Health and Employment Workshop James Farr

Rapid change in policy and direction Re-balancing public and private sector roles in the economy and society New language - ‘responsibility deal’, ‘big society’, ‘self reliance’ But ‘personalisation’, ‘choice’, ‘efficiency’, ‘accountability’, and ‘localism’ are still in use Increasing clarity over the next few months? Opportunities remain but this requires a new way of working Overview

1.7 million working age residents, of which 74% are in employment (around 1.25 million) Of those in work DWP estimates that: c.110,000 manage a condition/disability with little support c.50,000 manage a condition/disability with additional support c.25,000 have poor health and poor condition management Some people fluctuate between employment and unemployment – sometimes this is health related (c40,000 have claimed JSA/ESA for under 3 months) The Greater Manchester – in work

320,000 GM residents claim the key out of work benefits (JSA, ESA, IB, Income Support etc) 155,000 people claim Employment and Support Allowance or Incapacity Benefit Only 14,000 of this number have claimed for less than 6 months Very limited data on the severity of condition Unknown numbers are out of work and not claiming benefit The Greater Manchester – out of work

From Dame Carol Black: One of the new Government’s commitments is: “Intelligent ways to encourage, support and enable people to make better choices for themselves.” Helping people to get work or stay in work is a key way of achieving this Strong economic case for addressing shared health and work priorities Strong health case for addressing shared health and work challenges Working for a Healthier Tomorrow – a review of the health of the working age population, TSO, 2008 Government’s position

Health, Work and Wellbeing Employment Policy Business Growth Economic Policy and Growth Health White Paper Public Health White Paper Welfare Reform Social capital – big society Treasury – growth and efficiency Health, Work and Wellbeing….

- Big structural change but still working through the detail - GP commissioning / public health - What gets managed nationally and what will stay local…? - The scope and powers of health and wellbeing boards? - JSNAs – key to setting local priorities - Local Authority role in public health – flexibility/ring-fencing - “Any willing provider” ‘Liberating the NHS’

Replace all existing DWP welfare to work programmes with a single programme for all key benefit claimants – The Work Programme Contracts more closely linked to results – ie payment mostly/all on outcomes, financial risk transfer to private sector Financing will reflect the fact that initial investment delivers later savings through lower benefit expenditure, - ie DEL/AME switch Making receipt of benefits conditional on claimants’ willingness to work Re-assessing all claimants of Incapacity Benefit for their readiness to work. Those assessed as fully capable for work moved on to Jobseeker’s Allowance Streamlining the benefit system to improve financial incentives to work Coalition Agreement - Employment

Broadly: Reduced reliance on the public purse Increasingly paid by results Delivered by private and voluntary sector Larger minimum contract sizes Reduced statutory planning functions Greater reliance on ‘the market’ Some examples: Skills – non-interventionist, market-driven approach. Place based budgets – pooling and un-ring-fencing Productivity funds – invest to save. ‘At risk’ investment in public services, generated savings shared with HMT New creative financing encouraged – social impact bonds etc Funding Policy

How have things changed for your organisation since May? What are the key risks? Where are the opportunities? Your turn

Economic resilience - workplace health as central to local business growth Key objective for health and wellbeing boards New relationship with GPs? Place based budgets – integration of support for vulnerable employed (drugs, alcohol, IAPT)? New business support model Creative forms of financing – social finance, bonds etc Shaping welfare to work provision Creating the space for employment within health commissioning and vice-versa Opportunities for Health, Work and Wellbeing

Improving the health of those in work – reducing absenteeism, presenteeism Reducing the number of people who are economically inactive owing to a health condition 7 priorities: Prevention and early intervention – access to key services Training and skills – managers and health professionals A work place charter for GM Healthy and safe workplaces – a consistent public health offer to employers Developing a strong health offer in the Work Programme Developing the health offer for other unemployed groups Health services for other unemployed groups Leadership and profile – health and work is prioritised in future An emerging Greater Manchester health and work plan

CASE STUDY: DWP WORK PROGRAMME

Replace all existing DWP welfare to work programmes with a single programme for all key benefit claimants – The Work Programme Contracts more closely linked to results – ie payment mostly/all on outcomes, financial risk transfer to private sector Financing will reflect the fact that initial investment delivers later savings through lower benefit expenditure, - ie DEL/AME switch Making receipt of benefits conditional on claimants’ willingness to work Re-assessing all claimants of Incapacity Benefit for their readiness to work. Those assessed as fully capable for work moved on to Jobseeker’s Allowance Streamlining the benefit system to improve financial incentives to work Coalition Agreement - Employment

Mandatory community activity Currently looking at whether customers who remain unemployed for a long period of time could undertake some form of community activity to get back into the habits and routines of working life An integrated, personalised welfare-to-work programme for a range of customers Contracted out, almost all funding for additional sustained outcomes Differential prices Two year programme with continuing provider support and payments Core Work Programme Specialist Disability Provision Work Choice will launch on 25 October 2010 and will provide an improved service to disabled people with complex barriers on contracted out basis – higher proportion of funding for sustained outcomes than now. Decisions regarding other Specialist Disability Programmes are ongoing. Timeline Jobcentre Plus Offer Will include broadly similar core and mandatory provision Will also include a number of support options to help customers to: - share experiences and skills - volunteer - benefit from a mentor and start up their own business - gain pre-employment training together with a work placement - get work experience.

For ‘stock’ and ‘flow’ claimants of: Jobseekers’ Allowance (>1 year, >9 months for young people) Incapacity Benefit (some, following reassessment) Employment & Support Allowance (new claims) ‘Black Box’ commissioning – flexibility in delivery Payment model to incentivise sustained job outcomes – up to 2 years DWP estimates around 150,000 GM residents enter WP over 5 years About a third of clients will have health issues Many clients will be entering an active benefits system for the first time Work Programme

Very rapid! Regional lots – with sub-regional contracts in each lot End Sept: Framework applications End Nov: Framework providers announced (3-8 per region) Dec : ITT released for Work Programme, although ‘black box’ Feb: Deadline for individual contract bids April: Successful prime contractors announced Programme in place summer 2011 IB reassessment will start from February 2011 Work Programme contract package area of Greater Manchester, Cheshire and Warrington 3 prime contractors to be appointed to this package. A dozen are competing No statutory or DWP-commissioned delivery role for AGMA Timetable for implementation

Which prospective primes will become one of three prime contractors How the Work Programme will operate – all primes have distinctive delivery models How much the prospective primes are planning to spend Precise contract volumes – estimates are likely to be on the low side…. Exact financial impact of benefit cuts on the WP client group What we don’t know yet

Chris Grayling, Minister for Employment, December 2010 “We have been very clear to all of the organisations on the framework that they must demonstrate their ability to address the specific needs and barriers of each customer in every locality. “In order to do so, they will need to engage with a range of smaller local and specialist organisations including those from the voluntary sector. If they do not include in their bid a range of organisations with the expertise to meet all these diverse needs, it is highly unlikely that they will meet the criteria we have set out to win Work Programme contracts.” The Minister’s view

Getting the best Work Programme and Greater Manchester Local authorities/LSPs have no statutory role but prospective prime contractors are keen for our input We need to ensure that: There is a high quality Work Programme offer to individuals, especially those furthest from the labour market We maximise opportunities to deliver efficiencies for all partners who deliver services to the unemployed – co- location, client engagement costs etc The Work Programme develops sufficient capacity to cater for the needs of its client group – eg mental health, debt, skills etc

Role for LSPs – led by council Shaping the Work Programme Telling prime contractors -What services are already being provided - the existing infrastructure looks like / who the key partners and providers are -Local priorities eg neighbourhood, particular client groups -Local opportunities eg key employers / sectors / developments -What has been funded through WNF and our experience of what has and has not worked The council, on behalf of the LSP, setting out an ‘ask of’ and ‘offer to’ prospective prime contractors Ensuring there is coherent and cost efficient offer for our priority groups Opportunities for providers to ‘sell’ services to prospective primes

What this means for local providers Opportunities to join Work Programme supply chains – but there are no guarantees Imperative to deliver / maximise performance between now and March 2011 Limited money likely to be available outside of the DWP Framework / Work Programme. You will need to partner up with a Framework provider even for ESF Payments on results not activity – implications for cashflow and risk management. You need to be really successful in order to make money If the Work Programme isn’t appropriate for you you need to be looking at other funding options very quickly Need to be talking to potential Primes and building up your business cases now. You need an evidence base!

Building a Business Case: Key questions What are you really good at? How much does it really costs you to deliver that? Is the size of your organisation appropriate to be a Work Programme subcontractor? Do you need to be thinking about mergers/consortia? What scale of contract could you take in terms of cashflow and risk management? This will influence your choice of potential Primes What other contracts have you got or could you win that could help with the cashflow, or that would be useful to a Work Programme provider (eg skills / health / other community-facing). Where would you raise cashflow from (Big Society Bank?) Do you have the commercial / business acumen in your organisation to negotiate with a large Prime?

What Primes are looking for Different Primes will have different approaches but: - Successful delivery Sound leadership and a credible organisation Good customer satisfaction Culture of -‘no excuses’ performance management - skill and people development - transparency and openness Collaborative skills and good working relationships with other agencies / organisations Information about why job brokerage, or the ‘standard approach’ fails certain client groups, and what you can offer to improve it

Your Turn (again!) How is this different from your experience of accessing funding? What development needs does your organisation require to participate in similar contracting approaches in future? Where can you get that support from? Are you currently seeking to join a Work Programme supply chain? What’s been your experience / learning?

Background information for the prospective prime contractors: local priorities, infrastructure, contacts Capacity building for potential providers Local ‘asks/offers’ to prospective Prime Contractors GM Work Programme events early December Detailed negotiation and deals with prospective prime contractors Best possible service for residents What we’re doing in GM

Thank you for your participation Questions?