Employment of people with long-term conditions

Increasing employment of people with long-term conditions (LTCs) is one of the goals within the NHS Outcomes Framework. There is a strong evidence base to show the links between employment and good health and wellbeing (Waddell, 2006).

How have employment rates changed?

It is estimated that around one quarter of working age adults have one or more LTC, and the employment rate for this group is around 60% - typically 11-15 percentage points lower than for the general population. Trends in employment in the general population fell from 73% at the end of 2007 to 70% 2010, while employment of people with LTCs remained broadly steady. This resulted in a narrowing of the gap between the two rates (from 15% in 2006 to 11% in 2010). From mid-2013, employment increased in both groups, which resulted in the highest employment rate seen in people with LTCs in 2015/16 Q4 of 61%. The gap between the two groups, however, has not decreased and remained at 13.3 percentage points in Q4 2015/16.

Updated August 2016

How do employment rates for people with LTCs vary by age?

In Q4 2015/16, the disparity in employment rates between people with LTCs and the general population was lowest in the youngest (with a difference of 5.9 percentage points in 16-19 year olds and 11.6 in 20-24 year olds) and oldest (10.4 percentage points in those aged 60-64, 12.8 in those aged 55 -59) age groups. However, there is an increasingly large difference in employment rates between people with and without LTCs in the younger and older age groups. Between Q4 2006/07 and Q4 2015/16, the employment gap in the 20-24 years age group increased the most (by 2.6 percentage points) from 3.7 to 5.9 percentage points.

In people aged 25-54, the difference ranges from 13.2% to 14.7% across five-year age bands. The gap in employment between those with and without a LTC has narrowed for all groups across these age bands - most notably for those 45-49, which was 16.9% in 2007 and 13.8% in 2015/16 Q4.

Updated August 2016

How have regional employment gaps changed?

In 2006/07 Q2 - the first quarter for which data are available - the difference between employment rates for people with LTCs and the general population varied by region, from 11 percentage points in the South East to 21 percentage points in Merseyside. The narrowing of the national gap in employment for people with LTCs between 2006 and 2010 was reflected by falls in all regions of England, though reductions were greater in some regions than others.

Since 2011, gaps in all areas have increased again. In most regions the gap increased at similar rates, although Merseyside appeared to increase much more sharply and the gap was 19.1 percentage points in 2014/15 Q3. It is worth noting that Merseyside is by far the smallest region and is about a 7th the size of the largest region (London) so variation may be due to its comparatively small size.

Updated August 2016

About this data

One potential confounding factor is changes to disability benefit, which may change employment patterns of people with LTCs without functional improvement in their condition.

For full indicator specification, as of September 2013, see NHS Digital's Specification: NHS Outcomes Framework 2.2.


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