NALW Response To The ‘Keep Britain Working’ Review (Autumn 2025)
NALW Response To The ‘Keep Britain Working’ Review (Autumn 2025)
Introduction
The National Association of Link Workers (NALW) welcomes the publication of the Keep Britain Working Review and its focus on the relationship between work, health and economic inactivity. The Review recognises that ill-health and disability are now major drivers of people leaving the labour market and calls for a new, shared responsibility across employers, employees, government and health services.
As the professional body for social prescribing link workers, we are pleased to see explicit recognition of non-clinical, holistic support as part of the proposed solution. Link workers already work at the interface of health, community, work, income and wider social determinants. We believe this workforce is central to delivering the Review’s aims – but only if reforms protect core social prescribing principles and avoid creating fragmented or coercive systems.
Our overarching position
NALW:
- Welcomes the ambition to keep more people in good, meaningful work as a route to better health and reduced inequality.
- Supports investment in early, person-centred support around work, especially for people with long-term conditions, disabilities and multiple disadvantages.
- Insists that any new “workplace health” provision must be built on the values and practice of social prescribing: voluntary, person-led, anti-oppressive and rooted in communities.
- Warns against models that primarily serve employer productivity or welfare savings at the expense of people’s rights, autonomy and wellbeing.
- Calls for social prescribing link workers numbers to be expanded in the upcoming NHS 10 Year workforce plan, to be supported to be regulated via an accredited register, developed and funded as a core workforce within the emerging work-and-health system.
The role of link workers in work and health
Link workers already:
- Work with people whose health, employment, income, housing and caring responsibilities are deeply intertwined.
- Provide relational, trauma-informed and non-judgemental support that enables people to talk honestly about work, stress, disability, discrimination and caring.
- Connect individuals to local VCSE services, employment support, skills and training programmes, advice agencies, peer support, and employer or statutory schemes.
- Help people navigate complex systems – including the NHS, DWP, Access to Work, local authorities and employers – in ways that make sense for them.
This is exactly the kind of holistic, non-clinical case management that the Review proposes scaling through improved Workplace Health Provision. NALW believes the government should expand, support, empower and properly integrate the existing link worker workforce and build around it.
Principles that must underpin any new workplace health system
NALW believes any implementation of the Review’s recommendations must be guided by the following principles:
- Person-centred and voluntary
- Engagement must be voluntary, with clear, informed consent.
- Work should be explored as part of “what matters to you?”, not imposed as a narrow target.
- People must be free to decline employer involvement or specific interventions without fear of sanction.
- Independence and trust
- Link workers require clear professional boundaries and independence from employer HR, performance management and disciplinary processes.
- People must feel safe to talk about difficult issues -such as workplace bullying, discrimination, unsafe conditions or burnout – without fear of repercussions.
- Equity and anti-poverty focus
- Many people experiencing work and health problems are also facing poverty, insecure housing, racism, caring pressures and other systemic disadvantages.
- Interventions must actively tackle health inequalities and social injustice, not simply move people into any employment regardless of quality or sustainability. Employers need to play a greater role in addressing workplace stressors and discrimination.
- Integration, not fragmentation
- Workplace-related support should be integrated with primary care, ICSs, PCNs and community services, not run as a standalone employer product.
- Data flows, referral pathways and accountability should support joined-up care around the person, not parallel systems that confuse patients and staff.
- Ethical use of data and outcomes
- Outcomes frameworks must look beyond absence rates and productivity to include wellbeing, participation, quality of work, safety, and reduction in inequalities.
- Data about individuals’ health and work should be handled with the highest standards of confidentiality and ethics.
What we are calling for:
From Government
- Recognition of link workers as a core national workforce in the new work-and-health landscape, including in the design of any Workplace Health Provision and related standards.
- Direct involvement of NALW in:
- National governance of workplace health reforms
- Design of competency frameworks and training standards
- Advisory structures for any national “workplace health intelligence” function
- Sustainable funding for social prescribing and link workers, including explicit commitment in the upcoming NHS 10-year workforce projections in term of adequate numbers, professionalisation, accreditation and training commitment
- Safeguards in policy to ensure voluntary participation, anti-discrimination protections and ethical practice.
From the NHS, ICSs and PCNs
- Compassionate clinical leadership and one team approach
- Recognition of work, employment and financial wellbeing within social prescribing and pathways.
- Commissioning models that:
- Support link workers to spend enough time with people with complex work-and-health needs
- Provide supervision, training, reflective practice around employment-related issues and ongoing CPD as required
- A review of the current NHS PCN social prescribing contract including job description, support and training requirements which we believe is inadequate based on the evidence.
- Strong collaboration between link workers, primary care, mental health, occupational health, IAPT/psychological therapies and employment support services.
From employers and workplace health providers
- Partnership with existing local social prescribing teams, rather than creating parallel, unconnected schemes.
- Commitment to good, inclusive and safe work- addressing workload, culture, flexibility and discrimination -not just attendance and performance indicators.
- Co-produced “stay in work” and “return to work” plans that respect the individual’s pace, health condition, caring responsibilities and broader life circumstances.
Conclusion
The Keep Britain Working Review presents an important opportunity to re-balance the relationship between work and health in the UK. If implemented well, it could help thousands of people stay in work, recover in work, or return to work in ways that support their long-term wellbeing and security.
Social prescribing link workers are already doing this work every day in communities across the country. NALW stands ready to work with the government and partners to build on this strength, ensure reforms are ethical and person-centred, and secure a fair, properly supported role for link workers at the heart of the UK’s new work-and-health system.
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