Guidance

Employment advisers in musculoskeletal pathways: prospectus

Published 24 April 2024

Applies to England

Ministerial foreword

A healthier population is also a wealthier and more productive one. Work is an important social determinant of health for individuals, their families and communities. This government is dedicated to opening up opportunities to good work. We know that poor musculoskeletal (MSK) health has a significant impact on people, their families, their employers, the NHS and the wider economy, with over 23 million working days being lost due to MSK conditions in 2022. MSK conditions also disproportionately affect areas of greater deprivation, in women, in the older population and in certain ethnic groups.

MSK conditions affect the bones, joints, and muscles and associated tissues such as nerves. This includes inflammatory conditions, such as rheumatoid arthritis, conditions of MSK pain (such as back pain) and osteoporosis and fragility fractures. The reality of many MSK conditions is the pain, fatigue and limited mobility that people suffer, which can limit people’s ability to gain the health benefits of good work and participate in society.

We announced in the 2023 spring budget, a suite of measures to enable people to better manage their MSK condition so they could remain economically active. This included the introduction of employment advisers (EA) into MSK pathways, building on the successful EAs in NHS talking therapies programme.

Embedding EAs into MSK services will improve health and work outcomes by helping people with MSK conditions to start, stay and succeed in work, while aiming to free up clinical capacity. In this prospectus, we are inviting integrated care boards (ICB) and MSK services to work with us to rapidly integrate employment advice into MSK services and test how this works. This project aligns with ICBs aims to reduce health disparities and support social and economic development.

We are also supporting people with health-related barriers to work through initiatives such as universal support. This will extend support in England and Wales to help economically inactive people with disabilities, health conditions and other barriers to work, move into jobs quickly, then succeed and stay in them. In addition, we are launching WorkWell, an early intervention work and health support and assessment service. We were pleased to see an encouraging response from ICBs to participate in the WorkWell vanguard opportunity. We would encourage potential WorkWell vanguards to consider the opportunities and links to EAs in MSK as part of their strategies and potential core pathways.

We want everyone to be able to find a job, progress in work and thrive in the labour market, whoever they are and wherever they live.

Mims Davies MP, Minister of State for Disabled People, Health and Work

Helen Whately MP, Minister of State for Social Care

Introduction

The spring budget (2023) announced funding over 4 years to introduce EAs into MSK services. This project builds on the successful EAs in the NHS talking therapies programme. This prospectus sets out the project requirements, including objectives, key principles, guidance and roles.

We invite applications from ICBs and their local partners, including MSK providers, who wish to commence a proof of concept (PoC) site from early autumn 2024 onwards. We also invite applications from ICBs who would like to state a preference to commence roll out from April 2025.

The prospectus provides information about the EAs in MSK project and should be read in conjunction with the 4 accompanying appendices:

• appendix A: application guidance - contains the information and instructions eligible ICBs need to submit a completed EAs in MSK PoC site application

• appendix B: application form - this form should be used to apply to become an EAs in MSK PoC site

• appendix C: funding guidance - provides an overview of the available funding, payment mechanism and management Information (MI)

• appendix D: service specification - provides guidance to healthcare practitioners, MSK service leads, clinical leaders and supervisors on the roles and service characteristics, to support the set up and implementation of the EAs in MSK project

Subject to the UK government’s right to change the timetable (see appendix A), all applications must be received by the submission deadline of 11:55pm on 24 May 2024.

This project aligns with ICB aims and the 4 purposes of integrated care systems with reference to reducing health disparities and helping the NHS to support broader social and economic development (section 3A of the NHS Act 2006).

The ambition underpinning the introduction of EAs into MSK pathways is to:

• support better health outcomes for patients, including reducing health disparities

• help individuals with MSK conditions to start, stay and succeed in work, improving workforce participation

• reduce pressures on the NHS, including by optimising clinical time

This prospectus is focussed on the first phase of the EAs in MSK roll out project, which will design and test what works through the introduction of PoC sites. The PoC phase is expected to commence delivery from autumn 2024. Our current plan is that this informs a larger and evaluated phase of implementation, across more ICBs, beginning in 2025.

We want to work closely with ICBs and their partners, to better understand how employment advice can be rapidly and effectively integrated into MSK services, highlighting core components and maximising opportunities to support individuals to start, stay or succeed in work. The PoC phase will help inform design approaches for the roll out - building in consideration for local circumstances, population health needs and support for people living in more deprived areas.

Alongside the guidance set out in this prospectus, the MSK team within the Joint Work and Health Directorate (JWHD) is on hand to offer support, answer any questions and facilitate connections with EA services based in NHS talking therapies (TT) services, the Department for Work and Pensions (DWP) strategic partnership managers and the Office for Health Improvement and Disparities (OHID) regional leads. Email us with any questions to jwhd.msk@dwp.gov.uk.

Importance of work and health for MSK outcomes

Context

Good work is good for health and there is a need for greater access to support that can enable people with health conditions to overcome barriers to employment and help them to stay, start and succeed in work.

Over 20 million people in the UK, have a MSK condition such as back pain, arthritis or osteoporosis. There are significant health disparities in MSK health. For example, deprivation is also linked to chronic pain - 4 in 10 people (41%) living in England’s most deprived fifth of society report chronic pain compared to 3 in 10 (30%) in the least deprived quintile. 

It is estimated that 23.4 million working days were lost due to MSK conditions in the UK in 2022. On top of this, MSK accounts for up to 30% of GP consultations in England.

Poor MSK health greatly impacts people, employers, the NHS and the wider economy. MSK is one of the main reasons given for ill health-related inactivity and can reduce productivity in the workplace. However, research (2020) showed that many NHS commissioners did not commission MSK services specifically with employment needs in mind.

Evidence base

Key findings from an evaluation of a trial of EA in NHS talking therapies included that accessing employment advice has a significant positive impact on mental health. For example:

• seeing an EA had a positive impact on mental health of clients who were out of work when they entered improving access to psychological therapies (IAPT) (the former name for NHS talking therapies), 66% experienced a ‘reliable improvement’ on IAPT’s routine clinical measures, compared to 59% of those who received therapy only

• employment effects were also positive, particularly for the out of work groups. More than two-thirds (68%) of those who accessed the service reported a positive employment outcome between entry to the service and 12 months later (meaning either remaining in work, returning to work after sickness, or finding work)

• integrating EAs within therapeutic teams helped to free-up therapists’ time, as practical problems relating to employment could be dealt with separately by EAs

Vocational rehabilitation and vocational advice have been shown as beneficial for individuals with MSK conditions, resulting in earlier returns to work when compared to individuals not receiving vocational advice. Multiple studies suggest a robust evidence base for the value of embedding employment support within healthcare settings, including small scale impact settings. For example:

• a 2023 study of MSK patients in Norway found that those who received vocational advice took fewer sickness absence days than those who received usual case management
• a study of work and pain (SWAP) trial (2018) examined the impact of vocational advice, provided by vocational advisers embedded within health practices, for patients who were struggling in work or absent from work due to MSK pain. A key outcome was fewer days of work absences over a 4-month period for MSK patients who received vocational advice compared to those who received no advice
• a Canadian programme, which is currently examining the effectiveness of specifically targeted employment interventions designed to help people with inflammatory arthritis, has shown significant success in reduced productivity loss and work cessation over a 2 year period

Project overview

Learning from the EAs in TT model the government has committed to introduce employment advice within MSK pathways. Initially this will involve building an understanding of the most promising local approaches, gathering evidence of impact and developing the case for wider roll-out. 

The project will explore this by offering non-clinical employment guidance to people who are receiving clinical support for an MSK health condition and who may be at risk of falling out of work, on sickness absence, or who are facing MSK-related barriers to finding employment.   

We are delivering a roll out over 2 evaluated phases:

1. PoC phase, with the first wave of sites going live from autumn 2024.
2. A larger, roll out, with the second wave of sites going live in 2025.

Successful ICBs will not be required to make the EAs in MSK service mandatory for patients. ICBs will have flexibility to implement employment support in a way that aligns with local needs and circumstances.  

We are keen to work closely with ICBs and their partners, including MSK services, to inform development of the PoC and importantly, how ICBs could make the earliest start to introducing EAs into MSK services.

Phase 1

The PoC phase will go live from early autumn 2024 and sites will test out how to integrate employment advice within MSK services. The PoC phase will seek to test delivery models in various MSK settings, services and geographies. The PoC will help ensure we are designing an approach that is reflective of local circumstances and informed by a range of delivery models. 

The objectives of the PoC phase 1 are:

• designing and testing models, which incorporate innovative and novel approaches, meeting the work and health needs of MSK patients and narrowing health disparities
• delivering joined-up EAs in MSK pathway models, which integrate EAs with existing MSK services and are co-developed with system stakeholders
• stimulate a culture of learning, and capture data and evidence, which helps to inform us about what is effective and ineffective when integrating EAs in MSK pathways

This phase will consist of setting up to 14 PoC sites across England and integrating EA teams, typically including a senior employment adviser (SEA) and several EAs within MSK services from as early as possible in autumn 2024.

It is initially expected that there will be one SEA for an average of 4 EAs working in an MSK setting (team size will be determined by local set up and patient flows).

We anticipate in the region of 14 EAs in MSK sites to start in autumn 2024 to 2025. Up to an additional 10 teams, the fast followers, will commence delivery in 2025 to 2026.

Therefore, ICBs are encouraged to apply to form the cohort of ICBs who will start delivery from autumn 2024. We also want ICBs to apply who want to start from April 2025.

The application guidance can be found in appendix A. The application form can be found in appendix B.

Evaluation

ICBs should note that if successful there is a requirement that they will fully participate in a formal evaluation of the PoC that will be commissioned by the JWHD in 2024 to 2025.

This will include ICBs:

• collecting a set of MI (including a clinical minimum dataset to be collected by HCPs) specified by the JWHD and reporting the data monthly (on aggregate) to the JWHD
• engaging with the external researchers throughout the PoC to share provider or stakeholder experiences to inform an analysis of how the programme is structured and functions, how and what works or doesn’t work and the mechanisms that may support impact (through a process evaluation)

Phase 2

This will begin 2025 and aims to develop our understanding of the barriers and enablers of embedding EAs in MSK services and help to provide guidance for further roll out.  
 
Further details of phase 2 will be shared with successful applicants in due course.

Application information

Applicants

It is expected that ICBs will hold overall responsibility for the development and submission of the EAs in MSK application. We expect ICBs to work in partnership with MSK services to prepare their applications. We would also encourage engagement with other stakeholders, including local and regional colleagues. This could include DWP strategic partnership managers, OHID regional leads, and existing EAs in TT sites, who can share their expert knowledge and understanding of the local provision landscape.

Applications for the project will be assessed by the JWHD. To maintain impartiality, the MSK policy team will therefore not have a direct role in helping ICBs to develop bids. 

Eligible ICBs

The application to become a EAs in MSK PoC site must be supported by an eligible ICB. An eligible ICB is any NHS ICB, which is not in the NHS national recovery support programme (RSP) at the time of submitting their PoC application. ICBs in the RSP are not eligible to apply to deliver an EAs and MSK PoC site.

The application guidance can be found in appendix A.

Funding

Funding for the PoC sites, starting in 2024, will be up to March 2026 and will cover:

• EA and SEA salaries, yearly salary uplifts (exact amounts to be confirmed), on costs (NI and pension contributions)
• overheads (training, estates)
• set-up costs (such as IT)

Funding has been allocated to provide each EA team with the facility to bring in some project management support and to support the integration and promotion of the EA function within the MSK service.

Additional support will be provided through a team of JWHD relationship managers (RMs), mirroring the existing EAs in TT model, to facilitate implementation. The JWHD are scoping and planning to provide a full national evaluation of this PoC phase.

Applicants should note that funding to PoC sites will be routed through service development funding. The named ICB in each application will enter into a memorandum of understanding with NHS England. This reflects the approach taken in EAs in TT.

The funding guidance can be found in appendix C.

Joined-up delivery

Core to EAs in MSK pathways, is to explore how to integrate the service so that from a patient and system perspective the experience is joined up, timely and provides personalised and wellbeing-based support. To achieve this, applicants will need to demonstrate strong collaboration with MSK services and healthcare professionals (HCPs) delivering MSK services. ICBs and their local partners will have different providers. Thus, it will prove important for ICBs to undertake a local needs assessment and consider how to integrate employment advice within the MSK services they provide.

The EAs and TT programme is now rolling out across every ICB. This provides a significant opportunity for ICBs and providers to consider how the EAs and MSK PoC could align with how EAs and TT operate. There are likely benefits for both services to explore, such as shared EA team resources, linking across services through multi-disciplinary teams and, where relevant, ensuring that there is a streamlined route of employment advice for a patient who might have mental health and MSK healthcare needs. ICBs are therefore encouraged to consider how this might work.

It is anticipated that other local organisations, involved in delivering employment and/or social support and MSK care could also have a role. This may include, though is not limited to, primary care networks, local employers, Jobcentres, local authorities, local economic development and public health services, other organisations that provide employment advice and voluntary and community sector organisations. ICBs, which applied to and/or are successful in becoming WorkWell vanguards, and who have an interest in EAs in MSK, are strongly encouraged to consider how to integrate and test these approaches.  

It is strongly encouraged that applicants design propositions building on local insights from MSK service users and/or engage with MSK service users and those with lived experience during the process of preparing the application.  

PoC sites: delivery expectations

Essential components

This is an exciting opportunity to work with the JWHD to develop and test innovative models that meet the work and health needs of MSK patients and contribute to narrowing local disparities.

A set of key principles have been developed to assist PoC sites to design models and complete the application process. These principles take the form of questions and should guide and enable local systems to develop proposals that are tailored to meet local context and need. This includes how best to design a model that actively addresses health disparities by consideration of how and where employment support, within MSK services, is most needed.

Applications to be a PoC site must fully integrate the EA team into the MSK local service delivery. JWHD are particularly interested in testing employment advice within 4 main MSK pathways:

• services for conditions of MSK pain, including chronic primary pain and axial pain
• services provided by physiotherapists and occupational therapists, who are legally able to certify fit notes
• services for people with inflammatory MSK conditions, which often require long term management
• services for people with osteoporosis and fragility fractures

Key principles, which underpin the application questions, set out that successful PoC sites must consider:

• the model: how does your proposed approach align and deliver the intended objectives of the programme, identifying where in the MSK service EAs will be embedded to deliver most impact?
• health disparities: how have you used population health methodology and other tools to identify where support is most needed?
• co-developing: how will you co-develop a model to embed EAs in MSK services, both with multi-disciplinary teams (MDTs) and patients, including consideration of people with lived experience?
• integration and workforce: how will you integrate EAs within local MSK service delivery teams to work in a combined way with MDTs and part of caseload reviews where appropriate?
• evaluation: how does your model demonstrate an ability to capture and provide data in relation to the metrics identified (see the ‘Project evaluation’ section) to support the evaluation process

The application guidance can be found in appendix A; the application form can be found in appendix B; and the service specification can be found in appendix D.

The support provided by an EA working in MSK

EAs are non-clinical, and work in a combined way with health practitioners to provide tailored advice and support people to start, stay and succeed at work. This includes talking to people about their abilities and interests and helping to empower clients in the pursuit of their employment goals. EAs assess peoples’ skills and abilities, helping them to identify suitable learning and work opportunities. EAs also support people to overcome barriers to employment and provide advice about in-work support, such as workplace adjustments or building relationships with local employers. 

EAs support patients irrespective of their employment or benefit status - that is, whether in work, out of work, self-employed, unemployed, and participation in employment support is entirely voluntary. In line with the EA in TT model, we expect that EAs in MSK will work closely with HCPs delivering MSK services to:  

• provide clients with information and advice on entering and/or remaining in employment in line with their MSK condition and individual circumstances
• empower MSK clients to set their employment goals and work with the client and/or HCP to support the client in reaching them

Further details on the roles and responsibilities of EAs and the range and type of employment support they can offer, is provided in the service specification (appendix D).  

Integration of employment advice within the MSK service

It is essential that the employment advice team is fully integrated with the MSK setting or services. This will enable PoC sites to test and learn how such approaches can operate to provide an effective service to patients with MSK conditions.

While NHS TT services are different from MSK services, ICBs and MSK providers are encouraged to reflect on:

• how their local EA and TT service integrates
• how processes and arrangements work
• how these may translate and adapt across to EAs in MSK pathways and services

While PoC sites should consider local set up and established MDT, it is anticipated that ICBs and MSK services ensure that the following measures are in place to enable EAs to work effectively alongside their MSK colleagues:

• EAs must be integrated members of an MSK service, co-locating if and where possible
• EAs should have an NHS email address, like those of their NHS colleagues providing MSK services. EAs can also be provided with a mobile phone and a laptop or equivalent to enable them to work effectively from home and from community settings
• a senior manager or managers - such as a service lead or business manager - should be responsible for managing the SEAs within the ICB or MSK provider, thereby supporting the SEAs to embed the employment support function within the local NHS MSK service model

The service specification can be found in appendix D.

EAs and teams

Recruitment considerations

PoC applicants are required to provide detail in the application on the configuration and capacity of the EA team they are looking to deploy (see the application guidance, appendix A, for further information). As a rule of thumb, it is anticipated that an EA team is based on a configuration of one SEA to an average of 4 EAs (see appendix D for more information on EA capacity).  

Using EAs in TT as a guide, there is no standard model for recruitment of SEAs and EAs. Employment support could be arranged and delivered by an NHS provider, a charity, a private company, or the ICB. It is expected that either the ICB or the MSK provider will recruit the SEAs or EAs into the service.  

Taking learning from the EAs in TT, ICBs or services are expected to recruit SEAs before EAs. The SEA will play a key role in building the employment support team. This will enable the SEA to work with the MSK service and clinicians to put in place and begin to operationalise the process of triage, the MDT approach and how the clinical and employment service will integrate and work together to support patients with MSK conditions.    

SEAs will have oversight for the employment advice service and will ensure that the service connects with other local work and health arrangements. PoC sites should ensure that SEAs are integrated into relevant MSK service management teams, which provide a forum to consider the performance of the combined MSK treatment and employment support offer. SEAs will assume responsibility for the recruitment of EAs and embedding employment support within the MSK setting and/or service. Example job descriptions for SEAs and EAs are provided in appendix D.

When developing applications, ICBs and services should factor into proposals realistic timelines for the recruitment and induction of EA teams. Ideally services will have EA capacity and begin to start to support patients with MSK conditions from autumn 2024. ICBs are encouraged to consider how the EAs in MSK PoC might align with their EAs in TT service and the merits of considering joined up recruitment approaches and/or pooling employment advice. We normally expect EAs to see a minimum of 120 patients a year. SEAs are expected to see around 12 patients per year, this is 10% of the average EA caseload.

DWP strategic partnership managers^{[footnote 1]} and OHID regional leads^{[footnote 2]} are key points of contact for interested applicants and who can, depending upon availability, share their expert knowledge and understanding of the local provision landscape. As such, local and regional colleagues may be part of any discussions and engagement with local stakeholders that would provide the basis for their proposals for the local EAs in MSK service such as by sharing a view of where there are gaps, helping connect multiple stakeholders, for example from Jobcentre Plus (JCP) networks and the voluntary sector.

Service capacity and troubleshooting  

ICBs and MSK providers are expected to provide a realistic and pragmatic approach to setting up the EA team, while considering how to design and test out innovative approaches to providing such a service. JWHD relationship managers (RMs) will be in place to support ICBs to deliver the project.

In most circumstances, within the duration of the PoC, it is anticipated that ICBs and MSK services will achieve set up and active deployment of a core team (as per the model designated in the application). If circumstances arise where there is an anticipated and/or observed increase in demand for employment support, beyond the EA team’s capacity that is to such an extent that each EA is required to support more than 10 new clients per month, then sites will initially discuss with their designated RM who will inform the JWHD team. This will enable the central delivery team to support options appraisal with the PoC site.

Similarly, PoC sites are required to alert RM of any lag in recruitment, EA vacancies and/or persistent high or low demand for employment support. Early notification will mean that RMs are better placed to support ICBs and MSK services to consider options.

The service specification can be found in appendix D.

Governance and accountability    

Clinical governance is the system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence will flourish.

ICBs and MSK services and/or settings applying to become an EAs in MSK PoC site must consider and provide information on how the PoC will align and comply with existing local clinical governance arrangements. ICBs should also consider indemnity of the EA teams.

PoC sites will need to align with NHS best practice on clinical governance. It will be for individual PoC sites to determine the governance approach that is most appropriate for how they intend to deliver^{[footnote 3]}.

Project evaluation

PoC evaluation outline

While there is growing evidence to support embedding employment support within healthcare settings, there is a need to fill the evidence gap on the impacts of employment advice on work and health outcomes for people with MSK conditions. Evidence and evaluation are at the heart of the EAs in MSK PoC and larger evaluated roll out (in the form of a larger scale study). The proposed approach to the evaluation is outlined in this section. To note that this is subject to change and further development.

The PoC evaluation will develop our understanding of the barriers and enablers of embedding EAs in MSK services and help to provide guidance for further roll out. The process evaluation will explore provider and stakeholder experiences to inform an analysis of how the programme is structured and functions, how and what works or does not work and the mechanisms that may support impact.

We anticipate that the PoC evaluation will take place from late 2024 until March 2026. Evidence from the PoC evaluation will play a key role in the wider evaluated roll out.

We plan to use a mixed-methods approach including:

• process evaluation
• MI or data strand

As part of the PoC evaluation, all sites are required to report on the delivery of EAs in MSK, using a standard set of metrics specified by the JWHD as part of the MI data capture process. MI requirements are in development and are likely to include delivery, participant and outcomes metrics (see below). The data will be captured by sites at the individual level, using a template supplied by the JWHD, and returned to the JWDH as site-level (aggregate) data.

Note: MI requirements may change over time, particularly as the JWHD seeks to gather more comprehensive data on outcomes for example.

The data has been discussed in detail and agreed upon with stakeholders through various forums including an interim working group. JWHD colleagues will work with PoC sites to determine the best approach to data collection in their site. The means by which data or MI will be collected and analysed in-house is currently being considered and will be confirmed before funding is approved. We anticipate using either standard MI templates or an IT-driven solution. We recognise that sites have different IT systems and that seeking consistency of data or MI returns is likely to be challenging but is essential to the success of the evaluation. The MI collected and the method of collection will be included in the evaluation, so that we can learn lessons for the evaluated roll out.

EAs in MSK project leads are working with colleagues across other work and health programmes to align data requests and have collaborated with local areas to refine requirements. The JWHD will carry out in-house analysis and monitoring of the data. The metrics captured will include:

• delivery metrics (such as participant volumes, sources of referral or number of EAs)
• participant metrics (such as participant demographics, work and health status)
• outcome metrics (such as health and work status changes over time)

All PoC sites must actively engage with the evaluation to support the test and learning from the models being implemented to inform the larger scale roll out and analysis. In addition to the MI, the PoC evaluation will include a process study involving provider and/or stakeholder perspectives, to share learnings from the process (through surveys and interviews to explore experiences and outcomes).

High level research questions

Delivery and implementation:​

How is the intervention operating? ​How do referrals take place?​

What employment barriers do clients face?​

Do employment outcomes differ for those who undertake EA in MSK support compared to those who do not?​

Do health outcomes differ for those who undertake EA in MSK support compared to those who do not?

Is the intervention cost effective?​

What’s the best model to take forward to trial?

What is in and out of scope for the PoC sites

In scope	Out of scope
EAs in MSK PoC is a test and learn approach to deliver integrated employment and clinical advice for people living with MSK conditions who are in-work and at risk of falling out, or out-of-work and where health is a barrier to work.	EAs in MSK is not a standalone service and so PoC sites should not design as such.
EAs in MSK PoCs will integrate employment advice within MSK services and settings.	EAs in MSK is not a standalone service and so PoC sites should not design as such.
PoC will provide service for patients diagnosed with MSK condition and symptoms and living with other morbidity.	Patients, who might benefit from employment advice, though only diagnosed with other chronic diseases, not defined as a MSK condition.
EAs in MSK will co-exist alongside and enhance other existing local work and health offers where available, including NHS TT, WorkWell and JCP.	The PoC is not a replacement for existing services.
The role of EAs in MSK during the PoC should comply with that outlined in the service specification albeit flexibility to integrate novel and innovative models and/or approaches is in scope.	EAs employed and funded, through the project, should not undertake tasks not outlined in the service specification and/or what is agreed with JWHD as part of the PoC.
PoC is focussed on what works for EAs in MSK services or settings - some limited patient data will be collated.	PoC sample sizes will not be powered to enable significance testing on any patient outcomes.
EAs support vocational work and health training within local healthcare systems.	EAs employed as part of the project are not to be exclusively tasked with promoting and/or training of HCPs on work and health issues.

Across England​

In scope	Out of scope
Participate in a programme of national and regional cross-system learning with PoC sites, to share learning and delivery experience and expertise that ensures all areas can benefit.	The devolved administrations are out of scope for this project.

Support available for ICBs and healthcare providers

Engagement

The JWHD wants to enable ICBs and MSK providers to apply and become PoC sites. Building on the mini-series of development workshops (held in November 2023) 2 national webinars will be hosted in late spring 2024, with further details announced in due course.

These webinars will provide opportunities for interested ICBs, MSK service providers and other national and local stakeholders to come together, hear from the national team, NHS England colleagues and importantly EAs working on NHS TT. These events will provide a forum for questions, which the national team will compile and provide answers to ensure that all interested parties have access to the same information.

The national team will liaise with OHID and DWP regional colleagues and wherever possible will attend regional work and health network events as another means of supporting interested parties.        

National support

The JWHD is developing an induction learning pack, adapted from the EAs in TT programme, which will become available to support locally-driven continuous professional development. A community of practice and support offer will support continuous improvement.

Relationship managers

RMs have proven pivotal in supporting ICBs to deliver EAs in NHS TT. The EAs in MSK project will benefit from a cohort of RMs being deployed to support ICBs and MSK services as they embark on preparing applications and becoming PoC sites.

RMs will play a role in liaising with NHS England regional teams, ICB commissioners, clinical and service leads and SEAs in each site. The RM should be the initial contact point for all enquiries about the EA in MSK PoC.     

RMs will organise themselves against NHS England regions. During the application stage RMs will be on hand at engagement sessions to assist with queries and their experience, from EAs in NHS TT, will support responses to questions submitted to jwhd.msk@dwp.gov.uk.    

During the PoC, each EA in NHS MSK site will have access to the support provided by a RM. The RM is the initial contact point for all enquiries about the EA in MSK project. Further detail on the role of a RM is included in appendix D.

Strategic partnership managers and OHID region and place health and work contacts   

Question and answer documents about EAs in MSK will be available for sharing. To be added to the distribution list and for all other EAs in MSK enquiries, email jwhd.msk@dwp.gov.uk.

Applicants may also contact regional OHID leads or the DWP strategic partnership managers (below) for further information and discussion about the regional work and health landscape and how EAs in MSK fits in.

Contacts for regional work and health leads within OHID:

Region	Contact
OHID Midlands	sean.meehan@dhsc.gov.uk
OHID East of England	neil.wood@dhsc.gov.uk
OHID South west	dominic.gallagher@dhsc.gov.uk
OHID Yorkshire and the Humber	nicola.corrigan@dhsc.gov.uk
OHID North east	helen.ford@dhsc.gov.uk
OHID London	elaine.rashbrook@dhsc.gov.uk
OHID South east	victoria.heald@dhsc.gov.uk
OHID North west	rachel.swindells@dhsc.gov.uk

Contacts for DWP strategic partnership managers:

Region	Contact
North west	nicki.o’connor@dwp.gov.uk
South west	sarah.carhart@dwp.gov.uk
West Midlands	mandy.williams@dwp.gov.uk
North Central	sharon.riding@dwp.gov.uk, lynsey.ellis@dwp.gov.uk
Northeast	sharon.thorpe@dwp.gov.uk
London and Essex	marian.keane@dwp.gov.uk
South east	anna.marshall@dwp.gov.uk
North and East Midlands	brendon.downie@dwp.gov.uk

View the geographic descriptions of each DWP region.

Getting and staying in touch

EAs in MSK related enquiries can be sent to jwhd.msk@dwp.gov.uk.  

The application guidance is available in appendix A.

1. The strategic partnership manager role is a key strategic regional interface between DWP policy directorates, other UK government departments regional teams policy teams, local authorities, key regional stakeholders. Acting as head of employer and partnership activity across the region ↩

2. OHID supports the delivery of national and regional priorities for prevention and health inequalities and ensuring a joined-up approach to public health, building strong interfaces with different teams and areas of public health across the regional system ↩

3. Applicants may wish to refer to the NHS and LGA Thriving places guidance (PDF, 360KB) ↩