Within the past week the Government has published a Green Paper “Improving Lives” which has been jointly published by the Department for Work and Pensions and the Department of Health commencing a consultation process on issues affecting work, health and disability. The aim of the consultation is to seek views on how to improve levels of sustainable employment for disabled people and those with long term health conditions, with a view to reducing the gap between non-disabled people who are in work and those with disabilities or long term health conditions. The Green Paper sets out a number of different proposals on which views are sought, including a section on employment which would be of interest to employers. Consultation on the proposals closes on 17 February 2017.


The main underlying rationale for the review and consultation is the Government’s aim to reduce the disability gap, as currently, 80% of non-disabled people are in employment, compared with on 48% of disabled people. In total, 4.6 million people with disabilities or long term health problems are out of work with only 8% of employers reporting that they have recruited a person with a disability or long term health condition over the past year. The paper also highlights a need to reduce long term sickness absence with 1.8 million employees on average having a long term sickness absence of four weeks or more in a year, with an estimated cost of £9billion pounds a year for employers.

The consultation is seeking views not only from employers but also disabled people and their carers, healthcare providers and specialist disability groups. Specific view are being sought as to how employers, the healthcare system and also the welfare system can provide better and more co-ordinated support to those with disabilities and long term health conditions, with a view to getting them into work.

Specifically, the key aims of the consultation which are set out in the Green Paper are:

  • Ensuring that disabled people and people with long-term health conditions have equal access to labour market opportunities
  • Helping employers to take a long term view on the skills and capability of their workforce and manage both an ageing workforce and ill health conditions
  • Ensuring people have access to the right employment and health services at the right time
  • To integrate health and social care and welfare systems to help disabled people and those with long term health conditions moving to and remaining in sustainable employment
  • Put mental and physical health on an equal footing, ensuring people get the right care
  • Investing in innovation to gain a better understanding of what works, for whom, why and at what cost
  • Change cultures and mind sets around those with health problems to focus on their strengths and what they can do.

Key areas of interest for employers

Chapter 4 of the Green Paper “supporting employers to recruit with confidence and create healthy workplaces” sets out some of the key areas which the Government intends to review in relation to disability, ill health and employment. Details of these areas and the key proposals are set out below:

  1. The Green Paper refers to difficulties employees and employers have in discussing disabilities or health conditions and are seeking views as to what steps employers can take to create an environment and culture where discussion and disclosure of health conditions are encouraged. The Paper sets out an example where Barclays have introduced a campaign to tackle the awareness and understanding of mental health in the workplace and the effects that this has had.
  2. The paper also seeks views as to what more could be done by the Government to make employers aware of the information and support that is available to them to assist supporting disabled people and those with health conditions. This also includes a suggestion for providing practical information including case studies of reasonable adjustments that have been made by other employers to demonstrate the business case for making changes.
  3. There is a commitment to establish a Disability Confident Business Leaders Group which will work alongside government ministers to increase employer engagement around disabled employment, with a view to promoting the business case within communities for recruiting those with disabilities and people with health conditions. Views are also sought on the best way of establishing supportive networks between employers, employees and charities around health and work.
  4. In relation to managing sickness absence, the Paper refers to the importance of employers maintaining contact with employees during their absence from work to try and ensure that steps are being taken in order to try and facilitate an early return to work. Evidence does show that the longer someone remains off work due to ill health, the less likely they are to return. Examples are given of other countries where there is a legal requirement for employers to maintain contact with employees who are absent from work due to sickness. Whilst there are no specific proposals in the paper for introducing such a requirement in the UK, views are sought as to what it would be reasonable to expect of employers and employees in relation to the level and extent of contact during sickness absence.
  5. Reference is made in the Green Paper to a proposal to reform the Statutory Sick Pay system to ensure that it encourages supportive conversations and phased returns to work. Specifically, as SSP is only paid by employers when a person does not undertake any work, those employees who are low paid may be disincentivised to return on a phased basis, as they may be worse off than when in receipt of SSP. Accordingly, the Paper puts forward a proposal for employers to top up wages to at least the SSP level to ensure that employees are no worse off if they return to work on a phased basis.
  6. The paper also includes a section exploring the provision of income protection insurance and whether more could be done to encourage the availability and use of such insurance cover and other ill health prevention programmes for employees. Whilst it could be argued that the provision of such insurance, providing income protection for those absent due to ill health, would act as a disincentive for employees to return to work, the Paper refers to analysis by the Centre for Economics and Business Research which indicates that employees who have access to early intervention and rehabilitation services and use them have shorter duration long-term absences compared to those that do not. Also, income protection policies do support employers in the retention of disabled employees and those with health conditions. Accordingly, the Government is seeking views on the reasons why employers are not making better use of policies and products alongside looking at how the insurance industry can develop income protection products which are more affordable and tailored towards the needs of smaller employers.
  7. In Chapter 5 of the Green Paper, reference is made to the current Statement of Fitness for Work (or “fit note”) which was introduced in 2010 with the stated aim of encouraging more detailed discussions about an employee’s health and return to work. The Paper does recognise however that the fit note is not fully achieving what it set out to do as specifically, the option for a doctor to indicate that an employee “may be fit for work subject to the following advice” is actually rarely used in practice. Accordingly, the Government has committed to review the current operation of the fit note and also whether its use should be extended from doctors to other healthcare professionals.


In addition to the Green Paper, the Government has also recently committed to additional funding for the fit for work service whereby employers can refer employees for an occupational health assessment after 4 weeks of sickness absence and it is clear that the Government views this as an important component of reducing levels of sickness absence and supporting employers. Many of the stated aims and proposals will be welcomed by employers, although, to a certain extent, these mirror those set out by Dame Carol Black in her review which was undertaken in 2008, which also referred to early intervention before ill health problems become more long term. Despite the introduction of the fit note and also the fit for work service, it is clear from the statistics set out in the Green Paper that long term ill health issues and providing sustainable employment for disabled people and those with health conditions is still very much a challenge for employers. We will of course keep you updated as to any further developments and specific reforms when they are announced.