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What did we learn from the Disability and Health Employment Strategy?

Jenny Gulliford

07 January 2014

Just before Christmas (17th December)  the Disability and Health Employment Strategy (DHES) was finally published. Whilst an interesting read, with some potentially important and positive policy changes being put forward at least in principle, the subheading ‘the discussion so far’ emphasised that this was primarily a summary of the ‘conversation’ surrounding disability and employment. A fact that is somewhat lost in the accompanying press release.

Whilst I welcome talk of getting employers more involved, discussion of the benefit of co-commissioning, and the number of interesting pilot studies being announced, it all felt a bit flat. The discussion feels somehow incomplete with many positive suggestions left hanging and  no concrete policy planning or funding to back them. With the promise that this report ‘will be followed next year by a further paper - setting out our delivery plan’, perhaps we’ll have to wait a little while longer before we get the whole picture of how this strategy will be implemented.

One of the more positive things I took from the report was the announcement that  NHS England will work with the Health and Social Care Information Centre to develop a Clinical Commissioning Group Outcomes Indicator  for the employment of people with mental health conditions. The Work Foundation highlighted the importance of recognising employment as a health outcome in our report on Schizophrenia nearly a year ago, and it has been an issue that has long been at the heart of a number of organisation’s campaigns to improve employment outcomes for people with long term health conditions.

Whilst this is a positive step (and if it moves beyond the discussion stage I would be very pleased indeed)  it seems a little strange that this proposal is confined to people with mental health problems. Employment is important for both mental and physical health conditions – this seems obvious. Yet, it is unclear in the report why the discussion could not be broadened to include other forms of disability.

In terms of welfare and benefit announcements, the creation of a ‘Gateway’ tool was perhaps the most intriguing. As with many policies suggested in the report, the details are still vague (and will be clarified in a separate paper in the coming year). The report seems to suggest the creation of a specialist employment support service, or advice and assessment tool, that will provide information and support on a range of topics related to returning to work. Intended to be an early intervention tool, not only will people claiming an out of work benefit use the gateway , but individuals can be referred to the service by their employer or via the new Health and Work Service before they actually become unemployed. Presumably this would occur when it has become apparent that they cannot continue in their role and all attempts have been made by the employer to make the role suitable.

According to the DHES, users of the gateway will be placed in different categorises and offered different services according to the level of support that they’ll require:

‘1. those people who can self-direct and self-manage their job search process without any specialist intervention; they will receive mainstream support;
2. those people who require limited guidance and support, but not referral to a specialist service; they will receive mainstream support, perhaps with some additional help; and
3. those people who may need co-ordinated support to enable them to return to work and possible referral to the specialist offer. This process will involve a much more detailed assessment.’

Although not specified in the DHES, it seems possible that this could be a first step towards basing Job Outcome Payments for Work Programme Providers on the level of support needed by services users  rather than benefit type (as suggested in both the ACEVO/Shaw Trust report and the ERSA report).

The announcement of the ‘Information Portal’ is also potentially significant. Taking a similar role to the ‘Job Access’ program currently used (though not yet evaluated) in Australia, the Portal is intended as a one stop shop for employers, JobCentre Advisors, advocates and individuals with disabilities. It will provide information and advice, explain employers’ legal duties and signpost individuals to support services. The Portal will also act as an account management service for larger employers and handle job vacancies.

Overall then an interesting but inconclusive report, and as the title admits -  a discussion half finished. With the latest set of Work Programme statistics showing little  improvement for new jobseekers claiming ESA, the issue of disability and employment is more urgent than ever. We will however have to wait for the next report until we know exactly what the government plans to do about it. Let’s hope that  this conversation will find an end soon.