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Keep Britain Working Review: Explore health risk pooling similar to AE for SMEs

by Owain Thomas
05 November 2025
Keep Britain Working Review: Health at work overhaul with onus on employers could save £18bn a year
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The Keep Britain Working Review has urged the exploration of pooling mechanisms to help make investing in the workplace health provision (WHP) affordable for SMEs.

It likened the process as similar to that successfully employed for auto-enrolment in workplace pensions.

Last month Health & Protection reported that review lead author Sir Charlie Mayfield believed pooling for health insurance could be very important.

That has been maintained in the final edition of the review where it appears in two locations

Under the potential incentives, it noted pooled funding or risk pooling could make high-quality WHP services more affordable, especially for smaller employers – similar to auto-enrolment in pensions.

Adoption of the certified lifecycle could be a condition for access to the economies of scale or built into pricing, it added.

Giving further details of how the WHP services would be funded, the review argued that strategic support will be needed to ensure SMEs and the self-employed can access provision fairly.

For this to be feasible the model must be affordable and scalable.

“Many employers, particularly SMEs, struggle with the capital, time, and knowledge needed to invest in workplace health,” the authors said.

“Costs are frequently higher for smaller employers, arising from the relatively larger administrative burden to providers, reduced risk pooling opportunity, and limited negotiating power.

“In the vanguard [initial] phase, we propose the exploration of pooling mechanisms to reduce costs and create economies of scale, particularly for SMEs.”

 

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