Sam Atwell
swjatwell.bsky.social
Sam Atwell
@swjatwell.bsky.social
💼 Employment and health at the Health Foundation. Trustee at Big Futures Foundation.
www.health.org.uk
November 5, 2025 at 11:19 AM
In general, really positive direction.

Government will need to get behind implementation, and take wider action to support healthy working. This includes

Strengthening our weak SSP scheme
Aligning the welfare system to support quick work returns
Clarifying employee/er roles and responsibilities
November 5, 2025 at 11:19 AM
On a 'Workplace Health Intelligence Unit'

This is welcome - employers mostly want to do the right thing, but often find it difficult to apply general guidance to their workplace. We have called for industry partnerships to develop evidence around best practice

www.health.org.uk/reports-and-...
www.health.org.uk
November 5, 2025 at 11:19 AM
Welcome focus on getting timely support to people at risk of leaving work.

The best examples of this - UK and overseas - are caseworkers who assess, support and triage people to the right kinds of help.

We are working with @randeurope.org on how to scale access

www.rand.org/randeurope/r...
Preventing health-related job loss: An evidence-based response to what is needed to provide effective, tiered caseworker support in the UK
International evidence suggests that early-stage interventions can help people with health conditions remain in or return to work. RAND Europe has been commissioned by the Health Foundation to provide...
www.rand.org
November 5, 2025 at 11:19 AM
With the Keep Britain Working review expected soon, the government has an opportunity to rebalance work and health support towards retention and rehabilitation.

A better integrated Access to Work scheme should be at the heart of this.
October 14, 2025 at 11:45 AM
With growing pressures on economic activity and welfare, the only sustainable approach to reduce long-term costs is to help people stay healthy and in work in the first place.

This is what AtW aims to do, any reforms should aim at making the scheme more user friendly and efficient
October 14, 2025 at 11:45 AM
Despite higher spend it’s important to remember that AtW still reaches only a small fraction of disabled people.

For those that get it, it can be transformative but there are ongoing admin issues that limit effectiveness.

The govt announced plans for reform in the green paper earlier this year.
October 14, 2025 at 11:45 AM
As I say, we discussed these challenges in the final report of the Commission for Healthier Working Lives, which came out last week.

And more importantly, the report makes some recommendations for what we can do about them!

www.health.org.uk/reports-and-...
Action for healthier working lives
The Commission for Healthier Working Lives’ final report sets out the need for a new approach to work and health, outlining seven key recommendations to lay the foundation for long-term change.
www.health.org.uk
March 20, 2025 at 11:59 AM
The annex on international comparisons is also useful.

This chart/table highlights one of the issues that has got a bit lost in the employment rights bill debates - just how low our statutory sick pay is!
March 20, 2025 at 11:59 AM
In a week where a lot of attention has rightly been focused on steep health-related benefit cuts, it provides a helpful corrective to the narrative - focusing on the critical role of worker retention and making workplaces accessible for disabled people to begin with.
March 20, 2025 at 11:59 AM
But on to the main issue...

We await next weeks OBR publication to find out the depth of cuts to PIP/UC, but initial estimates of 1+ million people affected are deeply concerning.

To echo the point made elsewhere, its simply not clear how this will help people into work, or promote health.
March 19, 2025 at 9:15 AM
I am minded here of the work done by @benbgeiger.bsky.social and others highlighting the impact of conditionality on people with mental health conditions - which obviously reflect a growing share of the caseload.

inequalities.substack.com/p/conditiona...
Conditionality and mental health: new evidence
A new study of Danish RCTs shows how the impact of conditionality depends on people's pre-existing mental health
inequalities.substack.com
March 19, 2025 at 9:15 AM
Again, this reflects a recommendation from the Commission for Healthier Working Lives for a caseworker support model for people experiencing work and health challenges (see below)

But for this to work, people need to feel that the 'help' will actually help, and not be forced through the door.
March 19, 2025 at 9:15 AM
There will be lots to work out with regards to the £1bn of new funding for employment support.

The green paper sets out some principles:

- Individualised 1-1 support
- Signposting to wider services
- Building around people's aspirations

But also suggestions this will be compliance driven
March 19, 2025 at 9:15 AM
We were also pleased to see a 'right to try' guarantee, that was called for by the Commission, and others (including @jrf-uk.bsky.social and @neweconomics.bsky.social )

The Commission called for 18 months 👇 it sounds like the current proposals could potentially be more radical (devil in detail etc)
March 19, 2025 at 9:15 AM
The time-limited 'Unemployment Insurance' benefit is potentially transformative, moving us closer to a model found in many similar countries.

It reflects a recommendation from the @healthfoundation.bsky.social Commission for Healthier Working lives last week

www.health.org.uk/reports-and-...
March 19, 2025 at 9:15 AM
Not a full answer, but colleagues at the Learning and Work Institute looked into this as part of an evidence review for the Commission for Healthier Working Lives

learningandwork.org.uk/resources/re...
March 18, 2025 at 3:33 PM