PLUS Project Welfare reform & employment support Paul Anders

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1 PLUS Project Welfare reform & employment support Paul Anders

2 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

3 Overview Revised benefit cap Work & Health Green Paper Employment support Dame Carol Black Review Work & Health Programme What works? Broader policy issues

4 Revised benefit cap With effect from 7 th 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

5 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

6 Cumulative impact To March 2016 To Westminster Brent Barking & Dagenham Enfield Barking & Dagenham Newham Enfield Hackney - 410

7 Distributional effect

8 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

9 Mind the gap c.15% c.28%

10 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

11 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

12 The prize Reoffending rates based on propensity score matching 24.4% Custodial sentences 1 year or more 18.8% 41.7% Custodial sentences less than 1 year 32.2% 0% 10% 20% 30% 40% 50% One year proven reoffending rates 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 of return to work 3.6-7K gross cost per job for LMPs No P45 employment P45 employment

13 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

14 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?

15 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 supportrelated 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?

16 Dame Carol Black Review III What are the views of employers on supporting these groups to stay in work or return to work, or of 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?

17 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?

18 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

19 Work & Health Programme 6 CPAs, plus Scotland & national Different funding model Focus on what works & building evidence Co-commission/design London is cocommission Disability, ex-offenders, substance misuse & homeless any time, but targeted & voluntary Long-term unemployed 2 years, mandatory Market engagement in London, 13 th October

20 Work & Health Programme II Much smaller programme c. 130m pa vs. 750m

21 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

22 What works?

23 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

24 Individual placement & support Number entering employment Results for IPS 43 Results for pre-vocational training Burns, Tom et al (2007), The Effectiveness of Supported Employment for People with Severe Mental Illness: A Randomised Controlled Trial, Lancet 370, 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

25 IPS international comparisons

26 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

27 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

28 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?

29 Contact Paul Anders Revolving Doors Agency South Bank Technopark 90 London Road London SE1 6LN

30 References Slide 6: Slide 7: Slide 9: Slide 12: Slide 20: & Slide 21: Burns, Tom et al (2007), The Effectiveness of Supported Employment for People with Severe Mental Illness: A Randomised Controlled Trial, Lancet 370, Slide 22: Burns, T. and Catty, J., (2008. IPS in Europe: the EQOLISE trial. Psychiatric rehabilitation journal, 31(4), p.313.

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