R-Health welcomes the Keep Britain Working Review as an honest and much-needed diagnosis of a system that is quietly allowing ill health and disability to push people out of good work. The report rightly highlights that over one in five working-age adults are now out of the labour force, with significantly more people out of work due to health problems than before the pandemic, and the economic cost of sickness and worklessness now running into hundreds of billions of pounds each year. We strongly endorse its positive emphasis on prevention, earlier support and shared responsibility: proposals such as a clearer “healthy working lifecycle”, scaled-up workplace health provision, and a vanguard of employers working with government to pilot better stay-in-work and return-to-work support are exactly the kind of practical levers that can move the dial if implemented with care.

At the same time, as a specialist occupational health provider working with both large organisations and SMEs, we recognise the harder edges of the Review. Many of the recommendations depend on employers and NHS services that are already stretched, and there is a real risk that only well-resourced, early-adopter employers will fully benefit while smaller organisations struggle to engage. There is also a delicate line between encouraging people back into meaningful work and inadvertently pressuring those whose health genuinely limits their capacity.

From R-Health’s perspective, the Review is a powerful starting point rather than a final destination. To truly “keep Britain working”, the next phase must include sustained investment in occupational health, simple and subsidised routes for smaller employers to access evidence-based support, and safeguards to ensure that efforts to reduce welfare dependency never come at the expense of people with serious long-term conditions. If government, employers, clinicians and employees can hold that balance, this Review could mark the beginning of a more humane, inclusive and economically resilient approach to work and health in the UK.

Practical steps employers can take now

While national policy evolves, there are concrete actions organisations can take immediately. Based on our experience at R-Health, we suggest:

• Treat early help as standard, not exceptional*
  Build clear triggers for occupational health input (for example, at 4 weeks of sickness absence, or earlier for complex cases) so that problems are addressed before an employee becomes detached from work.
• Equip line managers for confident, compassionate conversations*
  Train managers to have simple, structured health and wellbeing check-ins, to recognise early warning signs, and to understand when to escalate to HR or occupational health support.
• Use personalised stay-in-work and return-to-work plans*
  Replace ad hoc adjustments with short, written plans agreed between the employee, manager and OH, setting out temporary changes to role, hours and support, with review dates built in.
• Make reasonable adjustments visible and normal*
  Create internal guidance and examples of adjustments (for physical, mental health and neurodiversity needs) so employees feel safe to ask, and managers know what is possible.
• Give SMEs access to expert support*
  For smaller organisations, partnering with an external occupational health provider such as R-Health can offer practical, proportionate support – from one-off complex case reviews to ongoing advisory clinics – without the cost of an in-house service.
• Measure what matters*
  Track a small set of meaningful indicators – sickness absence patterns, causes of long-term absence, time to occupational health referral, and successful returns to work – and use this data to refine policies rather than simply reporting it.

At R-Health, we stand ready to work with employers and system partners who want to translate the Keep Britain Working recommendations into reality on the ground – creating workplaces where good work genuinely supports good health, and where long-term conditions are managed with dignity, evidence and care rather than leading inevitably to exit from the workforce.