1. Employability and Health -An Integrated Approach Stirling Council and Stirling CHP

2. Background Partnership established in 2004 - Development of an Employability and Health project through the European Equal Programme (Well Connected) The Fit for Work European Partnership Beyond Equal - Mapping and Assessment of Health and Employability Networks New Council Employability Service created in 2007 through mainstream funding An Integrated Approach - Stirling CPP Fairer Scotland Fund (2008)

3. The Employability Service was created to support individuals who have disabilities, learning difficulty, mental health problems or other health-related conditions Current breakdown of service users 32% Learning Disability 28% Mental Health 15% Health Conditions 14% Physical Disability 8% ASD 3% Sensory Impairments (Based on current caseload of 153 individuals)

4. Current Developments Social Return on Investment Study The Supported Employment Framework for Scotland - Stirling Demonstration Site New ESF Priority 5 - Stirlings Employability Pipeline

5. Our Partnership Vision of Health and Employability The physical, psychological and social aspects of work as they relate to health and wellbeing

6. Our Focus Inequalities Clarity and Realism of Purpose Ownership and Commitment to Joint Learning Building Evidence of What Works Assets and Solutions, Person Centred

7. Integrating Policy Strands Equally Well, Change Programme Anticipatory Care, Keep-well Stirling Long Term Conditions Community Planning Priorities Well Connected

8. KEY LEARNING POINTS WELLCONNECTED PROJECT The importance of the team approach when working with this client group and of the skill mix of the team to providing a range of skills from Employment services and Health. The need for a robust Partnership agreement. The need for staff to remain connected to their original service to remain updated on relevant clinical or service developments. The need for flexibility of time spent with clients and location in which they are seen, particularly with the more debilitated clients. The need for staff to be experienced in their field and have good networking skills and local service knowledge. The benefit of direct access to some health services (which was not a feature of this project).

9. Challenges for Joe!

10. Now, please turn to your colleague sitting next to you and discuss this question for a minute. What are the challenges in working with people with complex health conditions and barriers, who aspire to, including sustaining work?

11. Supported Employment Model Supporting the aspirations towards employment Engagement By Service Helping people with disabilities and Health conditions most distanced from the labour market to make informed decisions on their own future Vocational Profiling Identifying skills and preferences for work, giving work experiences that will help the individual make their own vocational choices Job Finding Identifying the preferred job through employer engagement, also providing support to the employer Employer Engagement Finding out about The workplace Environment, co- Workers and the supports a person might need On/Off the Job Support and Aftercare Providing help, Information and backup to the employee and their employer, developing independence through natural supports in the workplace and addressing career progression in due course

12. Engagement By Service Vocational Profiling Job Finding Employer Engagement On/Off Job Support and Aftercare Client Journey Challenges Susans Journey Engagement By Service Vocational Profiling

13. Making sense for Susan-Case formulation Presenting Problem Depressive symptoms Depressive symptoms Poor management of multiple Health conditions Poor management of multiple Health conditions Environmental stress. Environmental stress. Low self-worth and low value. Low self-worth and low value. Anxiety. Anxiety. Lifestyle factors. Lifestyle factors. Maintenance Cycle 1 Lack of purpose/routine/work in my life. Too much time to think on my problems. Leads to avoidance behaviour. Reduces my motivation. Leads to isolation. Maintenance Cycle 2 Past and present life events have shaped certain rules and beliefs that I have about myself. self-critical/blame. I am not good enough person. people are more needy than me. Maintenance Cycle 3 Growing up gave me certain coping strategies, yet these coping strategies also make me vulnerable. Not trusting people to help. Not asking for help, when I need it, People perception-strong able Not seeing my needs Maintenance Cycle 4 Lots of people in my life come to me to sort out their problems. Put peoples needs before mine As people expect it, its difficult to say no Feel overwhelmed with demand Susans Strengths I have worked most of my life I have worked most of my life Most of my life I have coped I have managed my diabetes, asthma in the past Engagement By Service Vocational Profiling Job Finding Employer Engagement On/Off Job Support and Aftercare

14. Engagement By Service Vocational Profiling Job Finding Employer Engagement On/Off Job Support and Aftercare Clients Journey Challenges Early Intervention On/Off Job Support and Aftercare

15. Engagement By Service Vocational Profiling Job Finding Employer Engagement On/Off Job Support and Aftercare Future Development Learning Keep well Health Checks Mental Health Services

16. Stakeholders -Job Centre + -Carers -Employability Network -Clients -Employer -Core services -Keep well -Community Partners -Gps -Primary care services -LTC Partner Network -HR/Occ. Health Health Pathway AX/ Screenin g Health Check HADS LAZER CORE WHEEL Client centred planning Initiate Self-care Health and Employability Baton Partner with CORE Services Social Stressors support e.g. Housing Initiate Condition Management Exercise Scheduling Social Prescribing Psychological Intervention Change Lifestyle Factors Education/ Education/ Support Employers Complex Job Analysis Functional Capacity Evaluation Engage person in long- term supports Partners Health and Employability Pathway - Blueprint Engagement By Service Vocational Profiling Job Finding Employer Engagement On/Off Job Support and Aftercare Health and Employability Pathway- Blueprint Future Development