NDTi employment research - summary findings

8/11/2019 NDTi employment research - summary findings

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people lives communities


Commissioning effective

employment support

BASE Conference11 September 2014

Rich Watts, NDTi


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Overview

Context

Quantitative research

Qualitative research

A word on Personal BudgetsConclusions

Discussion


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Key messages

There are significant opportunities for localareas to achieve better employment outcomes

for disabled people

To maximise these opportunities:The right conditionsneed to be in place

The right modelsneed to be in place

The right expectationsneed to be in place

Of peopleOf providers

Of outcomes


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Why important

2.3m people with a mental health conditionare on benefits or out of work

Employment rates:

Non-disabled people is approx. 79%Disabled people is approx. 48%:

Only 8% of adults using secondary mental health

services on CPA known to be in employment

This proportion is actually decreasing

Only 7% of people with learning disabilities are in

paid employment


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Why important

Access to paid work is both a policy priority and whatmany people say they want

But

Significant investment in employment but with low and very

variable numbers of people actually getting work as a resultOnly a third of commissioned employment support is evidence-

based

Suggestion of disinvestment in employment

Not felt to be an organisational or political priority

Not delivering outcomes


7/44people lives communities

Changing spending patterns

Some evidence of cutsmore budgetsdecreasing than staying the same or increasing:

0%

100%

200%

300%

400%

Social Care

Health

CombinedChanges in budgets

2011/12 to 2012/13

Social Care Budgets (n = 59) 30% 26% 44%

Health Budgets (n = 29) 29% 34% 37%

Combined budgets (n = 25) 47% 12% 41%



Existing employment evidence

Clear evidence on place and traini.e. individual placement and support(mental health

services) and supported employment(learning

disability services)

Little or no evidence for other approaches (train& place, volunteering etc.)

Some evidence around cost benefit analysis,

very little on cost effectiveness

Some newapproaches not evaluated (e.g. self-

employment; Personal Budgets)



Is it possible to get more for more?

Or more for the same?

Or even more for less?

So



Research aims

What is the cost effectiveness of currentemployment supports, in terms of people

consequently achieving paid work? (If we invest

xamount, how many people will get / keep jobs

as a result?)

How is the value for moneyimpact affected by

different approaches to implementing local

employment strategies?



Funder



Methods

Main components:National data collection from local authorities and PCTs (as

was) in England83 areas

In depth data collection and study in a sample of local

areas70 returnsQualitative study of 11 areas and 6 in-depth visits

Action learning with 30+ commissioners in three areas



Quantitative findings


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Caveats:Self-reported

No common definition of an employment outcome

Monitoring data varied (e.g. gender, age, type and level ofimpairment)

LD-focused services = 32; MH-focused services = 31

Spend levels are across 2011/12 (n=33) and 2012/13(n=37)

Things not included / collected:

Hours workedPayment received

Sector work is in

Caveats / limitations


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263,132

What an averageservice looks like

1,730

per person

Supports

198 people


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Job outcome rate


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Job outcome rate


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Job outcome rate

38%


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Headline figures


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Headline figures

If 100 people came through the door:

23 would gain a new job (100 x 0.38 x 0.61)

14 would retain a job (100 x 0.38 x 0.36)

1 would become self-employed (100 x 0.38 x 0.03)

Peoplewho

secured ajob

outcome

New job Retainedjob

Self-employed

All 38% 61% 36% 3%

LD 43% 53% 45% 1%

MH 34% 68% 26% 6%


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Average hides the range

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

11,000

Costs per person supported


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Delivering job outcomes


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Interesting questions

Do any of the following have an impact?Size of service

Type of employment outcome

The level of peoples impairments

Evidence-based approaches


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All: r=0.47

LD: r=0.26

MH: r=0.59

Size of a service

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

11000

0 250000 500000 750000 1000000 1250000 1500000 1750000 2000000 2250000

Relationship between cost of service and costper person supported


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Types of job outcomes

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

%age

ofpeoplewhogainednewjob

s

Gained new jobs against overall gain/retention rateGained new jobs Linear (Gained new jobs)


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Types of job outcomes

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

%

ageofpeoplewhoretainedjo

b

%age of people who gained/retained job

Retained jobs against overall gain/retention rateRetained jobs Linear (Retained jobs)


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The most effective services in terms of

outcomes are those that aim to get a good

balance between gaining new jobs for

people and helping people retain existing

jobs

Trend stronger for

MH than for LD

Types of job outcome


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Do peoples support levels affect job outcomes

and/or costs?

No

Impact of peoples support levels

51%41%

8%

Support needs of peoplesupported (LD services)

40hrs

support who received

support who

gained/retained job


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Impact of peoples support levels

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

667 670 687 818 908 1,008 1,087 1,129 1,145 1,227 1,611 1,629 1,711 1,935 2,017 3,063 3,447 4,734

Cost of service per person

Distribution of level of support needs by costs per person of service(LD services)


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Costs / job outcome: good practice

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

50000

55000

60000


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Findings: Good practice sites

n.b. Do not misinterpret. This does not mean it costs 2,818 to support someone into work.


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Size of a service doesnt have a strong impact

Good services balance gaining and retaining jobs

Peoples support levels dont affect outcomes/costs

Results from good site sample give tentativesuggestions of what what to expect if things areworking well

More predictable

Lower average costsBetter job outcomes

Overall average per job outcome: 8.2k / 2.8k

Summary of key data findings


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Qualitative study

Theory of Change 1


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Theory of Change 1

Shifting Culture: Increasing opportunities

A positive decision by key decision

makers (like elected Members) to

make employment a central strategic

outcome and contextualise that tolocal circumstances so it becomes

part of the culture of service

behaviour and performanceexpectation

Theory of Change 2


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Theory of Change 2

Employment outcome: Local agreement

A clear understanding of what is

meant by employmentbased on

real work including proven steps

towards it, so inappropriate and

non-evidence based approaches

are not tolerated

Theory of Change 3


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Theory of Change 3

Strategic direction: Joint vision

A comprehensive strategy, owned

by key players, based on

evidence linked to wider

strategies that is used to guide

action/delivery

Theory of Change 4


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Theory of Change 4

Developing relationships and the market

Knowledgeable leadership (if not

commissioners then

commissioners listening to it) that

works with all stakeholders, but

especially providers, to specify,

support and manage the

development of systems and

market that can deliver 1, 2 and 3

Theory of Change 5


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Theory of Change 5

Performance management

Not gathering information to

inform achievement of 1,2 and 3

enables cost ineffectiveness of

services to continue


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Right conditions for effective strategy

1. Make employment a priority

2. Be clear what is meant by work

3. Have a plan everyone agrees to4. Strong partnership working

5. Check it is being done


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A word on Personal Budgets

Clear evidence of non-use for PBs for employment

support

Probably under 200 people in total through employment

agenciesPlus a few more through (mainly families) doing their

own thing

Some clear systemic barriers as to why this is the

case


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Systemic barriers


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Conclusion


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Discussion / implications

www.ndti.org.uk

[email protected]

@ndtirob / @rich_w

/ndti.org.uk
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NDTi employment research - summary findings