Your Wellbeing Budget Isn’t The Problem. The Turnout Is.
British employers have never offered more health benefits, and roughly three-quarters of staff never touch them. Almost everything that looks like failure in workplace wellbeing comes back to that one gap.
If You Read Nothing Else
- The absence figure in your board pack is roughly a fifth of what poor health actually costs you. The rest is people at work, not working well.
- Two causes — mental health and bad backs — take nearly three-quarters of all days lost. For one of them, exercise is in the clinical guideline.
- Wellbeing programmes test badly in trials for one reason: hardly anyone uses them. Of those who do, 85% say they were useful.
- So the question isn’t whether exercise works. It’s whether anyone turns up. That is the part I’m paid to fix.
The Number You’re Looking At Is The Small One
Every managing director I meet can quote their absence rate. Almost nobody can tell me what ill health actually costs them, because the figure they track only counts the people who stayed at home.
Absence is up sharply — the same annual survey had it at 5.8 days per employee before the pandemic. It’s 9.4 now. But that rise isn’t the interesting part.
The gap · days per employee per year
What gets recorded is not what gets lost
Same zero, same unit, same scale. Two very different views of the working year.
9.4
49.7
6.1 formal absence · 43.6 presenteeism
Common zero · linear scale
The taller column is presenteeism: the person at their desk with back pain, or three hours’ sleep, or a head full of something they haven’t told you about, getting through a fraction of their day.
It is never recorded, it appears in no report, and it is seven times bigger than the number you are managing. On Deloitte’s modelling it accounts for about £24bn of a £51bn annual bill to UK employers.
You are already paying for this. The only question is whether you get anything back for it.
What’s Actually Taking The Days
It’s worth being precise about why people are off, because it decides what an employer can sensibly do.
Where the days go · UK · 2024/25
More than half is mental ill health
One tile is one per cent of the 40.1 million days.
ill health and injury
100 tiles · exact percentage split
Two things take nearly three-quarters of it. And the second one is where I want to stop, because it’s the one place in this entire article where I can point at a clinical recommendation rather than an association.
For low back pain, NICE guidance to the NHS is to “consider a group exercise programme”. Cochrane’s review — 249 trials, more than 24,000 people — found exercise reduced pain by around 15 points on a 100-point scale against no treatment or usual care.
Musculoskeletal problems cost 7.1 million working days a year. Exercise is in the guideline for treating them. Most people never get it, because nobody organises it.
What Training Does To Illness
Now the part everybody asks about, and the part where I’m going to disappoint you slightly, because my industry has spent twenty years overselling it.
Regular moderate training is consistently associated with lower chronic inflammatory markers, and in trial evidence with fewer days of respiratory symptoms. That’s real, measurable and reasonably well understood. It is also modest, and it does not keep improving the harder you go. It turns back on you.
Training load vs infection risk
More is not better
The benefit is in the trough. Past it, the risk climbs back.
Shape after Nieman’s J-curve model · illustrative, not a dataset
That shape is the whole argument for coaching rather than encouragement. Telling a sedentary workforce to “get active” sends some of them straight past the useful part of the curve and out the other side, into the fortnight where they’re more likely to pick something up, not less.
What I’m not going to claim. I won’t tell you exercise “boosts the immune system” — that phrase means nothing, and the curve above is why. I won’t tell you it prevents any particular infection.
And I won’t quote you the industry’s favourite line, that wellness returns £3.27 for every £1. It comes from before-and-after studies of firms that chose to take part. When researchers finally ran a properly randomised trial, the return disappeared.
If I put that number in front of you and you looked it up, you’d be right to stop believing everything else on this page.
So Why Does Workplace Wellbeing Keep Failing?
Two serious studies — the RAND workplace wellness study, and a randomised trial at the University of Illinois — found that wellness programmes moved almost nothing. Not absence, not spending, not productivity.
I’d rather hand you that myself than have you find it later.
But look at what they tested: gym discounts, health screenings, seminars, step challenges. Things offered to people. And look at what sat underneath the headline — the staff who took part were already the fit ones. The programmes never reached the people they were bought for.
The turnout gap
The programmes work. The turnout doesn’t.
One mark is one employee. Roughly 47 health measures are on offer to all of them.
Each mark = 1 employee · exact 25/100 split
The studies didn’t prove wellbeing doesn’t work. They proved nobody turns up.
Eighty-five per cent of the people who used something said it was useful. The benefit was never the weak link. Getting a human being through the door was.
And that is a fixable problem, because it isn’t a medical one. It’s the same reason a January gym membership doesn’t make anybody fit, and the same reason people who train with a coach are still training in March.
What We Do About It
The whole model is built around turnout, because turnout is the thing every study says is broken.
- A real coach, in the room, at a fixed time. Not an app you’re meant to remember and not a discount code. Someone who notices you weren’t there and asks why.
- Built around the person, not the average. Bad backs, dodgy knees, pregnancy, menopause, coming back after illness. The people who need it most are exactly the ones a generic gym benefit never reaches.
- Progressive and moderate, on purpose. The bottom of that curve, not the far side of it. Knowing where to stop is most of what a coach is for.
- Made competitive, deliberately. Teams score points, there’s a table, and it resets every Monday. Turnout is the entire game.
What It Has To Be Worth
I’m not going to give you a return-on-investment multiple. Here instead is the only calculation I think is honest: how far the needle has to move before it pays for itself.
Break-even · productive days per person
How far the needle has to move
Against 49.7 productive days lost, this is the entire ask.
4 days = 8% · the other 45.7 are still lost
Put your own day rate in. A fair starting point is salary ÷ working days.
Illustrative break-even frame, not a forecast
Set against 49.7 productive days lost, recovering one is a 2% improvement. That’s the bar. Not a transformation — one day, per person, per year.
I can’t promise you that, and I’d be wary of anyone who does. What I can tell you is that the thing standing between an employer and any result at all is turnout — and turnout is the part I know how to fix.
More on how the corporate programme runs, what it costs and who it’s for: Corporate wellbeing at Pete Gawtry Fitness.
Sources
- CIPD Health and Wellbeing at Work, 2025 — 9.4 days’ absence per employee; 5.8 pre-pandemic
- HSE Summary statistics for Great Britain, 2024/25 — 40.1m days lost; 22.1m stress, depression or anxiety; 7.1m musculoskeletal
- Deloitte Mental health and employers, 2024 — £51bn annual cost to UK employers, ~£24bn of it presenteeism
- Britain’s Healthiest Workplace (Vitality), 2023 — ~47 measures offered, ~25% take-up, 85% found useful, 49.7 productive days lost (6.1 absence + 43.6 presenteeism)
- NICE NG59 1.2.2 — “consider a group exercise programme” for low back pain
- Cochrane Hayden et al., Exercise therapy for chronic low back pain, 2021 (CD009790.pub2) — pain −15.2 points/100 vs no treatment or usual care
- RAND Workplace Wellness Programs Study · Jones, Molitor & Reif, Illinois Workplace Wellness Study (NBER) — null findings, cited deliberately
- Nieman — J-curve model, training load and upper respiratory infection
This article is general information for employers, not medical advice. Anything that involves a specific person’s health — a bad back, a new symptom, a return to work after illness — belongs with their GP or a clinician first.
Where To Start
A conversation, and an honest look at what your own absence data says. If it tells me a programme won’t shift anything for you, I’d rather say so than sell you twelve months of it. Suite 1, Arena Business Park, Tarn Lane, Leeds, LS17 9BF.
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