Annex A (continued)
3. THERE
ARE LARGE
NUMBERS OF
PEOPLE IN
THE COALFIELDS
UNABLE TO
WORK BECAUSE
OF A
HEALTH CONDITION
OR DISABILITY.
WHAT IS
THE DOH
DOING TO
HELP A
SIGNIFICANT PROPORTION
OF THESE
PEOPLE TO
RE-ENTER
THE LABOUR
MARKET AND
OBTAIN EMPLOYMENT
BY OFFERING
APPROPRIATE SUPPORT?
We know that long periods without work can be
damaging for not just the individual, but for their families and
their communities more widely. It can lead to poverty, poor health
and social isolation.
Work can provide stability, fulfilment, opportunities
and self-respect. That is why paid work has been a central element
of the Government's strategy to tackle social exclusion. For those
that are able to, work is the route out of poverty and associated
poor health.
Unemployment is currently at the lowest it has
been for a generation—a key achievement of this government.
But despite this success, there are still neighbourhoods in Britain,
many in the coalfields, where far too many people are out of work.
These neighbourhoods are often those with the poorest health and
lowest life expectancy.
The NHS is a major business in many of the disadvantaged
neighbourhoods with high unemployment rates. It has a major role
to play both in the recruitment of the local workforce and in
the procurement of supplies. The Department of Health is encouraging
and supporting the NHS to behave as a Good Corporate Citizen;
to help to tackle health inequalities by opening up employment
opportunities to people in disadvantaged areas.
The NHS is increasing and changing its workforce
considerably to meet the demands of The NHS Plan. The human
resource aspects of The NHS Plan, published in July 2000,
sets out that the NHS workforce needs to reflect its local community.
This means that NHS employers in areas of deprivation will be
expected to draw their workforce from their own local area. To
do this they will need to look at offering a variety of access
routes to employment, such as the skills escalator, cadet schemes,
secondments, work experience and employability programmes.
SKILLS ESCALATOR
Our strategy to deliver the challenging objective
of growing and changing the workforce is called the Skills Escalator.
The Skills Escalator is the workforce development strategy linking
together Lifelong Learning, Recruitment and Retention, Pay modernisation
and Changing Workforce Programme to deliver the objective of a
growing and changing NHS workforce. It is about attracting a wider
range of people to work within the NHS by offering a variety of
career and training step on and step off points. It is also about
encouraging all staff, through a strategy of lifelong learning
to renew and extend their skills and knowledge, enabling them
to move on the escalator. Meanwhile, efficiencies and skill-mix
benefits are generated by delegating roles, work and responsibilities
to the most appropriate level.
Traditional entry points such as pre-registration
programmes for the established professions will continue but they
will be complemented by other entry routes such as cadet schemes
and role conversion, attracting people in other careers who are
seeking new challenges and drawing people back into the labour
market. This offers the dual benefit of growing the NHS workforce
whilst also tackling problems of longer-term unemployment and
social exclusion, which have such a high correlation with poor
health. It will enable people to start or further develop careers
in the NHS, as young people starting out or in mid- or later-life
as a second career. Age, background and existing academic attainment
will no longer be barriers to those with the potential and will
to progress their careers. It will also enable the NHS to have
a workforce that is more representative of local communities and
touch with their needs.
Employers will benefit because a structured
programme of skills development and acquisition will help them
to recruit and retain staff, developing them to fill posts which
are traditionally hard to recruit to. Individuals will benefit
in a range of ways. Those who are finding it difficult to get
into permanent employment, who have limited formal education and
older people looking for second chances can be introduced or re-introduced
to the working environment and developed so that they can subsequently
be employed within the NHS. Those already within the NHS will
benefit from the opportunity to develop and enhance their skills
and take on new and more challenging roles. Communities will benefit
from an active approach to employing and developing staff by major
local employers.
There are many Skills Escalator schemes operating
at a local level, including one which is located in a coalfields
area.
The South Humber Employability Project at Northern
Lincolnshire & Goole Hospital NHS Trust is opening up employment
opportunities within the NHS. By encouraging participation the
project aims to promote social inclusion, reduce poverty and improve
the overall well being of participants by providing sustainable
long-term employment. The NLG Employability Project aims to provide
long-term unemployed, or disadvantaged people to chance to experience
working life in the Trust.
To generate the interest in what's available,
training opportunities are circulated to Jobcentre Plus, Adult
Guidance as well as Community/Resource Centres for individuals
to consider their options. Candidates are screened to establish
their skills base, suitability and aptitude—the programme
then offers a tour around the hospital so they can consider it
as a place of work/Q&A Session—followed shortly afterwards
with an interview. Once appointed the Adult Learners work alongside
an experienced member of staff to gain occupational experience
and knowledge so they can competitively apply for internal vacancies.
The programme also offers 6-12 month work tasters
for people to join Grimsby & Scunthorpe hospitals. While they
are at the hospitals they continue to receive any/all welfare
benefits (including up to £160 per child per week for childcare
costs).
PATHWAYS TO
WORK
The Pathways to Work Incapacity Benefit Reform
pilots are looking at ways of helping those off work for more
than six months re-enter the labour market. The pilots are being
launched in two waves, the first in October 2003 and the second
wave six months later. The pilot areas include three coalfield
communities: Derbyshire is involved in the first wave, and East
Lancashire and the North-East are involved in the second wave.
The pilots include a package of measures (better
adviser training in Jobcentre Plus offices, more work-focused
interviews, additional financial benefit) of which one is being
delivered through PCTs.
These Condition Management Programmes (CMP)
are based on a bio psycho-social model of disability and take
the form of short, work-focused, cognitive/educational interventions
aimed at helping participants to understand and manage their conditions
in a work environment. The CMP will cover the three main conditions
cited in Incapacity Benefit (IB) claims—mental ill health,
musculo-skeletal disorders and cardio-respiratory conditions.
The main aims are:
— to help participants better to understand
and manage their condition in a work environment;
— to help them feel more confident
about what they can safely do and therefore about returning to
work; and
— to enable them when in work to feel
more confident and expert about negotiating with their employer.
There is an inevitable interval between launch
of the IB reforms pilots and the first participants joining a
CMP: the first claimants to enter will do so in January 2004.
It is therefore not possible to give any data or any indication
of the actual help delivered.
4. How are policies for health helping to
empower coalfield communities?
The Government has set up a new system of patient
and public involvement to both support and empower local people
in their contact with the NHS.
Support for patients as they use NHS health
care is provided by Patient Advice and Liaison Services (PALS).
PALS provide advice, information and support to patients, their
carers and families as they use services. PALS are intended to
deal with concerns and problems on the spot and before they become
major issues.
The Independent Complaints Advocacy Service
(ICAS) has recently been introduced to support and empower patients
who may wish to complain against the NHS. ICAS is available free
and is independent of the NHS.
For every trust and PCT a Patient and Public
Involvement Forum has been set up to monitor services from the
patients' perspective. Forums are patient-led and have the responsibility
to feed patients' views into the decisions of local health services.
Local authorities now have powers to review
and scrutinise local health services. They are able to require
senior health service managers to attend meetings and explain
decisions. Local authorities can use their new powers to assess
whether local health services are meeting the needs of their local
residents.
All NHS organisations now have a duty to involve
and consult the public on their plans and developments—and
also to ensure that there is rigorous consultation on any changes
to services.
All these elements together mean that local
people are now far more involved in their health services and
how they are delivered. Residents within coalfields areas will
of course be able to access these arrangements and make their
views known about how local services can better met their needs.
5. How is the Department of Health encouraging
health providers to train local residents so that they can provide
healthcare for other members of their communities?
The Expert Patient Programme (EPP) provides
courses for people suffering from long-term conditions. The EPP
course is generic in nature and offers a tool-kit of simple techniques
that patients can undertake to improve quality of life. The programme
strives towards building participants' confidence and sense of
control. It helps patients to develop better communication skills,
manage their emotions and daily activities, interact with the
medical care system, find health resources, plan for the future,
understand exercising and healthy eating, and manage fatigue,
sleep, pain, anger and depression.
The Programme is currently piloted in 300 PCTs
across England and by 2004 it is expected to be mainstreamed and
become part of NHS health provision.
The courses are lay-led and volunteer tutors
from the local communities are recruited to set criteria, trained
and accredited to deliver the course. In the case that volunteer
tutors are not available, EPP trainers will deliver the course.
During the pilot phase, recruitment, training
and accreditation of volunteer tutors is the responsibility of
Primary Care Trusts in collaboration with EPP trainers who are
supported by the Department of Health.
Table 7 shows the number of EPP courses, patients
and volunteer tutors in the PCTs that are located in coalfields
communities.
Table 7
EXPERT PATIENTS PROGRAMME IN COALFIELD COMMUNITIES
|
| PCT | Volunteer Tutors
trained
| EPP Courses | Patients
|
|
| Barking and Dagenham | 1
| 3 | 26
|
| Barnsley | 2
| 4 | 39
|
| North Eastern Derbyshire | 1
| 0 | 0
|
| Chesterfield | 1
| 1 | 12
|
| Durham and Chester-Le-Street | 1
| 3 | 37
|
| West Cumbria | 1
| 3 | 42
|
| Northamptonshire Heartlands | 2
| 2 | 31
|
| Derwentside | 0
| 2 | 20
|
| Doncaster Central | 0
| 1 | 12
|
| Doncaster East | 0
| 1 | 8
|
| Doncaster West | 1
| 0 | 0
|
| Easington | 0
| 1 | 12
|
| Halton | 0
| 2 | 32
|
| Hartlepool | 0
| 1 | 9
|
| Eastern Hull | 0
| 1 | Data awaited
|
| West Hull | 0
| 0 | 0
|
| Mansfield District | 2
| 3 | 42
|
| Middlesbrough | 0
| 0 | 0
|
| North East Lincolnshire | 0
| 0 | 0
|
| Middlesbrough | |
| |
| Langbaurgh | 0
| 3 | 38
|
| Rotherham | 1
| 2 | 20
|
| Sedgefield | 5
| 5 | 68
|
| St Helens | 1
| 3 | 44
|
| North Tees | 2
| 3 | 29
|
| North Stoke | 0
| 1 | Data awaited
|
| South Stoke | 1
| 1 | Data awaited
|
| Eastern Wakefield | 0
| 2 | 12
|
| Wakefield West | 1
| 4 | 26
|
| Northumberland Care Trust | 0
| 0 | 0
|
| Durham Dales | 1
| 2 | 28
|
| Ashton, Leigh and Wigan | 2
| 3 | 59
|
|
| 
