Health and Work Conversation
Booklet
WORK COACH VERSION
Work coach guidance:
These grey boxes contain information for you about how to guide
a claimant through the Health and Work conversation.
1. This document contains the claimant version of the Health and Work
Conversation booklet as well as work coach instructions for guiding the
claimant through each part of the Health and Work Conversation.
2. The booklet has two types of instructions for work coaches:
a. Work coach guidance sections provide instructions you need to
follow.
b. Script sections suggest what to say to the claimant. You don’t have
to follow these exactly - adapt them to your style.
1
Employment and
Support Allowance
Health and work conversation
Please ask your work coach if you need this booklet in braille,
large print or audio.
What is the health and work conversation?
The health and work conversation is a type of work-focused
interview. This isn’t your Work Capability Assessment.
The conversation isn’t about you looking or applying for work now,
it’s about helping you get into work when you’re able to in the
future. It can help you get to know your work coach and plan
simple steps to help build your confidence and motivation.
You and your work coach will use simple tools to talk about an
action that you want to do, and plan how you can do it. You’ll be
able to talk openly to your work coach who can put together a
plan of support for you.
Please fill in the About me section
Before you see your work coach, please have a go at answering
the questions in the
About me section on page 2. The answers you
give will help you have a better conversation with your work coach
and help them find the best support for you.
There are no right or wrong answers – just think about what
matters to you. If you feel uncomfortable answering any of the
questions, you can stop and come back to them later.
Please only fill in page 2, because your work coach will talk you
through the rest of the booklet.
Do you need to take part in the health and work
conversation?
Yes. The health and work conversation is part of your claim to ESA.
Your ESA payments could be reduced if you don’t take part in
your conversation.
Is this your Work Capability Assessment?
No. The health and work conversation isn’t a Work Capability
Assessment. The details of this health and work conversation will
not be shared with the healthcare professional that carries out
your assessment.
HWC1 1/17
Work coach guidance:
Starting the Health and Work Conversation
Work coach guidance
Greet the claimant and thank them for coming in.
Explain to the claimant that the purpose of the HWC is to help them think
about what’s important to them and how to move towards their goals.
Reassure the claimant that:
1. this conversation is not their Work Capability Assessment
2. all actions will be voluntary
3. they do not have to do anything that they are not comfortable with
If the claimant hasn’t done so already: Ask the claimant to complete the
‘About Me’ section of the booklet.
NB. The claimant only has to fill out the sections of the ‘About Me’ form that
they want to fill out – you do not have to ensure that every question has an
answer. The About Me is just a quick way to find out a bit more about the
claimant to inform the rest of the conversation.
Script
Hello. Thanks very much for coming in today. My name is….
The Health and Work Conversation is a new thing that Jobcentres are
doing. It’s to help you think about your interests and goals and how to
achieve them.
This is not your Work Capability Assessment. This is not the appointment
where we assess your capability for work.
Also, any actions we come up with today will be voluntary - it’s up to you to
carry those things out if you think they’re helpful.
During the conversation today, we’ll go through a few different things. First
I’ll ask you to tell me a bit about yourself. Then we’ll talk about your goals
and how to help you achieve them. Finally, we’ll end the conversation by
talking about the support available for you.
At any point, you can just let me know if you don’t feel comfortable
discussing something.
To start, I’d like you to write down a little about yourself. We’ll be using this
booklet, and I’d like you to take a seat and complete the page that says
“ABOUT ME” on the top. When you’re finished, come over and let me know.
3
About me
Please fill in your details below:
First name
Last name
Please answer the following questions honestly, as this will help you and your work coach
have a good, open conversation and focus on the things that matter to you.
What kinds of things do you like
doing in your life and at work?
For example, cooking, speaking
to people, being outside.
What are you good at?
For example, working with others,
computer skills or being patient.
How does your health affect
your life and your ability to
work?
For example, you cannot sit for a
long time, or you are nervous in
some situations.
What work have you done
in the past, if any?
What are some of the things
that have made you proud in
your life or at work?
For example, helping someone,
being thanked or doing
something for charity.
Is there anything else in your
life that makes it difficult for
you to work?
For example, housing or debt
issues, you are a carer for
someone or you are having
relationship problems.
What help do you need to get
back to work?
Tell us how and what you want
to do and if you need support.
Please do not fill in any more of this booklet.
Your work coach will speak to you about your ‘My 4 steps’ on the next page.
2
Work coach guidance:
Discussing the About Me
Work coach guidance
When the claimant has finished completing the About Me, tell them you will
take a few moments to look through it.
Start the discussion by acknowledging the claimant’s health condition but
then quickly move onto something positive they have mentioned, such as
an activity they enjoy doing.
If you notice any specific support needs (such as a need to refer the
claimant to mental health services), make a note of these and come back to
them in the My Actions section at the end of the HWC.
The entire discussion regarding the About Me shouldn’t take more than 5
minutes.
It’s just a start to the conversation and you can come back to any support
needs later in the conversation.
5
Please use separate My Values sheet
6
Work coach guidance:
OPTIONAL: Give the claimant the separate “My Values” exercise
sheet
Work coach guidance
The My Values exercise is optional. However, it is an evidence-based way
to encourage people to be more open to challenges, so it can be very useful
during the HWC.
We recommend you use the My Values especially if the claimant seems like
they don’t want to engage, but it is useful for all claimants, so try to use it as
much as possible.
This exercise is done on a separate sheet as the answers can be quite
personal. Don’t make a copy of that separate sheet or record the claimant’s
answers.
The claimant does not have to share their answers to this exercise with you
if they don’t want to – they can do the exercise but keep their answers
private.
The most important thing is that the claimant is comfortable doing the
exercise. Encourage them to do it by explaining that a wide range of people
find it helpful.
If the claimant has language barriers, you can ask them to write their
answers to My Values in the language they are most comfortable with.
If writing is a problem, you can do the exercise verbally with the claimant –
either directly or using an interpreter.
After the claimant has finished, ask them if they would like to share anything
about the exercise, but don’t push them.
Script
Next, I’d like you to spend a moment thinking about your personal values –
things that matter to your or that make you happy.
The reason I’d like you to do this exercise is because I want to make sure
that in our conversation today we really focus on things that you care about.
Other people have found that this exercise can be really helpful for thinking
about wishes and goals.
When you’ve finished, you won’t have to show or tell me what you’ve written
unless you want to. It’s completely up to you
I’ll just be here if you have any questions.
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My 4 steps
What are the My 4 steps?
One of the side effects of having a disability, illness or health
condition, can be loss of confidence and motivation. The
My 4 steps
exercise in this booklet can help you talk about taking steps to move
forward in the future, looking at any challenges or problems that
you may have.
You and your work coach will use your answers from the
About me
section to talk about your
My 4 steps.
You and your work coach will fill in one of the
My 4 steps, but there
are more you can do yourself at home.
See how My 4 steps can help you.
3
Work coach guidance:
Introduce the claimant to the “My 4 Steps” section of the HWC
Work coach guidance:
“My 4 Steps” is a four step process to help claimants identify a goal and
make a plan to achieve it. The four steps are WANT, OUTCOME,
OBSTACLE, and PLAN.
Before the claimant completes this section, try to make the claimant feel
calm and comfortable (even in the middle of a busy Jobcentre). You can ask
the claimant to take a deep breath, or remind them that this time is about
thinking about the things they care about.
Don’t rush – My 4 Steps should feel like a conversation. Use the scripts to
help claimants find their own answers to each step, then ask the claimant to
write their answers down.
Script:
Following on from the previous exercise, you’ll now have a chance to think
about some important wishes or goals you’d like to achieve.
Now we’ll do something called My 4 Steps. This is an exercise to help you
move towards your goals. It’s based on years of research - lots of people
have used it to help them achieve their goals.
At the end of the exercise we’ll make a plan to help you achieve your goal.
There are no consequences if you don’t carry out the plan. But I hope that
you will carry it out, because I think it can help you.
We’ll start by identifying a goal you’d like to achieve. It can be about
anything you want to achieve in your life – it can be about work or health, or
something else like a relationship or a hobby.
The thing to remember is that the wish should be challenging or realistic. It
should be something that is within your control or power to achieve.
There are no right or wrong answers when it comes to doing this exercise.
Just relax and think about what matters to you.
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My 4 steps continued
Fill in this section of the booklet with your work coach. Look at what you want to do
and how you can do it.
Step 1 – Want (This means ‘what would you like to happen’)
This should be something that is important to you, that you really care about or are excited to do.
It should be something that is not too easy, but still something you think you can do.
Write your answer here:
Step 2 – Outcome (This means ‘what do you believe can happen’)
This is about how you would feel (for example, excited, proud or happy) or what you would
be able to do if you get what you want in
Step 1.
Take a moment to imagine how you would feel.
Write your answer here:
Step 3 – Obstacle (This means ‘what is stopping you’)
This is about what is stopping you from getting what you want in
Step 1. It’s something
within you that you have some control over, and you’re able to do something about it, even
though it is difficult. It could be a habit, something you believe in, or a feeling you have.
Take a moment to imagine what is stopping you.
Write your answer here:
Step 4 – Plan (This means ‘what you are going to do’)
This should be something that helps you get over the obstacle in
Step 3. Your plan should be
something that you can do, and that you believe will be helpful to you.
Write your answer here:
Write down your answers from your
Obstacle in
Step 3 and from your
Plan in
Step 4.
Obstacle from Step 3
Plan from Step 4
If
then I will
4
Work coach guidance:
How to guide the claimant through step 1 (WANT) of My 4 Steps
Guidance: Read out the instructions for the “Want” step in the claimant version of
the booklet. If necessary
, use the script below to give the claimant some additional
guidance on how to think about their Want.
Script:
Your “Want” is something that you want to achieve. It’s a goal that you want
to work towards and reach. It should be important to you, something you
personally really care about or would be excited to achieve.
It should be challenging, but also realistic – something that you can see
yourself achieving in the coming weeks.
It could be something relatively small (e.g. getting to bed on time, spending
more time with family this weekend, completing a chore that you’ve put off
for a while) or something bigger.
Your wish can be about work or health but it can also be about anything
else.
Guidance: Check that the claimant’s goal (their “Want”) is realistic, meaningful, and
not too easy or too difficult by using the points in the script below.
Script:
Is it something that is within your control to achieve? Is it realistic?
Is the Want something that’s personally important to you? Is it something
that really matters to you and that you would be happy to achieve?
Is it challenging?
Guidance: Sometimes claimants choose a goal that is very broad or long-term like
“I want to get better” or “I want to get into work”. Break these down into smaller
Wants that help the claimant move towards the broader goal. For example, you
could use the script below.
Script:
It’s great that you want to achieve that, but it’s a big goal and would be
difficult to achieve in one go. Let’s break it into a smaller goal that will get
you on your way towards achieving that bigger goal.
What is a smaller goal you want to achieve in the next 2 weeks that would
help you move towards achieving that larger goal? We’ll make that smaller
goal your “Want”.
11
My 4 steps continued
Fill in this section of the booklet with your work coach. Look at what you want to do
and how you can do it.
Step 1 – Want (This means ‘what would you like to happen’)
This should be something that is important to you, that you really care about or are excited to do.
It should be something that is not too easy, but still something you think you can do.
Write your answer here:
Step 2 – Outcome (This means ‘what do you believe can happen’)
This is about how you would feel (for example, excited, proud or happy) or what you would
be able to do if you get what you want in
Step 1.
Take a moment to imagine how you would feel.
Write your answer here:
Step 3 – Obstacle (This means ‘what is stopping you’)
This is about what is stopping you from getting what you want in
Step 1. It’s something
within you that you have some control over, and you’re able to do something about it, even
though it is difficult. It could be a habit, something you believe in, or a feeling you have.
Take a moment to imagine what is stopping you.
Write your answer here:
Step 4 – Plan (This means ‘what you are going to do’)
This should be something that helps you get over the obstacle in
Step 3. Your plan should be
something that you can do, and that you believe will be helpful to you.
Write your answer here:
Write down your answers from your
Obstacle in
Step 3 and from your
Plan in
Step 4.
Obstacle from Step 3
Plan from Step 4
If
then I will
4
Work coach guidance:
How to guide the claimant through step 2 (OUTCOME) of My 4
Steps
Guidance: Read out the instructions for the “Outcome” step in the claimant version
of the booklet. Use the script below to give the claimant some additional guidance
on how to think about their Outcome.
Script:
Is your Outcome the best one you can imagine?
Are there any other positive Outcomes you can imagine?
Have you visualised the Outcome and imagined it as fully as possible?
13
My 4 steps continued
Fill in this section of the booklet with your work coach. Look at what you want to do
and how you can do it.
Step 1 – Want (This means ‘what would you like to happen’)
This should be something that is important to you, that you really care about or are excited to do.
It should be something that is not too easy, but still something you think you can do.
Write your answer here:
Step 2 – Outcome (This means ‘what do you believe can happen’)
This is about how you would feel (for example, excited, proud or happy) or what you would
be able to do if you get what you want in
Step 1.
Take a moment to imagine how you would feel.
Write your answer here:
Step 3 – Obstacle (This means ‘what is stopping you’)
This is about what is stopping you from getting what you want in
Step 1. It’s something
within you that you have some control over, and you’re able to do something about it, even
though it is difficult. It could be a habit, something you believe in, or a feeling you have.
Take a moment to imagine what is stopping you.
Write your answer here:
Step 4 – Plan (This means ‘what you are going to do’)
This should be something that helps you get over the obstacle in
Step 3. Your plan should be
something that you can do, and that you believe will be helpful to you.
Write your answer here:
Write down your answers from your
Obstacle in
Step 3 and from your
Plan in
Step 4.
Obstacle from Step 3
Plan from Step 4
If
then I will
4
Work coach guidance:
How to guide the claimant through step 3 (OBSTACLE) of My 4
Steps
Guidance: Read out the instructions for the “Obstacle” step in the claimant version
of the booklet. Make sure the claimant finds an internal obstacle that they can
create a Plan for, not an external obstacle that they have no control over. Help
them identify an internal obstacle by using the script below.
Script:
Is your Obstacle something you can influence or control?
Is your Obstacle an internal obstacle – something inside you?
Is that the true Obstacle?
Guidance: If the claimant feels uncomfortable with finding an internal obstacle,
remind them they don’t have to share anything they’re uncomfortable with, but the
exercise is most helpful if they are open and honest.
Note 1: Sometimes claimants choose
“Wants” that only have external obstacles
they don’t have any control over. For example, they might say they want to go to
language classes, but there are no classes near them. In this situation, check
whether there is another internal obstacle stopping the
“Want”. For example, you
could suggest to the claimant that they do a language class online. If they lack the
computer skills to do an online course, that is an internal obstacle they can
address by doing a computer training course.
If the
“Want” really has no internal obstacle, ask the claimant to choose a new
“Want” which does have an internal obstacle.
Note 2: Sometimes claimants have obstacles that are always present. For
example, a claimant might say their goal is to visit a friend more often, and identify
their chronic pain as an obstacle to this goal. Because the pain is always present,
work with the claimant to identify about specific ways to overcome this issue. For
example, you could say “
Your “Want” is to visit a friend. When is the next time you
could visit and how will your pain make it difficult?” The claimant could say they will
visit their friend on Saturday, and then make a plan to deal with their pain well
enough to be able to visit their friend by that day.
15
My 4 steps continued
Fill in this section of the booklet with your work coach. Look at what you want to do
and how you can do it.
Step 1 – Want (This means ‘what would you like to happen’)
This should be something that is important to you, that you really care about or are excited to do.
It should be something that is not too easy, but still something you think you can do.
Write your answer here:
Step 2 – Outcome (This means ‘what do you believe can happen’)
This is about how you would feel (for example, excited, proud or happy) or what you would
be able to do if you get what you want in
Step 1.
Take a moment to imagine how you would feel.
Write your answer here:
Step 3 – Obstacle (This means ‘what is stopping you’)
This is about what is stopping you from getting what you want in
Step 1. It’s something
within you that you have some control over, and you’re able to do something about it, even
though it is difficult. It could be a habit, something you believe in, or a feeling you have.
Take a moment to imagine what is stopping you.
Write your answer here:
Step 4 – Plan (This means ‘what you are going to do’)
This should be something that helps you get over the obstacle in
Step 3. Your plan should be
something that you can do, and that you believe will be helpful to you.
Write your answer here:
Write down your answers from your
Obstacle in
Step 3 and from your
Plan in
Step 4.
Obstacle from Step 3
Plan from Step 4
If
then I will
4
Work coach guidance:
How to guide the claimant through step 4 (PLAN) of My 4 Steps
Guidance: Read out the instructions for the “Plan” step in the claimant version of
the booklet. Use the script below to give the claimant some additional guidance on
how to think about their Plan.
Script:
Your plan should be an action that you will take would be helpful to do to
overcome your obstacle.
Your plan can be something you do (such as calling a friend) or it could be a
reassuring thought you tell yourself.
Guidance: If the claimant is struggling to identify an action they can take to
address the Obstacle, use the script below to help them think about it.
Script:
What is an effective action or thought to overcome your Obstacle?
Is there something reassuring or helpful you could tell yourself when your
Obstacle comes up? Even just telling yourself a reassuring message can be
a helpful for dealing with an Obstacle. What would your message be?
Is there someone you could talk to who could help you in any way? Your
action could be to talk to that person.
17
My 4 steps continued
Fill in this section of the booklet with your work coach. Look at what you want to do
and how you can do it.
Step 1 – Want (This means ‘what would you like to happen’)
This should be something that is important to you, that you really care about or are excited to do.
It should be something that is not too easy, but still something you think you can do.
Write your answer here:
Step 2 – Outcome (This means ‘what do you believe can happen’)
This is about how you would feel (for example, excited, proud or happy) or what you would
be able to do if you get what you want in
Step 1.
Take a moment to imagine how you would feel.
Write your answer here:
Step 3 – Obstacle (This means ‘what is stopping you’)
This is about what is stopping you from getting what you want in
Step 1. It’s something
within you that you have some control over, and you’re able to do something about it, even
though it is difficult. It could be a habit, something you believe in, or a feeling you have.
Take a moment to imagine what is stopping you.
Write your answer here:
Step 4 – Plan (This means ‘what you are going to do’)
This should be something that helps you get over the obstacle in
Step 3. Your plan should be
something that you can do, and that you believe will be helpful to you.
Write your answer here:
Write down your answers from your
Obstacle in
Step 3 and from your
Plan in
Step 4.
Obstacle from Step 3
Plan from Step 4
If
then I will
4
Work coach guidance:
Help the claimant complete the “IF-THEN” statement at the end of
My 4 steps.
The if-then statement at the bottom of the My 4 Steps page connects the Obstacle
(Step 3) with a Plan that will help overcome the Obstacle (Step 4). Example of
these statements are:
IF I feel stressed about leaving the house THEN I WILL phone my friend Jill
for support.
IF I feel uncomfortable during my physiotherapy exercises THEN I WILL
remind myself that I’ll get better with time.
Ask the claimant to say the if-then statement out loud after they write it. Tell them
they should repeat the statement to themselves to make sure it stays in their
memory. Then when the Obstacle comes up, they will easily remember their Plan
to overcome it.
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Work coach guidance:
Complete the Action Plan
• After you have finished the My 4 Steps exercise, you complete the Action Plan on
LMS.
• Unlike the My 4 Steps where we support claimants to overcome internal obstacles,
the actions in the Action Plan are focused on overcoming external obstacles.
• This includes external obstacles like housing issues, debt issues, or childcare
issues.
• The actions can include finding out more about the issue online, or through local
support, referrals to DWP provision, and charities.
• The actions recorded in My Actions can be related to the wishes from My 4 Steps,
but they don’t have to be.
• To come up with useful actions:
o Think back to the About Me – did the claimant mention anything where they
could need help or a referral?
o Think back to the My 4 Steps – did any external obstacles come up that you
could discuss now?
o Consider if there are any other actions that you think the claimant would
benefit from.
• Unlike in the My 4 Steps where it’s important that the claimant comes up with their
own wants, obstacles and plans, it is fine to make suggestions at this part of the
HWC!
• Check whether the claimant agrees these actions would be useful. The claimant is
more likely to do the actions if they understand the actions and believe they would
be helpful.
• Remind the claimant that the actions are voluntary.
• Coach the claimant to come up with a specific plan, including when and where
they will complete the action.
• When you have added 2-3 actions, issue the ESA49 letter with the agreed
voluntary actions.
Script:
•
So now you’ve used My 4 Steps to make a plan for achieving a goal and
overcoming an internal obstacle that might come up on the way to achieving
our goal.
•
However, there might be other things that you need help with as they are less
in your control, such as finance, healthcare, and other things that the Jobcentre
Plus can provide support for.
•
So now let’s take a moment to think about other actions that would help you
achieve goals that are related to health or work.
•
These actions are voluntary – there will be no consequences if you do not
complete them.
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Work coach guidance:
Closing the Health and Work Conversation
Thank the claimant for their time and effort.
Make a few notes for yourself on LMS regarding their My 4 Steps so that you can
ask them about how it went if you contact them again.
The claimant’s HWC booklet has several templates for “My 4 Steps”. You
complete one of these
with the claimant during the HWC. Encourage the claimant
to use the additional copies in their daily life to help them move towards their
goals.
Tell the claimant you hope the four steps are useful for them and that you’ll
contact them to see how they’re getting on.
Follow-up with the claimant to see how they are getting on with their
My 4 Steps
Check in with the claimant to see how their My 4 Steps is going.
This may be by phone, email, text message or a follow up appointment based on
what is feasible and most appropriate.
Remember these check-ins are not about monitoring the claimant to ensure they
achieve their goal – the check-ins are about making the claimant feel supported,
and possibly guiding them to revise their four steps if they feel it isn’t working.
Revising the My 4 Steps if the claimant say it isn’t working:
o Check if the Want they picked in Step 1 is something they genuinely care
about. Perhaps they forgot about the exercise because they didn’t pick
something they were truly motivated to achieve. If this is the case, ask the
claimant if they would like to pick a different Want.
o Check if the Want they picked in Step 1 was realistic and something they
could achieve. If it wasn’t, ask the claimant if they would like to pick a
different Want.
o Check if the Obstacle that the claimant picked was an internal obstacle and
something that they had some control over. If it wasn’t, explore if there is a
different obstacle that is holding them back.
o Check if the Plan the claimant made to overcome the Obstacle was
effective. It might be that the claimant had a good Want, Outcome and
Obstacle, but their Plan wasn’t the right one and they need to try a different
one.
o
Remind the claimant that My 4 Steps is a learning experience and that
they’ll get better at it over time as they keep using it.
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