GP practices should have ‘work coaches’ to get patients back to work, say NHS leaders

GP practices should host ‘work coaches’ and other career advice services to help people get back to work, NHS leaders have recommended.

The NHS Confederation said that ‘there could be value’ in reviewing the way career advice can be given outside of Jobcentres and in other places in the community, including GP practices.

Today, the organisation published new research exploring how the new Government can ‘tackle economic inactivity’, as this has risen by 900,000 people compared to pre-pandemic levels, with 85% driven by long-term sickness,

Their analysis, carried out with consulting firm Boston Consulting Group, argued that ‘reintegrating’ between half and three-quarters of people who have dropped out of the workforce for reasons of ill health since 2020 could unlock up to £57bn in fiscal revenue over the next five years.

The sharp rise in the number of people out of the workforce also has ‘significant impacts’ on people’s wellbeing and ‘requires concerted cross government action to reverse these impacts’, their report said.

It pointed out that previous work and health interventions, such as the Fit for Work service, ‘have failed’ partly due to ‘limited integration’ with the health system and therefore low referrals from GPs.

The report said: ‘There could be value in reviewing the way in which career advice, support and access to jobs can be delivered outside of Jobcentres and within community settings more broadly, for example, by expanding work coaches in GP surgeries and/or further expanding employment advice in NHS talking therapies.

‘This would recognise the different needs and services of geographical and urban communities. There are already examples of effective co-location in other settings, such as primary care networks.

‘We support colocating services whether in Jobcentres, GP surgeries other settings, providing it is the most effective location based on local need.’

NHS Confederation chief executive Matthew Taylor said: ‘The UK faces a series of enormous health challenges as seen in the sharp rise in the number of people out of the workforce due to long-term sickness. 

‘This spike has defied European trends and requires both additional investment in the NHS alongside coordinated and sustained action across government departments focused on building the nation’s health.

‘There is broad consensus that the NHS requires major transformation to respond to the changing needs of its patients, to be financially sustainable and to achieve better outcomes.’

The Doctors’ Association UK GP spokesperson Dr Steve Taylor told Pulse that most GP practices ‘do not have the physical capacity’ to host more services.

He said: ‘This comprehensive and excellent report on the factors and issues at play in terms of whole person health and wellbeing. I agree with the concept of whole person wellbeing linked to long term health and recovery.

‘However, most GP practices don’t have the physical capacity to host more services as good as this would be for patients.

‘Working in collaboration means listening to GPs who spend their days listening to patients, recognising that they are well placed to inform this important conversation.

‘There are many spaces which could provide a better space to host support services, libraries, community centres, church buildings and this should definitely be explored in collaboration.’

GP partner and Tower Hamlets LMC member Dr Selvaseelan Selvarajah also pointed out that a ‘systematic lack’ of investment in GP premises, core contract and workforce needs to be addressed before practices can host more services.

He told Pulse: ‘Addressing the causes ill health such as poverty will lead to improved life outcomes and sustainable health systems. Jobs and career development especially in deprived areas facilitates people to live happier and healthier lives.

‘Social prescribing was developed in our partnership and we have a strong pedigree of hosting coaches, partnering with external organisations to provide careers advice. So, welcome this proposal.

‘But, currently, there is a systematic lack of investment in GP premises, core contract and workforce. We are lacking spaces in surgeries. We have had to absorb 26,000 ARRS roles in the last five years. So, these need to be addressed urgently before we roll out the proposal to host even more staff.’

A Department of Health and Social Care spokesperson said: ‘We have seen record numbers of people excluded from the workforce due to long-term sickness and economic inactivity.

‘This Government will empower local leaders to tackle economic inactivity by giving them the responsibility and resources to design a joined-up work, health and skills offer that is right for local people.

‘The NHS and social care are a key part of economic growth – by cutting waiting lists and taking bold action on public health, we can get Britain back to health and back to work.’

Last year, a Government source said ministers were ‘actively looking’ at a plan for work coaches to hold sessions in GP surgeries, where they could reach the over-50s ‘more easily.’

In 2016, a similar project placing job coaches in GPs surgeries was set up in North London, but campaigners protested against the programme, defined at the time as an ‘intensive and personalised employment coaching pilot scheme’, saying it would threaten the doctor-patient relationship.

Organisers behind the ‘Surgeries for Treatment, Job Centre for Jobs’ protest warned that the Working Better scheme – rolled out across six GP practices in Islington – would ‘destroy’ the trust between doctors and patients in the north London borough.