The Academy of Medical Royal Colleges, the Royal College of Nursing and Allied Health Professions Federation have published their 2025 consensus statement as follows:
Since the last consensus statement between the Academy, the Royal College of Nursing and Allied Health Professions Federation in 2019 much has changed, not least the effects of a global pandemic. There has been a rising cost of living, a growing prevalence of multi-morbidity and increasing pressures on the health and care system. The burden of these changes is not experienced equally and varies by demographic, social, economic and protected characteristics. The way we work has also changed, with a greater proportion of people working from home; this may benefit some, but not those in roles such as teaching, health and social care, hospitality and manual workers, — potentially increasing health and social inequalities.
Office for National Statistics (ONS) data for July to September 2024 revealed that 9.25 million people in the UK aged 16 to 64 are economically inactive. Long-term sickness was given as the reason for 30% (2.8 million people) of these people, and of those 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. ONS also reported that the number of people who are economically inactive due to long-term sickness had increased by 400,000 between 2019 and 2023. In November 2024 the UK Government published the Get Britain Working White Paper to address the issues of health and economic inactivity, and to enable people who feel able to work to enter supportive workplaces.
The age of the working population is increasing, and many more people in work are experiencing ill health. But there is also a high proportion of young people out of work due to poor health – in particular mental health – alongside a greater acknowledgement of the importance of women’s health in work. In October 2024 the Health Foundation’s Commission for Healthier Working Lives published an interim report ‘Towards a Healthier Workforce’. It highlighted that among an estimated 8 million working-age people reporting health conditions that limit the type or amount of work they do, only 3.9 million are in work. People falling out of work due to ill health (around 300,000 a year) are much less likely to return to work than those without health conditions.
The relationship between employment and health endures. Working can give an individual a sense of fulfilment and purpose, whether paid or voluntary. Work is also one of the key social determinants of health; being in work is associated with improved mental and physical health, provided this is ‘good work’, i.e. good working conditions and supportive management. In contrast, ‘toxic’ workplace environments harm physical and mental health. As for any hazard at work, HSE require employers to reduce work-related stress as far as reasonably practicable.
Good work as a health outcome
So, good work is good for your health, and good health is good for your work. Being in good work can have therapeutic benefits. Conversely, being unemployed can have negative health impacts. Working can therefore be considered a health outcome in itself. People whose ability to work is at risk, including through ill health or disability, may be helped by healthcare professionals to remain in work or make a timely return to working. Some people will not be able to return to work, but healthcare professionals can still advise on enabling valuable activity.
A key factor impacting health and work has been access to healthcare interventions to enable people to return to work, as set out by Lord Darzi in his report on the state of the NHS in England. Lord Darzi comments that “having more people in work grows the economy and so creates more tax receipts to fund public services. There is therefore a virtuous circle if the NHS can help more people back into work”. In the Government’s Get People Working White Paper, priorities include “cutting waiting lists so people can get back to health and back to work, as well as having a greater focus on preventing people becoming ill in the first place”.
Lord Darzi also makes the point that sickness absence levels are high among NHS staff; improving the health of its staff is a key priority for the NHS. We support Growing Occupational Health and Wellbeing Together in England and similar strategies for NHS staff across the UK.
The role of health professionals in keeping people well in work and enabling return to work
In addition to asking patients what they do for work, and how they are managing it, healthcare professionals may support people in their work as an integral part of patient care pathways. Healthcare professionals can also promote a culture where good work is seen as a benefit to people. Through promoting healthy life choices and lifestyles, healthcare professionals might also contribute to the prevention of ill health and injury, so reducing risk of people falling out of work, as well as supporting people to enter, remain in, or return to work.
Statement for Action: Five principles for all healthcare professionals
We commit to work over the next five years to support healthcare professionals to engage more proactively with, and to celebrate and advance the concept of, ‘good work as a health outcome’ across the health and care sector. We will work together, as individual organisations and collaboratively, to enable every healthcare professional to:
- Ask the work question – what do you do for work, how are you managing in work, and what may help you get back to work?
- Understand through training the importance of work as a health outcome, how health may be promoted through good work, and where to signpost their patients who need further support.
- Be able to advise their patients through easy access to up to date guidance from Government, professional bodies, and work and health professionals on the impact of health conditions and treatment on their work, and on adjustments to assist those with disabilities.
- Derive most value from the ‘Fit Note’ in primary care, hospitals and in the community, through training for health professionals, and utilising updated easy to use guidance.
- Recognise their own role to support healthy and safe working environments, looking after their own health and wellbeing, and promoting the health and wellbeing of their colleagues within the organisations in which they work.
This statement was published on the Academy of Medical Royal Colleges website in January 2025.