1. Fit for Purpose: Transforming employment support for disabled people and those with health conditions Tony Wilson, Policy Director Centre for Economic and Social Inclusion tony.wilson@cesi.org.uk @tonywilsoncesi

2. The Fit for Purpose project A4e, Avanta, BASE, ESG, i2i, Ingeus, Interserve, intraining, Kennedy Scott, learndirect, Maximus, Prospects, PublicCo, Randstad, Reed, Remploy, RNIB, Seetec, Serco, Shaw Trust CDG, St Loye's Foundation, The Salvation Army, Wheatsheaf Trust, Work Solutions, Working Links

3. Many (most?) disabled people are not sharing in the recovery Employment ‘gap’ for disabled people Labour market status by level of disability Unemployment by duration Hiring rates by disability and econ. activity

4. Just one in ten receiving employment support 4.2 million disabled people out of work 3.6 million with ‘work limiting’ disability or health condition We estimate: Work Programme: 363,000 Work Choice: 20,000 Local provision/ progs:? Low thousands Complex landscape – for providers, participants, employers Reduced funding – and/ or low take-up Often poorer outcomes, compared with non-disabled peers But growing priority – health, social services, employment

5. So what works (and for whom)? The report sets out: Forms of support – Supported Employment; personalisation; employer engagement; financial incentives; ILMs... Specific groups – mental health; sensory impairment; musculoskeletal conditions; young people Common themes – timing; assessment; partnerships; workforce development; quality management

6. Supported Employment ‘Place, train, sustain’ Strong evidence – if it’s done properly Individual Placement and Support model for those with mental health conditions Relatively expensive, should be targeted

8. There are clear (common) themes Personalisation Right level of support, tailored to needs, with enough time Holistic approach – not (just) about health and employment Effective partnerships Different form of employer engagement – ‘individual-based’ as well as ‘employment agency’ approach Intervening at the right time Highly skilled advisers...... With small caseloads!

10. How we commission services is critical ‘Payment by Results’ has brought benefits Outcomes focus, financial management But also big problems – ‘parking’, vicious circles, dis- investment We estimate Work Programme funding for is now £550 per ESA claimant, cf. planned £1,200 Joint commissioning should underpin local partnerships But little evidence that this is happening in practice Evidence based commissioning also needs to improve – pre-requisite for devolution

12. So what should we do?!

13. Design of future employment support (1) 1.Future employment support for disabled people and those with health conditions should be built around three levels: ‘Into work’ support – for those closest to returning to work, with some specialist support Health and disability employment support – for those needing more intensive and joined up support to secure employment Supported Employment and rehabilitation – for those with the most significant support needs 2.Review the operation of Access to Work to improve utilisation and ensure that it fully integrates into a coherent and simplified system of DWP employment support 3.Access to, and funding for, employment support for disabled people and those with health conditions should be significantly increased

14. Design of future employment support (2) 4.Access to each of the three levels of support should be underpinned by a common, robust assessment process – joined up with other assessments, and with decisions reviewed after three months 5.Individuals should be able to access employment support on a voluntary basis, but the assessment process should include the scope to require individuals to participate where that is appropriate and in line with their conditionality rules 6.Participants should normally be able to receive pre-employment support in any one level for up to two years 7.Government and service providers should review their approach to employer engagement, with a focus on: simplifying employer access; co-ordinating work to improve awareness and education; and building sector-led approaches

15. The future framework of support

16. Commissioning and delivery of support 8.Local and national commissioners should work together to ensure that the three levels of support are in place – within a clear national framework but with approaches to devolution, joint commissioning, pooling or alignment that are appropriate to local areas 9.Jobcentre Plus and local Health and Wellbeing Boards (HWBs) should work together to develop protocols on joint working, including information sharing 10.Funding models for all three levels of support should include ‘payment by results’, but with clear safeguards to minimise risks of vicious circles, creaming and parking 11.There should be a common quality framework across all provision, based on self-assessment, external inspection, service user input and continuous improvement 12.A ‘What Works Unit’ should be established with a remit to collect, review and disseminate best practices; facilitate knowledge exchange between providers; and encourage innovation in service design and delivery

17. Workforce development 13.Jobcentre Plus and the wider employment services industry (through ERSA and Institute of Employability Professionals) should work together to ensure that all advisers have training in identifying health and disability needs and providing initial support and signposting 14.The Institute of Employability Professionals (IEP) should work with organisations including the British Association of Supported Employment (BASE) to develop industry-wide, best practice training for specialist disability employment advisers 15.Jobcentre Plus and employment services providers should commit to ensuring that all advisers leading on employment support for disabled people and those with health conditions will have been trained in line with industry benchmarks, or be on the journey to receiving that training

18. To sum up Clear case for reform – too many disabled people not sharing in the recovery Need to radically extend and transform support Growing consensus – and evidence of what works No one organisation, sector, level of government can do it – need to work together within a common framework

19. Fit for Purpose: Transforming employment support for disabled people and those with health conditions Tony Wilson, Policy Director Centre for Economic and Social Inclusion tony.wilson@cesi.org.uk @tonywilsoncesi