APPENDIX 27
Memorandum submitted by Surrey Supported
Employment (EDP 36)
1. SUMMARY
This is a joint submission between two elements
of the Surrey Supported Employment consortium. Surrey Supported
Employment is a partnership between providers of employment services
for adults with disabilities operating in the county of Surrey.
The consortium provides a mechanism to share good practice between
members and address structural and funding issues, for example
by seeking new funding streams. Our central concern is that adults
with disabilities can access employment and benefit from the social
inclusion which it brings. More information about Surrey Supported
Employment is available on our website: www.surrey-supported-employment.co.uk.
Two members of the Surrey Supported Employment have collaborated
on this submission on behalf of the other members and stakeholders.
This submission has been drafted by the Mary
Frances Trust and the Surrey Network of Employment Leads Steering
Group. In brief the Mary Frances Trust is a centre for people
who have experienced mental health problems. It has a strong focus
on the needs of people with mental health problems ("service
users") and their submission addresses the points raised
in the consultation from that perspective. The second part of
the submission is from the steering group of the Network of Employment
Leads which we have established in the county. This group of mental
health professionals meets to share ideas and develop good practice.
Research shows that people with mental health problems are relatively
poorly represented in the workforce. Good practice in mental health
care suggests that occupational issues are addressed in best practice.
However, the group contends that while there are identical social
inclusion concerns for the Department and Work and Pensions and
Health and Social Care providers, the cross cutting links have
yet to be fully developed. We propose a simple and cost effective
mechanism to achieve.
2. SUBMISSION
BY GARY
THOMAS, MEMBER
OF THE
MARY FRANCES
TRUST
The Mary Frances Trust
The Mary Frances Trust is a charitable company,
established in 1994, to work with people who have experienced
a mental health problem. We are based in Leatherhead in Surrey.
Our main activity is the Leatherhead Clubhouse. This is a project
which is run as a partnership between service users and staff.
Members (service users) are integrally involved in all aspects
of what is essentially a small business, from cooking to the accountancy,
marketing and business planning.
Our focus is supporting people to deal with
the consequences of mental ill health, such as low self esteem,
lack of confidence and social isolation. We take a non medical
approach, aiming to look at people as a whole, where housing,
work and social aspects are as important as the mental illness
itself.
We aim to enable people to lead the lives they
choose, which includes supporting people to have beliefs and expectations,
as independently as possible. From being involved in the day to
day running of the organisation, people regain confidence and
self esteem and interpersonal relationships, which then enables
them to look at education and employment. We offer a range of
support in these areas, both to individuals and employers. Some
of the activities include direct one to one support, or working
to change the way a course is delivered, or a job is structured.
We expand more on these support processes later in the proposal.
Participation, learning and employment all have
a number of different outcomes for us—it can enable someone
to become more engaged in what we do, it can give someone a specific
skills, it can give someone the confidence to do something else.
Or it can lead onto a job or full time course.
Members of the trust have been involved in a
wide range of meetings, including Surrey Supported Employment
and the Network of Employment Leads. See below for more information.
3. RESPONSES
TO QUESTIONS
RAISED BY
THE SELECT
COMMITTEE
Do the high numbers claiming incapacity benefit
represent hidden unemployment?
Yes, without question.
The Leatherhead Clubhouse is a work oriented
environment. We have members who are on different types of benefit
and members come in for support and for job placements. We have
an Employment Co-ordinator who liases with the different benefits
agencies when people want to take up a job placement or voluntary
work. We do this always within the rules of the Benefits Agency,
and members are able to work short hours per week (ie one afternoon)
without any problems. The types of placements that the clubhouse
offers both now and in the past have varied, with some members
moving on to proper employment.
The experience of members working both in a
job placement and in the clubhouse helps members with self esteem
and confidence, which is often one of the biggest problems to
overcome when dealing with mental health issues such as long term
depression. Some of the things that clubhouse members do is in
direct contradiction to the incapacity benefit rules, however
what makes it different is the amount of support there is, which
does not exist in a traditional employers environment.
What is or should be the role of Jobcentre Plus?
The role of Jobcentre Plus could be more "assertive"
in getting people back to work, and here in lies one of the biggest
obstacles.
The benefits system and the amount of money
people get through benefits to cover much needed living expenses
has the possibility of creating a "benefits trap" where
people who are on benefits, for whatever reason, cannot afford
to take on employment, as if they did they would lose their entitlement
to benefits. Because of the amount of money people are entitled
to on benefits due to the high cost of living in Surrey people
cannot take lower paid jobs and still afford to live where they
do. An alternative could be to keep paying housing benefits, at
whatever level, whilst still allowing people to be able to work
or study so they can achieve real potential and in the long term
get a job that would pay them an adequate salary equal to the
cost of living.
Are initiatives such as Workstep successful?
As a service user myself, I have not heard of
"Workstep".
The Tax Credits and Benefits system. Is it too
complicated?
Both the Tax Credits and Benefits System are
too complicated for many people to understand. The Benefits System
should especially be reformed so that people with disabilities
have better chances of getting work and being educated as above.
The current benefits system does not let people enter the education
system full time with out penalising their benefits. There should
be alternatives to this such as allowing people to access education
full time whilst still being on benefits provided that they are
being "monitored" and supported by an external organisation
which can provide the support people with disabilities need. People
with disabilities may only feel that they can achieve a higher
education if they receive the right amount of support which in
many cases colleges and universities cannot provide even with
new legislation.
The role of the private sector in delivering employment
services.
The role of the private sector, particularly
employers, could be made greater by being open to employing people
with disabilities and long term mental health problems.
Employers still need educating about disabilities
in all areas and to this end The Mary Frances Trust has just received
a grant of just over £30,000 for a wireless outreach network
from the Learning and Skills Council. This could, for example,
be used by service users to give presentations to employers.
Seminars such as those held by Surrey Supported
Employment, (SSE) a company formed by managers of service providers,
including the Mary Frances Trust, Work links, and Project 18 (North
West Surrey Mental Health Partnership Trust) could help in this
by approaching employers and joining groups such as local chamber
of Commerce meetings where they can give presentations to a target
audience of employers. In this we can re educate the employers
as we educate members with disabilities about work and inform
them of the companies that are most responsive to the presentations
delivered to them. SSE has held a number of successful seminars
this year for providers of services for people with disabilities,
and it is hoped to include employers in these more often.
How does discrimination hinder the employment
of people with disabilities.
Discrimination hinders the employment of people
with disabilities because it is still allowed to happen and can
happen on a level which people with disabilities would not necessarily
know that they are being discriminated against.
For example, if someone with a long term mental
health problems is happy working three days per week, but is then
asked to work more hours, the employee may feel they do not have
a choice in this because their employer refuses to be flexible.
If the employee then cannot cope with the new longer hours he
or she maybe forced to leave their job. Any explanation to the
employer about why the employee could not do the extra hours could
lead to difficulties as the employer may not understand or even
be aware that the employee had a disability for any number of
reasons. This can cause the employee to be anxious and fearful
of what may happen should any discussion take place.
New laws tackling flexible hours which are coming
into force may help in this particular situation, as well as the
DDA, but people with disabilities may feel unable to take any
case further because of a lack of confidence in themselves and
the added pressure that a case would bring, even with the right
support it would still be hard to guarantee any reasonable outcome
for the employee involved.
3. THE NETWORK
OF EMPLOYMENT
LEADS, SURREY
Summary
Adult Mental Health services in Surrey are in
touch with many people who are receiving incapacity benefits or
who are at risk of joining this group. This briefing note reports
on a local initiative which has drawn interested mental health
professionals into a learning circle with an employment focus.
This has been successful in sharing information and developing
good practice in the employment area. However the initiative lacks
management support, and we believe that the Health and Social
Care agencies should be required to establish a specific employment
support role within community mental health teams.
History of the group
The Surrey Welfare to Work Joint Investment
Plan (JIP) was launched in April 2001. As the information for
the JIP was being collated, a small sub-group was convened to
look at employment issues for people with severe mental health
problems. Adult mental health services in Surrey have many excellent
features and aspire to best practice. Multi-disciplinary community
mental health teams were established across the county in 1996.
There is a rich array of providers of mental health support services
and supported employment. The Mental Health Employment Strategy
group drew on this pool of talent and enthusiasm. Membership of
the sub group included representatives from service user orientated
organisations (particularly Leatherhead Clubhouse), managers from
adult mental health services, and representatives from local supported
employment provider services. This sub group drafted a care group
specific strategy for the employment of people with mental health
problems. The Surrey Mental Health Employment Strategy was launched
in September 2001. A key action from the strategy was for the
steering group members to promote the strategy to colleagues within
operational mental health services. Our objectives were to raise
the profile of employment issues for people with severe mental
health problems, to generate debate, and to draw interested parties
into an informal learning circle. Our idea was that best practice
(as for example in the Avon and Wiltshire NHS Trust) depends upon
a corps of well-informed practitioners with specific skills. These
employment specialists can then work directly with clients on
accessing employment and act as a resource for their colleagues
in community mental health teams. We have called this circle the
Network of Employment Leads, Surrey (NELS).
Content of Meetings for Network of Employment
Leads, Surrey
The first meeting of the NELS was held on 1
March 2002. The Keynote speakers were Dr Peter Drewis of UNUM
(now UNUM Provident) and Mr Ron Peponis (SE Regional Champion
for the National Service Framework for Mental Health). Over 40
people attended representing over 20 CMHTs in Surrey. The group
was multi-disciplinary with Occupational Therapists, Social Workers,
CPNs and Community Support Workers present. Subsequent meetings
have reflected the agenda and concerns of the group members. The
June 2002 meeting foregrounded the SW London Mental Health Trust
practice, with Miles Rinaldi and Melanie This was designed to
help members think around the parameters of the Employment Lead
role. Subsequent meetings have focused on Benefits issues and
the assessment process. This came about from delegates questioning
the operation of the 52 week linking rule.
Outcomes of the NELS process
Feedback gathered from delegates is universally
positive. Attendance has remained strong and is growing. Interestingly,
members who are moving on in their posts have introduced their
successors to the group to ensure continuity. However, the NELS
process is entirely voluntary and has grown out of the commitment
of the Steering Group members, and the enthusiasm of the delegates.
Joint training monies supported the first two meetings, but these
ceased and the costs have been carried "at risk" by
organisations on the steering group. The NELS process is essentially
"bottom up" and has yet to be recognised by senior managers
as a mandatory component of CMHT practice. We are concerned that
this will be compounded when new commissioning arrangements in
the NHS come into play: we are concerned that Primary Care Trusts
will see employment as peripheral to their health agenda.
Proposal:
We suggest that the DWP establish a dialogue
with the lead Health and Social Care agencies to define the priority
which employment issues will be given within community mental
health team practice. We believe that employment issues are central
to the well being of people with mental health problems, and form
a second overarching social inclusion theme along with accommodation
issues. Mental health professionals by definition adopt a personal
support role and also have a duty of care not to make things worse
for clients. They are thus a key resource in promoting the social
inclusion agenda.
While we do find these ideas reflected in the
guidance given to NHS managers, we do not see specific encouragement
to develop employment support roles within CMHTS. Employment is
highlighted in both the National Service Framework for Mental
Health and the revised guidance on the Care Programme Approach
(2002). It is also mentioned in the new NICE guidelines on the
management of schizophrenia. However this has not been translated
into a positive expectation that Community Mental Health Teams
(CMHTs) will establish an employment specific role. The resource
implications of this are not great. Informal advice we have from
colleagues where this has been put into practice is that one half
day per week is sufficient to make an impact. We do not believe
that the role is exclusively relevant to a specific group within
the CMHT. The skill set of Occupational Therapy fits particularly
well with the tasks involved, but our experience is that other
professionals can make a positive contribution.
Gary Thomas
(for Leatherhead Clubhouse)
Henry Woodhall
(for Surrey Network of Employment Leads)
3 January 2003
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