A report released recently by the Work Foundation has found gaps both in terms of legislation and policy initiatives supporting people with fluctuating health conditions.

Fluctuating Conditions, Fluctuating Support estimates that by 2030 around 40 per cent of the UK’s working age population will have at least one chronic and work-limiting health condition. For people over 50 in 2014 this figure already stands at 42 per cent. One of the features of many chronic conditions is that their symptoms can fluctuate significantly from week to week, and from individual to individual.

The paper found that:

  • The Equality Act still fails to protect many employees with fluctuating health conditions from discrimination
  • Reasonable adjustments (and likely flexible working) provisions are not being developed with consideration of the significant proportion of employees with fluctuating needs who seek to access them
  • There is limited access to specialist occupational health support for people with fluctuating conditions, including through Fit for Work
  • There is dissatisfaction around access to financial support and adjustment advice through Access to Work
  • There is a lack of compensation for employers for employee sickness absence (given the removal of the Statutory Percentage Threshold scheme).


The report calls on the government to support measures to increase the flexibility of sickness absence policies, to allow employees with fluctuating health conditions to preemptively arrange part-time sick leave. It also recommends that the scope of income protection insurance be further developed in order that businesses can better support those with fluctuating conditions to remain in work.

Other key recommendations include:

  • Improving and expanding Access to Work’s provision for fluctuating conditions
  • Developing an employee owned “health at work” record
  • Developing a “best practice” database of adjustments and supports for people with fluctuating conditions
  • Improving access to specialist occupational health support for small business through partnership with NHS and other providers
  • Increasing local commissioning of occupational health and vocational rehabilitation support.
  • To read the report, go to: http://www.theworkfoundation.com/Assets/Docs/Reports/FCFS_Final_ES.pdf


Neil Todd, of Thompsons Solicitors, commented: “The report of the Work Foundation contains a number of interesting recommendations to help support people at work with fluctuating health conditions. I hope any future government would give serious thought to the progressive proposals which seek to address this issue as there would be clear advantages to both employers and workers in doing so.”