Sir Charlie Mayfield’s Keep Britain Working Review lands a blunt message: ill-health has become one of the biggest drivers of economic inactivity in the UK, and employers, not just the NHS, have to lead on prevention. For anyone who invests in employee wellbeing, that reframes the question. It is no longer about which perks to offer, but about what genuinely keeps people healthy and in work. Physical wellbeing sits closer to the centre of that answer than most benefits packages assume. Here is how I read the review, and where movement fits.

The issue

The scale is hard to overstate. The review sets out a workforce sliding into an avoidable crisis:

What should catch the eye of anyone responsible for wellbeing is which conditions are doing the damage. The review is clear that older workers are leaving primarily because of musculoskeletal problems, while among young people there has been a 76 per cent rise since 2019 in those becoming inactive with a mental health condition. Those are precisely the two areas where regular movement has the most to offer.

Crucially, the review says this is not mainly a spending problem. Employers already invest billions in health and wellbeing. The money is simply fragmented and misdirected, described in the report as a confusing patchwork, or a random set of explosions, with no clarity on what works.

The solution

Mayfield’s answer is a shift from health being left to the individual and the NHS towards shared responsibility, with employers on the front foot for prevention. For how you invest in physical wellbeing specifically, that points to three moves:

Movement is one of the most direct and lowest-cost forms of prevention available, and it maps neatly onto the review’s two biggest cost drivers. Regular activity is frontline support for musculoskeletal health, and a 2023 review in the British Journal of Sports Medicine found physical activity can be highly effective in reducing symptoms of depression and anxiety. It complements professional care, it does not replace it, but as prevention it is difficult to beat on cost or reach.

The impact

The review puts hard numbers on why prevention pays, drawing on returns that are hard to ignore:

At a system level, the review estimates direct benefits of £3 to £8 billion a year, rising to £9 to £18 billion as adoption matures. For an individual employer the logic is simpler still: reduce absence and presenteeism even modestly and you protect both your people and your margins. In the review’s own words, the priority is to get employers off the sidelines and onto the pitch.

What’s the place for Total Active Hub?

This is the shift we built Total Active Hub for. We treat movement as infrastructure rather than a perk, and we design it for the silent majority the review worries about most, the people a conventional wellbeing offer never reaches. In practice that means:

The results back it up. Over two years of rewarding movement we have seen a 57 per cent increase in the number of people taking part. With Circle Health Group, 95 per cent of participants told us they felt more motivated to move, and in one organisation engagement climbed from 15 per cent to 60 per cent, against an industry benchmark where wellbeing schemes typically reach 15 to 25 per cent of staff. That is prevention actually landing with the people who need it.

If you are rethinking your wellbeing spend in light of Keep Britain Working, and you want it pointed at prevention that genuinely reaches your workforce, that is the conversation we have every week. We would be glad to talk it through.

Contact Tony Eames, Founder of Total Active Hub at tony@totalactivehub.com.

About Total Active Hub

Total Active Hub is a workplace movement platform that helps organisations make physical activity inclusive, rewarding and part of everyday working life. Built around consistency over intensity, our always-on approach and Active Rewards are designed to reach the silent majority most wellbeing programmes miss, turning movement into a lasting habit that supports both physical and mental health.

To find out more or book a conversation, get in touch at info@totalactivehub.com.