This review presents an analysis of the sickness absence system in the UK, the impact of sickness absence on employers, the state and individuals, and factors which cause and prolong sickness absence, leading to employees moving out of work and onto benefits. The review recommends that GPs should no longer be responsible for signing long term sick notes. Instead the Government should fund a new Independent Assessment Service (IAS). The IAS would provide an in-depth assessment of an individual’s physical and/or mental function. It would also provide advice about how an individual taking sickness absence could be supported to return to work. It also recommended expenditure by employers targeted at keeping sick employees in work (or speeding their return to work), such as medical treatments or vocational rehabilitation, should attract tax relief. This should be targeted at basic-rate taxpayers. The authors estimate that this will cost around £150 million a year, but will result in gains to employers of up to £250 million. A key aim of the Review has been to increase job retention. However, some long-term health conditions are simply incompatible with an individual’s current job. The review recommends that that the State should offer a free job-brokering service for anyone with a sickness absence period of 20 weeks or more. There are inefficiencies and delays in the benefits system. It takes an average of 17 weeks for people claiming Employment Support Allowance (ESA) to be assessed and then over 60 per cent are actually found fit for work (accounting for those who successfully appeal against being found fit, the proportion found fit is still over 50 per cent). This builds an unacceptable delay into the journey to get people back to work. The review therefore recommends that the Government ends the ESA assessment phase altogether. People should go onto ESA only if they qualify after a Work Capability Assessment (WCA) or as now, if they have sufficient medical evidence not to need a face-to-face WCA. This recommendation should be supported by reformed processes within Jobcentre Plus, to prevent high numbers of claimants being inappropriately directed towards ESA. The report estimates that this change could save the State up to £100 million a year, with an increase in economic output of up to £300 million.