Why healthy job design is critical to tackling economic inactivity

By Clare McNeil, Timewise CEO, and Tess Lanning, Director of Programmes

The Government has set out a welcome ambition to support full employment in the UK – with a big focus on tackling the large rise in the number of people who are ‘economically inactive’ due to ill-health.

Increasing the number of jobs that offer people the flexibility to manage their health conditions is critical to this agenda: surveys show that the majority of health and disability benefit claimants want to work in part-time, flexible roles, with the option of working from home.

In practice, however, this Timewise report demonstrates the huge mismatch between the work people say they want to do and the work they are most likely to do – with job quality issues in frontline sectors creating a revolving door of economic inactivity.

Our findings

Our analysis shows the realities of where people with health conditions end up working, and why many struggle to stay in employment. The sectors with the highest long-term sickness rates are retail, transport, hospitality, health and care, followed by construction, manufacturing and education.

Original Timewise analysis shows that:

• Just 2.5% of those that are economically inactive due to ill-health move back into work each year – suggesting significant barriers to re-entering employment

• Of those that do find work, over half (56.6%) move into ‘frontline roles’ in elementary occupations, as process, plant and machine operatives, and in caring and leisure occupations.

• These roles are often physically demanding and are associated with higher levels of unpredictable, inflexible and excessive hours – precisely the kinds of jobs many disabled people say they cannot sustain.

• More than half of the jobs held by those who are formerly inactive or long-term sick did not last for more than four months.

Policy recommendations

Without action to increase schedule flexibility and control for workers in these sectors, the government’s return on investment in back-to-work support for the formerly inactive long-term sick will be disappointing.

We call for a new industrial strategy for good jobs, focused on improving job quality and performance in the ‘everyday’ economy where most people work, starting with three central reforms:

1. Introduce new cross-industry Healthy Work Standards.
   Building on the Employment Rights Bill, which sets the minimum floor for employment practices, our work suggests a need to articulate clear guidelines for employers to encourage the design of high quality flexible jobs and minimise practices that can create or exacerbate ill health.

2. Introduce Workforce Innovation Agreements, backed by an initial £500m Frontline Workplace Innovation Fund.
   These sector-specific agreements would be negotiated by social partners and reward employers for committing to targets for reducing staff sickness, retention and return to work with access to preferential procurement, business support, innovation grants and training. Similar agreements in Norway have proved successful and have increased the probability of employed individuals signing up to staying in work and returning to work after sick leave.

3. Re-purpose existing government business and employment support to focus on job quality goals.
   The Department for Work and Pensions should maintain investment in Access to Work and reform it by building job design and in-work support capability into its offer, and building a stronger focus on job retention and in-work support into existing government employment and business schemes.

Successive government administrations have neglected issues of job quality in frontline sectors. New rights due to come into force will tackle some of the worst practices associated with zero- and low-hours contracts, including short term notice and cancellations to shifts. A broader industrial strategy for good jobs would signal a more ambitious approach that ensures jobs support employee health and wellbeing. In doing so, it wouldn’t just help people back into work, it would ensure they can stay in work and thrive.

Published September 2025