Worklessness epidemic as 11 million sick notes issued in a year

Almost four in 10 fit notes signed off people on mental health grounds between April 2021 and December 2023
Almost four in 10 fit notes signed off people on mental health grounds between April 2021 and December 2023 - Westend61

More than 11 million sick notes were issued last year, according to new figures that underline the growing worklessness crisis.

The official statistics show a doubling in the number of “fit notes” doled out in just seven years, fuelled by a surge in mental health problems.

Forecasts suggest the benefits bill for sickness and disability could top £90 billion within five years, with think tanks urging the Government to radically reform the system.

The figures from NHS England show 11.01 million notes were issued in 2022-23, up from 5.2 million in 2015-16, equal to one for every four adults.

Many recipients received multiple sick notes, often for months on end.

Four in ten notes were issued for five weeks or longer and one in five of such cases will never return to work, the report warns.

The study by the Policy Exchange think tank highlights further evidence that suggests once people are signed off for six months, 80 per cent will never come back.

The figures do not include the millions of people who are sick for less than seven days, which does not require a doctors’ note.

The statistics show a steep rise in people being signed off work for mental health problems. Almost four in 10 fit notes signed off people on such grounds between April 2021 and December 2023.

In these instances, 41 per cent were signed off for between one and three months.

The figures show a 20 per cent rise in notes linked to mental health since 2015-16.

This includes a quadrupling in cases linked to stress and neurosis, and a near tripling in cases linked to mood disorders.

‘Gone too far’

Mel Stride, the Work and Pensions Secretary said last month that Britain’s approach to mental health was in danger of having “gone too far” in labelling the “normal anxieties of life” as illness.

Setting out plans to reform welfare payments, he said: “There is a real risk now that we are labelling the normal ups and downs of human life as medical conditions which then actually serve to hold people back and, ultimately, drive up the benefit bill.”

Mr Stride set out plans to rewrite welfare guidance so that about150,000 people with “mild” mental health conditions are obliged to seek work.

The Policy Exchange highlighted estimates showing the cost of sickness absence and ill-health among those of working age has reached £150 billion, almost matching the NHS annual budget.

The UK’s system of “fit notes”, introduced in 2010, is supposed to help people with health problems to stay in work, or return to it, with adjustments made to allow for sickness and disability.

‘Not fit for purpose’

But Policy Exchange said the system was “not fit for purpose” as it highlighted evidence from last year that 93 per cent of notes sign people off work entirely.

Its authors said GPs had too little time, information or options to refer people to help, making the notes had become “a de facto system of self-certification” which is doing nothing to stop the swell in long-term sickness.

Sean Phillips, head of health and social care at Policy Exchange, and the report’s lead author said: “Our current approach to assessments of fitness for work are not effective in meeting the needs of individuals, employers, health professionals or the taxpayer.

“The ‘fit note’ should be reformed to direct people more effectively towards occupational health assessments which can monitor conditions where longer absences have been recommended. Too many people – particularly those with mental health conditions – are being signed off for periods of time which may be damaging to their prospects of a return to work.

“A greater focus on how good work can in fact support people with their mental health is a necessity.”

The report shows 186 million working days lost to sickness or injury last year, with estimates that businesses spend almost £1,000 per year on sickness absence.

Where a record was made, respiratory and parasitic complaints – such as flu and diarrhoea – accounted for 52 per cent of cases. Mental health problems made up the second largest category, at 38 per cent, while 17.5 per cent of cases involved musculoskeletal conditions, and some cases overlapped.

‘Economically inactive’

Latest figures from the Office for National Statistics suggest there are 2.7 million people with long-term sickness who are “economically inactive”, an increase of a third since 2019. The Office for Budget Responsibility last month forecast that health and disability benefits will rise by a third – £25.2 billion – to £90.9 billion by 2028-29.

The think tank is calling for reform of the system, with far more thorough assessments required for anyone seeking to be signed off work with a diagnosis of a mental or behavioural disorder for more than 14 days. It also called on the Government to disable the issuing of any repeat notes, unless an assessment had been made.

The Prime Minister has repeatedly pledged to reduce the benefits bill.

Rishi Sunak used his speech to the Tory party conference last autumn to vow to bring an end to “the national scandal, where our benefits system declares that more than two million people of working age are incapable of doing any”.

From next March, anyone getting talking therapy on the NHS will be offered the chance to get employment advice, under plans to get more people back to work.

A Government spokesman said: “We have already committed to reform the fit note system to better support people to start, stay and succeed in work”.

“These reforms are part of our £2.5 billion back to work plan – backed by specialist employment support and record levels of mental health provision – to help over a million disabled people, including those with long-term health conditions, look for and stay in work.”

Broaden your horizons with award-winning British journalism. Try The Telegraph free for 3 months with unlimited access to our award-winning website, exclusive app, money-saving offers and more.