Impact of Patient Advisory Service on Employment in Primary Care

Background The Department for Work and Pensions established the Patient Advisory Service (PAS) in 2008 to address rising economic inactivity linked to long-term sickness. Integration of PAS into primary care places Work Coaches and Disability Employment Advisors within NHS settings to provide person-centred employment support. Aim To evaluate the impact of PAS on employment transitions among adults with health conditions and examine how engagement patterns and support types influence return-to-work outcomes. Method Cross-sectional analysis of routinely collected PAS service data from 17 Integrated Care Boards in England between September 2022 and June 2024. Participants included unemployed, employed (including those on sick leave), self-employed, and pension-age individuals seeking to return to work. Advisors delivered non-clinical employment support through face-to-face, telephone, video, or digital consultations. Associations between participant and interaction characteristics and employment transitions were examined using logistic regression. Results Among 2,517 patients and 7,494 advisor interactions, 8.4% reported starting work after their latest consultation. Three or more interviews were associated with higher odds of returning to work (aOR = 1.69; 95% CI:1.19–2.38), while welfare benefit receipt predicted lower odds (aOR = 0.40; 95% CI:0.32–0.50). Face-to-face and telephone sessions were longer than digital interactions, but structured support tool use remained limited. Conclusion Sustained engagement with PAS enhances employment transitions, but welfare dependency and inconsistent practice constrain outcomes. Strengthened training, data capture, and tailored support pathways could increase the service’s effectiveness in primary care.