Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government, further to the Written Answer by Baroness Sherlock on 19 January (HL13274), whether they have now responded to the recommendations from the Keep Britain Working Review regarding the fit note; what further reforms to the fit note system they plan beyond the WorkWell Primary Care Innovation Fund pilots; and when they expect to publish those plans.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
On 20th May 2026, the Government announced that it would test reform of the fit note, beginning with pilots across four integrated care boards in England. These pilots are funded by £3m in the first year and will take place within a small number of GP surgeries across the following areas: Birmingham and Solihull, Cornwall and Isles of Scilly, Coventry and Warwickshire, and Lancashire and South Cumbria.
The pilots will explore replacing the traditional GP-led fit note process with newly designed plans that provide better support to people who fall ill at work. They aim to move from a process of administrative sickness certification to a new service focussed on getting people the support they need to stay in work and sustainably return.
Whilst specific elements of pilot design are to be shaped locally, broadly, the pilots will test:
The pilots have been designed through close engagement with GP leaders and the health system. We are also working with employer and patient groups to shape design as pilots progress. Within all four pilots, teams will be able to sign people off work who need time to recover from their illness. The pilots are focussed on the in-work population (either those who are at risk of falling out of work due to illness or those who are already signed off sick). Participation will be voluntary, and the pilots will not determine eligibility for any benefit entitlement or replace the Work Capability Assessment. Any future rollout or legislative reform will be informed by learnings from the pilots.
The fit note pilots are a key element of the Government's response to the recommendations made in the Keep Britain Working Review, published in November 2025. The Review was clear that the fit note is 'not working as intended', and called for the Government to test alternatives and replacements to the fit note. Any long-term system reform is expected to combine employer and state funded provision, balancing the engagement benefits of employer-led support with the necessity for non-workplace provision (for example, for those who leave work due to illness). We are working closely with the Keep Britain Working Vanguards as they test the 'best case' for an employer-led intervention, with the NHS-based pilots running in parallel, and learnings from each model being used to inform future reform.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government, further to the Written Answers by Baroness Sherlock on 19 January (HL13272 and HL13273), whether information on the shape and remit of the Vanguard Taskforce and the Workplace Health Intelligence Unit has now been confirmed; what the terms of reference and membership of the Vanguard Taskforce are; and what the remit, governance arrangements, and operational timetable of the Workplace Health Intelligence Unit are.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
Work is progressing at pace on the Keep Britain Working Vanguard Phase following publication of the review’s final report in November. Led by Sir Charlie Mayfield, Co-Chair of the Vanguard Phase, we have been working closely with Vanguard employers, regions and stakeholders to mobilise the Vanguard Phase.
As part of this, a Vanguard Taskforce/ Advisory Group has now been established and is chaired by Sir Charlie Mayfield, in partnership with the Department for Work and Pensions, the Department of Health and Social Care and the Department for Business and Trade. The Taskforce brings together external experts from across business, trade unions, health, and disability and inclusion fields; full membership has been published as part of the Keep Britain Working March update, on Gov.uk (Annex B).
The Taskforce is an external advisory body. It provides independent advice, insight and constructive challenge to support delivery of the Vanguard Phase, including testing and refining emerging proposals and advising on the feasibility and impact of workplace health interventions. It has no decision-making powers, with policy decisions remaining with Ministers. The full terms of reference will be published on Gov.uk in due course.
We are making progress on setting up the Workplace Health Intelligence Unit (WHIU). During the Vanguard Phase we are working with employers, experts and partners to design the Unit’s functions and operating model, including how it can best act as a central hub for evidence, insight and employer-facing support. This includes considering its governance arrangements and how it will work across Government to maximise impact. Further detail on the Unit will be set out in due course as this design work progresses.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government what assessment they have made of the reasons why the number of child recipients of the Disability Living Allowance is increasing.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
There have been steady increases over the last two decades in the number of children in receipt of Disability Living Allowance (DLAc), from 230,000 in May 2002 to 840,000 in May 2025, excluding Scotland claims. These increases are driven primarily by increases in the number of claimants with learning difficulties (including Autism Spectrum Disorder), hyperkinetic syndrome (including Attention Deficit Hyperactivity Disorder) and behavioural disorders which have increased from 48% of the caseload in May 2002 to 83% in May 2025.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government what pilots are currently underway to test reforms to the fit note system, including the locations and duration of those pilots, and the groups of patients and employers involved; what further reforms to the fit note system they are planning, beyond the current pilots; and when they expect to publish further details.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
On 11th July 2025, we announced a WorkWell Primary Care Innovation Fund, which offered a portion of £1.5 million of single year funding to each of the fifteen WorkWell pilot sites to test innovative approaches to the fit note within primary care.
The funding is supporting local areas to boost capacity in primary care to provide better work and health support via the fit note process, with the longer term aims of reducing pressure on GPs and improving patients’ work and health outcomes.
Each of the 15 WorkWell Integrated Care Boards has received up to £100,000, with interventions running from October 2025 to March 2026. The locations of the sites are:
Birmingham and Solihull,
Black Country,
Bristol North Somerset and South Gloucestershire (BNSSG),
Cambridgeshire,
Cornwall and Isles of Scilly,
Coventry,
Frimley,
Greater Manchester,
Herefordshire,
Lancashire and South Cumbria,
Leicester, Leicestershire and Rutland (LLR),
North Central London,
North West London,
South Yorkshire, and
Surrey Heartlands.
One of the key aims of the funding is to build the evidence base for how the fit note process within primary care can be improved, and findings will inform future policy development. Most sites are using the funding to test new or additional roles within Primary Care Networks, including social prescribers, work and health coaches, or physiotherapists, to either issue the fit note instead of the GP or provide wraparound work and health support to the fit note recipient.
However, we know that we need to go further. The Keep Britain Working Review was clear that the fit note is ‘not working as intended’ and recommended that we test alternative approaches to the fit note, working with GPs and health services to explore improvements and replacements. We are currently considering how to respond to the Review’s recommendations on the fit note, and we will bring forward more information in due course.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government what progress they have made on setting up the Workplace Health Intelligence Unit proposed in the Mayfield Review, and what its planned remit, governance arrangements, and timetable for operation are.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
Work has commenced on the Keep Britain Working Vanguard Phase following publication of the review’s final report in November. We are working with Sir Charlie Mayfield, Vanguard employers and regions to mobilise and design this next phase of work and establish effective ways of working. The vanguards will play a pivotal role in shaping how health issues and disabilities are managed in the workplace, building an evidence base and understanding of what works through effective partnership with employers.
As part of the Vanguard Phase, Sir Charlie Mayfield has agreed to establish and lead a Vanguard Taskforce/advisory board in partnership with Department for Work and Pensions, Department for Business and Trade, and Department of Health and Social Care. The Vanguard Taskforce will bring together a group of external experts from various sectors and organisations to provide external advice, and guidance to steer the Keep Britain Working Vanguard Phase. We are currently considering the Terms of Reference and potential membership of the taskforce.
The Workplace Health Intelligence Unit (WHIU) will serve as the central hub for delivery of the whole Vanguard Phase and to drive on-going work. We are currently working to establish the Intelligence Unit within Government and considering options for its design and details of its function. A comprehensive governance framework, incorporating the taskforce, will be established to ensure strategic oversight and accountability of the Unit as it is set up and developed.
Further information on the shape and remit of the Vanguard Taskforce and Workplace Health Intelligence Unit is expected in Spring 2026.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government what progress they have made on establishing the Vanguard taskforce proposed in the Mayfield Review, and when the taskforce is expected to start work.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
Work has commenced on the Keep Britain Working Vanguard Phase following publication of the review’s final report in November. We are working with Sir Charlie Mayfield, Vanguard employers and regions to mobilise and design this next phase of work and establish effective ways of working. The vanguards will play a pivotal role in shaping how health issues and disabilities are managed in the workplace, building an evidence base and understanding of what works through effective partnership with employers.
As part of the Vanguard Phase, Sir Charlie Mayfield has agreed to establish and lead a Vanguard Taskforce/advisory board in partnership with Department for Work and Pensions, Department for Business and Trade, and Department of Health and Social Care. The Vanguard Taskforce will bring together a group of external experts from various sectors and organisations to provide external advice, and guidance to steer the Keep Britain Working Vanguard Phase. We are currently considering the Terms of Reference and potential membership of the taskforce.
The Workplace Health Intelligence Unit (WHIU) will serve as the central hub for delivery of the whole Vanguard Phase and to drive on-going work. We are currently working to establish the Intelligence Unit within Government and considering options for its design and details of its function. A comprehensive governance framework, incorporating the taskforce, will be established to ensure strategic oversight and accountability of the Unit as it is set up and developed.
Further information on the shape and remit of the Vanguard Taskforce and Workplace Health Intelligence Unit is expected in Spring 2026.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government what are their plans for reforming the Access to Work scheme, including the objectives and timetable of any such reform, and how they will involve disabled people and representative organisations.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
This Government values the input of disabled people and people with health conditions, their representative organisations and people that support them. The Pathways to Work Green Paper launched a consultation which has now concluded. We are considering responses to the consultation.
We also have recently concluded the Access to Work Collaboration Committees, in which we engaged with a range of stakeholders, including disabled people’s organisation representatives and lived experience users, to provide discussion, experience, and challenge to the design of the future Access to Work Scheme.
Whilst the committees have now ended, we will seek opportunity to engage with stakeholders as we move forward with policy development, recognising the value of their input and expertise.
The findings from the consultation and Collaboration Committees will inform the chosen future direction of Access to Work. Once this is established we will set out our plans working closely with stakeholders to ensure an appropriate transition.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government, further to the Written Answer by Baroness Sherlock on 24 November (HL11931), whether the report into young people and work will also examine reasons for the increase in the number of young people with disabilities and health conditions, and if not, what plans they have to investigate the reasons for this increase.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
The rising number of young people who are not in education, employment or training (NEET) is a crisis of opportunity that demands more action to give them the chance to learn or earn.
To truly address the root causes of youth inactivity, we need a deeper understanding of the barriers that disabled young people and those with health conditions face. The Report will examine the drivers behind the rise in NEET rates and economic inactivity among young disabled people and those with health conditions.
On the 4th of December my right hon. Friend the Secretary of State for the Department for Health and Social Care launched an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism.
The review will look to understand the similarities and differences between mental health conditions, ADHD and autism. It will look at prevalence, early intervention and treatment, and the current challenges facing clinical services.
The review will also seek to identify opportunities to provide different models of support and pathways, within and beyond the NHS, that promote prevention and early intervention, supplementing clinical support.
Asked by: Baroness Shawcross-Wolfson (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government whether the report into young people and work will examine the reasons behind the number of young people claiming health and disability benefits.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
We recognise that some young people are struggling to find their place in work, education or training.
The report into young people and work will seek to:
The Right Honourable Alan Milburn will author the report and will be supported by a range of voices with expertise from the labour market and health spheres.