Work and Health Coach Fit Note Reform Pilot

Cornwall is one of 4 places chosen to trial new ways of supporting people who need to be signed off work due to ill health. This Government pilot will replace traditional fit notes with personalised Workability Plans – meaningful, strengths‑based conversations that focus on what people can do and the support they need to thrive in work. Each of the 4 regions is asked to trial a different workforce for providing this extra help and support to people. Thanks to the strength of social prescribing and coaching practice in Cornwall, our trial workforce will be primarily made up of work & health coaches, with expert clinical oversight from an occupational therapist.

The Government plans to use pilot learnings to inform national roll‑out of reforms next year, with legislative change backed by funding for the workforce that proves most effective in providing people with extra help and support when their health makes work a struggle. We’re looking for skilled, compassionate Work & Health Coaches to join us in trialling these reforms and put personalised conversations and support at the heart of the fit note process.

Key Responsibilities

• Lead workability conversations with patients seeking time off work.
• Explore the relationship between health, wellbeing & employment.
• Co‑produce personalised workability plans and, where appropriate, longer‑term support plans.
• Provide ongoing coaching & support to help people return to or remain in work.
• Work closely with GPs, OTs & other partners.
• Help shape & test an innovative new approach as part of a national pilot.
• Be at the forefront of delivering a single, holistic conversation that combines assessment, coaching & support – reducing duplication & improving outcomes for patients.

1. Workability Assessment and Coaching
   • Deliver structured workability conversations to assess the impact of health on work job role demands, opportunities for adjustments and support.
   • Develop personalised workability plans focused on functional ability and return‑to‑work opportunities.
   • Provide holistic coaching support, including: goal setting, action planning, motivational support.
   • Deliver ongoing Well coaching, typically across multiple sessions when appropriate.
   • Support patients to identify and overcome health‑related and social barriers to employment.
2. Triage and Case Management
   • Undertake or support triage of patients.
   • Identify when cases require no further intervention, coaching support or escalation to clinical colleagues (e.g. Occupational Therapist).
   • Manage a caseload of participants, ensuring timely follow‑up and progression.
   • Ensure appropriate risk identification and escalation to clinical staff.
3. Participant Support and Enablement
   • Provide person‑centred, strengths‑based support, focusing on what matters to the individual.
   • Co‑produce workability plans addressing physical, mental and social barriers.
   • Support access to services including: health services, community and voluntary sector support, employment and skills provision.
   • Liaise with employers (with consent) to support workplace adjustments and return‑to‑work plans.
   • Use available resources (e.g. personal budgets/solutions funding) to address barriers.
4. Partnership & MDT Working
   • Work as part of a PCN multi‑disciplinary team, including GPs, OTs and social prescribers.
   • Build strong relationships with employers, Jobcentre Plus, VCSE organisations, health and wellbeing services.
   • Participate in MDT meetings, case discussions and shared care planning.
     • Support integration of WorkWell and fit note reform pathways.
5. Service Development and Innovation
   • Support delivery of the Fit Note Reform Pilot service design.
   • Contribute to embedding: the work question in primary care, improved fit note/workability processes.
   • Test and evaluate new approaches, contributing to continuous improvement and learning.
   • Develop resources, case studies and best practice.
6. Data, Reporting and Evaluation
   • Maintain accurate and timely case records and outcome data.
   • Support monitoring and reporting requirements for the pilot.
   • Capture participant feedback and outcomes.
   • Use data to support service evaluation and improvement.
7. Professional Responsibilities
   • Work within organisational policies including safeguarding, confidentiality and information governance.
   • Participate in supervision, training and development.
   • Engage in coaching supervision and reflective practice.
   • Maintain professional boundaries and recognise when to escal…

Professional Responsibilities

• Skilled in coaching‑style, person‑centred conversations.
• Passionate about reducing health inequalities & supporting people into work.
• Confident working with individuals facing complex barriers.
• Able to work collaboratively within a multidisciplinary team.
• Comfortable with innovation, change & learning as we go.
• Experience in social prescribing, health coaching, employment support or community roles is highly desirable.

Experience and Skills

• Experience of supporting people, their families and carers in a related role (including unpaid work).
• Experience of partnership/collaborative working and of building relationships across a variety of organisations.
• Experience of working directly in a community development context, adult health and social care, learning support or public health/health improvement (including unpaid work).
• Experience of working for a voluntary or statutory organisation that has supported people with one or more of the following: money and welfare, housing, mental health, isolation, physical activity, bereavement, carers needs or support for elderly.
• Experience of using coaching approaches/frameworks and models or other helping strategies e.g. Motivational Interviewing.
• Experience of supporting people with their mental health, either in a paid, unpaid or informal capacity.
• Experience of working with the VCSE sector (in a paid or unpaid capacity), including with volunteers and small community groups.
• Experience of data collection and providing monitoring information to assess the impact of services.
• Ability to listen, empathise with people and provide person‑centred support in a non‑judgemental way.
• Able to get along with people from all backgrounds and communities, respecting lifestyles and diversity.
• Commitment to reducing health inequalities and proactively working to reach people from all communities.
• Able to support people in a way that inspires trust and confidence, motivating others to reach their potential.
• Ability to communicate effectively, both verbally and in writing, with people, their families, carers, community groups, partner agencies and stakeholders.
• Ability to identify risk and assess/manage risk when working with individuals.
• Have a strong awareness and understanding of when it is appropriate or necessary to refer people back to other health professionals/agencies, when what the person needs is beyond the scope of the link worker role e.g. when there is a mental health need requiring a qualified practitioner.
• Able to work from an asset‑based approach, building on existing community and personal assets.
• Ability to maintain effective working relationships and to promote collaborative practice with all colleagues.
• Commitment to collaborative working with all local agencies (including VCSE organisations and community groups).
• Able to work with others to reduce hierarchies and find creative solutions to community issues.
• Demonstrates personal accountability, emotional resilience and works well under pressure.
• Ability to organise, plan and prioritise on own initiative, including when under pressure and meeting deadlines.
• High level of written and oral communication skills.
• Ability to work flexibly and enthusiastically within a team or on own initiative.
• Understanding of the needs of small volunteer‑led community groups and ability to support their development.
• Knowledge of and ability to work to policies and procedures, including confidentiality, safeguarding, lone working, information governance, and health and safety.
• Understanding of the wider determinants of health, including social, economic and environmental factors and their impact on communities.
• Knowledge of community development approaches.
• Knowledge of IT systems, including ability to use word processing skills, emails and the internet to create simple plans and reports.
• Knowledge of motivational coaching and interview skills.
• Knowledge of the personalised care approach.
• Local knowledge of VCSE and community services in the locality.

Qualifications

• NVQ Level 3, Advanced level or equivalent qualifications or working towards.
• Coaching/counselling qualification/experience or other relevant qualification/experience involving reflective listening skills.
• Training in motivational coaching and interviewing or equivalent experience.

Additional Requirements

• Meets DBS reference standards and has a clear criminal record, in line with the law on spent convictions.
• Willingness to work flexible hours when required to meet work demands.
• Understanding of and a commitment to equality, diversity and inclusion.
• Access to own transport and ability to travel across the locality on a regular basis, including to visit people in their own homes.

This is a unique opportunity for you to join a high‑profile pilot, influence future Government policy, and help shape a new model of supporting people with health and work – all while working in a supportive community of practice and making a real difference to people’s lives.