Last week I found myself diving into a new policy area – work and health.

There is a Green Paper out: Improving Lives: The Work, Health and Disability Green Paper. It’s focusing question is:

‘What will it take to transform the employment prospects of disabled people and people with long-term health conditions?’

Through my work with New NHS Alliance, I now sit on the Fit for Work Coalition, and was lucky enough to attend a workshop led by DWP where The Coalition shared its views.

I am especially interested in this policy discussion because ELC discovery work shows us all the time that whether someone works or not has huge implications for their individual care and for whole system service and outcome design.

So it was interesting to learn that policymakers have recognised that current approaches to measuring impact need improvement. Part of their proposed strategy is getting the NHS to focus more on supporting people to stay at and get back to work by making work a health outcome.

This is a fascinating proposition, which plays to strong evidence that appropriate work is good for a person’s physical and mental health and supports recovery (reference 11). In fact, 16 organisations including: WHO, OECD, The Royal College of Psychiatrists and NICE have recognised this link.

However, at the workshop we discussed the need to take care around what and how we define what we mean by work.

Work is really about contribution and purpose, and along with its impact on financial health, it is the sense of personal contribution and social connection work brings that sustains health and wellbeing.

Some people’s health issues mean they will be unable to sustain paid employment. Yet, they still can and often want to contribute.

Some people no longer work. Many retired people want to contribute.

Unemployed people often want to volunteer and systems make it difficult for them to do so.

The concept of contribution chimes closely with what people have told us in ELC discovery work.

It is when people feel they are no longer contributing that they become depressed and really unwell.

What contribution means is very personal, and health and care systems that want to keep people well should absolutely focus on supporting contribution – including keeping and getting people into paid work.

But is it a health outcome? Or is it a life outcome?

Our work would suggest it is the latter, and that it is Life Improvement that health and care systems should be measuring – not only health and service improvement. People crave a life not a service and when their lives are fulfilling, they need the NHS much less.

That is why we developed The Life Improver Score – to help health and care systems improve lives. If you would like to find out more about it, please get in touch.