Only 5% of people with learning disabilities in employment, finds landmark Mayfield review

Only 4.8% of people with a learning disability are in paid employment, according to a new report that aims to drive action to prevent ill health, support people to stay in work, and help employers build healthier and more resilient workplaces.

The final report of Sir Charlie Mayfield’s Keep Britain Working Review found that disabled people face stark barriers not only in getting into work, but also in staying in work due to the lack of appropriate, timely adjustments. Disabled people are also more than twice as likely to be unemployed and nearly three times as likely to be economically inactive compared to non-disabled people.

Sir Charlie Mayfield also found that one in five working-age adults is now out of the labour force – 800,000 more than in 2019 due to health reasons, with employers losing £85 billion a year from sickness, turnover, and lost productivity.

He said that with the right approach, many more people could stay in work, recover faster, and live healthier, more secure lives. Employers would retain experienced staff and see higher productivity. The government would save billions and be able to focus resources on those who need them most. Everyone gains if we can keep Britain working. However, achieving that will require a new deal—one where employers, employees, and government each play their part.

Sliding into an avoidable employment crisis

The former boss of John Lewis added: Britain is sliding into an avoidable crisis. Ill-health has become one of the biggest brakes on growth and opportunity. But this is not inevitable. Employers are uniquely placed to make a difference, preventing health issues where possible, supporting people when they arise, and helping them return to work. If we keep Britain working, everyone wins – people, employers, and the state.

“That’s why the action the government is taking forward from my Review is so important. I’m looking forward to working with them and with employers, large and small, to keep people in work, unlock potential and build a healthier, more prosperous Britain.”

The review identified three persistent issues related to health and disability within the workplace. The first was a culture of fear, which is felt by employees and, in a different way, by employers, especially line managers. This creates distance between people and discourages safe and early disclosure, as well as constructive conversations and support, just when they are needed most.

Another issue was the lack of a practical or consistent support system for employers and their employees in managing health and tackling barriers faced by disabled people. This lack of support is sometimes compounded by a ‘fit note’ system that is not working as intended.

Thirdly, there are structural challenges for disabled people, creating barriers to starting and staying in work. Compared to international comparators, the UK lacks systemic levers to support disabled people in work, leaving them disproportionately excluded and talent wasted.

Recommendations from the report

The report stated that resetting workplace health and inclusion was a proactive, shared responsibility among the state, the employer, and the employee.

It proposes a fundamental shift from a model where health at work is primarily left to the individual and the NHS to one where it becomes a shared responsibility among employers, employees, and health services.

For employers, this means taking additional steps to remove barriers for people with disabilities and implementing measures to prevent illness and support rehabilitation. It added that much of what’s required is not additional expenditure, as employers already invest billions in health and wellbeing, but need greater clarity on what works.

The review said that employees, too, have responsibilities. It stated that work can be demanding and setbacks are a natural part of life. Disengaging from work and potential support leads to detachment and dependency; staying connected to work supports recovery and resilience.

For the Government, its role will be to reset the employment system – to enable and incentivise employers and employees to act. This means tackling barriers such as the fit note system, reorienting incentives, and establishing a robust evidence base.  With strong evidence, the government can utilise procurement, tax, welfare, and regulatory levers to embed shared responsibility and sustain change, keeping people in work, improving health, promoting inclusion, boosting growth, and saving billions.

Three-year vanguard phase to improve employment

Sir Mayfield said that a phased approach is required – working with willing employers and providers to develop and prove what works, before embedding and extending it across the wider economy over the next three to seven years.

He wants the government to build quickly on this engagement and immediately launch a three-year ‘vanguard phase’ to deliver three significant employment changes that together will constitute the framework for general adoption, which are:

• better retention of people with physical or mental health conditions, and those who are neurodivergent
• longer, healthier working lives for older workers
• stronger support for disabled people

Work and Pensions Secretary Pat McFadden said: “I want to thank Sir Charlie Mayfield for his excellent work. His message is crystal clear: keeping people healthy and in work is the right thing to do and is essential for economic growth.

“Business is our partner in building a productive workforce – because when businesses retain talent and reduce workplace ill-health, everyone wins. That’s why we’re acting now to launch employer-led Vanguards as part of the Plan for Change, driving economic growth and opportunity across the country.”

Responses to the report

Jon Sparkes OBE, Chief Executive of Mencap said: “We know that 86% of people with a learning disability are not in work, want a paid job, but there are currently too few inclusive roles and training opportunities to support them into employment. Change is urgently needed for people with a learning disability to access simple adjustments – such as more accessible communication or on the job support to help them get bedded into a role.

“We look forward to working with more employers on creating inclusive workplaces, and hope that this review will not only boost the economy but also create a fairer society – helping people with a learning disability to get onto the career ladder and reach their full potential.”

Dan White, policy and campaigns officer at DR UK,  said: “Yet another government-commissioned report blames Disabled people for not working. Mayfield’s report has a focus on “fixing Disabled people”, but you can tell he wasn’t listening to our community because it’s so rife with medical model-focused language. And fundamentally misunderstands that people are disabled by societal and workplace barriers, not just by their health conditions.

“The report comes at a time when the government is cutting schemes like Access to Work, which we know support us into the workplace, a scheme the report highlights as important to Disabled people. But it makes absolutely no criticism of the inflexibility and top-down cultures of employers, their failure to comply with the Equality Act, their inability to create disability inclusive cultures and their failure to adopt modern ways of engaging with their Disabled employees.

“Despite acknowledging the dangers work poses to many Disabled people, the review, like many before it, focuses mostly on employers and what can be done to support them, with little concrete suggestions to bolster Disabled people’s rights in the workplace. And thus, we struggle to see the impact it will have.”

Alison Bloomer

Alison Bloomer is Editor of Learning Disability Today.

See Full Bio