Paul Anders About Promote understanding of multiple and complex - - PowerPoint PPT Presentation

PLUS Project Welfare reform & employment support Paul Anders

About

• Promote understanding of multiple and complex

needs

• Stimulate evidence-based debate about public

service reform

• Partnerships: policymakers & commissioners at

national, regional & local levels, academic researchers

• Through policy, research and lived experience
• Involve experts by experience in every aspect of our

work

• Revised benefit cap
• Work & Health Green Paper
• Employment support

– Dame Carol Black Review – Work & Health Programme – What works? – Broader policy issues

Overview

Revised benefit cap

• With effect from 7th

November

• 50% of old cap cases in

London

• Cumulative c.76k; static

caseload c.20k – plus >90k new

Type Old New Ex- London Single £18,200 £15,410 £13,400 Family £26,000 £23,000 £20,000

Exemptions

• Following benefits are included:

– Child Benefit – Child Tax Credit – Housing Benefit – Incapacity Benefit – Income Support – Jobseeker's Allowance – Employment and Support Allowance (except when in the support group) – Maternity Allowance – Severe Disablement Allowance – Widowed Parent's Allowance & Bereavement Allowance

• Exemptions: State Pension and Pension Credit, DLA/PIP, WTC, War

Widows and Widowers, 39 week ‘grace period’

Cumulative impact

Westminster - £680 Brent - £550 Barking & Dagenham - £540 Enfield - £530 Barking & Dagenham - £530 Newham - £460 Enfield - £450 Hackney - £410 To March 2016 To 2020-21

Distributional effect

Work & Health Green Paper

• Replaces White Paper planned for early

2016

• May focus on:

– Halving the disability employment gap – Health, sickness & productivity – Approaches to sickness-related social security – ESA claim process & employment support

• Focus of the Green Paper unclear

Mind the gap

c.15% c.28%

Employment support

• Improves treatment outcomes, and reduces

the frequency and severity of relapse

• Positive associations – younger, male, more

affluent area, using drugs for shorter time, stably housed

• Improved outcomes when treatment &

employment are combined

• Associations between work & SM are complex

Current provision – JCP Offer

• JCP offer for substance misuse
• Freedom & Flexibility – according to client

needs

• Flexible Support Fund
• Conditionality:

– 6 months tailored conditionality – UC substance misuse, once per 12 months, no limit on times – 4 weeks easement – JSA homelessness, no limit on number of times

The prize

32.2% 18.8% 41.7% 24.4% 0% 10% 20% 30% 40% 50% Custodial sentences less than 1 year Custodial sentences 1 year or more One year proven reoffending rates

Reoffending rates based on propensity score matching

No P45 employment P45 employment

• Not a silver bullet, but

significant reductions and cost effective:

• £26k opiate/crack

cocaine user not in treatment

• £36k per prisoner per

year

• £13-15k economic value
• f return to work
• £3.6-7K gross cost per

job for LMPs

Work & health

• Work is generally good for health and wellbeing, but

the size and type of gain depends on the quality of the job and the social context

• There is growing evidence that some jobs (primarily

but not solely jobs with secondary labour market characteristics including low status, low pay, insecure, unpleasant, irregular/unsociable hours, low autonomy and limited progression possibilities) are worse for mental health and wellbeing than being unemployed

Dame Carol Black Review

• What is the experience of people with drug or alcohol

conditions within a) employment support services; b) health care; and c) the benefits system?

• What specialist employment support services are

available?

• What other physical and mental health conditions are

these groups likely to face?

• What works to a) treat those affected and b) help them

back to into work or keep them in work?

Dame Carol Black Review II

• What evidence exists on the effectiveness (including

cost effectiveness) of treatments and interventions that facilitate a return to work?

• How do health professionals/ commissioners/

Jobcentre Plus staff and wider employment support- related staff make decisions related to these groups?

• What are the legal, ethical and other implications of

linking benefit entitlements to take up of appropriate treatment or support?

• How are children and families affected?

Dame Carol Black Review III

• What are the views of employers on supporting

these groups to stay in work or return to work, or

• f recruiting people with histories of these health

conditions?

• What is the experience of people currently in

work with these conditions?

• Who are the groups most ‘at risk’ of being

affected by these conditions in the future?

To mandate, or not?

• Does mandated treatment work?
• Is it proportionate, legally & ethically sound?
• Does low penetration suggest it’s needed?
• Will it generate the desired behaviour change?
• Will increased take-up of treatment deliver more

jobs?

• Unintended/undesirable consequences?

Dame Carol Black Review - conclusion

• Publication date & priority unclear
• DCB – unlikely to favour mandation
• More likely to favour positive measures, such

as improving Jobcentre Plus Offer, trialling (e.g.) Individual Placement and Support

• Will need to be seen in the context of Work &

Health Green Paper

• 6 CPAs, plus Scotland & national
• Different funding model
• Focus on ‘what works’ & building evidence
• Co-commission/design – London is co-

commission

• Disability, ex-offenders, substance misuse &

homeless – any time, but targeted & voluntary

• Long-term unemployed – 2 years, mandatory
• Market engagement in London, 13th October

Work & Health Programme

Work & Health Programme II

• Much smaller programme

– c.£130m pa vs. £750m

The future landscape

• Relatively small-scale targeted LMP: most marginalised

may not receive additional/specialist support

• Broader access to probation support, but little

incentive on providers to focus on work

• Jobcentre Plus playing a bigger role (but level of

resourcing unclear)

• EU funding doubtful in longer term
• Universal Support
• Other local provision

What works?

What works? II

• General principles:

– Part of the journey, not the destination – But stability needed – Access to specialist support

• Good practice: Manchester Working Well

– Integration boards & case conferencing – Agile & innovative (e.g. dentistry as barrier) – Key worker relationship crucial – Address fundamental issues

Individual placement & support

Number entering employment

85 43 10 20 30 40 50 60 70 80 90 Results for IPS Results for pre-vocational training

Sample size – 312; comprised of 156 people accessing IPS, 156 people accessing pre-vocational training Entry criteria – Patients with severe mental illness in six European cities. All subjects had not been in competitive employment in the last year, and wanted to enter competitive work Burns, Tom et al (2007), The Effectiveness of Supported Employment for People with Severe Mental Illness: A Randomised Controlled Trial, Lancet 370, 1146-52.

IPS international comparisons

About IPS

• Manualised approach
• Fidelity review:

– It aims to get people into competitive employment – It is open to all those who want to work – It tries to find jobs consistent with people's preferences – It works quickly – It brings employment specialists into clinical teams – Employment specialists develop relationships with employers based upon a person's work preferences – It provides time unlimited, individualised support for the person and their employer – Benefits counselling is included

• IPS Lite – time-limiting increases outcomes by 17% in 18m

Broader policy context

• Referendum effect:

– Social Justice Strategy(?) – DCB Review – Drug Strategy – Work & Health Paper/Programme

• Policy changes – deficit, debt & capital spend
• Other reform – e.g. funding for supported

housing, broader homelessness matters

• Related provision – e.g. Transforming

Rehabilitation

Discussion

• Is your organisation prepared for Universal

Credit and the lower benefit cap?

• What does/could your organisation do to help

people into work?

• What works?
• Can this forum stimulate partnerships?

Contact

Paul Anders Revolving Doors Agency South Bank Technopark 90 London Road London SE1 6LN 020 7407 0747 paul.anders@revolving-doors.org.uk

References

Slide 6: http://www4.shu.ac.uk/research/cresr/sites/shu.ac.uk/files/welfare-reform-2016.pdf Slide 7: https://www.ifs.org.uk/uploads/budgets/budget2016/budget2016_weah.pdf Slide 9: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/406369/labour-force- survey-disabled-people.pdf Slide 12: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/217412/impact- employment-reoffending.pdf Slide 20: http://ersa.org.uk/documents/more-words-rethinking-employment-support-disabled-jobseekers & http://www.learningandwork.org.uk/our-resources/work-programme-statistics-september-2016 Slide 21: Burns, Tom et al (2007), The Effectiveness of Supported Employment for People with Severe Mental Illness: A Randomised Controlled Trial, Lancet 370, 1146-52. Slide 22: Burns, T. and Catty, J., (2008. IPS in Europe: the EQOLISE trial. Psychiatric rehabilitation journal, 31(4), p.313.