Research and analysis

Summary: Understanding Occupational Health Provision 2023-24

Published 5 August 2025

IFF Research 

Overview 

The Joint Work and Health Directorate, a joint unit between Department for Work and Pensions (DWP) and Department of Health and Social Care (DHSC) commissioned IFF Research to undertake research with Occupational Health (OH) providers to understand the structure, attitudes, and behaviour of the OH market. The research examines: the capacity of the OH services market, its workforce composition, and skills shortages; use of, and enablers and barriers to using multidisciplinary teams; engagement with, and enablers and barriers to working with Small and Medium-sized Enterprises (SMEs) and the self-employed as customers; engagement with, enablers and barriers to innovation; and pricing strategies and levels, and how these relate to delivery models.  

Research Context 

In 2019, IFF Research carried out a study for the Department for Work and Pensions (DWP) and the Department of Health and Social Care (DHSC) Work and Health Unit to explore provision of OH and the commissioning of NHS work-related musculoskeletal (MSK) services to inform policy development. This research report provides updated findings from the previous survey on OH provision. However, it should be noted that the surveys are not directly comparable due to different survey methodologies and questionnaire content. 

Key Findings 

• Workforce composition and recruitment: On average, OH providers are relatively small and still face significant challenges in recruiting skilled staff.
• Multidisciplinary teams: The sector is positive about using multidisciplinary teams, while their use is constrained by the availability of appropriately skilled OH staff; provider access to finance; and the extent to which customers accept their use. 
• Training: OH providers commonly engage with training but want to do more. 
• Demand for OH services and provider capacity: It may be more common for demand to be exceeding provider capacity than it was in 2019.  
• Pricing: Most specific OH services asked about tended to be charged at £51-£200 per person, per use.  
• Small and Medium Enterprises (SMEs) and the self-employed as customers: Despite positive provider attitudes, SMEs continue to be significantly under-represented in the customer base; and providers report a lack of demand from the self-employed.  
• Data collection, knowledge sharing and innovation: Almost all OH providers collected at least some data for their own central analysis; and the majority invested resource or staff capacity in keeping up to date with new OH research. Providers tend to innovate but do not have the funds or staff capacity to innovate as much as they would like to.  
• Accreditations: Awareness of and favourability towards Safe, Effective, Quality Occupational Health Service (SEQOHS) accreditation is high.  

Methodology 

The research took the form of a semi-structured telephone survey of 200 NHS, in-house and private OH providers headquartered in Great Britain, and 20 in-depth interviews with a subset of OH providers who had taken part in the survey. Fieldwork took place between 23rd August 2023 and 19th January 2024. 

The research was designed to provide: 

• New baseline information on the OH market in order to monitor change over time; 
• Updated findings from the previous survey on OH provision carried out in 2019; 
• New evidence to support policy development. 

Findings Explained 

Workforce composition and recruitment:  

On average, OH providers are relatively small, but NHS providers tend to be bigger on average than in-house or private OH providers. NHS providers were also found to have the broadest spread of OH roles when asked how many staff they employed in various specific roles, while in-house providers had the least diverse spread. 

The research also found OH providers still face significant challenges in recruiting skilled staff. The most acute staffing challenges in the sector are around nurses with an OH Specialist Community Public Health Nursing (SCPHN) qualification, registered nurses with (or training towards) other OH postgrad qualifications, physiotherapists, and doctors registered with the General Medical Council (GMC) as an Occupational Medicine (OM) specialist. Recruitment challenges were perceived to arise from a lack of OH staff with the right qualifications and experience; coupled with a perceived lack of training, and funding for training, to equip prospective staff for roles. 

 

Approaching four in ten OH providers had unfilled vacancies. The sector was found to be generally receptive to using newly qualified OH professionals without experience to meet its staffing needs; and OH providers with unfilled vacancies are particularly likely to be open to this.  

Multidisciplinary teams:  

The sector was favourable about using multidisciplinary teams1 and this was consistent across different provider types. Six in ten providers reported using multidisciplinary teams to deliver their OH services. Better patient care was the motivation driving favourability towards their use. However, their use is constrained by the availability of appropriately skilled OH staff; provider access to finance; and the extent to which customers accept their use.  

Training:  

OH providers commonly fund access to training and qualification for staff delivering their services and providers tended to do so as a means of providing quality OH services that met client needs and as a staff retention strategy. Three in ten OH providers wanted to be able to fund more but were unable to do at present. The most common barriers to funding access that were mentioned were lack of funding; difficulty for staff to find time to attend; and the cost of external provision. Staffing challenges suggest that the sector would benefit most from training that would help meet the shortfall in nurses with an SCPHN OH qualification.  

Demand for OH services and provider capacity:  

The four OH services that were the most in-demand as well as the most-commonly offered by OH providers were:  

• management referrals or assessments of fitness for work for ill or sick employees;  
• pre-employment or post-offer of employment health assessments;  
• ongoing health assessments for any employees, even if not ill or sick; and  
• support with health surveillance 

OH providers of all types reported having been working near their maximum capacity, at maximum capacity or above full capacity in the past 12 months. NHS and in-house providers were more likely to have been at capacity than private providers. Findings also indicate that it may be more common for demand to be exceeding provider capacity than it was in 2019. Providers are mostly open to seizing the opportunity to expand, but some are constrained by recruitment challenges.  

Pricing:  

Most of the specific OH services asked about tended to be charged at £51-£200 per person, per use. Pricing is most often shaped by the complexity of the services required, competitors’ prices and costs of delivery. In addition, three in ten providers reported that they tailored their prices to specific groups or types of customers, often formed by the size of employer or the level of utilisation of services. Providers interviewed also emphasised the need to balance attractive prices against not devaluing their services.  

Three out of ten providers that charged for their services had customers that paid them a retainer; and this retainer would often reduce the charges per person for their OH services. Around a quarter of providers offered OH services via annual contracts, without any additional fees being charged when individual clients take up these services. The majority of in-house providers did not charge for any OH services. 

SMEs and the self-employed as customers:  

Although most OH providers were generally favourable towards working with SMEs as customers, SMEs continue to be significantly under-represented in the customer base. The challenges with working with SMEs were mainly financial as SME’s have more limited budgets, along with lack of awareness among SMEs of the benefits of OH. Providers also showed willingness to work with the self-employed but reported a lack of demand.   

Data collection, knowledge sharing and innovation:  

Almost all OH providers collected at least some data for their own central analysis; and the majority invested resource or staff capacity in keeping up to date with new OH research and this was equally prevalent across all provider types. Most commonly, OH providers used what they learned from the research to identify ways of improving provider practice, share findings in team meetings and to inform continuing professional development, revalidation or peer coaching. 

Providers tend to innovate2 around their OH services but do not have the funds or staff capacity to innovate as much as they would like to.   

Accreditations: 

Awareness of and favourability towards the SEQOHS accreditation is high, and it is perceived as a way of establishing credentials and enhancing reputation.  However, only around half of the OH providers surveyed were SEQOHS accredited or working towards SEQOHS accreditation. NHS providers were more likely to state they were SEQOHS accredited and more likely to view it favourably.