Is there a sick note culture in the UK?

On Friday 19 April, the Prime Minister Rishi Sunak has announced intentions to tackle, what he believes, to be a sick note culture in the UK. But is this an accurate reflection?

The reality of sickness absence

It is a topic of debate reflecting attitudes towards the legitimacy of sickness absence, but it shouldn’t be forgotten that more often than not, sickness absence is genuine.  For employers, it is about balancing the needs of the business with the importance of supporting employees’ health and wellbeing. Challenges therefore exist in balancing the genuine need for sick leave with preventing an abuse of the system.

Building a supportive work culture

For employers, fostering a culture of trust, communication, and support within the business is key to addressing concerns. In our article of March 2024 ‘Why Are We Seeing an Increasing Need to Support Long-Term Sick?’, we highlighted several significant absence statistics reported by the Office for National Statistics (ONS).  In their report ‘Rising Ill Health and Economic Inactivity Due to long-term Sickness in the UK  2019 to 2023 (published 26 July 2023), the ONS stated:

1. More working-age people are self-reporting long-term health conditions, with 36% saying that they had at least one long-term health condition in Quarter 1 (Jan to Mar) 2023, up from 31% in the same period in 2019 and 29% in 2016.
2. The number of people economically inactive because of long-term sickness has risen to over 2.5 million people, an increase of over 400,000 since the start of the coronavirus (COVID-19) pandemic.
3. For those economically inactive because of long-term sickness, nearly two-fifths (38%) reported having five or more health conditions (up from 34% in 2019), suggesting that many have interlinked and complex health issues.
4. Over 1.35 million (53%) of those inactive because of long-term sickness reported that they had depression, or anxiety in Quarter 1 of 2023, with the majority (over 1 million) reporting it as a secondary health condition rather than their main one.
5. For those inactive because of long-term sickness and who had a main health condition that is musculoskeletal in nature, over 70% reported that they had more than one type of musculoskeletal condition.

Supporting employees back into work

We also explored in our article the ways in which an employer can support people back into work, including have a clearly defined and communicated absence policy and procedure, understanding your legal obligations for making reasonable adjustments, using flexible working practice, and most importantly, training your line managers on how to manage sickness absence fairly and in line with the law.

Economic inactivity and government reforms

In terms of the latest ONS labour market survey, it provides the latest position on ‘economic inactivity’.  This term measures the number of people who are aged 16 and over who are without a job and who have not sought work in either the last four weeks and/or are not available to start work in the next two weeks.  One of the main groups of those who are economically inactive are those who are sick and those who have a disability. Since the pandemic, the economic inactivity rate has increased. So Friday 16 April, the Prime Minister announced that in the next Government, the welfare system will be significantly reformed through 5 key steps:

1. The UK to become more ambitious in assessing the potential for work by tightening up on the work capability assessment, and to not assume that someone who has a medical capability is unable to work.
2. Reduce the number of people going from work to using the welfare system by designing a new system that will change how fit notes are designed and used. The Prime Minister reported that 94% of those who were economically inactive last year, were signed off as not fit to work, with just 6% being considered that they may be fit to work with adaptations.  The aim is to therefore change the focus on what a person can’t do, to what they can do and one proposal is to move the responsibility of who signs someone off as unfit for work by moving it away from GPs to other professionals.
3. Change the rules of the welfare system so that if someone hasn’t taken proactive steps to seek employment for 6 months, their claim will be closed, and the benefits removed entirely.
4. To look at the personal independent payments (PIP) and to match the support with the type of condition. This will involve a new public consultation on how to move to an objective and rigorous approach to meeting the needs by linking the assessment to a person’s condition and requiring greater medical evidence to substantiate a claim. It would also consider whether some conditions, like mental health, receive access to treatment like therapies rather than to receive PIP as a financial payment.
5. To crack down on exploitation and will introduce a new fraud bill that will align the DWP with HMRC to allow DWP to treat benefit fraud like how tax fraud is treated in terms of arrests and penalties.

Balancing business needs with employee wellbeing

Absence management is fundamental to every business, and whilst this announcement focusses on the UK approach to welfare from a societal perspective, employers must focus on the management of sickness absence in their own business to ensure the right balance is struck between supporting the health and wellbeing of the workforce with the needs of the business.