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Work-Related Ill Health in the UK Gig and Agency Economy

  • 1 day ago
  • 7 min read

Physical and mental health risks among temporary and platform workers — and why so much goes unseen. 



The UK gig economy is large, growing, and economically significant, but many workers face anxiety, low pay and health and safety risks, which recent guidance and legal changes aim to address.​ 


The size and shape of the UK gig economy 

Common forms of gig and agency work span a wide range of sectors: ride-hailing and food delivery, online freelancing, household services, construction labour, warehousing, rail operations and manufacturing.  

  • Around 1 in 6 UK adults currently work a gig job at least once a week.​ 

  • The UK gig workforce is estimated at about 1.7 million workers, based on averages of major studies since 2017.​ 

  • Gig workers contribute about £20 billion a year to the UK economy, roughly equivalent to the contribution of the aerospace industry.​ 

  • Around 20% of gig workers class this as their main source of income, with couriers and private hire drivers the most likely to rely on it (36% each).​ 


 

Who gig workers are and how they work 

  • Almost half of UK gig workers (about 48%) also have a fulltime job; for roughly 71.5%, gig work makes up less than half of their income.​ 

  • Men are somewhat more likely than women to work in the gig economy, and women earn on average about 10% less than men in gig work.​ 

  • Young people drive much of the sector: those aged 16–24 make up about 31.5% of the workforce, with participation falling in older age groups.​ 

  • London is a core hub, with more than onefifth of its workingage population regularly doing gigs.​ 


Platforms, pay and job quality 

Gig economy work is usually arranged through digital platforms that match customers to workers and pay per task rather than per hour.​ 

  • Key platforms include Uber, Deliveroo, PeoplePerHour, Fiverr, Upwork, TaskRabbit and Amazon Flex, many of which have seen large increases in web traffic and signups since 2019.​ 

  • Around half of gig workers are estimated to earn less than the UK minimum wage, with an average of about £8.97 per hour compared with a minimum wage of £10.42 at the time of the analysis.​ 

  • A University of Bristol study found that 52% of gig workers earn below minimum wage and that most experience “work related insecurity and anxiety”.​ 


A separate University of Cambridge survey of over 500 casual workers gives a detailed picture of riders’ and drivers’ working lives.​ 

  • Around two thirds of riders and drivers report working in fear of unfair feedback and experiencing anxiety over sudden changes to working hours.​ 

  • About threequarters are anxious about income dropping, and around 65% fear unexpected changes in working hours that threaten their stability.​ 

  • Local platform workers (riders and drivers) earn on average about £8 per hour, around 20% less than remote gig workers at £10, and below the UK minimum wage in 2022.​ 

  • Riders and drivers spend about ten hours per week logged into apps waiting for jobs—time in which they are effectively working but not being paid.​ 


Health, safety and wellbeing 

Physical and mental strain 

Gig work offers flexibility but also significant health and wellbeing challenges.​ 

  • More than threequarters (76%) of gig workers surveyed in one study reported work related insecurity and anxiety, and 28% felt they were risking their health or safety at work.​ 

  • In the Cambridge survey, just over half (51%) of riders and drivers said they risk physical health or safety in their work, nearly five times the rate reported by remote gig workers (11%).​ 

  • Around 42% of riders and drivers said they experience physical pain due to their work, more than three times the rate of remote workers (13%).​ 


Workers describe pushing their bodies to the limit to earn enough to cover basic living costs, with long hours, cumulative fatigue and persistent pain becoming normal features of their jobs.​ 


Musculoskeletal Disorders (MSDs): A hidden burden 

Both physical and mental health suffer in the gig economy, but for workers in physically demanding roles, riders, drivers, warehouse operatives, rail workers and manufacturing staff supplied through agencies, ill health frequently takes the specific form of musculoskeletal disorders (MSDs): injuries and conditions affecting muscles, tendons, joints and nerves. Repetitive manual handling, sustained awkward postures, whole-body vibration and cumulative fatigue are daily realities in these roles, yet the transient nature of agency work means that early warning signs are routinely dismissed as occupational inevitability rather than recognized as preventable harm. 

 

Anxiety, ratings and algorithmic control 

For many riders and drivers, platform rating systems and algorithmic management are central sources of stress.​ 

  • Around 68% of local platform workers reported fearing unfair feedback, and many worried that a few negative ratings could lead to deactivation and loss of income.​ 

  • Both local and remote workers said they faced tight deadlines threequarters of the time, and many were anxious about losing the ability to make a living on their main platform.​ 

Researchers argue that platforms exercise extensive control and surveillance over workers while claiming they are simply technology companies rather than employers.​ 


Legal status, rights and health and safety duties 

How regulators define gig work 

The UK Health and Safety Executive (HSE) describes the gig economy as involving short-term, informal working relationships where work is on-demand, arranged through online platforms and delivered on a task-by-task basis. 

For health and safety purposes: 

  • Gig workers should generally be treated no differently to other workers. 

  • Many gig workers will also fall into categories such as agency, temporary or self-employed workers, and some may be “limb (b) workers” with specific employment rights. 


Employer and agency responsibilities 

HSE guidance makes clear that suppliers (such as employment businesses and agencies) and end user businesses have duties under health and safety law towards gig, agency and temporary workers.​ 

Key points include: 

  • Employers need to think differently about how to keep gig workers healthy and safe as working patterns change. 

  • Gig workers’ health and safety must be protected by law, and agencies and end users must ensure they comply with relevant requirements.​ 

Although the specific duties are set out in wider HSE materials and legislation, this guidance stresses that gig workers should not be regarded as outside normal protections simply because of atypical contracts.​ 


Workers’ own responsibilities 

HSE also highlights that gig, agency and temporary workers themselves have responsibilities.​ 

They must: 

  • Take reasonable care for their own health and safety and that of others who may be affected by their actions at work.​ 

  • Cooperate with their employment business and any end user organization, including attending required health and safety training and following instructions.​ 

  • Use any machinery or equipment in line with the training they receive and inform the provider if equipment is lost or damaged.​ 

This shared responsibility model aims to ensure that everyone involved in gig work—platforms, agencies, client businesses and workers—plays a role in managing risk.​ 


Recent legal developments 

One major change came in 2021, when Uber agreed to treat all its UK drivers as workers, with rights to minimum wage, holiday pay and a pension scheme after losing a Supreme Court case.​ 

This decision has been widely interpreted as a warning to other platforms that misclassifying workers as independent contractors—while exercising significant control over their work—will not be tolerated.​ 


Legal and operational challenges 

Employers have clear legal duties under the Health and Safety at Work Act and the Manual Handling Operations Regulations to protect all workers from MSD risks — and HSE guidance is explicit that gig, agency and temporary workers are not exempt from these protections simply because of their atypical contracts. For roles involving physical labour, where an injury is serious enough to meet the threshold, it must be reported under RIDDOR. In practice, however, the fragmented nature of agency work creates significant structural blind spots. Discomfort, fatigue and the early stages of MSD conditions, the very point at which intervention would be most effective, rarely reach the threshold for formal reporting and are instead quietly absorbed as an accepted cost of the job. 


The onboarding reality for many agency workers compounds this risk considerably. In sectors such as rail, warehousing and manufacturing, temporary staff are frequently deployed with minimal induction, equipped with just enough training to begin work safely but not enough to internalize best practice around posture, load management or early symptom recognition. Unlike permanent colleagues who accumulate safety knowledge over time and benefit from ongoing H&S engagement, agency workers cycle through roles with limited continuity. Critically, in-house health and safety teams typically have no visibility of a worker's prior MSD history, a previous shoulder injury, a recurring lower back condition, because that information does not travel with the individual between assignments. Each placement effectively starts from zero. 


This creates a systemic under-reporting problem that is difficult to quantify but likely to be substantial. Workers who fear losing assignments or being seen as a liability have little incentive to flag discomfort. Agencies focused on fulfilling rosters quickly may not have the infrastructure to monitor physical wellbeing across dispersed client sites. And client businesses, while legally responsible for on-site safety, may lack the tools to identify emerging MSD risk in a workforce that is, by design, transient. The result is that musculoskeletal harm accumulates largely unseen, until it becomes serious enough to force absence, a RIDDOR report, or a civil claim. 

 

Pros, cons and the future of UK gig work 

Flexibility and opportunity 

Despite the challenges, many gig workers report valuing independence and flexible scheduling.​ 

  • Over half of those surveyed in one large government backed study were satisfied with gig work overall, especially with the autonomy it offers.​ 

  • Satisfaction is higher among those for whom gig income is significant and who can structure their working time to suit other responsibilities, such as childcare or study.​ 

Gig work can also help people build transferable skills, from customer service and communication to financial management and adaptability, which can support future employability.​ 


Insecurity, low pay and “forced flexibility” 

However, gig work often comes with unstable hours, earnings volatility and what researchers call “forced flexibility” – the need to be constantly available without guaranteed work.​ 

  • Many workers increased their hours in response to the cost of living crisis and rising fuel costs, illustrating how economic shocks fall heavily on those dependent on gig earnings.​ 

  • For a substantial minority, gig work brings persistent anxiety about ratings, deactivation, sudden changes to working patterns, and long-term health.​ 


Outlook 

Surveys of employers suggest that the gig economy is likely to continue growing, with some HR leaders expecting gig workers to make up a large proportion of their workforce within a few years.​ 

Experts and campaigners argue that the challenge now is not whether the gig economy will persist, but how to ensure that flexibility and innovation are matched by fair pay, robust health and safety protections, and meaningful rights for those whose labour underpins it. 

 

References 


 
 
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