What is the Keep Britain Working Review and why it was commissioned

5th December 2025

Quick Summary- What Sir Charlie Mayfield's Keep Britain Working Review Found.

The Keep Britain Working Review, led by Sir Charlie Mayfield and published in 2025, examines the UK's growing crisis of economic inactivity driven by ill-health.

With more than one in five working-age adults now out of the labour force — often due to long-term sickness or mental health issues — the review warns that the UK faces a quiet but urgent economic and social threat. It concludes that the current system is fragmented, reactive, and failing both individuals and employers.

The report argues for a fundamental shift in how the UK approaches work and health. It recommends a new "Healthy Working Lifecycle" framework, helping people stay in work, get timely support when health issues arise, and return to work faster after sickness. Central to this is the creation of Workplace Health Provision — a non-clinical, practical support service for employers and employees — along with better data, stronger national standards, and government-backed incentives.

The review also highlights a culture of fear and stigma around health conditions at work, leading to avoidable long absences and people falling permanently out of employment. Addressing these issues, it argues, would reduce costs for employers, improve individual wellbeing, increase workforce participation, and strengthen public finances.

The government has endorsed the report's direction and will begin piloting the new approach through employer-led Vanguards between 2026 and 2029. If successful, the review could reshape workplace health support in the UK — making employment more inclusive, reducing long-term sickness absence, and unlocking significant social and economic value.
--------------------------------

Going Deeper

What is the Keep Britain Working Review — and why it was commissioned

In 2025 the UK government asked Sir Charlie Mayfield (former chair of a major retailer/organisation) to lead a high-level review into the rising problem of economic inactivity driven by ill health and disability. The review aimed to examine why growing numbers of working-age people are out of work, what the consequences are, and how the system of workplace health, welfare and employment support could be rethought to reverse the trend.

The context: over one-in-five working-age adults in Britain are now economically inactive (i.e. not working and not seeking work), with ill health — including mental health problems and long-term sickness — a main driver.

The review warns this is not only a tragedy for individuals' life chances, but a huge economic and societal problem: lost output, increased welfare and healthcare costs, skills loss, and shrinking workforce participation.

Sir Charlie Mayfield calls this "a quiet but urgent crisis" — and argues that it can be addressed, but only if there is a fundamental rethink of how health and work interact in this country.

What the Review Found — Key Problems at the Heart of the Crisis

The Keep Britain Working Review identifies several deep-rooted problems that combine to push people out of work — and keep them out:

A culture of fear and stigma around health or disability at work: employees often fear disclosing conditions (especially mental health or fluctuating illness), worried about career impact; managers and employers fear getting it wrong — which leads to avoidance instead of early, supportive intervention.

A lack of consistent, effective workplace health support: the system is fragmented — sometimes good practice, sometimes not — meaning many employers (especially smaller ones) lack the capability, support or confidence to help staff stay in or return to work.

Institutional barriers for disabled people and those with health conditions, leading to disproportionate exclusion from employment or early exit from work. The combination of poor support, inflexible work design, and lack of adjustments means many capable people do not stay in—and the country loses talent.

Reactive rather than preventive approach: the system often intervenes after long-term sickness or disability has taken hold, instead of aiming for early intervention, prevention, and timely support which would make it much easier to avoid long absences or permanent exits.

Poor data and lack of coordinated framework: inconsistent tracking of workplace health outcomes, limited evidence base, and lack of a shared standard or "system" to guide employers and policymakers.

The review paints a picture of systemic neglect — not just of people, but of long-term economic and social wellbeing.

What Mayfield Recommends — A New "Healthy Working" Framework

To address these problems, the Keep Britain Working Review proposes a fundamental shift: rethinking workplace health and inclusion as a responsibility shared by employers, employees, health services and government — rather than leaving it to individuals or to the state alone.

The main proposals

A "Healthy Working Lifecycle"

The review outlines a framework covering all stages of working life — from recruitment and onboarding, through healthy working, sickness and return to work, to (if needed) exit and re-employment or transition support.
GOV.UK

The aim is to embed practices focused on prevention, early intervention, rehabilitation, and sustained participation — not just occasional sick-leave management.

Health Provision

Rather than ad-hoc or minimal support, the report recommends establishment of a non-clinical case-management service in workplaces — supporting employees, line managers, and employers with practical, consistent health-at-work support. This would include early intervention, return-to-work planning, advice, reasonable adjustments, and coordination with health services where needed.

Over time this could evolve into a certified standard employers can adopt — raising the bar across industries.

Better data and systemic support

The report calls for a new "Workplace Health Intelligence Unit" to gather and analyse data, build an evidence base about what works, and inform future policy including incentives, welfare reforms, and interventions targeted at disabled people or those with long-term health conditions.

Incentives & policy levers from government

Because the problem is systemic, the review argues government must enable and incentivise change — through legislation, welfare reform, procurement policy, and support mechanisms, not just through NHS funding.

Employer-led "Vanguards" to pilot the reforms

To test and refine the new approach, the report suggests a 3-year "Vanguard Phase" (2026-2029) involving a mix of large employers, smaller firms, local authorities — to pilot the Healthy Working Lifecycle and WHP, build evidence on outcome improvements, and scale up what works.

The report argues that with these reforms, the UK could markedly reduce sickness absence, improve return-to-work rates, increase employment among disabled people, and prevent long-term economic inactivity.

The Stakes: Why This Matters for People, Employers and the Country

The review paints a stark picture of what's at risk but also of what is to be gained if reforms are adopted:

Individual human cost: long-term health-related worklessness means lost income, reduced career prospects, poorer social and mental health outcomes, and diminished life chances for many.

Employer cost - frequent sickness absence, turnover, loss of experienced staff, recruitment costs, lost productivity all of which hurt competitiveness. The report notes employers are losing significant sums due to health-related absence and staff churn.

National and economic cost: with more than one-in-five working-age adults out of the labour force due to health, the UK is losing economic output, increasing welfare and healthcare burdens, and shrinking the active workforce — weakening growth, public finances and long-term prosperity.

The review argues this is not inevitable — other countries manage much lower rates of health-driven economic inactivity. With the proposed changes, many more people could stay in or return to work.

What Happens Next — The Government Response & Early Action

Immediately following publication of the report:

The government announced support for the key thrust of the recommendations, including backing employer-led “Vanguards” to trial the new approach to workplace health.

A cross-stakeholder “Vanguard Taskforce,” involving employers, disabled people's representatives, and health experts, will work with selected firms to implement the “Healthy Working Lifecycle” and “Workplace Health Provision” services.

The intention is to build evidence over the next 3 years (2026-2029), develop standards, and — if successful — roll out reforms more widely across the economy.

In other words, the Keep Britain Working Review is more than a policy recommendation — it's a roadmap for systemic change in how Britain thinks about health, work, inclusion and welfare in the 2020s.

What It Means (and Should Mean)
A New Approach to Work & Health

If widely adopted, the Keep Britain Working Review could lead to

Workplaces that are more inclusive, supportive and flexible — making it easier for people with illness, disability or fluctuating health to stay or return to work.

Lower rates of long-term economic inactivity (especially among disabled people, older workers or those with chronic health issues).

Better retention of experienced staff, reduced turnover costs, and more stable employment — beneficial for employers and the economy.

Reduced burden on welfare and healthcare systems, and stronger overall workforce participation and productivity.

A shift in public policy: from reactive welfare and sickness benefits toward preventive, supportive, and empowering employment + health integration.

In short: a chance to turn what many call a “crisis of inactivity” into an opportunity for inclusion, growth and social renewal — if the ambition can be backed with resources, commitment and cultural change.