Working well: Improving work & health in the North East
Earlier this year, new ONS figures showed unemployment in the North East falling to (almost) the UK average. This was a positive sign, but employment alone doesn't necessarily equate to good work and a good life; in-work poverty remains very high in the region, with some 67 per cent of children in poverty living in working families.
Not everyone is able to access work, however. Economic inactivity in the North East remains the highest in England (22.9 per cent), with long-term health conditions and poor healthy life expectancy significant factors. Nationally, IPPR has called on government to address the ‘missing million’ workers from the workforce since the pandemic, with health factors playing a major role. This is a two-way relationship; the existing evidence is clear that peoples’ health is correlated to both being in employment and also the quality of work (Marmot 2005; Kim and von dem Knesebeck 2015; Chandola and Zhang 2018). Being in work, and importantly, in good work, drives and is driven by good health.
The North East needs a shared, system-wide approach to good health and good work. IPPR North recently worked with the North East and North Cumbria integrated care system and local government partners in the region to explore what is needed in this system-wide approach, looking at local health systems and the interaction with employment support. Drawing on existing evidence on the link between work and health and supplemented by interviews with frontline professionals, we looked at what support is needed to help those in poor health into work, and to stay in good, fulfilling working environments.
We uncovered a wide range of findings, including on the need to provide personalised, patient-centred services, co-located at the community level. This is particularly important for those with learning disabilities or mental health conditions (Thomas 2022); indeed, poorly designed back-to-work initiatives have been shown to worsen mental ill health and make it harder to get into employment (Dwyer et al 2020). Rather than replicating services in siloes, people need a seamless experience, where they can easily enter at a point most suitable for them. This means bringing together services, and ensuring they work with people to foster genuine community networks and social relationships. Any attempt to do this well needs to have long-term stability, and therefore funding is an unavoidable issue; local government commissioning decisions should reflect that these initiatives take time. But based on our research, getting the personalised approach right is worthwhile.
Drawing on these insights, our research proposed the following actions to help move towards a joined-up system for work and health in the region.
- Working well for the North East
Local leaders should bring together employers, workers, the VCSE sector and local communities to build a new work and health body which unites partners under a shared identity, similar to the West Midlands’ ‘Thrive into Work’ programme. The body should strengthen data-sharing, including tracking service use and monitoring ongoing health challenges for working people. The new North East Mayoral Combined Authority can play an important convening role in helping establish it. This formal body should help foster informal links at the community level – for example, maintaining a directory of local services or supporting local community champions to provide connectivity between frontline professionals.
- Employment support at the community level
Employment support schemes for those in poor health should be developed further, especially through growing the positive work of community hubs to ensure services are embedded in the places of greatest need and as personalised as possible. The large number of social prescribers in the region could be drawn upon to develop personalised, short-term support for those with less severe health challenges. Existing supported employment schemes should be benchmarked to understand the range of existing models from employers.
- Good Work
The growing ‘good work’ agenda in the North East, including campaigns, charters and pledges for better wages and working conditions, should continue to expand. Anchor institutions play an important role here, both in terms of their own workforces and through sharing support and capacity for others. Local government should consider whether this agenda could be better enforced using the levers at their disposal. Commissioning, procurement and employment support decisions can all add weight to voluntary schemes.
Working with the TUC, a central point of information for employers on work and health should be set up, including specific support for SMEs; this could link with the existing well-established ‘Better Health At Work’ programme in the North East.
- Seizing the opportunity of devolution
Employers and local government leaders should work through and with the new North East combined authority and the integrated care system; the increased funding and powers available are a valuable asset, and an opportunity to pool capacity and decision-making. Co-commissioning and co-investment can help to provide better efficiency and closer join-up between services. As the size of local structures becomes larger, it is however vital to encourage local, place-based approaches.
Devolution is also an opportunity for North East leaders to consider the central government policy reforms that would most benefit local residents – or whether further powers should be devolved to make decisions locally. Previous IPPR research on work and health has included, among others, calls for ending welfare conditionality for people with mental health problems, reimagining the role of work coaches to improve health and wellbeing, and wider reforms to working conditions such as increased statutory sick pay without a lower earnings limit threshold.
The North East has great strengths: wide-ranging rural and coastal landscapes and a high-skilled workforce. In our work, we found consensus among frontline services and strategic decision-makers in local government and the health system. People are clear on what the challenges are, and if they can work together to tackle this vital area of economic and social policy, they can ensure that people living here benefit from better work and better health into the future.
Luke Myer is a research fellow at IPPR North. He tweets @IPPRLuke.
Chandola T and Zhang N (2018) ‘Re-employment, job quality, health and allostatic load biomarkers: prospective evidence from the UK Household Longitudinal Study’, International Journal of Epidemiology, 47(1), pp 47–57. doi:10.1093/ije/dyx150
Dwyer P et al (2020) ‘Work, welfare, and wellbeing: The impacts of welfare conditionality on people with mental health impairments in the UK’, Social Policy & Administration, 54(2), pp 311–326. doi:10.1111/spol.12560
Kim TJ and von dem Knesebeck O (2015). ‘Is an insecure job better for health than having no job at all? A systematic review of studies investigating the health-related risks of both job insecurity and unemployment’. BMC Public Health. Sep 29;15:985. doi: 10.1186/s12889-015-2313-1.
Marmot M (2005). ‘Social determinants of health inequalities’. Lancet. Mar 19-25;365(9464):1099-104. doi: 10.1016/S0140-6736(05)71146-6.
Office for National Statistics (2023) ‘Labour market in the regions of the UK: May 2023’, https://www.ons.gov.uk/releases/labourmarketintheregionsoftheukmay2023
Thomas (2022). ‘Getting better?: Health and the labour market’, https://www.ippr.org/research/publications/getting-better-health-and-labour-market
Thomas et al (2022) ‘Health and prosperity: Introducing the Commission on Health and Prosperity’, https://www.ippr.org/news-and-media/revealed-8bn-hit-to-uk-prosperity-as-long-covid-and-illness-drives-400-000-more-people-from-the-workforce