Economic inactivity in Scotland: supporting those with longer-term health conditions and disabilities to remain economically active

Summary conclusions: ‘good’ work, health, and economic inactivity

‘In general, the longer someone has been out of work, the less likely they are to return to work – hence the importance of focusing support on helping people to retain their job, and employment relationship, when they become ill or their health deteriorates.’^[136]

This review brings together literature on supporting those with longer-term ill health and disability to remain economically active. It is a rapid review and is not intended to be exhaustive of the literature in this area, but nevertheless provides a source of understanding of the major – and recurring – themes in the evidence base. It aims to support consideration of employer and policy options to provide support to those who may be at risk of becoming economically inactive due to a range of chronic conditions.

The evidence base provides a range of responses to support those with longer-term ill-health, including potential responses from government, employers/HR, and more widely within society. A summary of the main practical responses is provided below:

• Focus on supportive managerial conversations
• Ensure consistent, fair, timely, and ongoing workplace adjustments
• Encourage employers to introduce flexible, compassionate, and supportive absence and return to work policies
• Review, change, and/or influence the social security and sick pay systems
• Work to minimise discrimination in the workplace and beyond

Underpinning these recommendations for change is the theme of what makes work ‘good’. ‘Good’ work is something that can be developed through modern, flexible working policies that recognise the worker as an individual, include them in decision-making, understand their condition, provide tailored in-work support, and take a compassionate, non-punitive approach to managing their health, job role, hours, and attendance. Governments can play a role here through legislation, enforcement, and the creation and funding of in-work support programmes, but also through engagement with employers around meaningful policy change and best practice examples. Employers also have a highly significant part to play in reviewing their policies around workplace adjustments and attendance management, and focusing on staff training to create inclusive and open cultures that encourage discussion of health. They can also work to create health and wellbeing standards for their workforce, particularly around mental health, which should be monitored and reported on to staff, with appropriate action taken when there is shortfall.

Creating a ‘good’ working environment means providing flexible work for staff, including working at home, working part-time, being able to work shorter hours or around caring responsibilities, and being able to take breaks during work or for health appointments. It means cultures that tackle discrimination and encourage open, trusting conversations. It also means places where reasonable workplace adjustments are the norm, allowing individuals to feel positive about their employer and their work. Furthermore, ‘good’ work is connected to external factors such as the costs of childcare and the accessibility, affordability, and reliability of quality transport options. There are also wider societal factors, such as discrimination against disabled people, older people, minority ethnic groups, and women that need to be tackled.

The evidence base shows that there is also a good financial argument for tackling these issues. Employers can see their spend as a positive investment, though should consider what the most cost effective options are and how best to structure these for their own organisation.

Supporting those who are at risk of becoming economically inactive due to ill health and disability can provide health protection, financial security, and a more sustainable economy. It will also help to address inequalities in health and employment access across Scotland’s population.