Memorandum submitted by Turning Point
after the publication of the Welfare Reform Green Paper
Turning Point is the UK's leading social care
organisation. We provide services for people with complex needs,
including those affected by drug and alcohol misuse, mental health
problems or those with a learning disability. We provide services
in over 200 locations and have contact with 130,000 people a year.
Turning Point is, at present, the largest deliverer of progress2work
services (P2W) and has supported 4,000 people through P2W.
Progress2work is a programme supporting recovering unemployed
drug misusers into work. This programme has a critical role in
sustaining treatment gains and promoting reintegration into the
community. We also provide P2W LinkUP which supports a wider range
of people including ex-offenders, homeless people and recovering
alcohol misusers. Building on the New Deal proposes extending
this model to other disadvantaged groups. A new service, progress2work
Plus will be piloted as part of the BoND schemes in 2006. Turning
Point also provides integrated social care and employment packages
for people with a learning disability and other complex needs.
For more information about these services see the background briefing
Through our experience in delivering progress2work
and other employment services, Turning Point staff are aware of
the range of complex needs many people have which can form a barrier
preventing them from finding and keeping work. Turning Point understands
the importance of providing integrated employment and health and
social care services to ensure that even the hardest to help can
be supported into employment. We also strive to challenge prejudice
and discrimination whilst working constructively with employers.
The Chief Executive of Turning Point, Lord Victor
Adebowale, is a member of the National Employment Panel.
Lessons to be learned from the Pathways to Work
pilots and future rollout
Turning Point believes that the key to the success
of the pilot programmes is the combination of different elements
offered (specially trained advisers; condition management; return
to work support; financial incentives and involvement of employers).
While the pilot programmes have had success in helping people
back into work, the concern is that "the package" that
is rolled out nationally may not be as comprehensive or well resourced
in terms of funding and specialist expertise.
Employment Advisers in GP surgeries
The placing of employment advisers in GP surgeries
in some Pathways pilots reflects the right intentions of joining
up health and social care services with employment support. However
people with complex care needs do not always present in GP surgeries
and it is important to consider other routes of access to employment
Turning Point recommends that a pilot
programme be established to introduce an employment adviser into
drug treatment services. Staff in these services have already
built up a rapport, working with very marginalised groups and
so are well placed to reach out to them. Such clients may have
a fairly long journey towards work, but staff can start to prepare
people for work-focused interviews and think about referring people
to progress2work services at an early stage.
Is a dual benefit the right approach, could it
Whilst Turning Point supports the Green Paper's
proposals for benefits being based upon the impact of a condition
and not a specific illness or difficulty, we are concerned about
those with fluctuating conditions. We welcome the Green Paper's
intention to convene an Expert Group to address these issues.
The Green Paper states that engagement in the
work focused programmes will only be necessary for those who can
be expected to return to work, whereas those with more severe
challenges will be exempt. This is an inflexible approach which
would not meet the needs of people who fall between categories
or have a fluctuating condition. These people will need flexibility
from the government and from their employer to allow them space
to manage an episode of ill health. Furthermore, we are also concerned
that JobCentre Plus staff will not have sufficient training or
experience to make sometimes complex decisions. (see JobCentre
Conditional cuts in benefits
There is concern that the focus on conditionality
and the loss of benefits could further disadvantage those with
the greatest needs. Vulnerable people, who find it difficult to
engage with services, may not turn up for appointments and may
find themselves further away from the employment market, and living
on a substantially reduced income. If these reforms were to be
overly driven by financial incentives they could put inappropriate
and excess pressure on vulnerable people to go back to work. Work
offered may not be appropriate for the person being supported.
People may be pressured into signing up to a work plan they cannot
fulfil. Rather than making savings, this approach would have an
adverse impact on health and could lead to people spending longer
on benefits than they would otherwise have done. This would cost
more taxpayers' money in the long run.
Turning Point recommends that the
support and resources to help people back into work need to be
in place before putting requirements on people to use them. Otherwise
the most vulnerable people will simply end up more excluded. If
the system works and is properly resourced, we question whether
sanctions are necessary. The majority of people on incapacity
benefit want to work
so if the system is designed to support people into work the focus
on compulsion could prove unnecessary.
There is a currently a clear disincentive for
people on incapacity benefit who are unable to work for a long
time to earn more than £20 under the current system, as under
the permitted work rule you then start losing benefit entitlement.
The welfare reform proposals should
review the benefit rules to support the transition from benefits
to work, so that people can work for more hours without impacting
on benefit eligibility.
There needs to be a greater emphasis on supporting
retention of new entrants into employment. This might include:
Ongoing support from specialist providers.
Training for other employees to provide
support within the workplace.
Many people who need help accessing employment
have a range of complex, overlapping needs, which present further
barriers to someone finding and sustaining employment. Many of
the nearly 3 million people currently on incapacity benefits have
a range of difficulties which may not be solved by employment
Features from the progress2work (P2W) model
can help to support people with complex needs. These include:
dedicated funding, access to specialist employment advice and
flexibility to deal with relapse. At Turning Point we deliver
bespoke, one-to-one support to clients working to specific individual
aims to provide a rapid response to needs and fast track people's
entry into mainstream provision. By bridging employment, health
and social care, our person centred approach (PCA) means that
the client is involved in every step of the way through action
plans and working with the users' own aspirations.
Turning Point recommends that to
help people into employment, they need access to physical health
services, stable housing and strong social networks. We welcome
the intention indicated in the Green Paper to streamline Housing
Changes to the welfare system must
target the most disadvantaged who have a range of needs, not simply
those nearest to the labour market.
The Progress2Work programme should
be retained and extended to cover more marginalised groups, in
particular those with substance misuse and co-existing mental
health problems (dual diagnosis). The benefits of this approach
need to be kept in mind in the development of future welfare to
Turning Point welcomes the proposal in Building
on the New Deal to further develop services for disadvantaged
We believe that a separate approach
is needed for those people identified under "Building on
the New Deal" as the most disadvantaged groups (people with
substance misuse problems, homeless people, ex-offenders). This
approach should include increased flexibility for Jobcentre Plus
staff to tailor services to meet individual needs.
It is critical that programmes such
as progress2work Plus are safeguarded and expanded and that specialist
expertise in supporting people with complex needs, including their
health and social care needs, is retained in future programmes
so that these people are not left behind.
Turning Point recommends the development
of a national strategy to support the most disadvantaged people
into employment. The key elements should be:
A focus on moving people towards work
readiness (rather than into the first available job), rewarding
intermediate steps and distance travelled on the journey back
A reformed target regime that prioritises
those furthest away from work and removes perverse incentives
to cherry pick those most "work ready";
A focus on services that go out and engage
with those clients, rather than always expecting disadvantaged
clients to come to them;
Recognition that working with the most
disadvantaged involves long-term commitment;
Simplification of the welfare system
to make it more accessible.
By the very nature of the job, people working
for Jobcentre Plus will have generic skills in supporting people
into work. They often do not have the skills or the confidence
to work with people with complex needs, including substance misusers.
This means they will need further support and specialist training
to support people with the most complex needs. A guide for Job
Centre staff about employing former drug users would be a helpful
tool in their work.
There is a concern that inadequately trained
personal advisers in Jobcentre Plus will be relied upon to determine
whether or not someone has "refused to engage" in work-related
activity. People may be penalised because staff fail to understand
the full impact of their condition.
Furthermore there are concerns over the future
resourcing of Jobcentre Plus, which could impact on the delivery
of the welfare reform agenda.
Health and social care services are often funded
and organised separately from initiatives to get people back into
work. There needs to be much greater integration between services
in this area. Turning Point recommends that:
The government should improve the
interface between health and employment initiatives and to share
best practice between different models of employment support for
different client groups.
Explicit employment and training
targets should be set for health and social care providers.
Progress should be made towards single
assessment of people for a range of needs. People should have
access to a "passport" with their case history which
they can share with service providers and to which all providers
More should be done to integrate
funding streams covering social care and employment services.
Employment matters to people with a learning
disability. It is a route out of poverty and exclusion. Work provides
a sense of purpose, improves confidence and leads to greater independence.
65% of people with a learning disability want a job.
Yet only 10% are in work
and this is often part time and low paid.
Turning Point recommends that a new
Ministerial Group should be established and led by DWP to promote
cooperation in government to deliver effective employment support
for people with a learning disability.
Turning Point recommends that people
with a learning disability who have high support needs should
have a new support programme to help them with access to employment.
Specialist advisers and support workers
would work with people and employers to develop opportunities
for work and ongoing job support and training where necessary.
This should be an outreach programme
to engage with people with a learning disability rather than waiting
for people to ask for help.
Day services should be more integrated
with employment initiatives.
This programme should form part of a
new government strategy to get more people with a learning disability
into work, backed by specific targets.
Employment reforms often result in employers
"cherry picking" those who have milder learning disabilities,
and fail to help those with high support needs. In addition, to
access Government funded programmes like Workstep and Access to
Work people have to be able to work more than 16 hours a week
which may not be possible for all people with high support needs.
There is also a gap between the point at which work starts to
affect benefit entitlement and the point when Working Tax Credit
is earned (at 16 hours work a week). This is a disincentive for
people to work.
Turning Point recommends that a discrete
support programme is established on top of Workstep to support
those who are able to work between five and 16 hours and that
the gap between loss of benefit entitlement and earning the Working
Tax Credit is addressed for this group.
Furthermore, current work on welfare reform,
including the Pathways to Work pilots are not addressing the needs
of people with a learning disability. These people are currently
counted in the same bracket as people with mental health conditions,
but this approach does not adequately reflect the very different
needs of someone with a learning disability.
The government should separately
record the number of people with a learning disability under the
Pathways to Work pilots and review their experiences.
We believe that the experience of Turning Point
and other voluntary agencies, in working with vulnerable people,
networking with other professionals and developing strong community
links, is crucial to helping individuals move from incapacity
benefits to work-related activity or employment. However, we are
concerned about financial incentives and the implications of contracting
out some functions to other sectors. There is a concern that some
private providers could attempt to offer services which attempt
to support everyone back into work. It is essential that specialist
services, with expertise in supporting people with complex needs,
are retained in order that these people are not left behind.
Whilst some targets are helpful and necessary,
the nature of targets and the way they are measured and rewarded
need to be very carefully considered. Turning Point's experience
is that current initiatives do not take account of "distance
travelled" towards work-focused activity or employment and
that they emphasise short-term outputs rather than outcomes which
are long-term and meaningful to individuals. For example, we fear
that the Green Paper's proposals to reward primary care staff
who support individuals to return to or remain in work, may result
in staff putting undue pressure on people to return to work too
Turning Point has 12 progress2work contracts
P2W: Berkshire, Lancashire, Cardiff, Swansea,
Neath, Sandwell and Dudley, Oxford and Buckinghamshire, Cambridge,
Somerset, Herts, South London and Loughborough.
P2W LinkUP: Berkshire and Leicestershire.
progress2work aims to support recovering
and stabilising unemployed drug misusers into work and to access
and benefit from existing Jobcentre Plus Programmes and services.
The clients must be in receipt of working age benefit, and have
completed a drug treatment programme, or still be in a drug treatment
programme but stabilised and ready to move forward. Under P2W,
JobCentre Plus can award discretionary grants to individuals on
the programme to help them overcome barriers to employment they
may be experiencing.
P2W LinkUP was developed to provide further
support for those facing the greatest disadvantages in the labour
market. This includes ex-offenders, homeless people and recovering
alcohol misusers. Nine pilots went live in autumn 2002, and a
further 16 in 2003-04.
Building on New Deal (BoND)
BoND proposes building on P2W and P2W LinkUP
and its extension to the most disadvantaged groups. Progress2work
Plus will be piloted as part of the BoND schemes in 2006.
Turning Point runs other initiatives providing
employment support. These include:
EESProEmployment and Education
Support Project in Birmingham.
EESPro, supports current and former drug and
alcohol users who wish to access learning or work opportunities.
Service users do not have to be drug free to use EESPro but do
need to have a realistic level of stability, be unemployed and
be motivated to find work. Staff provide a wide range of assistance
such as career advice, confidence building, interview coaching,
and CV writing. Criminal Justice work is undertaken though Birmingham's
Prolific Offenders Partnership. EESPro also provides training,
advice and support to employers relating to managing drugs and
alcohol in the workplace.
The Wakefield Accord Project offers one-to-one
support to ex-offenders and ex-substance misusers with the aim
to help people back into employment and training. We are currently
developing a sound recording studio to enable service users to
work towards qualifications in music technology and we also have
an IT suite.
Access Point is an outreach service aiming to
deliver support to people with a learning disability, mental health
problems, autism and acquired brain injury. It provides a range
of support services geared towards the needs of the service user,
including support with access to employment.
224 Around 80 to 90% of those who come on to benefits
expect to work again, A new deal for welfare: Empowering people
to work, DWP, Chapter 2, paragraph 1. Back
Employment and People with Learning Difficulties, S Glenn and
C Lyons, European Journal of Supported Employment and Vocational
Rehabilitation 2. 1996. Back
Valuing People White Paper, Department of Health 2001. Back
Working Lives: The role of Day Centres in Supporting People
with Learning Disabilities into Employment, S Beyer, B Grove,
J Schneider, K Simons, V Williams, A Heyman, P Swift, Emma Krijnen-Kemp,
HMSO, 2004. Back
The recommendations on learning disability are derived from
Turning Point's report "Hidden Lives", 2004, and from
the recommendations of the joint Department for Work and Pensions
and Department of Health working group "Occupation supports