Keep Britain Working

Why Workplace Health Needs to Start Before Someone Goes Off Sick

Something significant is happening in the way we talk about health and work in the UK. The Government is developing a new Workplace Health Intelligence Unit (WHIU) as part of Sir Charlie Mayfield's Keep Britain Working Review, with a greater national focus on prevention, early intervention and helping people remain in work when their health or circumstances change.

On the surface, the announcement could easily sound like another government initiative: a new unit, more data, more measurement and another acronym for employers to remember. But when I started reading about what the Government is actually trying to achieve, I found it fascinating, because underneath the policy language is a much bigger question: what if we became better at supporting people before they reached the point where they could no longer work?

It is a question that feels particularly important to us at MOCO, because in many ways, this is exactly why we exist.

The scale of the challenge is enormous. The Government's latest Keep Britain Working update reports that around 300,000 people with a health condition leave work every year, while the number of working-age people out of work because of ill health has increased by around 800,000 since 2019. The estimated economic cost is around £212 billion every year.

Perhaps even more interesting is what happens once somebody has already stopped working. According to the Government's September 2026 update, somebody who has been absent from work for between four and six weeks still has a 96% chance of returning to work. After a year of absence, however, fewer than half return.

Those numbers tell us something incredibly important: timing matters. The longer somebody becomes disconnected from work, the harder returning can become. But at MOCO, I think there is an opportunity to take that thinking even further. Instead of only asking how we intervene earlier during sickness absence, perhaps we should also be asking what happens before the absence begins at all.

Because people very rarely wake up one morning having gone from completely fine to completely overwhelmed.

There is usually a period before that point. Someone might be caring for an ageing parent while trying to maintain a full-time job. They might have returned from maternity or parental leave and be struggling far more than they expected. They may have received a diagnosis and be trying to understand what it means for their life and career. They might be grieving, navigating fertility treatment, becoming a carer, experiencing menopause, living with a health condition or dealing with a significant change within their family.

And throughout all of that, they may still be turning up.

They are still answering emails, attending meetings, hitting deadlines and doing the school run before logging on for the day. Their colleagues may have absolutely no idea how much they are carrying because, from the outside, they still appear to be coping.

Until eventually, they aren't.

That space between “I'm fine” and “I can't do this anymore” is something I believe we need to talk about much more seriously within workplace wellbeing. It is also the space MOCO was created to work within.

For years, workplace health has understandably been structured around identifiable moments: somebody becomes unwell, they take time away from work, HR becomes involved, occupational health may become involved and eventually there is a return-to-work process. Those services are incredibly important, but by the time we reach that point we are often already responding to the consequences of something that may have been developing for weeks or months.

The direction of the Keep Britain Working Review suggests a move further upstream. The proposed Workplace Health Intelligence Unit is expected to help create consistent measures around sickness absence, sustained return to work, retention, work ability and disability participation. By bringing together information from employers and workplace health providers, the ambition is to understand much more clearly what is actually happening to the health of Britain's workforce and, crucially, what interventions make a difference.

Better data could be incredibly powerful. But data on its own will not keep somebody in work. Ultimately, prevention happens through people, conversations and timely support.

It happens when somebody notices that a colleague isn't quite themselves. It happens when a manager feels confident enough to ask a meaningful question rather than simply saying, “Let me know if you need anything.” It happens when an employee feels safe enough to admit that they are struggling. Most importantly, it happens when there is somewhere useful for that person to go next.

This is where I believe transitional coaching has an important role to play.

When we created MOCO, we weren't trying to replace counselling, occupational health, HR or clinical services. Those services all have distinct and essential roles. What we saw, however, was a group of people who didn't necessarily fit neatly into any of those boxes. They weren't necessarily ill. They weren't necessarily in crisis. They didn't necessarily need therapy and they hadn't necessarily reached the point of taking time away from work.

They were simply going through something.

Their life had changed, and they were trying to work out how to continue functioning within a version of life that suddenly looked different.

That might be returning to work after having a baby. It might be receiving a medical diagnosis, going through treatment or returning after an extended period of absence. It might be losing somebody they love or suddenly becoming responsible for caring for somebody else. It could be a significant change within their family or simply one of those periods of life where several things seem to happen at once.

We sometimes underestimate how destabilising transition can be. Even positive changes can affect our identity, confidence, capacity and priorities. The person returning to work after maternity leave may technically be returning to exactly the same job, but she isn't necessarily returning as exactly the same person. Someone who has experienced bereavement may be physically back at their desk but still learning how to function within a life that has fundamentally changed. Someone receiving a diagnosis may be simultaneously trying to understand their health, their family, their future and how much they want to disclose at work.

These people can still be incredibly capable employees. Struggling and capable can exist at exactly the same time.

That is an important distinction, because too often support arrives only once somebody's ability to function has visibly deteriorated. What if, instead, we recognised significant transitions themselves as moments when offering support could be valuable?

This is what MOCO is already doing.

Our transitional coaching gives somebody an independent, confidential space where the focus can be entirely on them. It gives them an opportunity to understand what has changed, what they need now, what is within their control, which conversations they need to have and what moving forward might realistically look like.

Sometimes those conversations are about work. Sometimes they're about home. Usually they're about both, because despite how often we talk about “work-life balance”, human beings don't divide themselves neatly into separate compartments.

A bereavement doesn't disappear at 9am. A difficult diagnosis isn't forgotten during a Teams meeting. A parent doesn't stop worrying about their child because they have walked into an office. Someone caring for a relative doesn't suddenly stop being a carer during working hours.

People bring their lives to work because they bring themselves to work.

That is why I think this national shift towards prevention is so important. Workplace health cannot only be about what we do once somebody becomes ill. It also needs to consider the periods when someone's life changes and their capacity changes with it.

There is, of course, a balance to strike. Making workplace health performance more visible cannot simply become another corporate league table where the organisation with the lowest sickness absence is automatically considered the healthiest. Low absence does not necessarily equal a healthy workforce. People can turn up while struggling enormously. They can work through illness, hide difficulties because they are worried about their career or remain physically present while becoming increasingly exhausted and disengaged.

A genuinely healthy workplace isn't one where nobody ever takes time off. It is one where people feel able to speak honestly when something changes, where managers know how to respond and where there are meaningful pathways to appropriate support.

Nor should this responsibility simply be handed to line managers. Managers are not doctors, therapists, counsellors or coaches, and we shouldn't expect them to become those things. What we can do is equip them to recognise when something has changed, ask better questions and understand where somebody can access the right support.

Sometimes that will be occupational health. Sometimes it will be counselling or clinical intervention. Sometimes workplace adjustments will make the biggest difference. And sometimes what somebody needs is coaching: a space to process the transition they are experiencing and work out how they want to navigate what comes next.

Imagine if that support began at the moment somebody said, “My mum has been diagnosed with dementia and I'm going to become her carer,” rather than months later when they were exhausted and struggling to maintain their workload.

Imagine if somebody returning from parental leave wasn't simply welcomed back and expected to pick up where they left off, but was given space to navigate the enormous transition happening both personally and professionally.

Imagine if someone receiving a medical diagnosis had somewhere to talk through what that meant for their working life before things became unmanageable.

Imagine if the response to somebody experiencing bereavement wasn't simply, “Let us know if you need anything,” but an actual pathway to somebody who could support them through what came next.

This is the workplace health model I would love to see us move towards, and it is the model we are supporting sp many businesses with at MOCO.

The Workplace Health Intelligence Unit and the wider Keep Britain Working programme are still developing, and there are plenty of questions to answer about what employers will ultimately be expected to measure, how employee privacy will be protected, which interventions produce meaningful outcomes and how organisations of different sizes will access effective support.

But the direction of travel matters.

We are beginning to move away from a model that simply asks “What do we do when somebody becomes too unwell to work?” and towards one that asks how employers can help people remain healthy, included and able to participate in work for longer.

For MOCO, that feels incredibly significant because it validates something we have believed from the beginning: you shouldn't have to reach breaking point before somebody offers you support.

Behind every statistic on sickness absence or economic inactivity is a person. Someone whose circumstances changed. Someone who perhaps tried very hard to keep everything going. Someone who may have needed support long before anybody realised they were struggling.

Perhaps the biggest opportunity within Keep Britain Working isn't simply getting better at bringing people back once they have left.

Perhaps it is becoming much better at recognising the moments when life changes — and being there before they have to leave in the first place.

That is what we are trying to do at MOCO.