Britain is quietly sliding into a health and work crisis.
The government’s Keep Britain Working review reveals the scale of the challenge. Ill health is now the biggest reason people of working age are not in employment. More than one in five working-age people are now out of work and not looking for work, including 2.8 million who are economically inactive due to health conditions, 800,000 more than in 2019.
The review estimates the cost to society of lost economic output, higher welfare spending and pressure on the NHS at £212 billion a year, about 7 per cent of GDP. Employers also bear a additional £85 billion in lost productivity, sick pay, and staff turnover.
Its author, Sir Charlie Mayfield, calls for prevention and rehabilitation to happen at work, where adjustments can be made quickly. He sets out a framework of shared responsibility between employees, employers and the state, supported by better data, stronger incentives and employer-led provision.
Better workplaces that understand and respond to people’s health needs can be a powerful part of the solution. Our research shows that when organisations separate health and work, everyone loses: individuals, employers and the economy.
A new Era
My colleagues, Dr Belinda Steffan and Dr Jakov Jandrić, and I developed Era to bridge the gap between the support employers offer and what employees feel able to use. Created in collaboration with Evan Morgan, Research Software Engineer at the University’s Institute for Design Informatics, the app gives people a confidential way to explore how their health and work interact, and connects them to the support their employer already provides. Short for Explore, Reflect and Act, Era builds on the University’s Supporting Healthy Ageing at Work (SHAW) project, which found that many employees want to discuss health at work but do not feel safe doing so.
Through text-based conversations with a secure University-hosted AI-powered chatbot, employees can reflect on issues such as sleep, stress, physical or mental health and work–life balance. The chatbot helps them recognise patterns, understand how work affects their health and take action through tailored links to occupational health, employee assistance or workplace adjustments. Crucially, the generative AI used is contained within the University, meaning conversations remain private to the app.
For employers, Era provides a secure, anonymised overview of workforce wellbeing. By aggregating data across users, it highlights where support is most needed and where existing services are underused, helping organisations target investment, improve retention and design healthier working environments while maintaining complete employee privacy.
All data are stored securely on the University of Edinburgh servers. Employers never see individual responses; they only see aggregated insights that reveal wellbeing trends. Early trials show promising results: employees found it easier to reflect on health and access support, while employers gained a clearer picture of workforce needs and gaps in provision.
From insight to action
We are now working with healthcare plan provider Simplyhealth to test Era, refine the employer dashboard, and assess whether interventions such as stress management or physiotherapy improve attendance, retention, and wellbeing.
Nevertheless, technology alone will not solve the problem. Managers need the confidence to make timely adjustments, and employees need trusted ways to seek help. Building that trust is essential. Era acts as a guide, not a monitor, giving people agency while helping organisations respond to real needs.
Creating better workplaces also requires a cultural shift. Ill health at work is not only a medical issue; it is a question of design, communication and leadership. Employers cannot treat wellbeing as a perk. It must become part of the infrastructure of a healthy and productive economy.
Making work part of the solution
After 25 years researching ageing and employment, I’ve learned that progress rarely comes from sweeping reform but from steady, practical change. The real challenge is to reshape how we think about work and health – to see good work as a foundation for wellbeing, not a risk to it. That begins with the environments we create. When employers build workplaces where people feel safe to talk about health and confident that support will follow, they unlock the potential for longer, healthier working lives.
Universities have a vital role in that shift by turning research into real-world innovation. Era is one such example: a privacy-protecting bridge between individual wellbeing and organisational action. If we make work part of the solution rather than part of the problem, we can begin to close the gap between health and employment – for people, for business and for the economy as a whole.
Better workplaces will not solve every part of Britain’s health crisis, but they can help transform how we respond to it – turning work itself into a source of recovery and resilience.
Wendy Loretto is our Professor of Organisational Behaviour.