banking Group
Loughborough University
LSN Diffusion
Marks and Spencer
Maximus UK
McLaughlin & Harvey Ltd
Medicash
Mental Health First Aid England
Mental Health UK
Microlink PC
Mind Matters Counselling LLP
Mission Remission
Moneypenny
Motionspot
Nando’s
National Hair and Beauty Federation
NCPS
NHS Business Services Authority
NHS Cheshire and Wirral Trust
NHS Greater Manchester Integrated Care Board
North Yorkshire Hospice Care
Northern Trains Limited
Northumbria Healthcare NHS Foundation Trust
Nuffield Health
One Medical Group
Onebright
Optima Health
PA Consulting
PAM Wellness
Parachute
Passion4Social
Patchwork Hub
Pathways CIC
Peak Health Coaching Ltd
People Partner 4U
Peppy Health
PepsiCo UK
Pharmacy2U
Places for People
Places Leisure
Posturite
PreCure ApS
Psychiatry UK
Public Health Scotland
Pure Gym
Pure Unity Health Group
PwC UK  Rail Safety & Standards Board
Ramboll UK & Ireland
Renew Beauty
Retail Trust
Rethink Mental Illness
Rio Tinto
Road Haulage Association
Rolls-Royce
Royal Mail
Scottish Union of Supported Employment
Seddon
Serco
Severn Trent Water
Sick in the City (SIC)
Siemens
Simplyhealth Group
Sky UK
Sonder
Sopra Steria
South Warwickshire University NHS Foundation Trust
SpaMedica
Spire Healthcare
Square Health
SSE Plc
Standard Life plc
Teladoc Health
TELUS Health
Tesco
The Anti Burnout Club
The Association of Medical Insurers and Intermediaries (amii)
The Busy Group
The Chartered Management Institute (CMI)
The Clear Company
The Gym Group
The Human Centre
The Ink Group
The Migraine Trust
Thrivall
Transport for London
Transport for Wales
Truro & Penwith College
Turning Point
UKHospitality
University of Cambridge
Unum  Vercida
Vitality
Vitality 360
Vivam Health
Waltham Forest College
Wellebit
Wellhub
Wise Corp
Working to Wellbeing
WPA
Zellis Group
Zurich UK

The Regional Vanguards working with us are:

Cornwall Council
East Midlands
Greater London Authority
Greater Manchester
Liverpool City Region Combined Authority
North East Combined Mayoral Authority
South Yorkshire Combined Mayoral Authority
West Midlands Combined Mayoral Authority
West of England Combined Mayoral Authority
West Yorkshire Combined Mayoral Authority
Worcestershire County Council