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Information Leaflet: Bridging the Gap

Referral form - BTG GP

Referral form - BTG JCP

Information Leaflet: Health and Work Service

Referral form - HWS GP

Referral form - HWS JCP

Referral form: Notts Fit for Work (GP)


Improving Health and Work outcomes for Troubles Families.

Short Explanation

This programme of work seeks to integrate organisations working on the Troubled Families Programme to engage with health and with the system locally in Manchester and nationally. The model by contrast to the national Troubled Families model utilises health issues as the engagement mechanism and targets addressing these as central for improving outcomes including health, employment, reducing antisocial behaviour, and reoffending. People of working age, not in employment, education or training, are more likely to suffer poor health outcomes and greater health inequalities. Children from workless households have poorer health and are more likely to suffer worklessness. Getting people into work is identified as a key factor in protecting longer term health and wellbeing and reversing the negative impact of worklessness.

Black (2008) recommended that more is needed to be done to raise the aspirations and motivations and address the health conditions of those people made workless through disability or ill-health in order to help them recover from or manage their health condition so that they could move into / return to productive employment.      

The Economy Scrutiny Committee, Work Programme - Update on Performance Report  (17 July 2013) confirmed that nationally, new Employment Support Allowance (ESA) claimants saw the poorest performance levels of the Work Programme.  Nationally 5.3% of new ESA referrals gained employment against a target of 16%.  The Work Programme, therefore, does not appear to be providing intensive enough support for people with health issues.

The HWWG is working with Manchester City Council initiative to support people who are out of work, and for whom health is a major barrier, and are identified as a Troubled Family, to move closer to or into, secure and lasting employment.  The Service seeks to support people out of work with health conditions to benefit from a holistic work -focused, case-managed, multidisciplinary approach which maximises the linkages to primary care, employment support and Troubled Families.


This project will include 4 webinars / and one Troubled Families Leads Masterclass on how to engage GPs to improve health outcomes for Troubled Families.

It will also pilot a fully integrating bio psychosocial assessment into initial assessment, and co-case management between Troubled Families and Health for 30 families.

Relevant outputs or anticipated outcomes and impact


30 Troubled Families will receive holistic bio-psychosocial assessment as part of their initial assessment of needs.

The sequencing of appropriate support for 30 Troubled Families includes health support, to improve sustainable success outcomes of reducing worklessness and/or crime and anti-social behaviour for 30 Troubled Families.

30 Troubled Families show measurable improvement in health outcomes.

30 Troubled Family parents show distance travelled closer to work.

150 Troubled Families case managers / leads gain insight into how to engage GPs with Troubled Families and how to co-case manage / co-produce with health by learning from the Pilot.

A webinar of the results of the pilot to include barriers / success factors to integration with health. 


Providing a tested model of how to integrate organisations working on the Troubled Families Programme to engage with health and with the system locally and nationally in order to improve health outcomes, reduce worklessness and reduce crime / anti-social behaviour.

Why is this project/activity important and how might it provide value for money?

The project directly targets health inequalities through the Troubled Families initiative. Troubled families are considered to be households experiencing compounding difficulties at any one time. These families cost the public purse on average £78000 per family annually, and thus are high users of services. Integration of services is key to sequencing the right support at the right time, to reduce the inequalities which family members experience and support public sector reform.

Local research in Manchester and in Cheshire East shows that 75% of Troubled Family households believe that poor health is precluding them from bringing about changes for their families. This qualitative research shows that for families with health conditions, without support for conditions management and / or focused employability support which takes into consideration their abilities / limitations, then clients believe that their outcomes will be curtailed / after Troubled Families support is withdrawn and that the outcomes will not be sustainable. This programme of work seeks to ensure health is integrated and addressed from assessment in order to improve the outcomes of the National Programme.