Preventing health-related job loss

An evidence-based response to identifying what is needed to provide effective early-intervention caseworker support in the UK

More than 4 million working-age people in the UK are in employment with a health condition that limits their ability to work. Each year, around 300,000 people leave work and become economically inactive with a work-limiting health condition. 

This has significant consequences for individuals and the wider economy. Leaving work because of poor health can worsen health and increase the risk of poverty, while high levels of health-related economic inactivity constrain economic growth and put pressure on public finances. 

The Commission for Healthier Working Lives identified caseworker support as a key intervention to help people remain in work. In this context, a caseworker is an independent, skilled professional who intervenes early when health problems affect work, assesses a person’s health and wider needs, advises employers on appropriate adjustments, and connects people to relevant support. 

Access to this kind of support is less common in the UK than in comparable countries, and there is limited consensus about what makes it most effective. 

Drawing on a comprehensive evidence review and consultation with experts, this report identifies the key features of effective caseworker support and sets out recommendations for expanding access across the UK.  

The report finds: 

• Caseworker support can improve employment and health outcomes. Evidence from the UK and internationally shows that caseworker support helps people remain in or return to work. Economic benefits generally outweigh the costs of delivering the support. 
• Early, work-focused and personalised support appears most effective. Stronger models engage people within days or weeks of sickness absence, maintain a clear focus on work, build trusted relationships with clients, and tailor the intensity of support to individual need. 
• Access to caseworker support in the UK is fragmented and uneven. Public provision is often delivered through short-term programmes and varies by place, while private provision is concentrated among larger employers. 
• There are sufficient workers and skills in the current workforce to enable expanded provision of caseworker support, but important capability and capacity gaps remain. Effective caseworkers need a combination of health, employment and coordination skills, while existing roles, training pathways and professional standards remain fragmented.  
• Scaling up caseworker support is possible but will require a more coherent national system. This includes, sustainable funding, stronger workforce development and professional standards, and better coordination between employers, health services and employment support.