Joseph joined the NHS in 1996 as a Practice Manager in Easington. He led on GP Fundholding within his practice and developed his local GP Out of hours co-operative from 1998-2004. He was elected Chair of Easington Practice Based Commissioning Group from 2005-2012. In 2011 he was appointed Director of Practice Based Commissioning for Durham Primary Care Trust (PCT). In 2012 Joseph founded South Durham Federation. In 2013 he was appointed as Director of Performance for DDES CCG before being appointed as Director of Primary Care in 2014. Joseph took up the role of Director of Primary Care for North Durham CCG in April 2016 also and is now working across both CCGs in this shared role. Joseph was non-clinical partner in four GP practices until recently and now remains the Management Partner in two local East Durham GP practices. Joseph is also a GP surgery property developer.