Get Britain Working white paper: what you need to know

Overview 

The UK is the only major economy that has seen its employment rate fall over the last five years, reversing the previous long-run trend of declining rates of economic inactivity. This has been driven predominantly by a rise in the number of people who are economically inactive due to long-term sickness. Economically inactive people are those without a job who have not sought work in the last four weeks and/or are not available to start work in the next two weeks. This differs from the definition of unemployment, where people are without a job but are seeking work and available to start.

A range of complex and interacting factors have contributed to the rise in ill-health-related economic inactivity since 2019, which is a near-record high of 2.8 million people. These include population ageing, a higher prevalence of ill health among people aged 16 to 64, particularly since the COVID-19 pandemic (affecting both mental and physical health), and potentially, factors related to the benefits system: a combination of the strictness of ‘conditionality’ for jobseekers, administrative changes to health assessments, and differences in benefit rates, may have contributed to increases in the number of people claiming health-related benefits.

People who are economically inactive due to long-term sickness are likely to face multiple barriers in returning to the labour market. Most have several long-term health conditions and no recent work history. They are also more likely than the population as a whole to have no qualifications, and some may also face other complex disadvantages. 

There has also been a decline in the health of those who are working. 4.1 million people are currently in work with a health condition that is work-limiting: an increase of 300,000 over the past year.

White papers are policy documents that the government produces to set out its proposals for future legislation as a basis for further engagement before any bill(s) are formally presented to parliament.

Proposals for action and change

The white paper sets out the government’s proposals for action and change in the following areas:

1. Scaling up and deepening the contribution of the NHS and wider health system to improve employment outcomes

• Supporting the NHS to provide 40,000 extra elective appointments each week and deploy dedicated capacity to reduce waiting lists in 20 NHS trusts in England with the highest levels of health-related economic inactivity
• Addressing key public health issues that contribute to worklessness, through an expansion of Talking Therapies, the Tobacco and Vapes Bill and a range of steps to tackle obesity 
• Expanding access to expert employment advisers as part of treatment and care pathways, in particular mental health and musculoskeletal services. The government will also continue to expand access to Individual Placement and Support (IPS) for severe mental illness, reaching 140,000 more people by 2028/29

2. Backing local areas to shape an effective work, health and skills offer for local people, with mayoral authorities leading the way in England

• £125 million for eight trailblazer areas across England and Wales, to integrate and improve local work, health and skills support. This will include funding in three of the trailblazer areas for ICS accelerators to stop people falling out of work due to ill health. They will all have a set of agreed outcomes, shared governance and a commitment to robust evaluation and learning. These areas will be selected on the basis of having a combination of high rates of health-driven economic inactivity and people in work with health conditions, communities more likely to be affected by deprivation and inequality, and with demonstrated proactive action on integrating work and health support.
• Supporting all areas in England to develop local Get Britain Working plans and to convene local partners to work together to deliver these.
• Launching Connect to Work, a new supported employment programme matching people with disabilities, health conditions and additional barriers to work to vacancies and supporting them to succeed in their roles 

3. Delivering a Youth Guarantee so that all 18-to-21-year-olds in England have access to education, training or help to find a job or an apprenticeship

• Working with mayoral authorities to mobilise eight place-based Youth Guarantee trailblazers with £45 million of funding in 2025/26. 
• Expanding opportunities for young people by transforming the apprenticeship levy into a more flexible growth and skills levy. 
• Establishing a new national partnership to generate a range of exciting opportunities that engage young people and set them on the path to success, beginning with leading sports, arts and cultural organisations.
• Exploring a new approach to benefit rules for young people to make sure they can develop skills alongside searching for work, while also preventing young people from falling out of the workforce before their careers have begun.
• Acting to prevent young people losing touch with education or employment before the age of 18, with a guaranteed place in education and training for all 16- and 17-year-olds, an expansion of work experience and careers advice, action to tackle school attendance, and steps to improve access to mental health services for young people

4. Creating a new jobs and careers service to help people get into work and get on at work 

• The new digital service will offer personalised support to help people get into work, build skills and get on in their career, underpinned by a clear expectation that jobseekers do all they can to look for work. 

5. Launching an independent review into the role of UK employers in promoting healthy and inclusive workplaces led by Sir Charlie Mayfield

• The review will run until next summer and involve wide-ranging engagement with employers, employees, trade unions, health experts and disabled people, and those with health conditions.
   

Key funding announcements

Analysis

• We welcome the government’s Get Britain Working white paper in light of the finding shared in our recent report that since 2020, economic inactivity in the UK has risen by 900,000, with 85 per cent of the increase being people who are long-term sick. 
• The NHS Confederation has been making the case for the importance of the two-way relationship between health and the economy for some time. Good work is key to building healthy communities and boosting local economic growth.   
• ICSs have a key role in supporting their populations to work, working in partnership with other local partners. This includes working closely with local government to improve employment opportunities, through their integrated care partnerships and their fourth purpose of supporting broader social and economic development. It is crucial that funding builds on existing programmes, including the new WorkWell services which went live in 15 integrated care boards at the start of October. 
• Poor workforce health can lead to high costs for employers due to high sickness absence and turnover rates. In the 2023 NHS staff survey 41.7 per cent of staff reported feeling unwell as a result of work-related stress. The overall sickness absence rate for the NHS in England in 2023 was 5.5 per cent. It is imperative that employers continue to support people with disabilities and health conditions to thrive in work. 

Next steps

We will continue to support members to understand the wider work, health and skills landscape. If you have any questions please contact Eloise.Crockett@nhsconfed.org.

NHS Employers, which is part of the NHS Confederation, has a number of resources and case study examples of existing work on recruiting from local communities to widen participation and the positive impact good work has on local economies. We’re also working closely with the Department for Education and with Skills England to represent your views as they take forward the reform of skills policy and the new growth and skills levy.