The UK is facing a welfare crisis as ever more people claim benefits as they are unemployed and too sick to work. The NHS has a central role to play in creating social impact and unleashing their potential and building a new future for our society.
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Millions Are Too Sick To Work and The Numbers Are Rising.
This week’s welfare reform announcement is a stark reminder of what happens when systems operate in silos. With 2.8 million people now classified as unable to work due to long-term sickness, the UK’s benefits bill is projected to escalate to £70 billion a year by 2030.
Beneath these daunting figures lies a more troubling truth: an increasing number of our young people are becoming sick, and staying sick. Instead of receiving help and support, they often encounter punishment and exclusion.
The Cost of A Disconnected Health and Welfare System
We’ve created a system so disconnected that assessing someone as unfit for work is entirely isolated from the very services capable of improving their health.
This isn’t just a minor oversight; it’s a systemic failure. When a person, particularly a young adult, is told they are too ill to work, it should trigger immediate responses across health and wellbeing services. Behind every statistic is a human being in crisis, urgently needing support.
The Downward Spiral of Poor Health and Unemployment
Unemployment and low socioeconomic status are strongly correlated with prolonged ill health. Unemployed individuals are five times more likely to report poor health compared to employed counterparts, 10.5% versus 1.9%. Additionally, just 28.1% of unemployed people rate their health as very good or excellent, compared to 49.4% of those employed (Health Foundation).
People living in the lowest 20% income bracket are two to three times more likely to experience mental health issues than those in the highest income bracket (Mental Health Foundation). This disparity is evident in life expectancy; Blackpool, for example, has the lowest male life expectancy in the UK at approximately 73 years, six years below the England average, primarily due to poverty and associated health issues (ONS)).
Support, Not Punishment, to Escape the Spiral of Unemployment and Poor Health
When someone falls out of employment due to a health condition and receives no meaningful support to return, they don’t just stagnate, they spiral downward. We cannot expect individuals struggling with health conditions to recover spontaneously. This cycle of poor health, unemployment, and social exclusion interacts and accelerates, pushing people further into ill health. Interrupting this spiral is critical.
From Tick Boxes to Tailored Health Support
Currently, our systems treat people as boxes to tick, forcing them into rigid processes that ignore the complexities of their lives. We are measuring people and not focusing on what matters to them. Instead, we should focus on building people up rather than pushing them down. Moving from a top-down assessment process to a bottom-up approach, centred around genuinely understanding and meeting individuals’ needs, is essential.
Our narrow KPIs and targets too often miss the point. We need to have measurement processes that captures what is affecting people and and allow us to determine the best way to act to improve their help (such as the change radar)
The NHS as a First Stepping Stone Back to Work
Healthcare can play a significant role in creating opportunities for people to gradually re-enter employment. The NHS possesses real expertise in helping individuals overcome barriers preventing them from working. Numerous meaningful roles exist, from providing companionship for lonely older adults, assisting with data analysis, caring responsibilities, to administrative tasks that free clinicians to focus on patient care.
Opportunities abound for individuals to contribute meaningfully to the nation’s wellbeing, enhancing their health, confidence, and sense of purpose.
Creating a Virtuous Circle of Health And Work
This isn’t about another ambitious centralised NHS reform. As argued previously, meaningful change emerges from the edges, from those who see the need clearly and act decisively. Small, practical shifts can yield exponential benefits and magnify the social impact.
This approach would create a virtuous circle: helping people escape their existing their comfort zone, overcome their fears, re-engage with work, improving health, saving society money, and reducing future demand on services. This is not theoretical. Reducing what John Seddon calls failure demand; when people go round in circles without getting real help, could save up to £37 billion across public services.
The Financial Cost
Critics will inevitably ask, “Won’t this cost money?” Perhaps initially. But consider the alternative: millions of individuals abandoned, deteriorating in health, losing confidence and hope, only to return needing even greater support at higher costs. We should not be asking whose siloed budget this is. But asking how can we work together to get funding where it is most needed and can be most effective.
The real question isn’t whether we can afford to take action, it’s whether we can afford not to.
Conclusion
The NHS cannot remain passive as an entire generation slips into ill health and social exclusion. It has a duty to make a positive social impact. It’s essential to reconnect healthcare to the genuine, everyday lives of individuals and communities, not just treating sickness but actively enabling recovery, contribution, and thriving.
It’s time to halt the spiral, and build a virtuous circle of health, hope, and human potential.
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