New plans to help more people with long term conditions reap the benefits of work and improve their health.



The plans proposed today include:

a review of Statutory Sick Pay and GP fit notes to support workers back into their jobs faster, and for longer

encouraging Jobcentre Plus work coaches to signpost claimants to therapy

the launch of a consultation on Work Capability Assessment reform

encouraging employers to work with their employees with long-term health conditions to stop them from falling out of work

a wide-ranging debate about recognising the value of work as a health outcome
Statutory Sick Pay will be reviewed so it better encourages supportive conversations and phased returns to work.

Consideration is also being given to extending fit notes from doctors to other healthcare professionals to help ensure people receive more tailored support.

Ministers believe the system this government inherited in 2010 simply wasn’t working. Good progress has been made encouraging those who can work, while ensuring a safety net for those who can’t.

However, there is further work needed to ensure the system is better targeted and works for everyone.

The Green Paper announced by the government today includes:

the creation of a Disability Confident Business Leaders Group to work alongside Ministers and officials to increase employer engagement around disabled employment, starting with FTSE 250 companies
a consultation on the Work Capability Assessment, the process for assessing Employment and Support Allowance (ESA) and Universal Credit claimants’ capability for work – the proposals would put an end to the binary ‘can work/can’t work’ groups
developing large scale trials on how health-led services and support can help get disabled people and those with long-term conditions back into work – with a specific focus on mental health and musculoskeletal conditions
working with Health Education England, Public Health England and others to make the benefits of work an ingrained part of the training and health workforce approach
The Green Paper also includes a new Personal Support Package. This includes:

a new Health and Work Conversation between new people on ESA and their work coach, focusing on what they can do rather than what they cannot
recruiting around 200 Community Partners into Jobcentre Plus, including expertise from the voluntary sector
a trial voluntary work experience programme for young people with limited capability for work, enabling them to benefit from experience with a mainstream employer to build confidence and skills, enhance their CV and demonstrate their ability to perform a role
extending ‘Journey to Employment’ job clubs to 71 Jobcentre Plus areas with the highest number of people receiving ESA with limited capability for work
Work and Pensions Secretary, Damian Green, said:

When things need improving, like the Work Capability Assessment and fit notes, we mustn’t shy away from big decisions.

We must be bold in our ambition to help disabled people and those with health conditions.

This Green Paper marks the start of our action to confront the attitudes, prejudices and misunderstandings that, after many years, have become ingrained within the welfare state, within the minds of employers and across wider society.

Secretary of State for Health, Jeremy Hunt, said:

The additional cost to the NHS of treating long term health conditions that keep people out of work is estimated to be in the region of £7 billion per year.

This means it is vital the health service is part of this new conversation on health and work. This Green Paper launches a wide–ranging debate about recognising the value of work as a health outcome.

With all the evidence showing that work is a major driver of health, this is a big opportunity – to make sure that people get the support they need, improve their health and benefit the NHS all at the same time.

I hope that health professionals will contribute their expertise so that we can ensure the best possible outcomes.

Plans are set out in the government’s Work, Health and Disability Green Paper. It outlines how disability or a health condition should not dictate the path a person is able to take in life – or in the workplace.

What should count is a person’s talents and their determination and aspiration to succeed.

The gap between the employment rates of disabled people and non-disabled people sits at 32 percentage points – a gap the government is determined to start closing.

Despite a record-breaking labour market, 4.6 million disabled people and people with long term health conditions are out of work.

Disabled people, employers, health professionals, and a wide range of other stakeholders will be asked for their views on how to make sure the health and welfare systems support those who can work with better opportunities to stay in employment, while protecting those who can’t work.

Work and Pensions Secretary Damian Green has also reiterated his commitment that no new welfare savings are being sought through this Green Paper.

Stakeholder reaction to the Green Paper
Simon Stevens, NHS England’s Chief Executive, said:

The evidence is now clear that early treatment for mental and physical health problems helps working age adults get and keep well–paying jobs, and this in turn positively improves their own health and social wellbeing.

So for most people, health and work are a virtuous circle. The NHS has a major contribution to make to the health of working age adults and, as Europe’s largest employer, to the health of our 1.3 million staff.

The NHS is also committed to helping catalyse action by other public and private sector employers to support their own employees’ health, in workplaces across the nation.

Duncan Selbie, Chief Executive of Public Health England, said:

Our health, wellbeing and happiness are inextricably linked to work.

People in work generally have better health. So it makes perfect sense for the government to do all it can to support employers to close the gap around employment, disability and illness and to enable people to work when they can.

Mark Atkinson, Chief Executive at disability charity Scope, said:

Disabled people are twice as likely as the general public to be unemployed. It is right that the government has recognised this is an injustice that needs to be tackled.

We welcome the publication of ‘Improving Lives’, which recognises the need for real change and sets out some bold ideas for reform.

Scope wants to see this Green Paper lead to an overhaul of the fitness for work test, better access to specialist and personalised employment support, more action by employers and more flexibility and support at work for working disabled people.

For this consultation to succeed it must lead to real changes in policy, legislation and employer attitudes.

Louise Aston, Wellbeing Director at Business in the Community, said:

Employee health and wellbeing are business critical issues. We welcome this Green Paper and its commitment to support employers to take strategic ownership.

Our Mental Health Toolkit for employers demonstrates the value of bringing together best employer practice aligned with access to public health services.

Karen Steadman, Policy Manager at the Work Foundation, said:

The Work Foundation welcomes the publication of the Work, Health and Disability Green paper. We have consistently advocated that good work and the benefits it brings to individuals, employers and society at large should be recognised as a positive outcome from a health perspective.

We see the publication of the Green Paper as a major opportunity to work together to improve the system of support for those who are able and keen to work while managing their physical and mental health challenges.

We especially encourage employers to engage constructively in the consultation to develop solutions that address both the current barriers that people with health conditions experience and release a reservoir of talent that is currently excluded to the detriment of all.

Cathy Garner, Chair of the Fit for Work Coalition, said:

The Fit for Work UK coalition welcomes the publication of the Green Paper. In particular we welcome the opportunity for greater focus on the conditions which are most common among people of working age, and which can present considerable barriers to working – such as musculoskeletal conditions and mental health conditions.

As an active partnership of researchers, charities, healthcare professionals, and employers, we know that collaboration will be crucial in improving the health and productivity of our nation’s workforce.

We look forward to working with all interested parties to improve understanding, attitudes and behaviour around health and work.

If we can empower and support people with long-term conditions to remain in or return to work, individuals, employers, and society as a whole will all reap the rewards.

Dr Liam O’Toole, Arthritis Research UK chief executive officer, said:

We welcome the government’s recognition of the impact arthritis and musculoskeletal conditions can have on people’s ability to work, and the need for timely access to health and employment support.

Ten million people in the UK are living with the pain, fatigue and isolation of arthritis, many without the support they need.

Problems affecting the muscles, bones, and joints account for 30.6 million working days lost in the UK each year.

Today’s Green Paper offers the government a vital opportunity to better understand and then meet the needs of people with arthritis.

We will be examining the details and ensuring that the voices of people with arthritis are heard.

As the government has acknowledged, ‘action, not words’ is needed to push back the limits of arthritis. Together, we can make changes that give fuller lives to millions of people with arthritis.

Federico Moscogiuri, CEO, the Arthritis and Musculoskeletal Alliance (ARMA), said:

The Arthritis and Musculoskeletal Alliance (ARMA) welcomes the opportunity to contribute to this very important consultation.

Musculoskeletal (MSK) conditions are the single biggest cause of the rising burden of disability and a major cause of work loss in the UK, accounting for roughly 9.5 million working days lost per year and over a third of all long–term sickness absence in England.

We are pleased that the Green Paper recognises the importance of effectively tackling MSK conditions and regarding work as a health outcome in its ambition to reduce the disability employment gap, and we look forward to working with government, employers and all other stakeholders in identifying workable, person-centred solutions to effectively support all people with MSK conditions who are in a position to do so to remain in or return to work, as appropriate to their needs.