Cat Moore and Ross Murray say that health related barriers to employment often sit alongside other issues – from childcare to housing – and that successful support to get people back into work must look at a whole person’s life.
The government has set its sights on reducing the number of people in the working population that are ‘economically inactive’. The largest cohort with this group – around 2.8 million - is those who are inactive due to a long-term illness. Helping these people back to work will make a huge difference to their lives, as well as boosting the government’s mission to achieve economic growth.
Launched at the end of 2024, the Get Britain Working white paper laid out plans to invest more than £300m to ‘tackle economic inactivity by better connecting work, health and skills support’. The money will primarily be directed through ‘trailblazers’ led by Combined Authorities. This investment fits into a wider landscape of employment and health-related support alongside existing initiatives including the ICB-led WorkWell pilots.
How important are health-related barriers to work?
Evidence from a range of studies and surveys tells us that health-related barriers are the most significant factor underpinning economic inactivity.
A survey undertaken for the Pathways to Work Commission in Barnsley found that 76% of economically inactive residents had a health condition. When asked to say what made it difficult to get employment, the most frequently selected option was ‘health issues/disability/illness’.
We know that within this definition, poor mental health is the most prevalent issue. Figures from the ONS show that 60% of those out of work live with some form of mental health condition, which often co-exists alongside other health needs such as musculoskeletal disorders.
Broader labour market statistics and figures on benefit claimants replicate these patterns, making it clear how closely tied a person’s health and employment status are.
However, it is always tempting to simplify the problem. For national and local policy-makers there is a definite appeal to following what looks like a straightforward correlation between health and worklessness. The easiest story to tell ourselves is that if we address the health needs of individuals, we will make them employable again and they will find work.
But we know it is not that simple.
Looking at more than just health barriers to work
Half of those surveyed for the Pathways into Work study cited ‘family or caring commitments’ as the main barrier to work, in addition to just over a fifth that said a lack of suitable or affordable childcare. Transport, housing and skills also featured as significant issues.
What this shows is that people aren't taking part in the labour market for a range different reasons – and reasons that may overlap each other.
This insight was illustrated clearly by the experience of Stronger Families in Leeds and Bradford, a partnership programme that focused on supporting parents or carers who were unemployed and experienced multiple barriers to accessing work or training from 2017 to early 2023.
By listening to the experiences of workless families, the programme was designed to provided one-to one holistic support to people. A relational approach to support, with a combination of a keyworker and specialist interventions, acknowledged the different experiences people face, and the combination of barriers to work – including those beyond health needs.
Of the 2,500 vulnerable families it supported, Stronger Families supported 22% into work, 33% into education and training, and 15% with achieving job search outcomes. 99% of participants said the programme had a ‘positive impact on them and their families’.
What next?
Health is the most important barrier to work but it is by no means the only one. As the authors of the report for the Pathways to Work Commission note, ‘there is no one experience of economic inactivity’. When designing any health and work programme, this is an insight that should be remembered.
Successful support for those out of work requires acknowledging health barriers alongside a range of other needs. To do this means breaking down siloes within existing services and listening to the voices of service users. Support must be organised around the person, rather than around service lines. These principles underpin Mutual Ventures’ ‘Radical Place Leadership’ approach, which provides a model to knit public services together and create sustainable change.
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