Case study

Working Well: an approach to work and health

Greater Manchester's whole population approach to health, skills and employment.

Working Well logo


Working Well is Greater Manchester’s whole population approach to health, skills and employment. Based on personalised support and a new ecosystem of work, health and skills, it is on track to significantly exceed its target of supporting 20% of clients into work.


Of Greater Manchester’s total working age population of 1,781,000, 236,000 people are out of work. Of these, 64% (150,000) are out of work due to a health condition. Greater Manchester lags behind both the national employment rate and the employment rate for those with long-term conditions.

Reducing inequalities and increasing productivity are at the heart of the strategic intent of the Greater Manchester Combined Authority (GMCA) and the Greater Manchester Health and Social Care Partnership (GMHSCP).

What is involved?

Greater Manchester has recognised that being out of work can have a significant impact on both physical and mental health.This in turn affects the Greater Manchester Strategy’s objective of inclusive growth. This means more healthy people benefiting from the positive effects of work and also supporting the growth and productivity of the local economy.

Working Well is a joint GMCA and GMHSCP whole-population approach to health, skills and employment.

Working Well has 4 strands:

  1. Care and support: for people with complex and enduring health conditions or disability. Support for employability, meaningful activity, volunteering and wellbeing (currently in development).
  2. Work and health: support for longer-term unemployed people with health conditions or disability to find and sustain work (programme already in place).
  3. Early help: for employees with health problems who are at risk of falling out of the labour market. Support for small and medium businesses, self-employed people and newly unemployed people with health problems (going live in early 2019, with the ultimate aim of supporting 14,000 people in these categories).
  4. In work: health promotion (in development) through:
  • the Greater Manchester good employer charter
  • public service leadership
  • social value through procurement
  • modernising employee assistance and occupational health

The ‘work and health’ programme strand of Working Well has drawn on devolved powers for joint commissioning with the Department for Work and Pensions (DWP), as part of the 2014 devolution agreement.

The 3 Working Well programmes have been funded jointly by the DWP, the Ministry of Housing, Communities and Local Government, the European Social Fund and Greater Manchester.

A pilot programme, from 2014 to 2016, provided support for 5,000 employment and support allowance (work-related activity group) claimants who had not secured sustained employment through the DWP Work Programme. A further 15,000 people from a more varied, but equally complex, client group were referred from 2016 to 2017 and will be supported until 2020.

As a result of the waiting times for mainstream services and the high prevalence of poor mental health among Working Well clients, a GP referral route was introduced and the commissioned offer expanded to include a bespoke ‘talking therapies’ service. A ‘skills for employment’ service is also in place to ensure that ready access to skills provision is available to secure and progress in work, creating an ‘ecosystem’ of employment, health and skills support.

The programme is on track to significantly exceed its target of supporting 20% of clients into work. In January 2018, the third iteration of Working Well was launched as Greater Manchester’s devolved work and health programme. This will run until 2023 and support 23,500 people primarily out of work due to poor health or disability.

What works well?

Working Well has been developed on the basis of a number of key principles:

  1. Personalised support: providers support clients to access an appropriate range of services, and provide bespoke packages to ensure that clients’ personal barriers to employment and progression are tackled comprehensively and in an integrated and sequenced way.
  2. A new ‘ecosystem’ of work, health and skills: Working Well has fundamentally changed how skills, health and employment services function together by offering a seamless, coordinated and sequenced package of services, enabling the achievement of multiple outcomes. Key worker support for those with the most significant barriers to employment sits at the heart of this ‘ecosystem’.
  3. Evaluation: there is a robust evaluation process to ensure wider application of successful delivery and outcomes. This informs the development of future work.
  4. Market shaping: devolution provides an opportunity to build capacity and shape the market to provide the conditions for locally commissioned and managed services to be able to integrate and achieve better outcomes.

Next steps

Next steps for the Working Well system will include:

  • developing a Greater Manchester approach to learning disabilities and carers
  • looking at new ways to support older people to participate and progress
  • challenges to public service leaders to be exemplar employers
  • integrating all GP and health services in work and skills pathways
  • significant further ‘asks’ of central government devolution of services
  • continuing to test, learn and evolve

With thanks to the Local Government Association.

Published 31 January 2019