Unequal access to sick pay and time off work risks deepening UK’s long-term health crisis


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More than a million UK workers are unable to claim Statutory Sick Pay (SSP) due to their low earnings and may feel forced to work when they are ill, a new report warns.

Analysis by the Work Foundation at Lancaster University suggests nearly two thirds of the 1.15 million UK workers who currently fail to meet the SSP earnings threshold of £123 per week are women (69.2%); while a third are disabled (33%) and more than half are young workers aged 16-24 (52.4%) – leaving these groups acutely vulnerable to working whilst ill and burnout.

This is compounded by the number of businesses who only offer the statutory minimum level of sick pay. In a new survey of more than 1,000 senior business leaders across Great Britain, commissioned by the Work Foundation, almost half of employers (47%) say they do not provide more than the statutory minimum level of sick pay – which currently replaces just 17% of a worker’s average weekly earnings.Meanwhile, just over a quarter of employers (27%) provide a policy that either ‘moderately’ or ‘substantially’ exceeds statutory requirements.

Two in five senior business leaders (43%) say financial constraints are preventing their organisation from providing enhanced sick pay. Others list challenges including compliance with legal requirements (31%), perceived impact on staffing levels (31%) and administrative burden and complexity (28%).

Alice Martin, Head of Research at the Work Foundation, said: “The truth is our workforce is getting sicker and yet not everyone gets the time off they need to live healthy lives.

“The current low rate of sick pay compels some people to work while they are unwell to make ends meet. This risks compounding existing health conditions and can lead to people dropping out of the labour market altogether.

“We currently have a record 2.83 million people economically inactive in the UK due to long-term health issues – and our previous research suggests many of these people want to work but aren’t given the necessary support to do so.”

The Work Foundation analysis also looks at other leave policies offered to workers across the UK and assesses if they are fit for purpose. It highlights that, overall, lower earners have less access to paid time off. Analysis of Office for National Statistics data shows that, in 2022, employees with higher than average earnings of £32,882 per annum have on average two more days of annual leave entitlement than those with below average earnings.

Almost a third (32%) of those earning an above average income have an annual leave entitlement that exceeds 30 days. By contrast, the same allowance is only available to a quarter of those who earn a lower than average income (25.4%). This makes above average earners 1.26 times more likely than lower paid workers to have over 30 days annual leave.

This can create a ‘vicious cycle’, researchers warn, as people with lower incomes and insecure work lives find themselves having to risk their health by having less time away from work for holidays and other forms of leave.

“Forecasts suggest that a growing number of workers will be grappling with major illnesses year on year,” Alice Martin continues. “It is imperative that the next Government works with employers to create an effective plan to enable workers to have healthier working lives – or the UK’s sickness crisis is likely to worsen. This includes ensuring people have time off to rest and recuperate.”

The report also examines the UK’s family friendly and carers leave arrangements – and finds them lacking.

“We know workers on low incomes already lose out on time off because they can’t afford to take it, so the new right to carer’s leave that came into play this Spring will be no different,” Alice Martin adds. “It is good that the Government acknowledges people increasingly need time off work to care for relatives, but we must pay them for it.

“Workers’ variable access to paid time off – whether for sickness, holidays or caring responsibilities – could compound over a lifetime. Employers and the Government should not see leave policies as ‘perks’ – instead uptake must be monitored, protected and improved on where possible.

“Yes, we have come a long way over the last century in terms of providing people with protections to ensure they get time off from work, but the reality is, access to this time off is unequal.”

Amongst the report recommendations, the Work Foundation calls on the next Government to:

  • Strengthen statutory leave policies through a comprehensive Employment Bill within the first 100 days in office
  • Reform Statutory Sick Pay by:
  • removing the lower earnings limit and enabling SSP to start on day one of illness
  • creating a roadmap for increasing SSP to 60% of usual wages or the equivalent of Real Living Wage, pro-rated by the usual number of hours worked, whichever is highest
  • providing a Government rebate on offer to support smaller employers who might find it challenging to meet the cost of sick pay
  • ensuring flexibility of sick pay to support a phased return to work
  • Create a Single Enforcement Body for Employment Rights to enforce Statutory Leave and Pay entitlements
  • Commission an Independent Review on Statutory Leave and Pay to establish the fairness, flexibility, and suitability of leave for the future labour market as the pension age rises.

‘Time off: Redesigning leave policies to support longer, healthier working lives’ is published in full on the Work Foundation’s website and is available here: https://www.lancaster.ac.uk/work-foundation/publications/time-off

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