DOH and DWP: Improving Lives: the Work, Health and Disability Green Paper. Consultation

Attachment 9a

DOH and DWP: Improving lives: The Work, Health and Disability Green Paper. Consultation questions.

You can respond to this consultation online: https://consultations.dh.gov.uk/workandhealth/consult/

Email at

Write to: The Work, Health and Disability consultation,

Ground Floor, Caxton House, 6-12 Tothill Street, London,

SW1H 9NA

The consultation will run until Friday 17 February 2017.

Response from VISION 2020 UK

VISION 2020 UK is the umbrella organisation which leads collaboration and co-operation between organisations with an interest in eye health and sight loss.

Research has shown the obstacles that disabled people face in accessing employment. This is especially important for blind and partially sighted people. Only one in four blind or partially sighted people are in employment, whilst the employment rate amongst disabled people in general is one in two and that of non-disabled people is four in five.

VISION 2020 UK are supportive of the Green paper and its objective to encourage and maintain people into employment. This outcome fits with outcome 3 of the UK Vision strategy: ‘A society in which people with sight loss can fully participate by: Improving attitudes, awareness and actions within education, employment and other services.’ http://www.ukvisionstrategy.org.uk/strategy-2013-2018/outcome-3

‘Action taken to reduce health inequalities will benefit society in many ways. It will have economic benefits in reducing losses from illness associated with health inequalities. These currently account for productivity losses, reduced tax revenue, higher welfare payments and increased treatment costs.’' Fair Society Healthy Lives' (The Marmot Review) http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review

It is worth noting that the severity of visual impairment has a significant impact upon likelihood of employment – those who are registered as blind are less likely to be employed than those registered partially sighted.

Also that the level of educational attainment has a significant impact upon likelihood of employment. People with higher qualifications are significantly more likely to be employed. While age appears to be a key factor in predicting employment in this population it seems that it is educational attainment which has the greater association (in fact the highest association of all the variables examined).

Network 1000 Report: Visually impaired people’s access to employment – Summary of Findings http://www.vision2020uk.org.uk/network-1000-report-visually-impaired-peoples-access-to-employment-summary-of-findings/

Consultation questions

Chapter 1: Tackling a significant inequality – the case for action

We want to hear from you about areas you are already exploring or have learnt from:

·  What innovative and evidence-based support are you already delivering to improve health and employment outcomes for people in your community which you think could be replicated at scale? What evidence sources did you draw on when making your investment decision?

·  Any Initiatives to innovate and support PWD’s to improve health and employment outcomes should build on extant successful schemes. This will allow for lessons to be learned from the positive and negative experiences of such schemes. An example would be local authorities who have workplace teams that signpost and help PWD’s into employment such as the “I-work” team in Nottinghamshire http://www.nottinghamshire.gov.uk/leadership/posts/i-works-supporting-disabled-people-into-employment.

·  The Thomas Pocklington Trust general ethos and ‘Works for me’ project supports people with sight loss to gain and retain paid employment. (http://www.pocklington-trust.org.uk/thomas-pocklington-trusts-london-employment-programme-wins-award/ contact: )

·  Evidence shows that for people with sensory impairments there is a general need to underpin work around assessing for/providing mobility support and equipment to improve equality. This should be dealt with on a strategic and country wide basis and not in limited areas of excellence.

·  The RNIB’s research provides useful and practical information to PWD’s and employers to increase recruitment and workplace accessibility http://www.rnib.org.uk/information-everyday-living/work-and-employment this information should again be used in a strategic and wide ranging way to increase opportunities and accessibility countrywide.

·  The RNIB and the Institute of Employability Professionals have joined together to create a guide outlining what good employment support for blind and partially sighted people looks like which is a useful resource: http://www.rnib.org.uk/services-we-offer-advice-professionals/employment-professionals

·  What evidence gaps have you identified in your local area in relation to supporting disabled people or people with long-term health conditions? Are there particular gaps that a Challenge Fund approach could most successfully respond to?

·  A strategic review should be undertaken around the skills and competencies of the disability employment adviser’s teams. If necessary a training programme should be rolled out to provide good and practical awareness training not just in physical disabilities but also sensory disabilities and special needs. This would enable an increase in the potential for positive action to be taken for and with PWD’s.

·  Strategically local and national advisory teams need to be involved in identifying gaps and training to enable individual service users to increase their skills and potential in the workplace. The approach needs to be both top down, with training being funded and offered across the board, and bottom up, with service users being aware of, accessing and influencing training.

·  Challenge funding could be used for strategic training of dynamic and influential employers in the capabilities of PWD’s, accessibility and positive ways to deal with any perceived or real obstacles to employment and retention. This would enable the employers involved to be champions in industries which have not previously employed PWD’s. The funding should, therefore, provide incentives for both employers and PWD’s.

·  Planned retraining and support for people with acquired disabilities (such as sight loss) needs to be accessible countywide, adaptable and appropriate to conditions and individuals. There is potential for funding to be used with these individuals and employers for PWD’s to aid skills and confidence in a work context; as well as for employers to increase knowledge, adaptability and accessibility.

·  How should we develop, structure and communicate the evidence base to influence commissioning decisions?

·  Development of national and local online forums to share good practice and successes and failures (for lessons learned) would allow interactive and responsive relationships with local authorities, the voluntary sector and local partnerships to increase both understanding and engagement.

·  The RNIB Employment Practice and Research Network (EPRN) is a good place to find and disseminate information http://www.rnib.org.uk/services-we-offer-advice-professionals-employment-professionals/employment-practice-and-research. Again used strategically this can allow a consistency of approach countrywide.

·  Using extant organisations such as ADASS, Disability Rights UK (https://www.disabilityrightsuk.org/careers-and-work-disabled-people )and VISION 2020 UK (http://www.vision2020uk.org.uk/ ) and Visionary (http://www.visionary.org.uk/ ) as strategic bases for information and dissemination can communicate evidence to a large and diverse audience.

Chapter 2: Supporting people into work

Building work coach capability

·  How do we ensure that Jobcentres can support the provision of the right personal support at the right time for individuals?

·  A strategic approach is needed to ensure that support is available and understood across the country. Centres of excellence can be useful for trailblazing innovation and there is a good argument for coherent messages to be worked out and agreed pre national rollout. As above there is a strategic need within Job centres for appropriate training to ensure sufficient management and staff have multi disability awareness and a person centred approach to empower PWD’s into employment.

·  To increase integration with the third sector and voluntary organisations within a locality, where possible, the use of volunteers and local experts by experience (as used by the CQC in their inspection programmes http://www.cqc.org.uk/content/how-we-involve-you ) within jobcentres to provide extra specialised services would improve not only the prospects of PWD’s but also influence staff and management. With appropriate training and management this could also provide the potential for mentoring and further support

·  The need for an increase in physical as well as IT accessibility is central to national government policy (https://www.gov.uk/service-manual/helping-people-to-use-your-service/making-your-service-accessible-an-introduction and https://www.gov.uk/government/publications/accessible-britain-challenge-good-practice-examples/accessible-britain-challenge-good-practice-examples ) and the accessibility of job centres countrywide can only improve the prospects and acceptance of PWD’s and it has been shown that accessibility in both technology and physical space is an advantage to all not just PWD’s. The NHS Accessible Information Standard is a key component link in health and social care for people who have a disability, impairment or sensory loss so they can be provided with information that they can easily read or understand and with support so they can communicate effectively with health and social care services (https://www.england.nhs.uk/ourwork/accessibleinfo/ ) The Standard is not an employment tool but can certainly increase the ability of people with a disability, impairment or sensory loss to access information and empower themselves towards employment.

·  What specialist tools or support should we provide to work coaches to help them work with disabled people and people with health conditions?

·  With appropriate training and management the ability of Jobcentre staff dealing with PWD’s should be increased to enable them to become sufficiently competent in their understanding of accessibility and accessible technology to enable them to understand how to integrate PWD into the system at large and also to interact with employers to disseminate this knowledge and confidence.

·  As above the NHS England Accessible information standard aims to make sure that people who have a disability, impairment or sensory loss are provided with information that they can easily read or understand and with support so they can communicate effectively with health and social care services. This should be extended to other areas of social care including jobcentres, transport etc. As above we are not suggesting this is an employment tool but a way which would allow people with a disability, impairment or sensory loss to empower themselves towards employment.

·  There is a notable omission in The green paper in that it does not mention how the government plans to support young people with disabilities at the transitional stage between education and employment. This is a group which is often neglected in both public and voluntary sector initiatives. A Strategic approach is highly recommended to consider what support is required at this stage. It would be advantageous for the DOH/DWP to reach out to organisations such as the council for disabled Children https://councilfordisabledchildren.org.uk/ Guide Dogs http://www.guidedogs.org.uk/blindchildrenuk/#.WKRZ4vmLRPY VICTA http://www.victa.org.uk/ and Royal Society for Blind Children (RSBC) http://www.rsbc.org.uk/ who can provide specialist advice in this area.

Supporting people into work

·  What support should we offer to help those ‘in work’ stay in work and progress?

·  Disabled people are all too often seen as being risky to hire due to misconceptions about their disability, availability of flexible working arrangements and poor support arrangements. As a result many disabled people lose out on job opportunities.

Even when disabled people are in employment, the support they receive is often not good enough. Once in work, disabled people may be hit by rigid employment contracts, which fail to take account of their disability. This makes it a struggle for them to keep a job.

In 2016, 3.8 million disabled people were out of work.[1] The human and economic cost of this is profound: 10 percent of unemployed disabled people have been out of work for five years or more, compared with three percent of non-disabled people.[2] There is an also urgent need to give more support to disabled people already in work, in order to help them keep their jobs. Only about half of disabled people of working age are in work (50 percent), compared with 80 percent of non-disabled people of working age.[3]

Demographics are not only changing for disabled people, but for older people. Supporting people to remain in work will become even more important as the workforce becomes older. Demographic changes mean that there are increasing numbers of disabled people of working age. By 2035, the Office for National Statistics predicts that older people will account for 23% of the population compared with 17% in 2010, with over a third of the workforce aged 50+ by 2020. Therefore it is essential that we develop inclusive workplaces.[4]

There is little reference within the green paper to the importance of improving support to housing, social networks, public transport, in enabling people with a disability or a fluctuating health condition to remain in stable employment. The Government needs to ensure that the level of financial support people receive is sufficient for them to maintain an independent life and have equal employment opportunities.

·  On a very general level working needs to be financially beneficial so there needs to be a look at entry level wages vs benefits (including part time).

·  What does the evidence tell us about the right type of employment support for people with mental health conditions?

·  Competitive but supportive employment,

·  Integration of rehabilitation and mental health,

·  Attention to employee preferences,

·  Flexible working,

·  Continuous and comprehensive assessment,

and

·  Time-unlimited support

These principles represent a departure from traditional ways of thinking about vocational rehabilitation. Considerable research suggests that the traditional ways of providing vocational services to people with severe mental illness are ineffective.

·  The benefit of having a mental health champion in organisations cannot be over emphasised especially in relation to acceptance and normalisation within society (Such a Mind’s Blue Light Champions http://www.mind.org.uk/news-campaigns/campaigns/bluelight/champions/ )

·  If you are an employer who has considered providing a supported internship placement but have not done so, please let us know what the barriers were. If you are interested in offering a supported internship, please provide your contact details so we can help to match you to a local school or college.

Improving access to employment support

·  Should we offer targeted health and employment support to individuals in the Support Group, and Universal Credit equivalent, where appropriate?

·  Needs and support need to be individually focussed but nationally based. Support should be universal and consistent.

·  The assumption that PWD’s will ‘never work’ needs to be removed on both sides.

·  What type of support might be most effective and who should provide this?

·  Training and communication support.

·  Active practical support both in work and allowing flexibility at work.

·  As discussed above this should be viewed as an opportunity for interaction with local third sector and voluntary organisations who often have the facility and ability to train and mentor.