The Keep Britain Working report is clear that without clarity and support for employers, the ambition of a healthier, more inclusive workforce will not be realised.
As report writer Sir Charlie Mayfield put it bluntly when speaking to BBC’s Today Programme recently:
“You’ve got to get clarity for employers. You’ve got to tell people what they actually need to do.”
Which is why this feature is packed full of inspiration of what action all employers can take on the back of the Healthy Working Lifecycle (defined and explored in this feature).
And while the government has a role to play in incentives and standards, progress depends on collective action. Employers learning from each other, testing what works and sharing practice openly; which is also the point of our series of features like this one. And why the Keep Britain Working report has been a central theme at our Leaders’ Club, too, with Sir Charlie even addressing one of our meetings personally.
Below, Leaders share practical examples of what they are already doing at every one of the five stages set out in the Keep Britain Working report. Some are simple, low-cost actions any SME could take tomorrow. Others reflect more mature health and wellbeing strategies with budget behind them.
1. Recruitment and onboarding
Set expectations early and reduce fear
Low-cost, high-impact actions
Being honest and transparent during recruitment about flexibility, workload and culture can prevent problems later. One leader, Something Big Chief Executive, Sally Pritchett, described how an employee joined her organisation after being open in interview about leaving a previous role that had damaged her mental health.
She expected honesty to rule her out. Instead, it led to a conversation about values, adjustments and support on day one. A year later, she is a high performer with no absence related to poor mental health.
Clear communication costs nothing, but it changes who applies and who feels safe enough to stay.
Jane Austin, Director of HR for utilities company Wave, also highlights how many SMEs unintentionally make recruitment harder than it needs to be. Job adverts often assume candidates understand unwritten rules about shortlisting, scoring and interviews.
Simple actions include:
- explaining the recruitment process clearly on your website
- outlining how essential and desirable criteria are assessed
- explicitly inviting candidates to request adjustments and explaining what that might look like
This is particularly important for people returning to work after illness, neurodivergent candidates or those experiencing menopause-related symptoms. Reassurance removes fear and fear stops people from applying.
More advanced actions
More established organisations are embedding health and wellbeing into employer branding and onboarding itself. Simplyhealth, for example, integrates conversations about life stages, flexibility and support into onboarding, signalling early that it is part of how work is done, not an add-on.
2. Healthy in work
Prevention and everyday culture
Low-cost, high-impact actions
Prevention is where SMEs can make the biggest difference with the least spend.
At Something Big, a small inclusion group acts as a confidential feedback loop. It has surfaced issues most Leaders would never have spotted, from anxiety caused by hot-desking to sensory challenges in noisy office areas. Small adjustments, like seating choices, were normalised for everyone rather than framed as special treatment.
The result is fewer issues escalating into absence.
Austin describes how creating employee-led wellbeing networks transformed engagement in her organisation. What started as basic health and safety conversations quickly evolved into menopause groups, men’s health discussions and informal support networks. These initiatives cost little more than time and trust, yet they radically changed how supported people felt.
As Austin puts it, when employees drive the agenda, you “stop guessing” what matters.
At Wave, considerable effort goes into providing preventative interventions, including education campaigns on topics such as healthy eating and healthy habits, lived experience speakers on topics such as cancer awareness, suicide prevention, addiction, poor sleep etc. Sometimes these are followed up with a talk by a clinical psychologist on tips to manage such situations. These campaigns are then accompanied by resource packs, signposting to outside agencies that can help and podcasts.
More advanced actions
Larger employers are layering in structured prevention. At Transport for London (TfL), early health checks picked up hypertension, high cholesterol and other risks in a predominantly male, shift-working population who rarely visit GPs. While the financial return is long-term, the moral and health benefits are immediate, and the likelihood of serious future absence is reduced.
Simplyhealth also emphasises data-led prevention, using health insights, regular listening and life-stage benefits to anticipate needs rather than react to crises.
3. Unwell in work
Moving beyond “fit” notes or “off sick”
Low-cost, high-impact actions
One of the strongest themes across interviews was the need to move away from a binary view of health.
Many people are unwell at work with longterm or fluctuating conditions. SMEs can make a real, immediate difference by equipping line managers to have safe, two-way conversations about what is possible, what support is needed and how work can flex.
This is about confidence and empowering managers, rather than clinical expertise. Training managers to ask better questions, listen properly and respond humanely is often more impactful than formal policies.
Normalising adjustments also matters. Simple changes like concentration breaks, flexible hours or modified workloads are often stigmatised, despite being entirely reasonable. Reframing adjustments as performance enablers, not special treatment, shifts culture.
More advanced actions
Professional services, for example, are responding to long NHS waiting lists by investing in neurodiversity assessments and support through private medical provision. This is a clear example of employers stepping in where society’s medical systems are struggling, benefiting both individuals and organisational performance.
4. Absence and return to work
Keeping people connected and returning sustainably
Low-cost, high-impact actions
Phased returns are still underused, particularly by small employers who assume they are impractical. (See this case study for a best practice example of how an SME helped a returning mum back to work in a flexible way).
As Samantha Phillips, Head of Wellbeing, at TfL points out, bringing someone back part-time for a few weeks often means they return earlier, not later. It can reduce anxiety, rebuild confidence and prevent relapse.
Clear communication during absence also matters. When people know what will happen if they become ill, absence becomes less frightening and returns become smoother.
More advanced actions
Some organisations are taking a “spend to save” approach. TfL has paid for medical interventions, such as cataract surgery, to enable employees to return to safety-critical roles rather than waiting months or years on NHS lists. While not all employers can do this, the principle is transferable: look creatively at the true cost of absence versus intervention.
5. Exit and re-employment
Ending well and leaving the door open
Low-cost, high-impact actions
Exit is part of the lifecycle too.
Clear, compassionate processes when people leave due to ill health protect dignity and trust. Staying in touch, offering references, and being open to future re-employment can make the difference between someone leaving work permanently or returning later.
Simply explaining options and signposting support helps people navigate what can be an overwhelming transition.
More advanced actions
Some employers are beginning to track re-employment and redeployment more systematically, recognising that health journeys are not linear. A good exit does not have to be the end of the relationship and, if re-employed, can lead to significant time and cost savings.
Relevance for all
Across every stage of the Healthy Working Lifecycle, the same themes recur.
Leadership behaviour matters more than policy. Conversations matter more than labels. And action, however small, matters more than waiting for guidance to be perfect, or to be enshrined in legislation.
As one contributor notes, businesses do not exist in a vacuum. The health challenges facing society show up in workplaces whether employers are ready or not. The lifecycle is not about doing everything. It is about doing something, earlier, and co-creating solutions that work for the employee and the employer, regardless of whether you’re a small SME or a large global conglomerate.
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