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Agenda item

'System Change' on Health and Work in Islington


Lela Kogbara and Graeme Cooke introduced the report, which proposed the establishment of a dedicated Health and Work programme in Islington, jointly run by the Council and the CCG, in partnership with Jobcentre Plus.


The following main points were noted during the discussion:


·         It was explained that employment was generally beneficial to people’s health and wellbeing. A coordinated multi-agency approach was required to improve residents’ health and employment outcomes.

·         The Board noted recent developments which had contributed towards addressing health and employment issues. This included that Islington Council’s Assistant Chief Executive (Strategy and Community Partnerships) had recently been appointed as the Director of the Learning Disabilities Employment Programme at NHS England.

·         NHS England had agreed to trial partnership work with Islington Council, Islington CCG, and Jobcentre Plus to improve employment outcomes among people with a health condition or a disability. It was noted that this trial presented a significant opportunity to implement system changes as part of a wider Health and Work programme, which would re-focus services around addressing health and employment issues.

·         The Board considered the challenges that the Health and Work programme would face. It was commented that such a programme would require senior officer engagement, consideration of how those with health conditions can be best supported into work, information sharing arrangements, and reviewing the role of the Council and NHS as major local employers.

·         The CCG confirmed its support for the proposed Health and Work programme, and noted that work would be required to develop a narrative to underpin changes to systems and structures.

·         Further thought was required as to the mechanisms of how the health service would support the Health and Work programme. For example, it was suggested that the current arrangements did not provide sufficient time for a GP to fully assess a patient’s employment status during a standard consultation.

·         It was commented that the programme presented an opportunity to look widely at how all local services support employment and health outcomes. It was suggested that the programme could seek to work with schools to ensure that related support was universally available to young people. Engagement with the voluntary sector was also proposed.

·         A discussion was had on the structural changes required to support the programme and the need to avoid duplication. It was suggested that primary care services, such as GPs and pharmacies, may be best placed to ensure universal access to the programme; however it was noted that this could alter the dynamic between healthcare professionals and patients.

·         The importance of the multi-disciplinary Expert Reference Group was emphasised, which was helping to shape the programme trial in Islington by providing ideas and challenge to authorities. This group included mental health professionals and representatives of the CCG, DWP, Public Health England, and the Business Disability Forum, amongst others.

·         It was considered important to establish clear governance arrangements to ensure confidence in the programme.

·         It was queried if the programme could maximise its available budget by drawing on various external employment and health funding streams. It was advised that this would be explored further; however officers would need to review the entitlement conditions attached to each source of funding.

·         It was clarified that the Health and Work programme was a system change as opposed to a series of initiatives. This approach would ensure that the programme was sustainable, as it was not subject to additional funding, and the changes made to systems would become embedded into the work of each organisation. 

·         It was suggested that the programme could consider the merits of peer support sessions, as research conducted through the Islington Employment Commission indicated that residents found such sessions to be therapeutic and empowering.

·         The Board noted the importance of communicating the programme clearly. The programme needed to adopt the right tone and language to inspire people into addressing health and employment issues.

·         It was suggested that the programme could be supported in future by the devolution of employment support to local authorities.

·         Staff training was considered crucial to the success of the programme.

·         The programme would need to engage local employers to ensure that those with disabilities or health conditions were encouraged into appropriate, flexible and accessible jobs which paid the living wage.

·         In response to a query, it was advised that the success of the programme would be evaluated on an ongoing basis by reviewing the number of residents on Employment and Support Allowance and Incapacity Benefit. It was suggested that other robust evaluation metrics would be required to evaluate how effectively each part of the programme was working.

·         A further report to the next Board meeting was requested. It was expected that progress would have been made on the programme structure, communications, and bid to the European Social Fund to support the development of local employment support hubs.




1.    That Islington Council’s new corporate equality objective, ‘to increase the proportion of disabled people in employment, by supporting people with long term health conditions, mental health problems, and other disabled people into work, which can only be achieved in partnership with health services, Jobcentre Plus and other partners’, be noted.

2.    That the key actions planned and underway to improve employment outcomes for local residents with a health condition or disability, in particular those aimed at promoting and embedding a focus on employment within the local health and social care system, be noted.

3.    That the establishment of a Health and Work programme for Islington, to be run jointly between the Council and the CCG, in partnership with Jobcentre Plus, be agreed as set out in the report submitted.

4.    That the establishment of a ‘task and finish’ group of senior representatives from the Council, CCG and relevant external partners including Jobcentre Plus, to take responsibility for establishing the programme before the NHS England supported trial is ready to be implemented, be agreed.

5.    That the ongoing development of the Joint Strategic Needs Assessment on Health and Work be noted.

6.    That a report on the programme’s progress be made to the next meeting of the Board.

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