Yet it is all under the guise of so-called “WorkWell” – where doctors will send chronically ill and disabled people to employment coaching to try and a) make them better, and b) coerce them back to work.
The WorkWell scheme
As the Times reported, the DWP/Department for Health and Social Care/government pilot scheme, WorkWell, instructs GPs to reduce the issuance of “sick notes” and instead refer patients to employment advisors and wellness initiatives like gym memberships.
The new WorkWell primary care scheme, backed by £100,000 per region, will operate in 15 regions with high sickness and unemployment rates, including Birmingham and Manchester. The goal is to “help” up to 56,000 people return to work by spring 2026 by integrating support services such as physiotherapy, occupational therapy, and employment coaching into GP practices.
For instance, someone suffering from depression might be connected with a job coach skilled in finding flexible roles that accommodate mental health conditions, while patients with physical injuries could be referred directly to physiotherapy services, bypassing the traditional default of issuing a sick note.
However, intertwining health and a DWP agenda will undoubtedly lead to conflicts of interest. Patients may feel pressured to return to work prematurely, potentially exacerbating health issues. Moreover, the presence of employment advisors in medical settings could undermine the trust between patients and healthcare providers.
Major concerns
Despite the government’s enthusiasm for this reform, many within the medical community and disability rights groups have voiced concerns – as the Canary previously reported almost a year ago.
Professor Kamila Hawthorne, Chair of the Royal College of General Practitioners, cautioned that the primary focus must remain on the patient’s health and wellbeing, warning that any new referral system must be robust, practical, and sufficiently funded.
She urged policymakers not to rush the pilot into widespread adoption without thorough evaluation, highlighting risks that transforming GPs into quasi-employment officers could strain the patient-doctor relationship and fail to accommodate the nuanced and complex health needs of many patients.
Disability campaigners, particularly those advocating for mental health, have also expressed scepticism. They warn that pressuring vulnerable mental health patients—especially those receiving hospital care—into job coaching or exercise programmes prematurely could exacerbate their conditions rather than facilitate recovery.
Moreover, some of the services under WorkWell have already been outsourced to private companies. However, one major concern is the changes to sick notes (or what the Tory government rebranded as ‘fit notes’).
As the Times reported:
The pilot — which ministers hope to expand nationally — also aims to free up GP time by allowing other NHS staff, such as physios and occupational therapists, to issue fit notes and provide more work and health advice.
This further hollowing out of the sick note will have a direct impact on chronically ill and disabled people’s ability to access a) sick pay, and b) DWP support.
Junk science
As the Canary previously reported, the WorkWell scheme is based on junk science: the biopsychosocial (BPS) model for treating people with a range of health conditions. The DWP discloses that it is working with the BPS mode in WorkWell’s own prospectus, which says that:
There is good evidence that we can support faster returns to work through interventions that take a holistic view of the barriers an individual experiences through their physical health, their psychological situation and their social situation – often referred to as biopsychosocial interventions.
This rehabilitative dogma under the guise of BPS revolves around the idea of ‘patient beliefs’. In short, that a person’s very real physical pain and resulting disability is in their heads.
Evidencing this, the review listed the World Health Organization’s (WHO) 2001 definition of BPS model. Notably, one part of this said that:
the individual must take some measure of personal responsibility for his or her behaviour.
Meanwhile, a narrative review it cited also stated that:
Individuals with chronic illness and disability are among the most difficult patients to treat. The health-care provider is faced with an array of physical, psychological, and social factors, requiring adoption of a biopsychosocial approach to treatment. This approach necessitates consideration of the benefits for the patient of remaining ill and disabled. These benefits have been termed the ‘secondary gains’ of illness, and they may serve to perpetuate disability and illness behaviour
So, this particular narrative review was ostensibly suggesting that some chronically ill and disabled people are choosing to stay sick. Therefore, it is little wonder Labour is pushing WorkWell – given what it is doing elsewhere at the DWP.
The DWP Universal Credit Bill: a step backwards
The recently passed Universal Credit Bill further entrenches the problematic link between health and employment.
Despite significant opposition, including a rebellion from 47 Labour MPs, the bill reduces the universal credit health component for 90% of new claimants starting in April 2026. Critics argue that the bill, which reduces the Universal Credit health component for 90% of new claimants starting in April 2026, disguises deep cuts as social progress.
Though Labour paused its planned cuts to DWP Personal Independence Payment (PIP), it paradoxically presents this non-action as both a net saving and a positive welfare shift, despite leaving 100,000 more people in poverty.
The United Nations has expressed concerns over the bill’s potential impact on disabled people, citing risks of increased poverty and regression of rights. The government’s assertion that the bill lifts 50,000 people out of poverty is misleading, only feasible by comparing it with worse Tory policies.
A Conservative plan in Labour clothing
It’s important to note that the WorkWell plan and parts of broader DWP cuts originated under the Conservative Party.
The Labour government’s adoption of these measures raises questions about its commitment to progressive values. The Conservative Party’s legacy on the NHS includes years of underfunding and privatisation efforts, leading to a system in crisis. The Labour Party’s continuation of these policies suggests a troubling alignment with Conservative approaches to healthcare and welfare.
Integrating employment services into healthcare settings can have detrimental effects on patient care.Medical decisions should be based solely on clinical assessments, free from external pressures related to employment. Patients may underreport symptoms or avoid seeking care altogether if they fear being deemed fit for work prematurely.
Furthermore, this approach risks stigmatising those with chronic illnesses or disabilities, implying that their health conditions are obstacles to be overcome for economic productivity rather than legitimate medical concerns deserving of care and support.
The DWP in the NHS: we’ve been here before
The government’s current trajectory, blending healthcare with employment services, represents a significant departure from the principles of patient-centered care and social support.
Largely, the WorkWell scheme purports to focus on addressing chronically ill and disabled people’s “health-related barriers to work”.
However, as the Canary’s Rachel Charlton-Dailey previously noted, this doesn’t appear to be what WorkWell will actually do in practice.
Instead, as Charlton-Dailey pointed out, it boils down to a handful of physio sessions, some financial advice, and a support group for loneliness.
It won’t address woefully inadequate, inaccessible, and punitive social security benefits. It doesn’t tackle poverty wage-paying capitalists parasitising profits from workers pushed into the precarious gig economy. The scheme does nothing to address enormous NHS underfunding, ballooning waiting lists, and the dangers of privatisation.
Ultimately, WorkWell looks like more of the same DWP infiltration of the NHS, outsourcing to the private sector, and pushing the onus of ‘overcoming’ work barriers on chronically ill and disabled individuals.
The Labour government’s Tory-esque fixation on the numbers of benefit claimants speaks volumes. And what it says is – more WorkWell sham solutions are probably on their way to ‘fix’ the economy no matter the cost to sick and disabled peoples’ lives.