Supporting people with health conditions to stay in or return to work

Summary

Health Innovation Kent Surrey Sussex (Health Innovation KSS) worked with NHS Sussex Integrated Care Board (ICB)* to explore how a WorkWell service could be developed locally to support working‑age adults whose health affects their ability to work. We carried out in‑depth community research across three areas of Sussex to understand barriers to employment, gaps in support and opportunities for improvement. This work led to the development of evidence‑based recommendations and supported the implementation of tailored WorkWell pilots in two areas. These pilots are now delivering community‑based support, with formal evaluation planned.

Challenge

Many working‑age adults are out of work or at risk of losing their job because of poor health. National data shows that the disability employment gap continues to increase. In March 2024:

• Around 36 per cent of working‑age people reported having a long‑term health condition [1]
• 1.5 million people experienced sickness absence lasting four weeks or more[1].
• Mental health and musculoskeletal (MSK) conditions are among the leading causes of health‑related economic inactivity [1].

These challenges are not evenly distributed and can be influenced by local factors such as access to services, employment opportunities and social support [1]. NHS Sussex recognised the need to understand how these issues were affecting local communities and how a WorkWell approach could be designed to respond to different local needs.

Approach

NHS Sussex partnered with Health Innovation KSS to explore how a WorkWell service could be implemented in Sussex. Health Innovation KSS led a discovery phase to build an evidence base that could inform local decision‑making and service design.

Using data‑driven insights, we identified three initial transformation sites with different geographies and populations: East Brighton, Hastings, and Crawley. The lead organisations at the transformation sites were The Crew Club in East Brighton, St Leonards PCN in Hastings and Crawley Community Action in Crawley. We engaged with more than 80 participants across health, local government, employment services and community and voluntary organisations. This included people with lived experience of managing health conditions while working or seeking work.

The discovery work focused on people affected by poor mental health and MSK conditions. These conditions were prioritised because of their significant contribution to economic inactivity. Through interviews and system mapping, we examined existing support pathways, barriers to employment and areas where services could work together more effectively.

Health Innovation KSS brought together partners from different sectors to develop a shared understanding of local challenges and opportunities. We ensured health equity considerations were built into the work by engaging a wide range of voices and perspectives.

The WorkWell discovery work produced a clear set of insights and recommendations to guide the development of local WorkWell services.

Health Innovation KSS developed:

• a WorkWell Discovery Report with detailed findings and recommendations for three transformation sites
• a Horizon Scan outlining factors influencing health‑related economic inactivity

Impact

Using the tailored recommendations from the discovery phase, Health Innovation KSS has supported the implementation of WorkWell initiatives in the three transformation sites.

These sites are now delivering WorkWell services adapted to their local context.

• Crawley: Led by Crawley Community Action, a six‑month community‑based pilot is supporting working‑age adults who are unemployed or at risk of unemployment due to health issues, particularly MSK conditions. The pilot offers personalised one‑to‑one coaching in non‑clinical community settings. Support focuses on confidence‑building, goal‑setting and navigating health and employment services.
• East Brighton: Based at the Crew Club in Whitehawk, this pilot supports adults facing health‑related barriers to employment, with a focus on mental health and MSK conditions. The model combines drop‑in job club sessions, digital access, occupational therapy, social prescribing and peer‑led mentoring. Referrals come from community outreach, general practice, and social prescribing.
• Hastings: Led by a Hastings primary care network (PCN), this model targets working‑age adults who have recently been issued fit notes related to MSK or mental health conditions. The approach aims to prevent prolonged sickness absence and support return to work. It brings together integrated multidisciplinary clinics involving a First Contact Physiotherapist, Occupational Therapist, Health Coach and Social Prescriber. Delivery includes patient identification through the EMIS clinical system, fit note messaging, outreach activity and group‑based sessions.

East Brighton, Dr. Vandana Verma, Deans and Central Brighton Primary Care Network Clinical Director said:

 

“We are proud of the progress made through the pilot in the East Brighton ICT. Its success has been rooted in a genuinely local, relationship-based approach, delivered in partnership with trusted voluntary sector colleagues and embedded within neighbourhood teams. That relational model has been central to its impact.

 

“As clinicians, we see every day how closely good health and good work are connected. WorkWell is not about targets or pushing people into employment, it’s about recognising that for many patients, meaningful work can be an important part of recovery, stability and long-term wellbeing.

 

“If implemented thoughtfully, embedded within neighbourhood teams and shaped locally, WorkWell can strengthen holistic care and provide coordinated support at the right time, without creating additional workload or pressure for primary care teams. Thoughtful investment will be key to maintaining the integrity and impact of the model.”

Read this BBC News article from October 2025 to hear from more stakeholders about the initiative: New NHS scheme to help people in Sussex stay in work

Economic impact

The Defining the size of the health innovation prize report (by Frontier Economics) showed that strategic investment in health innovation could unlock £278 billion per annum in economic value for the UK, including £113 billion from targeting innovation towards four major health conditions associated with lost economic productivity (MSK, Mental Health, Cardiovascular & Respiratory) and £8.55 billion NHS productivity gains through reducing health related staff absence (233 million hours lost annually).

Formal evaluation of these services is underway with evaluation partner, Unity Insights, and will provide further evidence of outcomes and impact. Early results of the self-reported measures on patients who have completed their baseline assessments and follow ups in East Brighton and Crawley indicates positive trends in confidence and self-efficacy for those individuals support by the initiatives.

Spread and scalability

The WorkWell approach tested through this programme is designed to be adaptable to different local contexts. By starting with detailed local discovery work, the model supports tailored implementation rather than a single, fixed service design.

The insights, reports and recommendations developed through this work provide a foundation that other systems could use to explore WorkWell approaches in their own areas. Learning from the current pilots will inform future decisions about scaling and wider adoption, once evaluation is complete.

Find out more

Find out more about Health Innovation KSS discovery and implementation work here.

References and notes

[1] https://www.gov.uk/government/statistics/the-employment-of-disabled-people-2024/the-employment-of-disabled-people-2024

*On 1 April 2026, NHS Sussex ICB merged with NHS Surrey Heartlands ICB to form a single regional health authority known as NHS Surrey and Sussex ICB