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Pathways to Work: Progress in Government initiatives

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Pathways to Work: Progress in Government initiatives Dr Philip Sawney AOHNP(UK) Symposium 13 May 2004 – PowerPoint PPT presentation

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Title: Pathways to Work: Progress in Government initiatives


1
Pathways to WorkProgress in Government
initiatives
  • Dr Philip Sawney
  • AOHNP(UK) Symposium
  • 13 May 2004

2
Department for Work and Pensions
  • Created 2001 from former DSS and part DfEE
  • Corporate centre and agencies
  • Jobcentre Plus
  • Pensions Service
  • Disability and Carers Service
  • Child Support Agency
  • The Appeals Service
  • Spends 115 billion /year 3 bn running costs
  • 120,000 staff
  • Sponsoring Dept for HSC/ HSE

3
DWP
  • Promote opportunity and independence for all
  • 10 Public Service Agreement targets
  • Working with others
  • Health Depts England,Scotland,Wales
  • Inland Revenue
  • DfES
  • Local authorities
  • Employers
  • Voluntary sector
  • Commercial partners

4
People of working age
  • Objective to promote work as the best form of
    welfare whilst protecting the position of those
    in greatest need
  • Delivery Targets (PSA)
  • Increase overall employment rate over economic
    cycle
  • Increase the employment rate of people with
    disabilities, taking account of the economic
    cycle, and significantly reduce the difference
    between their employment rate and the overall
    rate.
  • Work to improve the rights of disabled people and
    to remove barriers to their participation in
    society

5
Jobcentre Plus
  • Helps people to find/access work and receive
    benefits
  • Helps employers fill their vacancies
  • Front office services for others eg DCS
  • Implements labour market policies
  • New initiatives
  • Employment Zones
  • New Deals
  • Worklessness pilots
  • Pathways to Work

6
Disability Employment Strategy
  • Focus on what people can still do - with support
    to work
  • Systems support/encourage activity rather than
    inactivity
  • Interventions at earlier stage
  • Agencies working together
  • Healthcare systems treat work outcomes as a key
    element of clinical management
  • Employer engagement
  • Further develop the evidence base for
    rehabilitation

7
Why do we need this strategy ?
  • 2.7 million people of working age on a state
    incapacity benefit lt 1 million unemployed
  • 1 million report sick each week 3000 remain off
    work at 6 months and 80 of these will not work
    again in next 5 years
  • 20 of people of working age have a long term
    disability
  • 50 of the disabled population in the UK are
    economically inactive (versus 15 of the
    non-disabled)

8
IB Growth 1979 - 2001
9
IB claim trends
10
IB some diagnoses predominate
11
Pathways to Work Nov 02/June 03
12
The case for reform
  • Health
  • Social
  • Economic

13
Return to work should be a positive realistic
option
  • Satisfying Personal Capability Assessment (PCA)
    does not necessarily mean incapable of any sort
    of work
  • Almost everyone moving onto Incapacity Benefit
    says they want to work again
  • Most have more manageable conditions where
    outlook should be positive
  • For most people return to full activity (incl.
    work) will improve health and well-being

14
Effects of worklessness
  • Acheson (1998)
  • worklessness as a major risk to health
  • For the majority being away from work has a
    significant adverse effect on health through
  • isolation, social exclusion and stigma
  • changing health related behaviour
  • disruption to future career
  • lower income than available through work

15
Obstacles to rehabilitation
  • Lack of intervention and support
  • Skills and qualifications
  • Medical issues
  • Financial support
  • Employers role
  • Communication problems
  • Managing uncertainty
  • Stigma and discrimination
  • steps to activation are undermined

16
Obstacles to rehabilitation
  • Not just Government saying this..
  • Vocational Rehabilitation The Way Forward -
    BSRM, 2nd Ed Dec 2003
  • Second UK Bodily Injury Awards Study - Oct 2000
  • CBI report Business and healthcare for 21st
    century - Dec 2001
  • ABI/TUC paper Getting back to work June 2002
  • Employment Opportunities and Psychiatric
    Disability RCPsych 2003

17
Helping people realise aspirations - creating
better pathways to work
  • Key principles
  • Early skilled intervention -gt best chance for
    help
  • Better specialist support, esp. health-work
    aspects
  • Making sure work clearly pays
  • Better support for people on JSA with health
    problems
  • Jobcentre Plus working in partnership- NHS and
    employers also key

18
Pathways to Work the bio-psychosocial model
of rehabilitation
  • Limitations of traditional health care
  • Models of disability
  • Modern concepts of vocational rehabilitation
  • Addressing the real obstacles
  • Developing the evidence base

19
Bio-psychosocial model and Pathways pilots
AXIS ELEMENT PATHWAYS FEATURE
Bio Impairment Function Legal framework Residual functional capacity
Psycho- Attitudes beliefs Psychological distress Coping strategies Illness behaviour Earlier intervention Integrated support Condition management progs Clearer messages
Social Occupational demands/adjustments Economic incentives Cultural attitudes Employer strategy Return to work credit Involving other stakeholders
20
Other stakeholders
  • DWP/Jobcentre Plus cannot provide the whole
    solution
  • Other stakeholders to focus on agenda that
    encourages those with health problems/disabilities
    to remain in, or return to, work

21
Pathways pilots update
  • Public consultation Govt response June 2003
  • working with key stakeholders especially NHS
    (Condition Management Programmes)
  • 7 pilot areas
  • Oct 03 - Bridgend Renfrewshire Derbyshire
  • April 04 -Somerset Essex E.Lancs Gateshead
  • Full evaluation 2003 - 2006

22
Other DWP/Government initiatives
  • Jobcentre Plus
  • Anti-discrimination / focus on abilities
  • New Deal for Disabled People
  • Benefit rule changes permitted work
  • Job Retention and Rehabilitation Pilots (RCT)
  • Health Inequalities / Social Exclusion Unit
  • Securing Health Together
  • ELCI and Framework for Vocational Rehabilitation

23
Culture - a new understanding
  • Recognise diversity and individual need
  • Disability and work a mainstream issue
  • Dynamic nature of conditions
  • Need to consider functional capacity
  • Recognise influence of psychological and social
    factors

24
More information
  • www.dwp.gov.uk/medical
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