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
Overview • Revised benefit cap • Work & Health Green Paper • Employment support – Dame Carol Black Review – Work & Health Programme – What works? – Broader policy issues
Revised benefit cap • With effect from 7 th November • 50% of old cap cases in Type Old New Ex- London London Single £18,200 £15,410 £13,400 • Cumulative c.76k; static caseload c.20k – plus >90k Family £26,000 £23,000 £20,000 new
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 To 2020-21 To March 2016 Barking & Dagenham - £530 Westminster - £680 Newham - £460 Brent - £550 Enfield - £450 Barking & Dagenham - £540 Hackney - £410 Enfield - £530
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 Reoffending rates based on propensity score matching • Not a silver bullet, but significant reductions 24.4% and cost effective: Custodial sentences 1 year or more • £26k opiate/crack 18.8% cocaine user not in treatment • £36k per prisoner per 41.7% year Custodial sentences less than 1 year • £13-15k economic value 32.2% of return to work • £3.6-7K gross cost per 0% 10% 20% 30% 40% 50% job for LMPs One year proven reoffending rates No P45 employment P45 employment
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 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?
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
Work & Health Programme • 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, 13 th October
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 90 80 Sample size – 312; comprised of 70 156 people accessing IPS, 156 60 50 43 people accessing pre-vocational 40 training 30 20 Entry criteria – Patients with 10 severe mental illness in six 0 European cities. All subjects had Results for IPS Results for pre-vocational not been in competitive training employment in the last year, and wanted to enter competitive Burns, Tom et al (2007), The Effectiveness of work 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
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