Five practical steps for putting work and health at the heart of Neighbourhood Health

A focus on helping people find and stay in fulfilling employment should be central to

neighbourhood health. John Copps and Matt Carter outline practical steps every local area could take, and argue that central government has a role to convene partners and bring learning from the successes so far.

Good work is good for your health, and is linked to improved wellbeing, longevity and overall life outcomes. In the UK, ill health keeps around 2.8 million working‑age people out of the labour market – equating to an eye-watering cost of close to seven per cent of GDP.

Yet the NHS still pays remarkably little attention to whether its patients are in work. How many times have you been asked by your GP, nurse or clinical about your employment? In the Neighbourhood Health Framework, published in March 2026, has little to say on the matter. Work does not feature in the ten core steps the framework asks systems to take, and it is not built into the design of integrated neighbourhood teams.

Neighbourhood health as system transformation

If Neighbourhood Health is only about clinical integration, it will fail to achieve the transformation we need. It has to be broader: about all the things that makes a life healthy and worthwhile including a decent home, a job, not being lonely, and having support around you. As part of this, neighbourhood Health must put employment in its right place – as a critical health outcome.

So, how can a focus on employment be integrated into neighbourhood health models? Here are five practical steps we think would help.

First, every Neighbourhood Health partnership should have an employment lead, drawn from local government, Jobcentre Plus, or an employer. It would put ‘work’ in the spaces where strategic decisions are taken, with someone whose job is to champion it, rather than it being an afterthought once the clinical priorities have been set.

Second, employment should become a defined Neighbourhood Health outcome, adopted as a core metric in local dashboards and owned collectively by the integrated neighbourhood team. In practice that means naming people at risk of falling out of work because of a health condition as a priority cohort within population health management, alongside groups such as those living with frailty or complex needs. What gets measured, gets resourced. If employment is an outcome the system is accountable for, financial alignment begins to follow. If it is not, it will keep losing out to the targets that are.

Third, employment advisers should be embedded within integrated neighbourhood teams, so residents can get direct, practical help and so health and employment services are joined up at the front line. With commissioner approval, there is flexibility within Primary Care Network contracts to recruit roles beyond direct patient care under the Additional Roles Reimbursement Scheme, but it is unclear how far this would extends to employment-focused posts.

Fourth, Neighbourhood Health Centres should make physical space available for employment advisers. Meeting people in a familiar, trusted local setting, rather than a separate office across town, is part of what gives this work community legitimacy. It also signals that work belongs inside the health offer, not alongside it.

Fifth, access and referral routes should be simplified. A single triage function within a neighbourhood, bringing together the various strands of health‑related employment support such as WorkWell and Connect to Work, would cut fragmentation and get people to the right help first time.

Testing and spreading what works

Encouragingly, the means to test these ideas already exist. The National Neighbourhood Health Implementation Programme is trialling new models of local integrated care, and the WorkWell Programme, managed by ICBs and rolling out across England, is connecting employment support with NHS services.

In this context, central government has an important role to play in convening local areas to share what works, learn from each other’s successes and failures, and inspire new ideas. A more deliberate effort to bring these two programmes together would provide a powerful forum and test bed for innovations that could be scaled.

For the incoming Prime Minister, we can expect work and health to be near the top of the public service reform agenda. The potential for impact is huge – not only for the NHS, but for the wider economy and quality of people’s lives.

Contact john.copps@mutualventures.co.uk if you'd like to discuss neighbourhood health.