Select Committee on Work and Pensions Written Evidence

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 attached.

  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 advice.

    —  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 be improved?

  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 Plus below)

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[224] 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 alone.

  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 Benefit.

    —  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 work programmes.

  Turning Point welcomes the proposal in Building on the New Deal to further develop services for disadvantaged groups.

    —  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 to work;

—  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 contribute.

    —  More should be done to integrate funding streams covering social care and employment services.


Learning disability

  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.[225] Yet only 10% are in work[226] and this is often part time and low paid.[227]

    —  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.[228]

  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 early.


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:

    EESPro—Employment 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:

    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

225   Employment and People with Learning Difficulties, S Glenn and C Lyons, European Journal of Supported Employment and Vocational Rehabilitation 2. 1996. Back

226   Valuing People White Paper, Department of Health 2001. Back

227   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

228   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 participation". Back

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