Employability through health? Partnership-based governance and the delivery of Pathways to Work condition management services

In Britain, as the government seeks to provide services to activate claimants of incapacity benefits, and help them overcome health-related barriers to work, the Pathways to Work initiative has been rolled out to 49 Jobcentre Plus districts across the nation. This development of the Pathways to Work has seen a heavy reliance on the contracting-out of services to the private sector, with Lead Providers paid according to job outcomes achieved for clients, and during the initial development of Pathways to Work, the initiative was defined by a flexible, partnership-based form of governance, with a key role for the National Health Service (NHS) in the delivery of health 'condition management' services - an approach that has been retained in a minority of Jobcentre Plus Districts. This article, based upon a review of previous evaluation evidence and more than 50 in-depth interviews with NHS staff and managers, critically assesses this partnership-based governance model and the potential added value flowing from the involvement of the NHS and its professional clinicians in the delivery of condition management services. The article concludes by outlining lessons for the development of governance and delivery mechanisms for condition management under the Pathways to Work regime and future employability and health interventions