Upload
alicia-cooper
View
218
Download
2
Tags:
Embed Size (px)
Citation preview
Back ground:
Green Paper -The Case for change (Nov 2002)
• 2.7 m people were claiming IB in 2002 (large increase from
1990’s)
• 1 in 13 in receipt of IB (6.6%)
• 1.5 million claiming IB for at least 5 years
• 500,000 claimants are aged under 35
• Duration on IB is , 9 years in 2002 compared to 3 years 1985
Background-
Depression and Anxiety within 3 months of being of of work
After 1 year on IB the chance of returning to work drops to
20%
2/3rds of new claims are due to conditions that are mild-
moderate in nature
2/3 of Dorset referrals report a mental health condition
Stereotype for those on Incapacity benefit
Older men
Former industry workers
Bad backs
From Northern England, Scotland or Wales
Neither want nor expect to work
No jobs for them
Reality
40% are women
50% are under 50 years
40% have mild/moderate mental health conditions
90% of all claimants expect to return to work at the outset of
their claim
IB by Diagnosis (2002)
Mental Disorder35%
Musculo-Skeletal22%
Circulatory & Respiratory System
11%Others16%
Nervous System10%
Injury,Poisoning6%
Worklessness!
“Long term unemployment /worklessness is harmful to physical and mental health”
• Isolation, social exclusion and stigma• Changing health related behaviour (e.g.
smoking, obesity, drug abuse)• Higher use of healthcare services• Disruption to future work career• Trapping people on lower incomes than are available
through work • Suicide in young men - 6 months out of work is increased x
40 (Ref: Waddell & Burton 2006, Grove 2006)
Most people do not cite their health as the main barrier
But:
Loss of confidence
Lack of skills
Lack of financial incentive
A feeling of inadequacy
Many people are treated as, and indeed come to believe, that their working lives have come to an end.
“I’ll never work again”
“There are no jobs that I could do anymore”
“Employers wouldn’t want to take me on”
“They’ll take one look at me/my application/CV and say No”
“Even if I got a job I’d never be able to
keep it”
Why Work?
• Economic, social and moral arguments that work
is most effective way to improve well-being of
individuals, families and communities.
• Research indicates work can be good for you.
• Many IB customers have a full employment
history, are dependable and actually prefer to
work.
Benefits of work
• Promotes recovery and rehabilitation• Leads to better health outcomes• Promotes social inclusion• Improves well-being• Reduces risk of long term incapacity• Financial reward• Social contact• Learning/training opportunities• Personal identity • Routine• Achievement
Waddell & Burton 2006
JCP “Pathways to Work” programme
• “Pathways to Work” started in 2003 in some JCP areas –
• Dorset in Dec 2006 & nationally 2008
• Incapacity Benefit Personal Advisers - Individual programme
• “Choices” - variety of voluntary options for customers
• Cash incentives for RTW, training opportunities, work focused
help
• 1 “Choice” – Condition Management programme
• CMP started in Dorset April 2008
Dorset Condition Management programme
• Dorset PCT is providing CMP across Dorset, Bournemouth and Poole
• Team consists of a multidisciplinary qualified health staff and associated staff
• Based in Ferndown, Weymouth & Gillingham
• Contract for 425 new IB engagements each year
What is “Condition Management” ?
• Uses a bio-psychosocial approach to educate customers to understand and manage their health condition better
• Emphasis on self help and NOT treatment
• To support customers in making appropriate life “choices”.
Aims of CMP
• To help customers to better understand and manage their condition in the work environment
• To help customers feel more confident about returning to work
• To enable customers when in work to feel more confident and expert about negotiating with their employer about their health needs.
Named CMP Practitioner.
Customer decides not to join CMP or fails to attend 2 appointments
Customer completes program.
This appointment may include IBPA
Customer chooses to continue CMP
Customer contacts CMP and agrees 2nd appointment
Initial CMPAppointment
Customer decides not to join CMP or fails to attend 2 appointments
SecondAppointment
One –to-oneSupport
Support Modules
Core Programme
Rolling programme of 5 core modules.
Condition specific Support modules as needed
FinalAppointment
Programme Delivery
CMP Core Modules:
Positively Healthy (healthy lifestyle)
Positive Pressures (stress management)
Communicate with Confidence (assertion skills)
Working Well (managing health & work)
SMART Steps ( pacing and goals)
Either 1 or 2, 3 hour group sessions. Non NHS settings
CMP Dorset Support Modules:
Anxiety Tool Kit - run with NHS (managing anxiety)
Lift Your Mood - run with NHS (managing low mood)
Move More! - run with Leisure centre (overcoming
barriers to activity)
Know Your Back – run with NHS ESP PT (managing
back pain)
Employment Support Allowance (ESA) replaces IB from Oct 27th 2008• Illness• GP certificate• Contact centre 0800• Benefits checks• WFHRA 140 centres -> WCA• 2 WF Interviews at 9-13/52• Personal Adviser• WRA and Support group• Work focused Interviews• Pathways and ‘Choices’ as before
References:
• Original Pathways to Work Green Paper available at• http://www.dwp.gov.uk/consultations/consult/2002/
pathways/pathways.pdf
• Waddell G & Burton AK (2006) Is work good for your health & well-being? TSO, London
• Eds: Grove B et al (2005) New thinking about mental Health and Employment. Radcliffe Publishing. Oxford.
• DWP (2006) A new deal for welfare: Empowering people to work.
• Warr PO (1987) Work, employment and mental health. Oxford University Press. Oxford
Further Reading:
• Ford J et al (2008) Rehabilitation for work matters. Radclliffe Publishing, Oxford
• Black C (2008) Working for a healthier Tomorrow: A review of the health of Britain’s working age population TSO, London
• Freud D (2007) Reducing dependency, increasing opportunity: options for the future of welfare to work DWP www.dwp.gov.uk
• DWP report No 479 (2008) “Evaluation of the GP education pilot: Health and work in general practice” www.dwp.gov.uk