“I can’t see me ever being well enough to go back to teaching, or actually to do any kind of meaningful employment, because I can’t concentrate. I have about an hour, and then it’s gone.”
Naomi Vann, a PE teacher at a special needs school, has been suffering from long Covid since November 2020, when she caught the virus for the second time.
“I’ve got constant pain, which is pins and needles in my arms and hands, and when it’s really bad it goes into my face and my feet. My joints ache most of the time, like they do when you have flu,” she said. “I used to read every night before I went to sleep, and now I don’t read as much, because I can’t remember the characters and the plot properly.”
She forms her words slowly and carefully – conversation is another thing she now struggles with.
“The other thing I have is depression and anxiety. I have always been happy-go-lucky, but now I’m on the maximum dose of depression and anxiety medication.”
Vann, is 53, has been on sick leave from the school where she worked for 27 years, and is now negotiating an exit settlement. When that is signed and sealed, she will join the 2.49 million people who are now economically inactive – not employed or actively seeking a job – because of long-term sickness. That’s the highest level since records began in 1993, and up more than 400,000 since the end of 2019 alone.
This rapidly expanding group is one reason why the UK’s activity rate – the proportion of adults either in work or looking for a job – has declined faster since the pandemic than in many major economies.
As well as those with long-term health conditions, a large number of older workers have left the labour market over the past two years, many voluntarily.
Stephen Evans, of thinktank the Learning and Work Institute (L&W), said: “There are now a million fewer people in the workforce than if pre-pandemic trends had continued, driven by rising numbers of people aged over 50 or with long-term sickness leaving the workforce.”
Having so many people too ill to work is not only painful and frustrating for employers struggling to recruit staff at a time when unemployment is at historic lows, but also a drag on economic growth.
Many, like Vann, have such severe conditions that they could not feasibly be in work, but in a survey released this month, 581,000 people told the Office for National Statistics they would like a job. Labour market experts believe there may be many more who could work if they had the right treatment and support.
The number of people not working because of long-term sickness was rising before the pandemic but has shot up since 2020. L&W estimates that up to a third of the increase may relate to long Covid.
Lesley Macniven, co-founder and chair of Long Covid Work, a support group for working people with long Covid, asked: “What percentage of our working population has to become disabled by this before we realise that long Covid is a chronic problem? We have this massive cohort of half a million people who have been ill for over two years.”
A sufferer herself, Macniven is urging employers to treat those with long Covid sensitively, as well as calling on the government to offer more support.
Another factor likely to be driving the rise in long-term sickness is the NHS’s rapidly lengthening waiting lists, with 7 million people now awaiting routine treatment. Many of these can go on working while they wait; others cannot, and may drop out of the labour market.
Danielle, who did not want to give her surname, has painful and debilitating osteoarthritis, and has been on the waiting list for two hip replacements for more than a year. She has kept working at an office job with a manufacturing firm near her home in Barnsley, but it’s becoming a struggle.
“Fortunately I have a very understanding manager: he is empathic and allows me to work from home when I need to. My worry is that as I’m deteriorating, and my mobility is getting less and less, I’ll be less and less able to make it into the office.”
Danielle said: “I would be devastated [if I had to give up work] because I love my job – I absolutely love it. I’m hoping it wouldn’t come to that, but you’ve got to do what’s best for the business as well.”
Matthew Taylor, chief executive of the NHS Confederation, said: “We do need a greater awareness of the way in which gaps in health and care provision are contributing to the problem we have with people of working age not working.”
He said the health system continued to face a “capacity gap” between what it was being asked to do – including bringing waiting lists down – and what it could achieve. He called on employers to be more sympathetic to staff awaiting treatment.
“I would very much encourage employers to recognise that waiting for health interventions may be a challenge for their workers and to support them in that,” he said.
The charity Versus Arthritis is calling for the NHS to be given a statutory duty to help those stuck on waiting lists for long periods. “People who are waiting years for joint replacement surgery have their lives put on hold, often unable to work, but rarely receive the support they need while waiting,” said a spokesperson.
A third driver of the rise in inactivity due to long-term sickness is likely to be the increase in mental health conditions – and in many cases, the struggle to access treatment – since the pandemic.
“With 1.8 million people currently on NHS mental health waiting lists, it’s clear that a significant number of the people currently not working due to sickness and waiting to see a clinician will be living with a mental health problem,” said Paul Spencer, head of health, policy and campaigns at Mind.
He added that some of these people might be able to return to work with the right support, while others would be unable to re-enter the workforce. “All of these people need mental health support if we are to thrive as a country and grow the economy,” he added.
Work and pensions secretary Chloe Smith acknowledged the challenge of long-term sickness in a speech last Thursday, calling inactive workers a potential “goldmine for growth and opportunity” – if they could be tempted back into jobs.
But she made it clear the government hoped to put the onus on employers. “In return for the government helping businesses fill their vacancies, we are expecting employers to invest in their workforce’s progression and health,” she said.
But her Labour shadow, Jon Ashworth, called on the government to do more. Jobcentre staff, he said, were focused almost entirely on ensuring that claimants of out-of-work benefits were searching intensively for jobs – and on penalising them through the sanctions regime if they were not.
He added: “Many people want to work if they have the right support. To offer no help is not only a monumental waste of talent but, when we have a million vacancies and rising cost of living, it’s an economic calamity as well.”
Tony Wilson, of thinktank the Institute of Employment Studies, said the dramatic break the pandemic caused in many people’s working lives may also have contributed to the rise in numbers off work through long-term sickness.
“A lot of people were separated from their jobs, either through furlough or by being laid off,” he said. “And a lot of people with long-term health conditions who were laid off are now finding it very hard to get back in.”
Like Ashworth, Wilson argues that the government should be providing more help for people who, while they are not on any unemployment benefit, could nevertheless be coaxed or supported back into work.
“Even people with multiple and complex conditions can often get back to work with the right one-to-one support,” he said. “Sometimes it’s just about finding the right match: the right employer, the right workplace.”
For Vann, though, the dramatic change the pandemic wreaked in her life feels permanent. “I had a panic attack when I realised that I was no longer going to be able to teach,” she said. “It kind of makes me feel worthless really, because I have lost my sense of purpose.”
