Building a unified work, health and skills system

The government’s aim to get people with health conditions back to work requires a whole-system approach to employment support. John Copps argues that the answers to the challenge are best found at local level and Ministers should resist the temptation of a top-down solution.

Last week's Spending Review reaffirmed the government’s commitment to helping people with health conditions or disabilities get back into work. As part of a £3.5 billion employment support package set to run to 2028–29, the Chancellor pledged to take action to support individual’s aspriations and grow the economy.

Whilst the intention to ‘get Britain working’ has been clear for some time, it is fair to say that how the government will achieve that is still a work in progress.

The challenge of system fragmentation

Behind the government’s ambition to reduce health-related economic inactivity lies an unstated challenge: that success relies on many parts of a disparate system – the NHS, Job Centre Plus, local authorities, employers and others – working together.

That’s no small feat.

Why? Because the component parts in work, health, and skills have got used to operating in silos. Even simple behaviours like conversations between professionals or signposting between agencies is not commonplace. If we’re serious about change, that pattern must be broken.

Every part of the system has its part to play. For employees struggling with health conditions, GPs are often the first point of contact. Yet they lack the time and tools to engage meaningfully with employment support. The decision to issue a ‘Fit Note’ is a pivotal moment – and an opportunity to explore whether, with the right support, a person could remain in work. But it tends to be treated as an isolated decision, without knowledge or awareness of what support might be available.

Jobcentre Plus and other employment support providers need to transition to a more personalised approach that recognises the diversity of people’s health needs and circumstances, and builds better relationships with NHS partners and local employers. Employers themselves should recognise the benefits of an inclusive workplace. Supporting them to do this is essential, particularly for SMEs that do not have the resources of larger firms. Managers need to feel confident that they are equipped and able to support people.

Central government has a role in creating the conditions for change, but the solution to these challenges predominantly lies at local and regional level – with the quality of leadership, strong relationships and supportive culture within services.

Steps to an integrated system

So, what ingredients do we need for a unified system?

An essential starting point is strong local leadership, and local partners aligning around common, shared goals. Robust relationships are at the centre of this. The development of Local Get Britain Working plans aims to accelerate this process – with our recent webinar showing the promise of new plans in Greater Manchester, Leicestershire and Worcestershire.

Second, we need better shared data infrastructure. Services cannot collaborate effectively without access to the right information. Has anyone cracked this? Perhaps not, but the WorkWell pilots are showing the value of connecting health and employment data, enabling support to be targeted at those who need it most.

Perhaps most importantly, the shift is about culture. We need staff who want to collaborate, see the value of other professionals, and are focused on what is best for the service user – whoever can provide it. This move is towards a more ‘relational’ culture of practice. The ‘health coaching’ approach, widely used across the NHS, has been delivered by work coaches in Birmingham, Leicester and Warwickshire and hopes to strengthen links between systems.

The answer is local

If we are going to ‘get Britain working’, a unified work, health, and skills system isn’t an abstract policy aspiration - it’s a practical necessity. There is a long way to go, but already progress at local level gives reason for optimism.

Central government must support this journey, but it is local and regional leaders that are best placed to drive integration. Ministers must resist the urge to control from the top-down. What’s needed is the energy and will to move a system to a position where employment support is designed around local people and what they need.

To learn more about MV’s work on work, health and skills contact John Copps john@mutualventures.co.uk.