Health secretary Wes Streeting has announced he wants to ‘replace sick notes with the gym’, but what does this really mean? Tom Harrington-Roberts has been involved in delivering WorkWell programmes in London, and has seen the benefits of building relationships with local employers, charities and public services in helping people back into employment.
Earlier this month, the government announced a £100 million funding boost to support people who are out of work due to health conditions or disabilities.
Wes Streeting said that occupational therapists, work coaches and “social prescribers” would play a key role in getting people back into work. There is hope that this will mean the expansion of the WorkWell programme nationwide.
I have been involved in delivering one of the 15 pilot schemes that have been in operation since 2024, delivered by the Shaw Trust, which exists to help individuals facing barriers reach their full potential.
We know that finding work is one challenge, but the journey doesn’t end there, as research suggests that disabled people remain over twice as likely to fall out of employment within their first year on the job.
This is where the wraparound in-work support provided by WorkWell is an asset.
Integrated support
In our pilot, we’ve benefited hugely from our relationship with our NHS commissioners at the North Central London Integrated Care Board. They’ve consistently promoted the benefits of integrating health and employment support across our communities.
Return to work
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GPs in the area have embraced WorkWell and have been our largest source of referrals for in-work support, recognising the increased health benefits associated with their patients remaining in employment.
In its current form, our service is entirely voluntary but may be recommended when exploring the patient’s health needs or upon considering the issue of a fit note.
It is presented as an additional source of support to prevent a two-week absence turning into four, or eight, or 26 weeks.
The longer someone remains on sickness absence, the less likely they are to ever return to work, and that’s why the early intervention WorkWell provides is so crucial.
Our work and health coaches help patients to identify and overcome the barriers preventing them from working, with a keen focus on health-based interventions and support.
Bespoke advice
The coaches, who meet with patients weekly, do an outstanding job at delivering bespoke advice and guidance and promoting the benefits of physical activity, socialising, self-care, creative expression, accessing therapies, and balanced diets.
They have developed extensive knowledge of the myriads of public services, charities, and community organisations available within their local communities, and connect patients to specialist support accordingly.
On top of this, their sessions provide a safe, supportive space for patients to express their concerns and reservations about returning to the workplace.
Returning to work
Unfortunately, one in five employers believes that staff shouldn’t return from sickness absence until they can perform all of their duties.
We have worked hard to dispel that myth and encourage our participants to engage with the elements of the job they can do rather than remove themselves from the workforce entirely.
As the programme’s employment retention practitioner, I am frequently asked what reasonable adjustments a disabled worker is entitled to but, as readers will know, the answer is “it depends on the circumstances”.
That’s why we stress the importance of communication between workers and their managers from the start. We want both parties to think about what a successful return to work would look like at the earliest opportunity.
Closer relationships with employers would allow WorkWell to intervene earlier than we do now and continue to make a positive impact in reducing the number of individuals exiting the workforce due to health-related challenges.
Lack of awareness
Managers welcome the opportunity for constructive dialogue when we reach out to discuss a particular case, but they are rarely aware of the WorkWell service and how it can support their staff and boost productivity.
WorkWell has demonstrated that when support is proactive, practical and personalised, the impact on individuals and communities is transformative.
We’re working to expand our partnerships with employers, and are committed to boosting public awareness as we’d like to see more businesses actively seeking support for their staff. Small and medium-sized enterprises stand to benefit the most.
They may be less likely to have a dedicated HR function or access to Occupational Health services and may experience greater disruption because of staff turnover and absences.
In the future, we would like to develop training and drop-in clinics aimed at local employers looking to responsibly manage their team’s health and wellbeing.
WorkWell North-Central London has demonstrated that when support is proactive, practical and personalised, the impact on individuals and communities is transformative.
In the past three months alone, we’ve helped 89 individuals successfully sustain or return to employment following sickness absence.
This is proof that timely and compassionate interventions work, and with continued investment, employer engagement, and alignment with NHS priorities, we can ensure that work becomes not just possible, but sustainable for those who need it most.
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