Keep Britain Working: disabled people, people with long term health conditions and work, with Sir Charlie Mayfield

Let’s start with some numbers - 

• 2.8 million people are economically inactive due to health conditions. An increase of 800,000 since 2019.
• 53% of disabled people are in work. People with learning disabilities: just 4.8%
• 300,000 people with a health condition leave work every year
• The total cost of health-related worklessness: £212 billion a year — roughly 7% of GDP
• Mental health inactivity among 16–34-year-olds rose by 76% between 2019 and 2024

How do you close the employment gap between disabled and non-disabled people? The latest person to step up is Sir Charlie Mayfield. Appointed by the UK government, he led the Keep Britain Working review examining how to support and enable employers to recruit and retain more people with health conditions and disabled people. 

Sir Charlie is our guest this month. He highlights three key issues stopping more disabled people get in to work: widespread fear among both employees and employers about discussing health and disability, a lack of proper support systems for navigating reasonable adjustments, and the exclusion faced by disabled people in the workplace. His solutions? There are many, and he’s focused on data, implementation and outcomes. He tells us about international examples, particularly from Denmark and the Netherlands, where better support systems and incentives have led to better employment outcomes for disabled people. 

Our conversation showed Sir Charlie’s commitment to this. As he says, whilst the problem is significant, it is also fixable through coordinated action across government, employers, and providers.

Links

Keep Britain Working Final Report (31.3.2026)

Keep Britain Working review – updates

Charlie Mayfield Wiki

Charlie Mayfield Government role and info 

The Disability Policy Centre response to Keep Britain Working review 

Transcript

Welcome And Why This Review Exists

Announcer 0:10

This is The Way We Roll, presented by Simon Minti and Phil Friend. You can email us at mintyandfriend at gmail.com or just search for Minti and Friend on social media. We're on Facebook, Twitter, and LinkedIn.

Simon 0:29

Hello and welcome to The Way We Roll with me, Simon Minti.

Phil 0:33

And me, Phil Friend.

Simon 0:34

Our guest this month is Sir Charlie Mayfield. After a five-year military career, Charlie went into business and consultancy and ultimately became chairman of John Lewis up until 2018.

Phil 0:46

Alongside this, Sir Charlie served as a member of the UK Commission for Employment and Skills and chaired it until its dissolution in 2017. And then in November 2024, he was asked by the Secretaries of State for Work and Pensions and for Business and Trade to lead the Keep Britain Working review.

Simon 1:05

Now this is an independent review in how to best support and enable employers to recruit and retain more people with health conditions and disabled people and promote healthy and inclusive workplaces.

Phil 1:30

This is holding back growth, damaging people's life chances, and costing the UK billions in lost output and welfare payments.

The UK Health Worklessness Crisis

Phil 1:49

So just before we meet uh Sir Charlie and begin to ask some questions around this report, some just quick facts for you. So 2.8 million people are economically inactive due to health conditions. That's 800,000 more than in 2019, a 40 percent rise in five years. Only 53 percent of disabled people are in work, and people with learning disabilities, it's just 4.8 percent. Disabled people are nearly three times as likely to be economically inactive as non-disabled people. And here's one that really stood out for me. 300,000 people with health conditions leave work every year. The total cost of health-related worklessness is 212 billion a year, roughly 7% of GDP. And the mental health inactivity among 16 to 34-year-olds rose by 76% between 2019 and 2024.

Why Charlie Took It On

Phil 2:45

So, so Charlie, um, before we get into all of that and the work that you did, can you start by just telling us why you took on the role? Because it's this is enormous.

Charlie Mayfield 2:57

Sure. No, well, thank you, Phil, and thank you, Simon. And it's uh it's great to have the opportunity to be to be with you. Um why did I take on the role? Well, I look, I was called up um by Liz Kendall. She was then the Secretary of State, um, or actually not by her directly, but by her office, and asked if I was interested in in this. And then when I looked into it a bit, I thought, well, I am actually, because I guess you know, my time at John Lewis Partnership um uh had sort of taught me that work and life are very closely interwoven. And those of us who are lucky to be in work and in hopefully in good work gain an enormous amount of fulfillment from that. Uh, and and and actually, therefore, people who aren't or or people who have to fall out of work prematurely for whatever reason uh are then losing that dimension to their lives. And um, and I and I'm a firm believer that um you know in addressing some of these challenges, and you you just had to look at some of the figures. I mean, even before we publish the report, some of the numbers that you've you've referred to are out there. Uh, I could see this as an enormous problem. And I've also felt for a long time that too often um when faced with big problems in this country, we we either look to the government or to employers to solve them. And and often most of them are better solved if we can bring employers and government together rather than what happens usually, which is they just shoot straight past each other without properly listening and paying attention. Um, and so I just hoped that maybe I could uh I could both understand the problem and encourage more of that kind of approach to resolving it.

Simon 4:30

And um, you spent about a year doing this review. Um I know there's uh sort of publication in November and then an update. Um what sort of pups stuck out? Was there something that when you were doing this, oh my goodness me, it really surprised you?

Charlie Mayfield 4:44

Um, quite a lot of things. But I mean, the first thing I should say is that it was about nine months, the review phase. Um, and one of the things I did early on is I looked at all the other reviews that have been done in this area, it's quite a lot. I mean, you know, some really good work by you know, you know, uh uh Carol Black, for example, um uh Paul Farmer and Dennis Stevenson done some great work in this whole broad area. Um, and I read all their reports, and I and what I saw is that they'd analyzed the situation pretty well, as you'd expect, and they'd made recommendations, uh uh, which all looks fairly sensible. But when you then thought, okay, but what when you went down the list of the recommendations, I mean, the first thing I'd say is there were a lot of them, but in some cases 20 or 40 recommendations, and you went through them and you could see that clearly they haven't happened, otherwise I wouldn't be being asked to do to do this review. So one of the things that struck me, or I had in my mind from very early on, was that um the the end game is not the writing of the report, it's actually making the change happen. And if you write the report and just leave it on the table for someone else to pick up and do it, you know, like most things in life, it probably won't be done, particularly if you if you leave that someone, that someone is government that's hugely distracted, got so many different priorities, got people moving around all the time. It's just it's not surprising that stuff doesn't get done. Um, so I I sort of approached this uh with a view to saying, yes, we need to do the review, we need to write the report, which which shows what the problem is and makes some clear recommendations. Um, but I also felt very strongly that actually my responsibility was also, if the government wanted me to, was to stick around for the implementation, and that's what I'm doing now. Um, just to build to your question there about what surprised me. Um, I'm not sure it was surprised as uh awakening, uh more of an awakening of sort of the significance of a few issues. And there are three things I would mention in particular.

Fear, System Gaps, And Exclusion

Charlie Mayfield 6:33

Uh the first is uh that around the whole question of ill health uh and disability in the workplace, there is a tremendous amount of fear. So if you're a person who has a health issue or has a disability, very often um you're a bit afraid of telling your employer about that. You know, that's probably your first instinct because you're worried about judgment, you know, you're worried about how you're going to be treated, all sorts of things. It may be very private, something you don't particularly want to share, particularly if it's a new employer, you don't know the people. So fear for the employee is very understandable. But that fear is also felt by the by the employer. You know, a lot of uh employers and line managers, uh, when when they encounter health issues or disability issues, they will often be afraid of stepping in and engaging people in that because they one of it's very human. It's a personal thing, and they don't want to sort of say something wrong or cause offense. They definitely don't want to do something which gives rise to a complaint or appears insensitive, and let alone a grievance and let alone a tribunal. So, but the point is so you've got a lot of line managers and man and employers who are who are also afraid, and you've got a lot of employees who are afraid. And what happens is that fear creates distance between people. They don't talk and they don't they don't discuss, and therefore issues which probably could be resolved through discussion and just human contact are not. Second big thing, so that's the fear issue. Second big thing was the system is then exacerbating that distance. So um, you know, there are a number of things, but we don't really have a proper system for supporting employees or employers in the context of how you handle ill health and disability. We kind of expect them to get on with it. I mean, in the context of disability, if you take something like reasonable adjustments, you know, it's enshrined in law, you know, it makes a whole load of requirements. But most employees and most employers are then pretty well unsupported in terms of how they navigate what is reasonable or what isn't. And we sort of expect that to get resolved. So instead, so what you're effectively doing is you're leaving a slightly tricky judgment to be to be reached between two individuals who may not know quite how to reach it. And sometimes that can end up in conflict, which again creates distance. And then there's a whole thing about GPs and fitnotes, which I could go on about. So the system is exacerbating the problem or the lack of a system. And then the third thing that we really called out, and in some ways it's not a separate thing, is the level of exclusion faced by disabled people. Um, because everything I've said about fear and everything I've said about system is kind of multiplied several times over if you're a person with with disabilities, with a disability. And and I was uh if there was an area I was shocked, it was about that. And I think you know, I I go around when I'm talking to people about the review, I often uh tell the story of Sheila. Now, I was in a I was in a round table in Glasgow about a year ago, and we had a great round table discussion. Sheila had come into it with her guide dog, she's blind, and um, and then right at the end, as I was sort of summing up, saying thank you for coming, really useful input. She said in a really quiet voice, yeah, I was 49 when I got my first job and I had five degrees. And I always stop after that, and I just let that sink in. And I say to people, just think what the 30-odd years of her adult life have been like, where she was able to work, wanting to work, wanting to participate, and was basically not able to do so. Uh and just imagine what that, let alone the economic consequences, just imagine what that does to someone's heart and soul and how they feel. And um, and it's uh it's shocking. And then you and then you go beyond that and you look at you, you mentioned the number. You know, if you if you're someone who has a learning disability or learning difficulty, less than five percent are in work.

Phil 10:19

Yeah. It's shocking. Can I just can I just ask a question before we go on? I'm interested to know how you differentiate between ill health and disability, because I think for many that is a kind of bridge that has to be crossed. What kind of definitions or whatever did you use to separate these two things out? Because clearly Sheila was disabled. Yeah. She wasn't ill. Absolutely. But yeah, so what's your take on that? Uh Chad?

Charlie Mayfield 10:46

So, I mean, the first thing to say is we got we've got into a bit of trouble with some of the some organizations who've who've taken real issue with the very fact that we mentioned both it ill health and disability in the same sentence. Yes. Uh, and um uh and I and I I I do understand where they're coming from, and we have been tried to be at pains not to conflate the two, because disability is not ill health. Having said that, it is true that disabled people also get ill. So, you know, the the two are also connected. Um, but we're we're we've we've tried to, and I don't think we've succeeded, but we've tried to say to people that we're not treating the two as the same. We are not treating disability as a health issue. We are uh but we are recognizing that we're talking, we're being asked to look at employers as a group and how do they play a bigger role in supporting people with health issues and disabilities to stay in work and to thrive in work. And so our audience, in terms of the number one people we're really we're speaking to, are employers. And so we kind of have to somewhat look at it through their eyes and say, right, so how do we how do we work with them to try and figure out what to do? Uh, I also think that there are some there are some opportunities as we start to move into the soul, you know, solving this, how do you solve it? That if we can create resources and better sources of advice, and you know, it yet you may we may find, we haven't got to this stage yet, but we may find that if we can create better resources and advice for employers around how they handle health issues, there may also be opportunity for the same advice or the same people to be the expert advisors around how they handle issues to do with disability, including things like reasonable adjustments. So we we tried to keep the two separate, but I I kind of acknowledge that we haven't pleased, yeah, that people have been concerned about that. I think I understand their concern, but I hope that uh I hope what you can understand is it's not we're not we're deliberately, we're really not trying to conflate the two. We're actually trying to treat them separately, but we've got we've got a job to do, we're trying to crack on and and and address it.

Simon 12:46

We did a podcast two or three years ago, which was long-term health conditions and disability. Uh, what was it kind of where do they overlap and where they distinct? It is our most listened to podcast. Is it because there is, and I think disabled people sometimes mean to be very protective saying, don't muddle us up. It's back to the fear though, because if you think I'm sick as well, I'm really gonna struggle to get an employment. I take that distinction.

Employer Risk And Hiring Bias

Simon 13:08

Um, you mentioned about the lack of support. So two individuals are trying to work out what reasonable might be. Now, when we worked with large organizations, they have policies procedures, they have HR departments, they have business partners, they've there's business disability forum that I know you've spoken at. I think there is stuff out there. So why are they why is that still an issue when there is support out there? Maybe they just don't know where to go to, or am I only thinking large employers, not small under 20 employees?

Charlie Mayfield 13:38

Um, I think uh I mean I think there are a variety of issues. I mean, you're right, there's lots of advice out there that you can go and find. But if you're and if you're a larger employer, I think it's fair to expect people to have the resources in place and the systems in place to to to to handle that. But if you're a small employer and you are you're you're almost struggling for survival or you're thinking your your whole your whole um world of work is is is much more sh near term and in your face and pressing. You know, even the fact that you have to go and find something is probably a reason why you probably won't. Uh not because you don't want to, it's just that other things become a bigger priority and they they crowd out that space. And um, and then I think there's a further point here, which is that you know, I think there is a there is a fear amongst some employers, uh and I I mean this is perhaps slightly controversial. This some employers are afraid of employing disabled people in the first place. Absolutely. And so I think you know, one of the things, I mean, I had we we spoke to many employers, and uh, you know, I I have had employers saying to me, and and they've usually prefaced it by saying, I'm not proud of what I'm about to say to you. But I think it's really worth being being honest about it. And I kind of thank them for being honest, even though that what what they what they're doing is not legal, is they said, if I've got candidate A and they're brilliant, but they've got a vulnerable characteristic, or I've got candidate B who's average, they'll recruit candidate B because they don't want to take the risk that candidate A might there might be a problem down the track.

Simon 15:03

Which is why Sheila's got five degrees and didn't get a job until she's 49.

Charlie Mayfield 15:07

I mean, how many times have you heard that story where people who are very, very capable of just not being able to get into the job market? And I think it's really important that that we talk about that, because I think it's also very important that we think it should then inform the solution space. Because any any amount of talk about how we make reasonable adjustments better, which I think is a good thing to do, by the way, won't resolve that problem. Because the problem is that people aren't even getting through the draw in the first place. And I think and the further point I'd make around this whole area of of exclusion is um, you know, I think Phil, you would you in your intro, you were talking about 53%. Um, but when I've spoken to disabled people, you know, there's a very large proportion of disabled people who are self-employed. Yes. So they've taken the matters into their own hands. They haven't been able to get a job with another employer. Yeah. And so they've taken it into their own hands. So actually, arguably, the dis the disability employment gap is actually bigger, in my view, than it is stated here. And then add to it the fact that if you've had to work incredibly hard to get into a job in the first place, then the the the barriers or the sort of disincentive for you to move jobs are so much greater than for somebody who's who who doesn't have a disability. You know, you're you you think, Crikey, it's been hard enough to get in here. So I'm not going to write and run the risk of moving, even frankly, if I'm if I'm dissatisfied with my job, and I think I could do better somewhere else. You know, so we've got we've got a we've got a system which is not working. Uh, and it's um, and I think that's a that's a huge problem, and we're losing out on some incredibly talented people who've got extraordinary resilience and so much to contribute at huge cost to the economy, but bluntly at enormous cost to their personal lives.

Simon 16:43

I think Phil and I are probably sitting here because we we agree and know what you just said because we've experienced it and come across it. It's a bit of a sobering thought for us because we've done a lot of work over decades, and it's still the

Lessons From Denmark And The Netherlands

Simon 16:56

same things. Um you did mention internationally there's some uh other countries got levers. I mean, an example of two where you thought that was quite good.

Charlie Mayfield 17:04

So um we went to we did we did quite a lot of desk research looking at other countries about their their uh their practices, uh, but we then we did visits to Denmark and to the Netherlands specifically. Um and I think in the context of disability employment, um the the Denmark model was very interesting. Um I'm not again you can't copy any other country's model, but there were a few things which are interesting about it. So the first is that in Denmark, it's actually they make it incredibly easy to fire people. Uh so it's it's actually far easier to fire people in Denmark than almost anywhere else in Europe. However, they're not fired into oblivion or they're not just chucked out of a company, they get picked up by a safety net, which is much stronger than the one that exists in this country and is geared towards saying, right, okay, you've you've fallen out of that job, you've you've been fired from that job. So what we're going to do is figure out what are you good at, what are you capable of doing, and where are the opportunities for you that we could try and get you into. This is for everybody. This is for disabled people and non-disabled people. It's not differentiating in that sense. Um, and so so but if you think about it from what I said before, where some employers are afraid of employing disabled people, in Denmark, generally speaking, they're not. Because they're not. Uh so you take away one of the barriers and they've got a better, much better rate of employment than we have. The other point that is very interesting, and this applies particularly to people with learning difficulties uh and sort of some um some you know some autism spectrum uh issues, for example. Um, but um they also have a requirement for all the municipalities in Denmark to provide participation opportunities for all the people in their municipality. Municipality is their equivalent of a region or a place. It's a sort of their devolution mechanism. So they have organizations which, if you've got someone who can't work, you know, in a normal sort of job context because of, you know, that perhaps they've got severe learning difficulties, they have to have participation opportunities regardless. So they've got organ, I mean, we went to we went to visit a really impressive organization in the outskirts of Copenhagen where there's this woman called Vie Becker, who again was amazing, uh, and she had 400 citizens. And so, and within her operation, she had a number of different working working operations, I mean, which were geared towards the capabilities of the people uh she she was looking after. But they were also doing things like employing work coaches. Uh, and so she told us of this example of the local supermarket where they employ 25 people with quite severe autism. Uh, and they employ three, sorry, the supermarket employs 25 uh people, and the organization employs three work coaches that work in the supermarket to act as a act as sort of mediators in a bridge to help. And they're very experienced of working with people with autism. And you know, they said this is an incredible success. You know, we've got these, these, some of these people are some of the most valued colleagues they have in that supermarket. Uh, they're incredibly loyal. I mean, they actually they laughed. They said we have to make them take holidays because they don't want to often. So I was just really struck that there are solutions out there that achieve much better outcomes. Um, I think the other one I would just uh give an example to is um uh I'm conscious I'm sort of into more into the learning difficulties space, but there's an extraordinary organization we came across in Belfast, uh, right in the heart of the Shank Hill called UCL. I can't remember what UCell stands for, but it was a it was uh uh I can't remember what it what it stands for, but it's an amazing organization. And they are supporting 1,500 people across uh Northern Ireland with uh with various forms of disability to be in long-term work, some of which is that they actually run themselves, and some of which is is is where they support people in other organizations. So there are solutions out there, which is which is you know, I think it is it's reassuring. And yeah, we we're trying to sort of draw on those as much as we possibly can.

Phil 20:57

Is there um I I was very struck when I was in America, I did some work in America when our act came in in 95. I looked at the Americans with Disabilities Act, came across an organization, I need to be brief, where what they were doing was taking the most severely disabled people and offering guarantees to employers that if this didn't work, we would find you another person and remove the one that didn't work and they'd find them somewhere else. Now, that sounds a bit fierce, but what they were doing, you you talked earlier about the risk, particularly for smaller employers, very worried about the amount of time expended and our law system, which makes it very difficult to fire people, actually. Is there something to be said then? It sounds like Denmark and others have got this kind of net which means that if I fall out of work, I'm immediately picked up and something else comes along. My question then is we've got occupational health physicians, we've got occupational health, we've got insurance companies, we've got all of this panoply of things going on, advising employers. Where do they fit in all of this? Clearly, it's there, but they don't appear to be tackling the problem.

Simon 22:04

Then we still have job seeker advisors who uh help disabled people as well. They used to be called DPOs and stuff. Sorry to interrupt. There's quite a lot, isn't there?

Charlie Mayfield 22:13

Uh there is quite a lot, but I think it's fair to say that the UK has kind of historically prided itself on having a pretty liberal labour market, um, which has relatively few requirements on employers, and it's been a bit more North American, a bit more freewheeling than some of our continental European uh European uh economies. Um and um, and you know, there's probably arguments either way about whether that's worked or not. Um uh, you know, you do hear people saying it's actually compared to compared to France or Germany, it's much easier to employ people in the UK because although it's not easy to fire people, this it is easier than it is there. Um, but I think what's happened is but and then in the context of occupational health, you know, but it's it's a it's a legal requirement to have that in place in quite a lot of European countries. It's not a legal requirement to have that in place in the UK. And so what we have is we have a quite a patchwork quilt of provision in the UK in terms of what employers actually have in place. Uh, it's of highly varied quality, some very, very good. Uh, and you have amazing employers doing great stuff in-house, and some who contract that in, others who have group group income protection policies, and they basically outsource that to the big insurance companies, and they on the whole do a pretty good job all the way through to nothing. And in between, you've got you know employer assistance programs, which are uh relatively cheaper, uh, but also the utilization isn't as great, and they're kind of a bit more in the employee benefits front rather than sort of really embedded in the banishment practices. So we have got a uh a uh a weaker system, I think, truthfully. And you know, again, you can argue whether that's been a good thing or a bad thing, but what is happening now is we are getting older as a society, we are getting sicker sooner, and we're also getting iller younger because there's been a huge surge in mental health issues amongst younger people. And of course, there's also a lot of comorbidities across all of this space. So if somebody uh falls out of work with one condition, it's very common for them to then develop others because they're once they become isolated or removed from the world of work, you know, that is that is what can happen, or they become less active. That's what can happen. So I really think that the system or the lack of a system that we've had historically may or may not have worked. But what I'm absolutely clear on is it will not work going forward. And we need to see a fundamental reset in terms of how we handle and support people with ill health and how we support people with disability to get in to get in and stay in work.

Simon 24:35

I I like where you're heading. I mean, this is a big significant culture shift. I'm I'm gonna throw a little curveball in because it's very topical. I heard Andy Burnham be interviewed um about would he cut welfare to uh give more money to defence? And he said yes. But he said, I would do that by supporting those disabled people and those people with ill health into work, therefore the welfare bill will drop down, therefore I can put more money into defense. Does that sound I mean, is that I'm not specifically part of the plan, but is that kind of part of this?

Charlie Mayfield 25:07

Well, I think I think most people would agree that it's better to spend money on getting people into work than on paying them not to be in work if they're able to work. That's that's the that's definitely the case. Um, it's the the difficulty is always the judgment that you reach about who is capable of work and to what extent. And I think the um so a couple of things I'd say. One is that again, in terms of uh lessons from other countries, in the Netherlands, uh the professionalism and the rigor with which they assess your work capability is on a different level to what we do here, a different level. And uh and then they've built their systems and the incentives around that in a way which means that you know people do get benefits if they really need them, but they they only get as much as they should have, depending on their workability. So it's almost that the focus is on what can you do, not what you can't do. Whereas I think here we tend to end up sort of just saying to people, no, you can't work. It's a binary thing, which is crazy. Um, but I think the other point I would make is that it sort of relates to what I did by the matter. I mean, if we can get if we can get more people into work, that would be a really good thing. It would reduce the welfare bill and it would boost the economy. Of that I'm sure. And I and I would I would also say that actually, when you look at all the opportunities and the challenges we face as a country, I don't think it's an exaggeration to say that doing better on this front is one of the biggest single economic opportunities we face to grow and to improve our economic performance, let alone the the benefits that would accrue in terms of life chances and personal benefits for the people affected. And the reason I say that is because actually a lot of the solutions are within our grasp. They're things we can do. We do not have to learn to do loads of brand new things that no one's ever done. We just have to coordinate better and put together our systems and tap into the incentives that are already there and the will and the capability that's already there to get much better outcomes. And um, and on that, I mean, I think one of the things that we did within uh Keyprint Working is uh as part of the review, we basically went out and asked employers to sign up and say they wanted to be vanguards. And essentially what we said is what this means is you you're saying to us and to the world, you want to be, you want to work, you care about this issue and you want to work with us to try and solve it. That's basically what they're saying. And at the point of publication, we had 60. Uh, we've now got over 180. We had five mayoral authorities at the beginning, we've now got 10 for all the devolved administrations. And one of the interesting things we did with those vanguards is soon after we published the review, we wrote to them all and we said we're going to do a survey and ask them of the various different areas you might now want to work with us on in terms of problem solving. You know, what's your level of appetite? Um, and and honestly, across across a number of it was things like musculosketal issues, mental health issues. We asked about disability inclusion, uh, various things. 74% of those of the respondents said they wanted to be working with us around how we could improve disability inclusion. And I took great encouragement, and by the way, that was pretty much the same as it was for some of the other the other things. So I took great encouragement from the fact there's a lot of employers out there who want, want, they know, they know kind of by feel that we're not good enough and they want to be better. And so what we're doing is we're working with them to try and figure out how. Uh and uh and that's that's an incredibly valuable

Measuring Outcomes And Building Incentives

Charlie Mayfield 28:27

resource.

Phil 28:27

Can I I I'm I'm this is very, very, very interesting. Can I just I'm hearing the listener that's sitting at home listening to this, uh, a bit like me, saying, I've heard all this before. This is you said at the beginning of our conversation that you know you're the you're in a long line of people that have written reports. And while some of the things you're saying I think are pretty unusual and unique, um that which is great, the cynical listener is saying, I've got to say on their behalf, what's gonna change here? We've heard employers before sign up for things like the disability two-tick system and then the disability convent thing. And the evidence seems to suggest otherwise. So, for example, you mentioned access to work, access to work is you put it much more diplomatically than I'm going to, which is it's fallen to bits. I mean, uh getting people into work via access to work is taking months and months and months. So long-winded thing, can you help me understand what's going to be different this time around?

Charlie Mayfield 29:32

So, and in a way, that is the challenge that we're kind of taking on. And I um and I'm um and I'm not yet in a position to say to you, we've got it all sorted because it's quite difficult. But what I what I can say to you is that I believe that we have got to crack the question of how do we properly measure the outcome we care about. If we want to improve it, we've got to start measuring it. So, and and what we will want to see is more disabled people in employment. That's what we want to see. You know, and and yet we don't really have a good measure of that, not at a firm level or a sector level or a regional level. And so what we want to try to do is to uh figure out how we could measure much more reliably and more frequently the level of participation by disabled people in different organizations. And I think one of the criticisms that I've heard loud and clear around disability confident is that it's got some quite good bits in it. I mean, there's some quite good things in it, but there's a sense from quite a lot of disabled people I've spoken to, which is that it's all very well, but the outcome isn't what you'd expect given the inputs. You know, it's it says all these good intentions, but the outcome is there still aren't opportunities and jobs for disabled people. And so I would like to see a situation where we find a way to bring outcome measures onto that, into that equation. And therefore, you know, you can't just be uh a top-tier disability confident employer unless you're employing more disabled people uh and probably a growing number of disabled people. And the good news is that I actually think that there are quite a lot of employees who want to do that. I don't I don't believe that, I mean, look, sometimes employers will do things because of for reasons of PR. But on the whole, I suspect that the 19,000 people who are member employers who are members of disability confident actually at some level at least do want to improve the employment outcomes of disabled people and be more inclusive. Uh, but what we've got to do is be able to tell them that you know they're either in the top tier in terms of actual outcomes or the bottom tier. Wouldn't it be interesting if we were able to say, let's imagine a I don't know, a large professional services firm, wouldn't it be great if we could say to them, do you know what? You're you're you have got, you know, you've got about 20% of people in your organization are uh uh are disabled, but your competitor over there has got 30%. What do you think about that? You know, uh and and and don't you think you should therefore look at how you can improve? Um and I think that kind of information could be very, very powerful. Uh and and of course, that's not to the exclusion of then tackling some of the mechanisms that help to achieve better outcomes, like access to work, like reasonable adjustments. But those are all parts of the process that get you to the outcome. And I want to put a bigger focus on the outcome.

Simon 32:12

Um I'm I'm quite well known for saying things and then not actually answering questions. So uh Charlie, you'll have to work out my point here. Um I the bit I'm still struck on is this shift, and I really like it, as in how we think. Uh, and at the risk of blowing Phil and my own trumpet, we've both delivered career development programs for managers who are disabled, neurodivergent, long-term health conditions at HSBC and Lloyd's and other big organizations. One of the things in that course is to get them to take over the management of themselves, to lose that fear we talked about. Uh, if their career's stopped, is it related to their condition or has it? Is it something else? And we pull it all apart, put it all back together, and off they go. And hopefully their career will develop. What's starting to happen for me now is that the managers of those individuals are saying, Hold up, we have these people come back who are so engaged and so alive, they're not ready. So now we have to train the managers to get them ready to be really good at this. I haven't worked on my question, but I what I'm sensing for some of the things is that intensity could be really helpful. I love the international model of so much support. So we remove the stigma, this is just normal, uh, the normal case or normal process. I suppose my fear is how do we do that at scale? How do we do that with large numbers of people?

Charlie Mayfield 33:25

Well, I think um so I think there's there's going to need to be a number of a number of um components to any answer. I don't think if there was a simple answer to this, somebody probably would have found it, if I'm honestly honest about it. Uh, I do think this focus on outcomes is is potentially of enormous importance. Yeah, if we could start to reliably measure how many disabled people there are employed in different organizations, that would be a very powerful piece of information that we could then use in lots of ways to drive better outcomes. And of course, one of the interesting thing questions is how do you collect that data? Because if you just go to somebody and say, Are you disabled? And it depends who you're asking the question as well, of course. There's 101 reasons why they might not want to tell you that. There'll be some people who are disabled, don't even realize it, but actually, you know, but they would have, they would, they would qualify as being disabled, but they wouldn't necessarily describe themselves as that. So we have we're actually doing some work right now to figure out how could you overcome some of the challenges of collecting the data so that you could get that data set. And then if you had that, how could you then start using it? Because I think the thing is for something like Keep Britain Working, yeah, we're we're trying to grapple with a sort of a nation which is and and all the employers within it to drive better outcomes. What we can't do, um, because it would be impossible for us as a team or even an organization, is to fine-tune the answer for every single eventuality. We can probably only do a few things which change the direction of the conversation and and tap into the will there is. So I'm I'm, you know, I'm I and I and I think once you get that to start happening, you know, then quite a lot of secondary effects can start to take place, which help. Uh, so I think outcome measures is incredibly important. And I and I kind of want to test a destruction, how we could go about getting better data around that. And then I think it's really interesting about what you could do with it and how you could use it. We want to, secondly, improve the support that's available to employers to help them to support their employees. And so we're doing quite a lot of work with providers and with other people to say, what how could we configure that? What should it look like so that we can get that to work? And then down the track, when we've when we've figured out the the the what and the how, we also have said to the government from right at the beginning is you've got a job to do because you're going to need to create the right incentives which encourage people to want to come on this journey. Um, and we, by the way, we haven't we haven't specified what those incentives are yet. Uh, but the truth is that if imagine imagine a scenario where somebody provides a participation opportunity for someone uh and they are, they therefore have a long and fulfilling career. Not only is it great for that individual and probably good for the company, but actually it's really good for the entire country uh and and it's really beneficial. And so, you know, down the track, once we've built built up some momentum and built some evidence, we we've absolutely said to the government, we need you to step in and say, right, how do you encourage people to come on this journey? And and and and there's a whole range of things you could do from you know saying this is part of public procurement measures through to uh providing you know perhaps tax relief on certain aspects, through to perhaps saying that if you if you're doing this and you're demonstrating you're a very good employer on the following criteria and we've got good data to show it, maybe you get the benefit of other other incentives as well. So we think there's a lot of opportunity to do some of that.

Keeping People In Work Through Better Support

Phil 36:43

Charlie, can I just ask, jumping back to the initial data that I read out and I said that one of the figures that stood out to me was the 300,000 people joining uh the queue every year. So it feels like, in a sense, what we've got is we've got we're really we're filling a bath and we've got the plug out. So as fast as you are coming up with initiatives to keep get people into work, they're leaving in droves because the employers are not, and I'm not having a go at employers here, but for whatever reason, people find it very easy to be got rid of. Interesting that Denmark think we're a bit worse at it than them. But uh this idea that we need to turn the tap off as well as approach those that are already out of work to get them back in. So, how do we stop 300,000 people joining that queue every year?

Charlie Mayfield 37:35

So um we uh we're we're we're doing a number of things. So, I mean, essentially we're we are saying that employees have got to get much better at supporting people so they stay in work. Quite a large number of that, 300,000, wouldn't need to leave work if they were better supported to stay at work. Some would, of course, because you always will have that, but quite a number of them would not. And so what we are essentially saying is that we're we're we're really uh trying to develop something called the we call it the healthy working life cycle. And and essentially it's about saying to employers that you need to get on the pitch. You know, it's it's not good enough for you to say that health andor disability is an issue for the individual and whoever's supporting them, and it's kind of not my problem, it's over to you. And if as soon as you can't do the job, well, you know, thanks for being here, but we'll let you let you drift off. That's not good enough. What we're actually saying is no, you, the employer, have got to be engaged in this. We need you on the pitch. And but in order for you to do that, we've got to be clear with you about what that means. It doesn't mean you can't, it's not reasonable to expect employers to do to have magic wands and improve every aspect of everybody's lives. Uh, but we do expect you to be engaged, to take accountability for health and for disability in your workplace and to making that a better and uh uh more supportive environment. Secondly, we're saying that the employee has responsibility and that you know, I think it there is a yeah, there's a lot of employers who sort of slightly throw their hands up in the air and say, Oh, there's nothing we can do about this because some of our employees aren't playing ball. And I say to them, you know what, have you have you looked at your contracts? Have you actually been clear about whether or not your your you know the way you've structured your contracts means that they're geared towards engagement? So you can't, you shouldn't have. I I think that the notion of something for nothing is a good one. Yeah, you shouldn't have a situation where if you if you say to people, you can be off sick for months on end and be paid sick pay at a high high rate, but have no requirement to engage with the organization about how we can rehabilitate you and get you back into work. That shouldn't be okay, shouldn't be the norm. So the employee has some work to do. Providers are very, very important. It's not possible for employers on their own to solve all the issues that they may face. I mean, you you mentioned uh training. I think Simon mentioned training a moment ago, uh, training of line managers. And I think it's a good thing to do, but it's impossible to train all the line managers to cope with every single situation they may face and to do it quickly and efficiently and effectively. So we've got to get the provider industry of occupational health, of insurance companies, of all sorts of all sorts of different organizations to step up and figure out how we can provide good support for employers and employees at an affordable and accessible price. And you we think actually that's very doable. Uh, I was in Hull yesterday and we were talking about I was with uh uh partly run by the city council, partly by this company called Latus. Um, and they're setting up a Hull resilience hub, which is basically 50 pounds per person per year. Uh, and they provide a pretty impressive suite of supporting support, which is very proactive. It's based on it's got health checks, it's got you know, it's it's a proactive support operation, all with a view of stopping people from leaving work. Uh and so the providers have got a big job to do, and that and that kind of that's an example of where we're seeing some innovation there, and we think there could be a lot more. And then the government's got to play a role to play. I talked before about incentivizing people and getting that all lined up. They've got work to do to make that make that work. So all those four areas, yeah, I believe could make a big difference in this in this space. Okay.

Simon 41:01

I'm looking at the clock and time now, yes. Yeah, um I'm getting twitchy. There's uh one little when you're trying to find out the numbers of disabled people uh in in employment within organizations. Something I found now, if I use the word access, do you have any access needs? People come forward. If I say are you disabled, there's a 50-50 chance they won't say it. But I I have three quick fire ones. One which is one thing that you really hope will absolutely land from your recommendations, one thing you think, okay, that may not happen. And my last question is, how long are you around for?

Charlie Mayfield 41:35

Um, okay. Um so um I'm I'm a bit of I'm a bit of a an optimist, so I find it quite difficult to say say what won't happen. Um, I I think I mean in terms of what I mean, I'm gonna I'm gonna go a bit general. I mean, I I'll be very clear. I think we want to try and pull off a fundamental reset in terms of how ill health and disability is handled across the UK, in the workforce across the UK. Um, and uh I say that it's easy to say, it's obviously hard to do, but I think anything less than that, setting out to achieve anything less than that would be wrong because the scale of the problem and therefore the scale of the opportunity is such that it warrants us really being ambitious about how we do it. Um I say that though, not because I'm pessimistic. I mean, I think I'm I'm realistic about how hard it will be to do it, but I've been I've been so hugely uh encouraged by the response that we've seen from a lot of employers uh and providers and other organizations out there. Because we're not doing this on our own. It's not just me and my smallish team. Actually, we've got we've got a growing coalition of people who want, who recognize that this is a problem that we need to solve. And and they've got a lot of those people have got the capability and the resources to do it. It's really a question about coordinating it and joining it up better and helping it, getting some barriers out of the way and then getting the whole thing to work better going forward. So I think we I think we can do it. That's my my first question. In terms of what we won't, what we may not achieve. Um, I I I I'm gonna slightly duck that because I I I'm not prepared too early. We've sort of got, I don't know yet. And then in terms of how long am I around for, well, I I signed up, I'm co-chair, uh, I'm one of four co-chairs uh of the implementation phase. So uh having done the review, um uh I basically said to the government, right, you've you've got you've got to do three things. And one of them was to to back it with senior leadership. And so there are four co-chairs, it's the three secretaries of state from Department for Work and Health, Work and Pensions, uh, Department for Health and Social Care, and Department for Business and Trade, and me. Um I I also then say that it's I I I say that's good because we need them to have skin in the game, but I also understand that the division of labor across the four of us is going to be quite uneven, which of course it is. Um, but we've got uh a good team, we're growing that team. We've got some fantastic support coming through from employers and you know, some of the people there are they're they're giving. their time and their expertise in a way which I'm hugely grateful for. And so I I kind of say to you, I'll be around for as long as it takes to make this happen. I'm certainly not planning to go away anywhere. It feels it feels incredibly important.

Simon 44:15

I mean to stop it risking being another fabulous report with great ideas that they're disposed by yeah.

Phil 44:20

Sorry I was gonna well I was just going to say that um obviously some of this is at the whim of whoever the government is let's just hope that this I I would argue and I think you have very very articulately argued this isn't a political issue actually this is this is about the benefit the welfare of the whole country so whatever government's in power should put their money behind this because it strikes me if they don't we'll Simon and I will have someone like you again in 10 years' time saying I've done this review you know and here we go.

Charlie Mayfield 44:51

And it's been in a way in a way that the trick is to make it you know it I it part of this is about saying let's stop looking to the government to solve problems that are better solved elsewhere. Let's recognize they've got a role to play but you can't outsource all the problems to the government yeah because that's when that's when things just don't happen because they can't they simply can't they haven't got the capacity or the time or the attention span. So let's say you know what the best people to solve this are actually employers predominantly and what we've got to do is figure out the solutions to a level which makes them highly implementable with a lot of support a really strong coalition of support at which point you then say to the government right well why on earth wouldn't you back that because you'd be mad not to and and actually if we're going to do all of this stuff we need you to do quite precisely this, this, and this, but not all of that, because we've sorted that over here. So why wouldn't you get on with it if this is going to improve the lives of the people who've elected you and indeed some who haven't and it's going to improve the economy and help you to you know to have more money to spend on public services and all the other good things you might want to.

Phil 45:51

Sounds like a good place to end to me.

Charlie Mayfield 45:54

A very optimistic note we've got a lot to do so I I I'm realistic but I I feel um I feel it's important work and uh and actually to be honest I feel very fortunate to have had the opportunity to spend nine months doing the review all across the country getting into this and meeting so many people yeah I couldn't be speaking like this I would not have been speaking like this in January 2025 because we haven't done the work uh we've done the work and you know it frankly it gets under your skin and and you feel you feel a sense of of of its importance and also you can see how we could go about making a difference.

unknown 46:30

Yeah.

Simon 46:31

I I I also think and this is me being more realistic is that the the revolution you're talking about which I think it is is amazing. I I generally think we have these incremental changes. So whatever it is that you do will move it forward even if we don't get quite to where it is as long as it keeps improving I just want to wish it could be a lot quicker.

Phil 46:48

I suppose there's there's no doubt at all in my mind Charlie that you've got the passion and the energy that comes off you in waves and I think that that's not a joke. I think that matters I think to get this thing rolling you've got to have both of those and I think Simon and I have spent many many hours with people who say stuff but don't really mean it.

Charlie Mayfield 47:07

You can tell the passionate ones and I think you're one of them so good luck is what I mean it's kind of you well we we we may well hopefully we won't need too much of it but we certainly need momentum.

Hosts Reflect And Ask For Feedback

Simon 47:16

I'm I'm a great believer that that most of the world's problems get solved not instantly but over time and momentum is key to that well thank you very much for your time thank you Simon thank you Phil um thank you thank you very much indeed take care thanks a lot we've just finished the recording with uh Sir Charlie Mayfield I I he's he's impressive he um very very tall de force I think he's got his head around the issues even it's very hard for us because I want to kinda say a lot of we've heard before there are certain things he's suggesting that are in place but they're just not very good at the moment and could we move to a model that we see in other countries which I'd imagine takes a a lot more funding a lot more training and a real shift in how people see this um well I mean what were your thoughts?

Phil 48:36

Well I um I think he's I mean on a human level I was very struck by he's very personable he's very persuasive he's very passionate I actually believe he does care about this um I think they're a good mix for for you know for seeing something happen because I think you and I have seen lots of previous reports written by committees or by individuals with committees where you kind of think oh god here we go I mean is is it is it just another are they just kicking the can down the road kind of thing I don't get the sense that's what's happening with Charlie Mayfield's work. I I think he and he's building a coalition of people now employers government uh insurance you know all of the component parts to see if he can make a real change the question I suppose that we always have is will he will he be given the time because this is not going to happen overnight.

Simon 49:33

Well and or has he got that commitment my my last question how long are you around for is a very real one because there are people like you and me and many others who've been around a lot longer who keep plodding away keep pushing keep nudging and we see people come and go but um yeah if he sticks around for three four five years that could make a big difference if he can get some of the things that he's talking about. And I did yeah I did like some of those ideas learning from the others I think that bit about much more support I think the I mean I get funny when it's OCealth an insurance company because it's a bit medical model but I also know that can be really powerful for those people who this is new or they don't know or they need that hand holding so if those support mechanisms are there for employers as well as employees.

Phil 50:23

Yeah and I think I think there's something to be said for OCHEL and the others to adopt a more social model approach. Because they're medically trained doesn't mean they don't get the barrier bit if you know what I mean but I take your point but they're there they're sitting there employers are paying them loads of money what what are they getting for it kind of thing you could argue I I I I felt more optimistic I feel a bit more optimistic that um Charlie Charlie's understands the issue he's come up with some ideas about how to resolve the issue and he's steering well clear of you know it's employer employee this stuff we've got to get that right. And you and I have if we've on said one thing throughout our working lives on this subject it is that the root of all of it is the relationship between the manager and the employee. At the bottom of it all that's what it's about.

Simon 51:14

And at the risk of reliving our whole lives we know managers who just get this and they can have that conversation what can I do to support you? How can we change it? Hold up that's a bit too much and they just do it. They don't need it but there's a bundle that don't know how to do that and there's clearly that gap.

Phil 51:28

Last bit what do you think about him wanting to drill down on the numbers of we'll get the statistics disabled ill health in employment right now well I am I misinformed but I thought there was a law passed recently where employers have got to measure the number of disabled people they have in employment in their organisations. Have I misheard that or has that not come in? Is that not the uh oh what's the pay gap regarding oh is it linked to that was it those who are disabled are you paying them equivalent anyway I mean the idea that you you I mean he's right to in in in the conversation with us he does say it's very difficult to get accurate figures because some people feel they're not disabled some people don't want to tell anybody da da da da da but yeah you can't deal we both agree I think don't we that you can't change it if you can't measure it. You have to know what you're dealing with.

Simon 52:22

And how many times you and I said these these are the statistics but we've got a few concerns about them ourselves. Yeah because it it seems to change every 10 minutes so I I I quite like that drilling in um I think it was a really good conversation I thought I got I got personally got a lot I hope the listeners did too I think it was um it was worth even worth the effort even like he says this is a pretty epic piece of work that's needed um I don't mind him doing it I quite like yeah yeah I'd rather he did it than some other people not going to mention any names you know what I mean oh hello oh yeah yeah yeah yeah any other nights you want to talk about uh uh and and listener we did ask him about the sea rch I lee Charlie and he was totally fine with Charlie so that's what he was um no interesting guy uh we'd love to hear from you if you got any thoughts questions I'm sure our listeners will have um uh come across this in their own life being the disabled person or the employer or both so what what did you

Phil 53:24

yeah maybe you could tell us what you think we should have asked that we didn't that would have been interesting

Simon 53:29

I had it it yeah okay yeah

Phil 53:33

we didn't have long enough need a week all right Simon well thank you very much thank you again of course because you uh you're responsible for getting Charlie in front of the microphone well done you

Simon 53:43

well I wanted to keep Charlie in employment because you know that's what I thought yes I'm not

Phil 53:51

I'm not aware he's a disabled person but there we go we'll help anybody

Simon 53:56

don't judge just based on jump to conclusions exactly don't use the word jump in my presence thank you very much all right off we go thank you listener take care take care everyone thanks for listening

Announcer 54:08

this is the way we roll presented by Simon Minty and Phil Friend you can email us at mintyandfriend at gmail.com or just search for minty and friend on social media we're on Facebook Twitter and LinkedIn