The government is piloting a radical new approach to tackling Britain’s long-term sickness crisis by asking GPs to move away from routinely signing patients off work and instead refer them to practical support such as job coaching, physiotherapy and social prescribing.
The new WorkWell scheme, now being trialled in 15 regions across England, gives surgeries funding to embed dedicated employment and health support teams into primary care. The aim is to reduce reliance on sick notes and offer a more tailored pathway back into work.
Health Secretary Wes Streeting said the current system is “failing patients and holding back our economy,” noting that more than 11 million fit notes were issued last year, 93% of which simply declared the patient “not fit for work” without exploring alternatives.
Tackling ‘Sick Note Culture’
The surge in long-term sickness absence is now seen as one of the biggest drags on the UK workforce. According to government figures, 2.8 million people are out of work due to health conditions, with the most common causes mental health issues such as anxiety and depression and musculoskeletal problems including back pain and joint injuries.
Fit notes, previously known as sick notes, are issued to employees who need to be off work for more than seven days. But critics say the current system offers no incentive or support to help people return to employment.
Streeting described the policy shift as “the end of a broken system”, adding: “We’re changing this conversation. Instead of GPs spending precious time rubber-stamping people out of the workforce, we’re supporting providers to bring in specialists — occupational therapists, work coaches, social prescribers — who can actually help people navigate back into employment while managing their health conditions”.
What the New Scheme Offers
Under the pilot, GPs will work alongside employment coaches who help patients draft CVs, prepare for interviews and find flexible job roles. Patients with physical conditions may be referred to physiotherapists or offered free access to gym sessions, while social prescribing teams might connect others to community activities such as gardening clubs or financial advice services.
Rather than being passively signed off, patients will be assessed for what they can do — and what help they need — to stay in or return to work.
Each region will receive £100,000 to run the scheme, which forms part of a wider £64 million WorkWell investment launched last year. The government says it hopes to support up to 56,000 people with health conditions or disabilities into employment by spring 2026.
Expanding the Role of Non-GP Staff
As part of the shift, the scheme will also allow other NHS professionals, such as occupational therapists and physiotherapists, to issue fit notes and provide work-related advice. Ministers believe this will free up time for GPs while giving patients access to more relevant, hands-on support.
NHS leaders have welcomed the move, with Claire Murdoch, the NHS national mental health director, telling The Times: “As the NHS, we want to help people find work or keep work. The NHS can, should and does think of itself as a contributor to economic growth.”
The Link Between Work and Wellbeing
Experts have long pointed to the relationship between employment and mental health. Unemployment or job insecurity can worsen depression and anxiety, while structured, purposeful work can play a significant role in recovery.
Teams of employment advisers are already embedded in mental health services across England, providing one-to-one support to around 100,000 people a year. These services offer practical guidance on finding work, including confidence-building, job searching and mock interviews.
Ministers hope expanding this model through primary care will help reduce the UK’s record levels of inactivity. Currently, 11 million working-age adults are not in employment, with nearly half of those signed off for long-term sickness citing mental health challenges.
What Employers Should Know
While the WorkWell scheme is focused on primary care, observers say employers also have a role to play in keeping people well and in work. This includes reviewing sickness absence policies, making reasonable adjustments for staff with health conditions, and exploring flexible working arrangements that support return-to-work plans.
The scheme does not remove the GP’s authority to sign someone off when necessary, but it reframes the conversation around capability, recovery and reintegration, rather than defaulting to absence.
If successful, ministers hope to roll out WorkWell nationally, positioning the NHS not just as a healthcare provider, but as a partner in workforce retention and economic growth.