BBC News website age & disability correspondent
In the areas where the number of incapacity benefit (IB) claimants is highest, the government has put in place a complex package of support to get people back to work.
Called Pathways to Work, the scheme combines elements of compulsion with attractive incentives. Initial results suggest that it is having the desired effect.
Smelling of roses - Frank had a successful experience
In 1979, Frank Duke from Jarrow had a serious car accident which resulted in arthritis of the spine.
He was a young man then, but as he aged the problem got worse and worse.
Mr Duke eventually went on to IB for four years.
He came into contact with the Pathways team in his area after attending an open day at his local college.
Having previously worked as a bus driver, in factories and as a gardener, he was directed to a South Tyneside gardening and exercise project called the Green Gym.
Because Mr Duke quickly demonstrated his gardening skills he was soon offered a job as a park ranger, where he now helps new gym members to improve their chances of getting a job.
Mr Duke's experience of the Pathways welfare to work scheme, in his words, "turned my life around".
"I'd been suffering from depression for some time," he told the BBC News website.
"At one time I'd actually given up my driving licence because I was feeling so down that I didn't feel safe to drive."
Since he has been working 30 hours a week in the park, he has got his licence back and has bought himself a car.
"I'm not depressed anymore - the help that I've had from everybody has been unbelievable," he said.
Although he still takes medication for pain relief, Mr Duke says returning to work has not meant that his condition has deteriorated.
"I've had lots of training for manual handling and health and safety - you learn not to do stupid things."
And if Mr Duke's condition did suddenly worsen, he is able to go back on to his original benefit without having to make a fresh application.
"It's taken the gambling element out of trying a new job," he said.
In order to reduce the estimated 2.7 million people claiming benefits related to their incapacity, the Department for Work and Pensions has been piloting a multi-layered programme called Pathways to Work since October 2003.
Between October 2005 and October this year, these pilots will be progressively extended to include the 30 local authority districts with the highest number of claimants.
The scheme includes:
- Six compulsory work-focused interviews after the eighth week of a claim
Access to a personal adviser
A 'choices' package consisting of employment programmes and condition management programmes, delivered by local NHS trusts
A £40-a-week return to work credit
In-work support - including job coaches, occupational health advice, financial and debt counselling as well as support from the Jobcentre Plus's own specialist Access to Work teams
The scheme has been extended to existing claimants in Pathways areas, but the return to work credit is £20 a week and there are only three work-focused interviews.
Although disability organisations have been broadly supportive of the programme, there are concerns that the government will press ahead with the elements of compulsion without making Pathways-type support universally available.
And for Frank Duke there is a more pressing concern: his contract runs out at the end of March and he will have to begin looking for alternative employment.
But he says that Pathways has given him the confidence and the skills necessary to look for another job.