Chelsea Tierney beams as she talks about her new part-time job as a cleaner at Morrisons supermarket. “It’s really nice, I like it. People are friendly – they’re lovely.” Struggling after the pandemic, 36-year-old Tierney had been out of work for more than five years when she was referred to a programme called Working Well, at its office in Bolton. “Covid hit and it knocked everyone’s confidence,” Tierney says. “It was awful.” Greater Manchester’s version of a nationwide scheme called Work and Health, the programme is delivered by two private sector providers in offices across the region. In Bolton, it is run by Ingeus and offers tailored support for up to 15 months. “It’s took a while, because I started this about a year ago and it’s took all that time to build my confidence back up,” Tierney says. It is a programme that tries to address what ministers have identified as a huge problem holding back the UK economy: its army of missing workers, who are contributing to a labour shortage and helping drive up inflation. Millions have left the workforce because of long-term health conditions or caring responsibilities – or simply because they have decided they can afford to retire early. With the work and pensions secretary, Mel Stride, expected to announce a package of policies alongside next week’s budget to tackle economic inactivity, Manchester’s politicians say devolution has allowed them to tailor Working Well to local needs. “You can have a much bigger impact by having that local flexibility and collaboration,” says Eamonn O’Brien, leader of Bury council and the combined authority’s policy lead on skills and employment. He and his colleagues are pressing for more funding for getting people back to work – with fewer strings attached – in negotiations for a new “trailblazer” devolution deal for Manchester, and the Observer understands expanding schemes like Working Well is one option under consideration by Stride. Assigned a one-to-one mentor, Tierney received help with everything from tackling anxiety to interview skills, and was pointed in the direction of the role at Morrisons. Phil Lewis, another Bolton client, recalls how staff went with him to a local charity shop to help him dress smartly for his interviews. “I got a couple of pairs of trousers and a pair of shoes.” A graduate of the University of Bolton, the 43-year-old returned to the town when a postgraduate degree in Bristol didn’t work out financially. He had been claiming jobseeker’s allowance for four years, before Working Well helped him find data-entry work, most recently for the NHS’s schools vaccination programme. With that contract over, though, he is job-hunting again with the help of staff. The Work and Health scheme in Greater Manchester had an annual budget of almost £10m in the current financial year, and the combined authority is spending another £7m on its own version of another national programme, the Job Entry Targeted Support scheme (Jets), also under the umbrella of Working Well. Ingeus is part of a vast global employment consultancy called APM Group, which operates in 11 countries. Outsourcing employment support to profit-making private sector operators is controversial and has a chequered history. Ten staff at one widely criticised firm, A4e, were found guilty of defrauding the taxpayer of £300,000 in 2015. There is no suggestion of wrongdoing by Ingeus. Since it kicked off as a pilot in 2014, Working Well has served 66,000 clients, helping 23,000 of them into work. Much of the government’s recent rhetoric on tackling economic inactivity has focused on persuading over-50s who have retired since the pandemic that life “doesn’t just have to be about going to the golf course,” as the chancellor, Jeremy Hunt has put it. But employment experts have suggested gains to the economy are more likely to come from breaking down barriers to work – including health problems – among the wider population. The latest official figures suggested 562,000 people who are economically inactive because of long-term sickness would like to work. Crucially, as well as help with CV writing, training, job-search and interview skills, Working Well includes a significant health component. The nature of this depends on what problems the team identify – it can be as simple as advising clients on how to get the best out of a GP appointment, or can include one-to-one mental health support, for example. Health educator Julia Sharratt holds regular workshops, over tea and biscuits, on issues such as self-confidence, depression management and healthy eating. “This is things that you probably wouldn’t think to go to the GP for. But if you’re not getting them right, they’re having a massive impact on your mental and physical health,” she says. “So it’s healthy exercise, it’s stress, it’s sleeping, recovery. It’s daily routine, confidence building, assertiveness – those things that are really holding people back.” Fay Turner, a 49-year-old mother of five who was on medication for depression and anxiety when she was referred to Working Well after losing her job, has found Sharratt’s workshops particularly helpful. “When you’re going through that, they give you a different perspective and you’re in a room with other people and they all have different experiences and life issues, and you can kind of go, ‘Yeah, I can see how you’ve overcome that,’” she says. She arrives on two wheels, having bought herself a secondhand bike after learning about the importance of physical activity for mental health. And she is holding a “memory bear” – a teddy made from scraps of old clothes. She is building up a business making them for people who want to remember late relatives or special occasions – this one is made from a school shirt that her daughter had signed by friends on her last day. “I got nine orders this week,” she says. Turner’s Working Well adviser has helped by printing leaflets, and pointing her to free sites where she could find equipment such as a laminator. When staff at the service helped her to get hold of her GCSE certificates, to prove she was qualified for work in a school, she discovered that she had scored a D in maths – so she is now retaking the subject. Turner’s story doesn’t yet have a happy ending. She and her children are about to be made homeless by their landlady, and are expecting to be rehoused in a hostel by the council. But she insists the resilience she has developed through the scheme has helped her to cope. “Without here, I don’t think I would have had the confidence or the motivation just to get through that,” she says. Once she has completed that GCSE, she hopes her adviser will help her to find work as a teaching assistant. “If I don’t do it now, I never will. And just think of the comeback story that I can say to all the kids at school: listen, I was homeless, I was this, I was that – and I still opened a business.”