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Health and work are inextricably linked. Ill health can act as a barrier to working, while having a good-quality job supports good health. But this relationship is also shaped by local conditions. Worse health and employment outcomes tend to be focused in the same areas, often reflecting long-term deprivation and deindustrialisation. Closer attention to residents’ needs can better shape support and help disrupt reinforcing cycles of ill health and poor-quality employment. 

The new WorkWell pilot programme is part of the government’s response to the increasing number of people out of work due to ill health in England. Set to start in April 2024, it aims to assist 60,000 people with long-term sickness or disabilities to start, remain and progress in work over the 2 years of the programme. It will focus on local action and the need for health and employment sectors to work in partnership. The £64m funding package is to be shared across approximately 15 locations.

WorkWell has the potential to support broader social and economic development by fostering better collaboration. But successfully implementing new schemes is challenging, especially when working across different local actors that often have their own terminology, structures, delivery approaches and, ultimately, aims. 

The Health Foundation’s Economies for Healthier Lives programme set out to strengthen relationships between local economic development activity and public health through five partnerships with local councils (see Box 1). This blog outlines some key lessons from this programme that could help inform the design of the WorkWell pilots and what support central government may need to provide.

Lessons from the Economies for Healthier Lives programme

1. Engage employers in designing interventions on work and health. This is essential to ensure different employers’ skills needs are met, appropriate support to move into work is available and the quality of work on offer supports good health. In Havant for example, mentoring at local colleges, in-person mental health support and work coaching are provided in a high-need neighbourhood. Alongside this, new partnerships between the council and local businesses aim to improve the quality of apprenticeships so they offer good work that will support good health. 

2. Ensure community engagement and participation. The Economies for Healthier Lives partnerships have engaged with local communities through listening panels and workshops to identify local needs – for example, the life stage and health conditions of people not in work and the barriers these pose – to jointly design interventions. Delivering this engagement through intermediary organisations with existing community links has ensured credibility and trust among local people that statutory bodies sometimes lack. 

3. Understand how to navigate differing local systems. The geographical boundaries of integrated care systems, local authorities and job centres tend to differ. This can require organisations to hold multiple relationships and make partnership working difficult. It can be hard for a given local actor, such as an integrated care board, to understand and navigate the differing organisational structures of other actors in order to effectively influence, design and deliver policy. The leadership fund component of the WorkWell pilots – £3.5m available across all integrated care boards in 2023/2024 – will help build understanding of how organisations differ and ensure the right people are involved to support the scheme’s success.

4. Obtain buy in from local senior leaders to sustain effective pilots over the long term. To sustain new approaches and secure resourcing locally, it is important to build support from senior decision makers such as mayors, councillors and cabinet members. This includes ensuring they understand the rationale for the activity as well as producing evidence to show its impact. 

5. Ensure resourcing to deliver change. WorkWell presents an opportunity to provide additional activity beyond day-to-day ‘firefighting’ in stretched health care systems and local authorities. While any activity would likely be impactful, Economies for Healthier Lives has shown that set up can take time, and wider resource constraints can limit the scope for engagement. Integrated care systems themselves are still building their processes. This phase of WorkWell will last 2 years, with consultation on its future to come this year. Certainty on future funding and a recognition of the timeframes needed to effect change will be key. 

Working-age ill health and its consequences for employment continue to loom large for government, business and individuals. It’s clear that locally led services that cut across different sectors can help ensure more people remain in work that helps to keep them healthy. Our Economies for Healthier Lives partnerships have benefitted from learning across the programme locations, and the WorkWell programme is expected to set up a learning network. We’re keen to ensure this learning is spread across local areas. Sign up at economiesforhealthierlives@health.org.uk to stay in touch and hear more.

The Health Foundation’s Economies for Healthier Lives programme aims to boost both health and local economies by supporting five partnerships with councils in Glasgow, Havant, Liverpool, Leeds and Salford. Below are some examples from each partnership.

  • The Havant partnership is working with local schools to address low education, training and employment outcomes for young people. We’ve seen how young people disconnected from work, training and education have been reached by in-person support.
  • The Leeds Inclusive Anchors Network is building employers’ understanding of how to improve people’s health through procurement, through service delivery or as a civic partner. Leeds is expanding this network into the private sector, and communities and employers are learning how to jointly design interventions and effectively measure impact.
  • The Liverpool City Region Combined Authority and the University of Liverpool are sharing data on employment and health, respectively, to better understand the challenges faced on a micro-neighbourhood level. These will form the basis of redesigning employment services to better address local needs.
  • The Glasgow City Region’s economic development and public health teams are working together to assess the impact of infrastructure spending on health inequalities through their Capital Investment Health Inequalities Impact Assessment tool. This tool will be used in the development and delivery of capital infrastructure projects at all stages to ensure that spending decisions focus on maximising benefits for local communities, including reducing health inequalities.
  • Salford’s Local Anchor Network is prioritising community wealth building through new social cooperative businesses that aim to benefit the health of local people and boost the local economy. Public and private sector commissioning organisations are being engaged to identify where new contracts can be set up with local social enterprises and where their spending can be shifted to the local system.

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