Multiple long-term conditions

Purposeful activity

14 June 2019

Review of interventions for people with multiple long-term conditions in Lambeth and Southwark

In brief

The progression from one to multiple long-term conditions is influenced by many factors. In this report, we explored the evidence around the relationship between purposeful activities (including work, work-related activities, education and volunteering) and the ability to slow progression to multiple long-term conditions.


Executive summary

Our hypothesis, that purposeful activities that can help people increase their resilience and ability to self-manage their health and condition, is based on the following principles:

  • Employment is shown to have a positive effect on health, resilience and wellbeing
  • However, some forms of employment, including precarious work, low-paid work, dangerous work and workplaces in which a person faces discrimination and stigma, have an adverse effect on mental and physical health
  • Purposeful activities which can have a positive effect on a person’s health therefore need to be aligned with the individual’s interests, aspirations and needs – they should be meaningful

There are many different access points to work and purposeful activities that a person diagnosed with a long-term condition may encounter. Our review considered these different pathways and the different categories of interventions that may be appropriate for people who are closer to or further from the labour market.

For example, people with long-term conditions who are already in work but are struggling to disclose or manage the increased demands of their condition might need support to communicate with employers about their needs, while people who are currently not working or feel unable to work may benefit from adult learning, return-to-work programmes such as paid work trials, or advice on entering alternative forms of employment such as self-employment or remote working.

Long-term conditions in Lambeth and Southwark

1 in 5

residents live with at least one long-term condition


residents live with three or more long-term conditions

In collaboration with

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Read the 'Purposeful activity' report