Occupational Health under review

7th September 2023

The Government announced two new public consultations focusing on Occupational Health on 20 July this year. The two consultations are authored by the Department for Work and Pensions (DWP) and HM Treasury & HMRC respectively and are intended to be read together. Why have the consultations been launched and what will this mean for employers?

Why have the consultations been launched?

According to the latest figures, long-term sickness is now the most common reason given by working-age people for economic inactivity which means people who are neither working nor looking for work. Despite this fact, according to the DWP, only 45% of workers in Great Britain have access to Occupational Health in their current jobs. Figures from February 2023 to April 2023 also show that the proportion of people who are economically inactive mainly due to long-term sickness has increased by 580,000 people over the latest four years, now reaching 2.55 million.

Managing sickness absence and supporting employee wellbeing is a priority for many employers, especially as health-related job losses are often preceded by sickness absences from work. The number of working days lost because of sickness or injury was around 186 million in 2022, a new record high.

What are the consultations considering?

There are two consultations:

  • Occupational Health: Working Better published by the DWP aims to increase employer up-take of Occupational Health services. By increasing the availability of the services themselves, the Government wishes to prevent employee sickness as much as possible and therefore prevent job losses and economic inactivity.
  • Tax incentives for Occupational Health published by HM Treasury and HMRC explores the role of tax incentives in boosting occupational health provision by employers.

The DWP’s consultation covers the following topics:

  • 1. Voluntary proposal of a national “health at work” standard which, together with other proposals such as the sharing of best practices, helps to create an embedded, clear and simple baseline for Occupational Health services.
  • 2. Practical examples of where Occupational Health provision is already working well, such as how the services are provided in other countries and case studies from UK employers.
  • 3. For England only, the consultation is seeking views on proposals to improve the current Occupational Health services and develop a “multi-disciplinary Occupational Health workforce in collaboration with the private sector”. Health is a devolved matter in Wales, Scotland and Northern Ireland but there has been engagement with the Devolved Administrations (DAs) who have similar issues in relation to the workforce. The intention is to share the findings of the consultation and to “explore opportunities to collaborate with DAs in the future.”
  • 4. A new legal duty on employers to provide Occupational Health access for their employees after a certain event such as a period of sickness absence. The Government would need to introduce a new regulatory body to oversee this new legal duty with employers required to complete a declaration of compliance.
  • 5. Whether the ability to certify fit notes should be extended to other healthcare professionals. Note that from 1 July 2022, the certification of fit notes was extended to a wider range of healthcare professions. Registered nurses, occupational therapists, physiotherapists and pharmacists, in addition to doctors, can now certify fit notes. There also needs to be thought given to whether this extension to any professionals who are not strictly regulated could undermine confidence in fit note certification.

The joint HM Treasury and HMRC consultation considers the following ideas:

  • Expanding the Benefit in Kind Exemption for income tax and national insurance contributions to include things such as health screening for employees (within a specific pre-defined limit), flu vaccinations, and treatments that aim to reduce workplace absence or enable employees to perform better (including preventative treatments).

However, there is no proposal to extend the Exemption to include other services such as wellness retreats (non-clinical treatments) and private medical insurance for employees.

What does this mean for employers?

Both consultations close on 12 October 2023, so we will have to await the Government’s response before getting a better understanding of what changes may be made in the future.

In the meantime, employers need to continue to take the necessary steps to manage short and long-term absence, with managers having a crucial role to play by having the appropriate conversations with their employees.

As the DWP consultation states, there is a business, legal, and moral case for investing in Occupational Health and it has been estimated that, on average, preventing a single job loss can save employers £8,000 in recruitment costs and business output.

On that basis, employers may want to proactively review how Occupational Health services can be used to improve employee health and productivity, regardless of the outcomes of the consultations. Preventative measures can prove more cost-effective in the long run, with a healthy workforce proven to contribute to a more successful business.


Finally, ACAS recently updated its extensive resources on sickness absence available on its website. There is updated guidance on a range of topics including fit notes and proof of sickness and creating absence policies. There is also a toolkit with various factsheets and top tips on managing sickness absence.

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