RBLI Green Paper Response Feb 17

A response to the Government’s ‘Improving Lives’ Green Paper on work, health & disability

Evidence submitted by Royal British Legion Industries - February 2017

INTRODUCTION TO ROYAL BRITISH LEGION INDUSTRIES (RBLI) RBLI has been delivering employment support in the UK for nearly 100 years. We have a team of specialists who are experts in supporting people with physical, mental and cognitive disabilities and health conditions and those with mental health difficulties. We have previously delivered programmes such as WorkStep (RBLI held the 2nd largest contract in UK), Pathways to Work, New Deal for Disabled People and Work Programme – consistently delivering above target performance. We are currently delivering Building Better Opportunities programmes to a number of groups including those with disabilities and health conditions, and people who are long term unemployed. We also employ people with disabilities in our social enterprise, Britain’s Bravest Manufacturing Co. (BBMC). Nearly 90% of employees in our BBMC factory in Surrey have a disability, and 60% have a disability at our factory in Kent. Overall across RBLI, over 25% of our staff have a disability. Our intensive employment support programme, LifeWorks1, which we deliver nationally, was evaluated by the Learning and Work Institute in 2016 and was shown to achieve an incredible 83% success rate of moving individuals into employment, training or volunteering within 12 months. 4 out of 5 participants were also shown to have a mental or physical health condition or disability.

EXECUTIVE SUMMARY Our response focuses on: the importance for early intervention, the need for an in-depth individualised assessment, and the need for a combination of a number of different solutions.

Our main points are as follows: 1.

Wherever possible, early intervention is key. We believe support should be provided as soon as someone is given a Work Capability Assessment (WCA), or similar, and language around support and assessments should be consistent to help individuals understand the expectations placed upon them.

2.

An in-depth personalised assessment of not just an individual’s health condition/disability but also of their experience, skills, support networks, and other personal, social and health barriers, will allow for better support from the start.

3.

We believe LifeWorks, currently only available to ex-service personnel, could be piloted to the wider community with disabilities/health conditions to help them into work. We have already submitted a proposal to DWP on this basis.

4.

LifeWorks should be just one solution of many to help halve the disability employment gap. Solutions should include more support for employers, more personalised support generally, as well as a new approach to the meaning of ‘work’ and an attitude which looks at what people can do, rather than what they can’t.

1. LifeWorks is an employability programme developed for ex-Armed forces personnel by RBLI’s occupational psychologist. It involves an intensive course lasting 4-5 days followed by 12 months of ongoing additional support delivered via phone and online.

RESPONSE We were pleased to see the recommendations made by the government in the Green Paper, and especially delighted that the paper emphasised that good work is good for your health – something which we have long advocated.

Following the publication of the paper we have reviewed the recommendations, and below have set out our suggestions for, ways to put the recommendations into action, and other factors to consider when considering how to support people with disabilities and health conditions back to work.

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When an individual applies for welfare support linked to an inability to work due to a health condition/disability, they are called for a Work Capability Assessment (WCA). The process from applying for support, to being allocated to a group (and then to Work Programme or similar if recommended) is a very extended - our research shows that in the past, it has taken over 30 weeks for an individual to have a WCA following a claim – and this is just the start of their journey for support! In this time, many people with a disability or health condition will have been receiving regular support from a health professional, whether that is a GP, consultant or psychologist, who may have advised them that due to their health they cannot work (we have previously spoken about this mismatch of advice in our evidence for the disability employment gap enquiry in 20162).

When talking about worklessness, 6 months is also a long period of time. Research shows that job loss generally has a rapid impact on mental health.3 By delivering an early intervention (potentially linked to social prescribing), we could minimise these risks and support people to get used to the notion of ‘work related activity’ as a step towards work.

For example, putting regular activity in their calendar to build up timekeeping and motivation to go outdoors, or volunteering with a local charity to build up experience for a new job which they can fit around their condition. We could also identify earlier those who are really scared of a return to work due to fear of the unknown or low confidence. We could also explore better ways of identifying those who can and want to work, those that can and don’t work to work, those that can’t work at this time. Better identification of each group would mean approaches could be better personalised to each individual – linked not only to the benefit they are claiming, but more-in depth information about them, their background and their attitudes (we focus on this in more detail in point 2).

Our suggestion is to have a meeting with a work and wellbeing coach on the same day as the WCA, so that following the WCA the coach can explain what will happen either way depending on the result of the assessment. This will reassure individuals and mitigate their worries, and advise the next immediate steps to help manage their condition, as well as allow them to think about the future and what they want from life. Supporting individuals into a more positive mindset can only be beneficial to the back-to-work process. We realise that a session immediately after may be stressful for individuals and not always possible, however this may be because they are attending something that they believe will only lead to them having their benefits stopped. Whilst for many this will not happen, it is a reality for some and if this is the case, then undoubtedly moving from one part of an assessment (the WCA - primarily designed to make a decision regarding benefits) to a second that is designed to build a possibility and different future, should give greater control to the individual. This can only be a good thing, as this is an opportunity to start a discussion regarding ‘what’s next’ for an individual and their future. This will alleviate some of the fear caused by having to attend an WCA in the first place, as more options and possibilities are opened up and understood by the individual.

Benefits of early intervention include: 1) potential for reduced time on benefits, 2) reduced cost to the health service due to a reduction in poor mental health due to inactivity/worklessness 3) a more positive approach from the start of back-to-work support.

2. http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/work-and-pensions-committee/disability-employment-gap/written/33090.pdf 3. https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being

RESPONSE CONTINUED 2

An in-depth assessment of an individual’s health condition/disability as well as their experience, skills, and other barriers, will allow for better support from the start of the back-to-work process.

Some people will require more support than others, and individuals with similar/the same health condition will not always need the same support, and this needs to be understood. Support provided needs to be personalised and tailored to reflect this – one size fits one, not all! Our view is that a rigorous assessment process at the beginning of a person’s journey towards work will better enable Job Centre Plus to direct an individual to the right support. An assessment should be holistic, covering aims, aspirations and barriers including skills, health and wellbeing. Where a health need is identified or they have a disability which will require extra support, they should then be referred to a health professional who can conduct an in depth health assessment.

At RBLI, we know that holistic assessments are a vital tool to supporting someone – we deliver vocational assessments to all wounded, injured and sick men and women leaving the Armed Forces (after which nearly 90% of individuals say they have greater clarity of a realistic job goal, and 95% state they have clear action points to move forward) as well as delivering assessments as part of our LifeWorks courses for the Armed Forces community (which have an 83% success rate of people moving into employment, education and training within a year4). An assessment process like this (including referral for a health and wellbeing assessment as necessary) for everyone on health related benefits could reduce long-term unemployment as people gain the right support quicker (with early intervention (as discussed in point 1) preventing further decline).

Our experience shows that an assessment often gets people to view their skills in different ways, gets rid of perceptions that they do not have skills in a certain area, and opens their eyes to new opportunities. For example, one individual who attended one of our LifeWorks courses said: “I was looking for work in a shop and […] it came to light that I was more suited for care work, legal work or management. Since then I’ve been working down one of those routes.”

On LifeWorks, the successful vocational assessment is conducted by a qualified Vocational Assessor, and consists of a telephone interview which forms part of the screening process. There are also oneto-one discussions during the five-day intensive course that build on this initial interview. A series of assessments – which may include Career Preference Profiling (CPP) and aptitude tests, among others – allow the individual and the assessor to explore the individual’s career preferences and identify appropriate career goals. Assessments are tailored to suit the requirements and circumstances of each individual based on the emerging outcomes of the ongoing dialogue between them and the assessor. Individual reports are created based on the assessment which identifies potential career goals, career progression research, specialised assessment feedback and interpretation in terms of vocational goals, recommendations for further training and development, and potential future support requirements and adjustments in the workplace.

Benefits of a more rigorous assessment process include: 1) reduction in wasted time as individuals are referred more quickly to specialist support if required, 2) a greater understanding of the connections between multiple barriers to work (including mental health and disability), 3) reducing mixed messages by having a health professional involved straight away with the welfare to work process, 4) sustainable results.

4. https://www.wearelifeworks.org.uk/ex-forces//files//Reports/LifeWorks%20Evaluation%20Report%20 -%20Digital%20version.pdf

RESPONSE CONTINUED 3

In the Green Paper, the government called for innovative ways to help those who remain far from work. As these are arguably the most dependent on welfare, there would be substantial savings in finding an effective new approach. As an example, for someone who has been out of work on ESA for 10 years, there is a minimum welfare cost of £100,000 to the taxpayer.

As a response to this call to action in the Green Paper, we have submitted a proposal to DWP to pilot LifeWorks for people with disabilities and health conditions. We believe we can reduce the cost to the taxpayer by helping individuals into work through this programme with a single £3,500 investment.

With so many LifeWorks participants becoming financially self-sufficient – 61% into full time paid work, we believe LifeWorks could play a part in helping to reduce the disability employment gap.

Following their independent evaluation, which showed that LifeWorks achieves its 83% success rate with a group where 4 out of 5 people have a disability/health condition, the Learning and Work Institute recommended that we should consider developing Lifeworks specifically around adults with health conditions to create a product that could be used more widely. This is what our proposal focused on, including how to adapt the current format of the course more specifically for this group.

With the call for innovation, now is the perfect opportunity for a pilot, and we are confident that we can deliver sustained outcomes which will improve individual wellbeing. We have identified the critical success factors5; and have already extended LifeWorks to support veteran offenders, and taken the course overseas. The case studies detailed at the end of this response demonstrate how in a very short time, we are able to help people overcome attitudinal barriers, and better manage complex physical, or entrenched emotional, difficulties.

We therefore propose to replicate LifeWorks, but with a longer intervention (4 days a week for 4 weeks) in recognition of entrenched cultures of dependency and those who have been out of work for a substantial period of time. The pilot could be tailored to meet DWP priorities and customised for particular health conditions or other barriers.

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As our Chief Executive, Steve Sherry, said when giving oral evidence at the Disability Employment Gap Inquiry last year, “You should have some ambitious, radical and different programmes out there and see what really does work. Otherwise we will just be doing more of the same. If we do more of the same, we will get more of the same, which is not good enough.”

A pilot of LifeWorks will be one way to do this, but it is just a small part of what needs to be done to make a systematic change and start closing the disability employment gap. Collectively, DWP, health professionals and those organisations supporting people back to work need to promote an attitude which looks at what people can do, rather than what they can’t. Both assessments and back-to-work support should look at appropriate goals, and focus on motivating and building an individual’s confidence – creating a gradual plan which builds towards suitable, sustainable work from a perspective that it is possible for the individual to achieve a different set of circumstances.

The role of all agencies should be to promote a sense of hope for a different future with positive outcomes dependant on the needs, wants and desires of the individual.

5. The critical success factors for LifeWorks are: Person centred approach; a multi-disciplinary team (experienced, knowledgeable, empathetic, able to challenge); the short term and intensive nature of the course; in-depth objective vocational assessment – identifies unmet need, challenges perceived barriers to employment; longer term support and follow up; Coaching 4 Change – growing understanding of personal coping mechanisms.

RESPONSE CONTINUED It is our belief that more support should be given to employers, again focusing on the benefits of providing employment to individuals with disabilities and health conditions and focusing on what skills they can bring to businesses. Social enterprises, including Britain’s Bravest Manufacturing Company, should be used by DWP to showcase how they are commercially competitive with over 60% of staff having a disability/health condition, inspiring other employers. More support also needs to be given to employers to help them understand how to support employees with health conditions/disabilities, so that those who move into work sustain that work.

We do not have all the answers for innovation. However, there are thousands of charities, private sector organisations and employers out there doing fantastic work that focuses on helping those with significant barriers back to work. We need to review these approaches, to find out what is working well and why, and then approach back-to-work and in-work support with fresh eyes, looking for real solutions which will make a difference now and into the future.

LIFEWORKS CASE STUDIES

Chris - Royal Engineer No benefit - service pension

Chris served in the Royal Engineers for 23 years before being medically discharged due to sleep apnea.

Chris believed that the condition would prevent him from working anywhere full time.

Immediately prior to the course Chris had begun to help renovate a property, and said initially that he hoped that through the course he might work out how to develop this career route further, but could only work part time. However, the LifeWorks course immediately consolidated his experience in the Royal Engineers in a way that raised his confidence significantly. He also learned to think differently about his health challenges, and gained confidence in talking about his condition.

A representative of the MOD carried out his mock interview during the LifeWorks course, and the feedback from this interview increased his confidence yet further.

In less than a month after the LifeWorks course, Chris had secured full-time paid employment with Southern Water as a Quantity Surveyor.

Norris - Mercia Regiment Jobseekers Allowance

Norris served as an Infantry Rifleman for 5 years but left for health reasons as he suffered from a musculoskeletal, lower-spine injury.

Prior to the LifeWorks course, Norris was unemployed and living in housing for ex-offenders.

His main social networks were all labouring and undertaking physical work and Norris believed that this was impossible for him. He wanted to work and become financially independent so that he could move into different housing, and he was feeling very isolated being out of work, but he just didn’t know where to start. While on the LifeWorks course it became obvious that he found it very difficult to talk about his health condition or express his needs; he couldn’t sit or stand in one position for long periods. On the course he was encouraged by hearing others learning to speak about their health conditions. He also heard that many employers are proactive about this issue for the health of ALL their employees, whether or not they have a health condition; employers discourage anyone to be sedentary for long periods. He began to believe that employers would not necessarily be put off.

Following LifeWorks, Norris attended an entry level Customer Service Course and has since secured a full time role with fast food chain, KFC.

Sean - Royal Air Force No benefit - service pension Sean served in the RAF and left as a Sergeant in November 2012. During his military career Sean saw active service in the Gulf, Bosnia, Iraq and Afghanistan.

When Sean left the RAF he had a job waiting for him in the oil and gas industry so he didn’t feel the need to take advantage of his resettlement entitlement. After two years in work he was made redundant. His partner was supporting them but on one salary they began to experience financial and housing problems. As a result Sean reached out to us for support. He secured a place on the LifeWorks Course which was facilitated by Poppy Scotland and run in Stirling.

Sean said: “We had to take on a private let which was very expensive. We’d hit rock bottom and were about to be made homeless. I wasn’t entitled to benefits, because of my MOD pension.

Additionally we could not secure council housing.”

Speaking about his employment difficulties, Sean said: “I applied for between 800-900 jobs but was only called for 10 interviews. It was soul destroying to apply for all these jobs.”

“I wasn’t prepared for interviews as I hadn’t had any interviews in the RAF. When I was at job interviews I would be happy to talk about myself but I didn’t make it relevant to the job I was applying for. Here, I was given support to tailor the manner in which I interviewed. It was genuinely a learning experience.”

Sean is now in full-time employment in quality assurance. He said “Life is fantastic now. We can’t speak highly enough of LifeWorks.”

“It couldn’t have come at a better time. 2015 was a bad year for me and my partner but ended on a positive note... This support has got me back to work and, importantly, given us a safe and secure home, getting us back on track and looking forward to a more positive future.”

Danny - Royal Fusiliers Jobseekers Allowance

When Danny left the Army he had no idea what to do. He couldn’t find work easily as he had been involved in the criminal justice system.

His confidence ebbed away and, aged only 25, he began to believe that he was unemployable.

While attending LifeWorks, Danny realised what had been holding him back, and was able to make new and realistic goals. He also had the time and support to focus on writing his letter of disclosure to prospective employers, which gave him new confidence to make approaches to employers.

Following the course he very quickly gained work labouring, and once in work he pushed to learn brick-laying skills. He has now joined a national and respected house-building company with holiday pay, sick pay and a pension. He has even got his own place!

Danny cannot believe how his life, and his future prospects, have transformed - just 8 months after attending the LifeWorks course.

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Michael - Parachute Regiment Still Serving When Attended The Course Michael was referred to LifeWorks on being told he was to be medically discharged after 3.5 years’ service in the Parachute Regiment.

He had injuries to both his knees which deteriorated to the point that he was no longer able to carry out routine operational duties. He had worked as a tree surgeon prior to joining the Army but was unable to return to this because of his knee pain.

He attended LifeWorks in order to find a new career, refresh his interview skills and develop his CV accordingly. His goal was to obtain a well-paid job and support his family.

Despite having difficulties at school, the initial vocational assessments showed that not only was Mike’s overall ability equal to the majority of the population but that his ability to understand and work with mechanical processes was well above average.

The assessments also suggested that he could do well in any role with a hands-on focus. Mike revealed that he was interested in carpentry and had already started to research courses that he might do. During LifeWorks he developed a CV targeted towards carpentry roles and took part in interview preparation and practice culminating in a mock interview for a carpentry job.

By the end of the week, he reported having improved job seeking skills, a realistic and achievable job goal and a more motivated and positive attitude.

Having identified a carpentry course, Mike was signposted to First Steps, a bursary scheme funded

by Walking With The Wounded providing access to entry level, formal education or vocational training. It was pointed out to Mike that as well as undertaking a carpentry and joinery course, he would need to secure his own work placement in order to gain the final qualification, and would need to be proactively networking to find opportunities.

The LifeWorks’ Progression Adviser continued to support Mike towards his goal and assisted Mike in sourcing funding to purchase the essential tools and equipment he needed for the course. Despite some initial frustrations, Mike managed to organise a work placement with Greenshields after the taught course components.

Mike has now gained full-time employment with a local carpentry company.

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Greg - British Army Employment Support Allowance (Support Group) Greg was going to join the Army but instead he ended up playing rugby for Great Britain and joined a professional club. When his contract wasn’t renewed he joined the Army aged 20.

Greg served 6.5 years before he was dishonourably discharged for drug misuse.

In 2011 he was convicted of fraud and given a 12-month sentence – he served four-months in prison and was given a four-month conditional release with restrictions.

Greg was diagnosed with PTSD in 2012. He was also forced to stop his work in joinery after a knee injury.

He attended LifeWorks in August 2015 in Doncaster and was given advice and encouragement from the LifeWorks team on self-employment.

Within 3 months he had started his own company designing and building kitchens and bathrooms, and now employs a young person for 16 hours.

He also volunteers as a prison visitor. “Leaving the army was hard for me and the years that followed were full of challenges which were made worse by my injury. However, LifeWorks gave me the support to take the plunge and start my own company. It means a lot to me that I can now help others as a prison visitor and offer some of the support that I received from LifeWorks.”

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