Integration is the buzzword but what works?

23 July 2015

Last week I attended Inclusion’s annual IntoWork Convention. The conference theme was ‘what works’ in employment, especially for the most vulnerable. Integration between government departments, providers and services emerged as the core underlying principle for many of the solutions.

In her keynote address, the Minister for Employment Priti Patel, identified integration as central to the Government’s vision for full employment: “We need to work in partnership with providers, stakeholders and employers to support individuals facing challenges to get closer to the labour market. Working across Government will help secure the right to employment outcomes that will transform people’s lives.” For people facing multiple barriers to work, integrated health, housing and employment services could achieve better outcomes for lower cost, avoiding duplication and gaps in provision and enabling the sequencing of interventions more effectively.

Before embracing the integration agenda however, it is important to understand whether it is effective in practice, and if so for which groups of people. The Work Programme (WP) overall has been as successful as previous programmes in achieving job outcomes, and at less cost. Performance has, however, been lower than hoped for people with a long-term health condition or disability. The latest cohort data shows that 11.8 per cent of new Employment and Support Allowance (ESA) participants secured a job outcome. This is below the DWP’s expectation of 13 per cent. Tackling this disparity by improving employment outcomes for people with a health condition or disability must be a top Government priority – but is integration the key?

Full integration would require radical restructuring of national and local government service provision and a new way of working with providers. For those claiming ESA, it would require strong communication between welfare and health. The lack of health representatives at the IntoWork Convention indicates that this could be a challenge.

Above all, integration is a potential means to an end, not an end in itself. We need to know which interventions will have the greatest impact on supporting this group into work, and that means assessing the costs and benefits of each. A recent service model study by York University compared the effectiveness of a ‘Work First’ WP with a ‘People First’ approach, which focused on health support in parallel to work-related activity and employment. The ‘People First’ programme increased participant satisfaction but the study revealed no difference in job outcome rates. This suggests that combined health and employment support may not significantly increase the job outcome rate for people further from the labour market. A ‘what works’ centre for employment, similar to that in education, health and policing, would allow for systematic testing of innovations and inform welfare-to-work decisions.

In his concluding remarks the Minister for Disabled People Justin Tomlinson, asserted a “collective responsibility- as policymakers, providers, employers – to halving the disability employment gap.” A collective responsibility is pertinent – under devolution local government and providers will have more decision-making power to adapt services to meet customer needs. Will this necessitate integration? For some groups of people, particularly for those facing multiple barriers to employment, integrated service delivery is intuitively of benefit. To get this right and deliver better outcomes and value for money the ‘what works for who’ must first be addressed.

Hannah Titley, Researcher, Reform



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