Sir Charlie Mayfield, who leads the government’s Keep Britain Working Review, has published a new report proposing a Workplace Health System that recognises the importance of early access to services including physiotherapy.
Role of physiotherapy
The latest Keep Britain Working (KBW) report strengthens the case that work should be considered a health outcome, and supporting people to stay in work should be part of good healthcare. The report says that longer, healthier working lives can protect earnings, pension wealth, confidence, connection and purpose.
The plans envisage clinical advice informing personalised stay-in-work or return-to-work plans, with case management helping people access appropriate services.
Importantly, the model identifies early, evidence-based treatment for musculoskeletal (MSK) conditions as part of the workplace health offer. This creates an important opportunity to build on the contribution of community MSK physiotherapy services, including independent providers, and improve access to timely rehabilitation.
In an interview with The Times, Sir Charlie Mayfield highlighted physiotherapy as one of the services that could help people address health problems earlier and return to work more quickly.
Mayfield is quoted in The Times:
We’re not replacing the NHS, this is early stage, relatively inexpensive treatment pathways. You don’t wait 14 weeks for a physio, you see them within five to ten days. And then you quickly develop a plan with that person to start addressing your immediate issue.
CSP welcomes the recognition of physiotherapy as an important part of workplace health and rehabilitation. Physiotherapists bring expertise in early intervention, assess function and help people develop realistic, tailored plans for returning to work where appropriate.
However, Sara Hazzard, CSP assistant director and co chair of the Community Rehabilitation Alliance, urged some caution:
Supporting people to remain in or return to work must not mean expecting people to work when they are too unwell to do so. Rehabilitation needs to be properly integrated into the system.
Fit notes
The Keep Britain Working review argues that the fit note system is not working.
Physiotherapists have been issuing fit notes since 2022 and recent NHS England data shows that physiotherapists were significantly more likely than any other health professional group issuing fit notes to recommend a person is fit for some level of work.
Sara Hazzard said:
Physiotherapists are well placed to identify when someone is capable of some form of work, rather than seeing the choice simply as fit for work/not fit for work.
'Any reforms to the fit note system must ensure people can quickly access high-quality physiotherapy and rehabilitation to support a safe return to work.’
Joining up health and work
Physiotherapists are already helping to join up health, employment and rehabilitation support through programmes such as WorkWell and Neighbourhood Health.
Advanced practice physiotherapists are also providing clinical leadership within community rehabilitation teams, helping to ensure people receive the right support to manage their health and remain active in their communities and working lives.
Sara Hazzard added: ‘Physiotherapists can help join these services up, identifying work difficulties early, incorporating work into rehabilitation and connecting people with employment support, occupational health and other local services.’
Keep Britain Working does not create a new role for physiotherapy. It provides an opportunity to build on the vital contribution physiotherapists already make to helping people stay in, or return to, work.
The CSP will continue to work closely with the government as the Workplace Health System develops, making the case for rehabilitation and physiotherapy to be embedded within the system whilst protecting workers’ rights.
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