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Fit for Purpose Report 03 07 14.Pdf Fit for Purpose Transforming employment support for disabled people and those with health conditions Ann Purvis Sarah Foster Lorraine Lanceley Tony Wilson July 2014 This report has been quality assured by: Name: Tony Wilson Position: Policy Director Date: 2 July 2014 Tony Wilson Centre for Economic and Social Inclusion Third Floor 89 Albert Embankment London SE1 7TP Tel: 020 7840 8346 Email: [email protected] Contents Acknowledgements ........................................................................................... 4 Executive Summary .......................................................................................... 5 1 Introduction ............................................................................................. 14 Context .......................................................................................................... 14 The ‘Fit for Purpose’ project ............................................................................ 19 2 The landscape of support ......................................................................... 21 The current framework ................................................................................... 21 Local provision ............................................................................................... 29 Conclusion ..................................................................................................... 30 3 What works (and for whom)? .................................................................. 31 Introduction ................................................................................................... 31 The effectiveness of different types of support ................................................. 32 What works for specific groups? ...................................................................... 43 Cross-cutting themes ...................................................................................... 52 Conclusion ..................................................................................................... 58 4 Commissioning support ............................................................................ 59 Payment by Results ........................................................................................ 59 Individual budgets .......................................................................................... 62 Local and joint commissioning ......................................................................... 64 Evidence based commissioning ........................................................................ 69 Conclusion ..................................................................................................... 70 5 Recommendations .................................................................................... 71 The framework for future employment support ................................................ 71 The management of future programmes .......................................................... 80 Workforce development .................................................................................. 85 Conclusions .................................................................................................... 87 Fit for Purpose: Transforming employment support Acknowledgements This project would not have been possible without the financial support of a number of organisations. We would like to extend our thanks, both for this support and for their time in attending workshops, shaping the direction of the work and discussing and commenting on findings and recommendations. Many also gave their time to be interviewed for case studies, for which we are grateful. A4e Avanta ESG i2i Ingeus Interserve intraining Kennedy Scott learndirect Maximus Prospects Randstad Reed RNIB Seetec Serco Shaw Trust CDG St Loye's Foundation The Salvation Army Wheatsheaf Trust Work Solutions Working Links We would also like to thank BASE, Remploy and PublicCo for the time and expert input that they have contributed throughout this project. Particular thanks go to the participants of our focus groups for their time and views on the emerging recommendations – as well as to Shaw Trust CDG, St Loye’s Foundation, The Salvation Army, and the Central and the North West London NHS Foundation Trust for arranging and hosting these groups. Finally, many thanks to Inclusion colleagues – past and present – for their contributions to this work and report, including Paul Bivand, Tim Riley, Malen Davies, Callum Miller and Lauren Bennett. 4 Fit for Purpose: Transforming employment support Executive Summary Disabled people and those with health conditions are far less likely to be in work, less likely to find work and spend longer out of work than the population as a whole. Despite more than a decade of near-constant reforms to disability benefits and to employment support, these gaps did not narrow by much during the boom years, and progress may have stalled more recently. Fewer than half of all disabled people are in work and we estimate that just one in ten of those not in work are being supported through either the Work Programme or Work Choice. Almost all of these are in the Work Programme, with only limited funding available to provide intensive or specialist support. This project sets out how the employment support system can be transformed to create a system that offers employment opportunity for all – with the right support to prepare for and take up work. It sets out twenty case studies of current good practice, and has been ‘crowd funded’ by twenty-two organisations that work with and support disabled people and those with health conditions. The landscape of support The current system of support for disabled people and those with health conditions is complicated and complex. Jobcentre Plus provides limited specialist support and more extensive support to jobseekers (many of whom may be disabled). However, concerns have been raised around resource levels and specialism. The Work Programme supports disadvantaged jobseekers and many claimants of ESA – however disabled people are less likely to find work than participants without an impairment and may also be less likely to receive appropriate support (driven in part by very low funding). Work Choice provides more specialist support to those with complex needs – supporting around 20,000 people a year, many of them on JSA and with pre-work support limited to six to twelve months1. 1 There is an option to extend the pre-work support module of Work Choice from six months to one year, although the evaluation of Work Choice (Purvis et al (2013) Op. cit.) found little evidence of this being used in practice. 5 Fit for Purpose: Transforming employment support Access to Work provides employers and individuals with funding to meet the extra costs of employing a disabled person – but awareness and uptake is often low. Finally, a range of local and national provision supports disabled people with specific (and often severe) needs – in particular through local ‘Supported Employment’ and national residential training. However budgets for the former are devolved and not ring-fenced, and for the latter have been reduced and remain under threat. What works (and for whom)? This complex landscape only partly reflects the evidence on what works. This evidence is far from complete, but points to a number of effective service models and common themes. Different types of support There is unequivocal evidence that Supported Employment, when implemented effectively, can lead to significant positive impacts on employment. This ‘place, train, sustain’ model is built around holistic engagement of the participant and those around them, effective profiling, job matching and then extensive support in work. However, Supported Employment when implemented fully is relatively expensive and needs to be effectively targeted. Personalisation of service delivery appears to be key, and in particular having adequate time to spend with participants and the opportunity to tailor services. Effective employer engagement includes both in-work support to employers and employees, alongside wider engagement to source and secure job opportunities – the so-called ‘individual’ and ‘employment agency’ approaches. There is no clear evidence that financial incentives – to individuals or employers – have had positive impacts in UK programmes, although there is a wide literature on the use of incentives for other groups and they remain a key pillar or support in many countries. Well-designed ‘intermediate labour market’ models (ILMs) – which create temporary employment with structured support to move into unsubsidised work – can have lasting positive impacts. However these are relatively expensive, and ‘supported business’ models have been criticised for increasing segregation in the labour market. We believe that there are clear opportunities to develop models that build on the strengths of ILMs and supported businesses. 6 Fit for Purpose: Transforming employment support What works for specific groups? There is some evidence on models that appear to be particularly effective for those with specific impairments or barriers to work. There has been extensive work on mental health and employment in recent years. This points to the importance of early engagement, co-operation with health and employment services, integration of psychological therapies and tailored support (including small adviser caseloads). Individual Placement and Support (IPS),
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