1. Improving Lives: the Work, Health and Disability Green Paper
Work and Health Unit
Improving Lives: the Work, Health and Disability Green Paper
Nicola Gilpin, Deputy Director, Work and Health Unit

2. In the Green Paper we ask:
What will it take to transform the employment prospects of disabled people and people with long-term health conditions?

3. The gap has persisted over time
Change to disability definition
Generally the gap has persisted over time. From 1998 to 2009…
The gap reduced by around 10ppt as the employment rate of disabled people rose from 39% to 47%
Meanwhile, the non-disabled employment rate had decreased from 80 to 78%
From 2010 to 2012…
The gap remained around 31ppt
From 2013 to 2016
The disabled employment rate has increased by around 5ppts and the non-disabled employment rate has increased by around 3ppt
The gap has therefore narrowed by 2ppt

4. Socio-demographic factors are linked to differences in employment rates
In social housing with mental health conditions S2
In social housing without mental health conditions S3
In a rented or owned house with higher level qualifications and aged between 16 to 55 S4
In a rented or owned house with higher level qualifications and aged between 56 to 64 S5
In a rented or owned house with lower level qualifications and 1 or 2 health problems S6
In a rented or owned house with lower level qualifications and aged between 3+ health conditions S7
In a mortgaged house with 1 or 2 health conditions S8
In a mortgaged house with 3+ health conditions
Disabled people in social housing and with a mental health problem (S1) have the lowest employment rate (16%)
They are also the largest out of work segment – almost 1 million disabled people.
They have the greatest employment rate gap (comparing to non-disabled people in social housing).
Disabled people with 1 or 2 health problems living in a mortgaged household have the smallest employment rate gap (comparing to non-disabled people in mortgaged households) of 12ppt.

5. Location is also linked to differences in employment rates
There is large geographic variation in disability employment rates (26 per cent in Liverpool to 69 per cent in Bracknell Forest)
Whereas non disabled people have relatively high employment rates across the whole UK (above 67 per cent in all local authorities)
The large geographic variation in disability employment rates may be explained to some degree by the large variation in the composition of the disabled population across all the UK local authorities.

6. The case for action

7. Building a shared vision

8. How big a role can we expect employers to play?
Key consultation themes
How big a role can we expect employers to play?
How can work coaches play a more active role for disabled people and people with health conditions?
How can we improve a welfare system that leaves people without any regular access to employment support?
How can we promote mental and physical health and ensure that people have timely access to the health and employment support?
How can we develop better occupational health support right across the health and work journey?
What will it take to reinforce work as a health outcome in commissioning decisions and clinical practice?
How can we ensure good quality conversations about health and work, and improve how fit notes work?
How can we best encourage, harness and spread innovation?
How can we build a culture of high hopes and expectations for what disabled people and people with long-term health conditions can achieve?

9. Building a movement for change: taking action together
Achieving real and lasting change will be challenging and Government cannot act alone
We have announced:
Intention to work with others to change perceptions and transform the culture around disability, health and work
Launch of public consultation to spark a proactive, wide-ranging and challenging conversation
We are consulting on:
How to bring about a shift in society’s attitudes to make progress and achieve long-lasting change
What the role of government is in bringing about positive change to our attitudes to disabled people and people with long-term health conditions

10. Supporting people into work
The current employment support offer is not tailored to the individual’s needs and circumstances
We have announced:
A new Personal Support Package
wide-ranging support delivered by Jobcentre work coaches to claimants
includes help for those with limited capability to work and a new Health and Work conversation in ESA
Qualitative and quantitative research, alongside larger trial, to build evidence for how to help ESA Support Group
We are consulting on how to:
How to build work coach capability
How to better mange transitions from education to employment
How to introduce improved access to employment support for ESA Support Group

11. Assessments for benefits for people with health conditions
The welfare system should be simpler and more user-friendly, particularly for those with most severe health conditions
The Work Capability Assessment process does not lead to individualised support – instead it places people in fixed categories meaning over half of all ESA claimants do not receive employment support
We are consulting on:
Reform of the Work Capability Assessment, including separating decisions on financial support and employment support
Further improvements to simplify the assessment process for a small proportion of claimants with the most severe, life-long conditions
How we can share information and assessment evidence more effectively across welfare and health systems

12. Supporting employers to recruit with confidence and create healthy workplaces
Fewer than 5 in 10 disabled people are in employment – we need to increase the number of disabled people recruited
Disabled people and people with long-term health conditions should be able to reach their full potential in work
When people do fall sick, employers might not provide the right support to help them stay in work
Employers do not invest enough in preventative and wellbeing measures for their employees
We have announced:
A Disability Confident Business Leaders Group to increase engagement around disabled employment, starting with FTSE 250 companies
Intention to lead by example in getting the ‘public sector house’ in order
Plans to build the business case on why health and disability in the workplace is worth investing in
We are consulting on:
The barriers preventing employers from recruiting and retaining disabled people and people with health conditions
Which measures would best support employers to recruit and retain disabled people and people with health conditions
Statutory Sick Pay reform to promote phased returns to work
How best to encourage better provision and take-up of Group Income Protection insurance
How to establish supportive networks between employers, employees and charities around health and work

13. Supporting employment through health and high quality care for all
Access to care and treatment can be poor – especially for mental health and MSK services
Evidence that work can bring health and wellbeing benefits is widely recognised, but not fully reflected within health services
Fragmented system leads to a disjointed experience – few incentives for integration between health / social care and employment
Occupational Health services are currently varied and fragmented – they are not easily accessible for all or well tailored to needs of individuals
We have announced:
Work with Health Education England and others to embed benefits of the right work in training and approach of health and social care workforce
More than double the number of Employment Advisors in talking therapies services
Trials to test whether health-led services and support are effective in getting disabled people and those with long-term conditions back into work
Intention to train healthcare professionals to ensure work is a health outcome
Intention to increase capacity of Occupational Health workforce
Fit Note Review
We are consulting on:
How to transform occupational health landscape to meet full spectrum of need
How best to bring together evidence in one place for commissions / local delivery partners
Improved sharing of health and employment data, innovation, co-location and local networks, all to support local service integration
How best to encourage health care professionals and commissioners to promote work as a health outcome

14. Consultation 31st October 2016 – 17th February 2017
Ways to get involved
Citizen Space online survey
Simple and accessible way to respond to all consultation questions
Face-to-face consultation events
Led by stakeholders
Tweet using #workandhealth
Contact the Work and Health Unit

15. Get involved - have your say
Knowledge and evidence
We want to understand the key areas for evidence development and how we can best support the system to take informed action:
What should we include in a basket of health and work indicators covering both labour market and health outcomes at local level?
What is the best way to bring together and share existing evidence in one place for commissioners and delivery partners?
How can we encourage the recording of occupational status in all clinical settings and good use of these data?
How can government and local partners best encourage improved sharing of health and employment data?
Culture and attitudes
Thinking about how we can bring about a change in culture:
How can we bring about a shift in society’s wider attitudes to make progress and achieve long lasting change?
What is the role of government in bringing about positive change to our attitudes to disabled people and people with health conditions?