Appendix 4: Summary of visit to Whipps Cross Hospital, 30 January 2024
Summary of visit to Whipps Cross hospital on Tuesday 30 January 2024
Summary
On 30 January 2024, the Committee visited Whipps Cross Hospital in Leytonstone. The purpose of the visit was to see the supported internship programme in place at Whipps Cross. The supported internship programme is for young people with learning disabilities who would otherwise have difficulty securing a job.
The Members first met with programme leads, before going on a tour of the hospital, and speaking with interns on the programme. There was then a question and answer session.
The model
The supported internship programme is based on a model built by DFN Project Search, who deliver the programme in partnership with an employer, job coaches, and education providers. The DFN Project Search model is in place in 200 settings in England (including 68 hospitals). The team have asked for figures on how many young people the project supports.
Young people with learning difficulties are enrolled at an education setting. In partnership with a local employer, young people undertake two or three rotations in different roles. These placements are designed to provide new skills to enable the interns to gain meaningful employment. The college sets a programme of study and work with the young people and job coaches to identify what the young people would like to get out of the rotation. The interns are supported by a job coach and tuition from the education provider.
Interns are not paid during the programme. After the programme, they are either offered a job by the host employer, or they are supported by job coaches to seek a job elsewhere.
Attendees said that all interns were “people who had been written off”. The Committee heard that the model encouraged both the employer and the young people to reconsider their ideas of what young disabled people can accomplish. For example, a disabled young person had been placed in the most stressful unit in the hospital: A&E.
Funding
Each young person has an Education, Health and Care Plan (EHCP). The college receives high needs funding for these students. The Access to Work fund enables DFN to provide job coaches, and the education provider funds the tutors who work with the young people. DFN would like to work with young people who do not have EHCPs, but access to funding is more difficult for these groups.
Benefits of the scheme
For the employer:
The programme leads told us that they had been told of a number of benefits for employers who run the supported internship programmes:
- Improved management because employers have to learn to communicate differently: “it’s not just people with learning difficulties who need good communication and adjustments: everyone needs that”.
- Increased staff retention.
- Existing employees disclosing their disabilities.
- Improved employee experiences of work.
- Increased productivity.
- A more representative workforce—particularly beneficial for public services with the staff community reflecting the community it serves.
- Disabled employees staying in jobs longer, taking fewer sick days, and being more punctual than non-disabled people.
- Employers not needing to employ temporary workers with their concomitant a higher costs.
It was stated that, in the DFN-supported internship model, there is no financial risk for the employers. No physical changes had been required to the hospital building in order to run the programme.
For local authorities and public services:
Employment is linked with better health outcomes, particularly for disabled people. Organisations argued that supporting an internship programme is cheaper over time for local authorities than not doing so, as it reduces the likelihood that people will require care. The Chief Executive Officer of DFN Project Search said she tells hospitals in particular: “You can either partner with us and host these amazing people or they are going to become your patients”. This programme was described by one attendee as representing a preventative service.
For the young people:
The Committee met a number of current interns. It was evident that the young people trusted their coaches and tutors, and had enjoyed the programme. One intern said that he “wants to be involved as long as I possibly can”. Several knew what they would like to do as their next placement, including one who wanted to work with special care babies. Another said that she found the programme helpful in “making new friends, learning new skills, having new experiences and working towards a job”.
Possible expansion
The CEO of DFN Project Search thought that the model could be part of national NHS infrastructure. Barts Hospital Trust had interns in most of their hospitals.
Barriers to expanding the scheme
Committee Members asked attendees whether there were barriers to expanding the scheme more widely, including potentially in all hospitals. A number of potential barriers were noted:
- Access to EHCPs (which “unlock” funding)
- There are many students who may be able to benefit from the programme but who do not have access to EHCPs and cannot therefore benefit from the programme.
- It was noted that the majority of people with EHCPs are male: this was thought to be because females with learning disabilities present differently.
- Availability and speed of funding through Access to Work programme.
- The quality of jobcentre support was questioned, one example was raised of a job centre not understanding what a supported internship is, and thinking an individual in one was unemployed.
- Poor networks between employers, education providers, job coaches etc.
- Low aspirations, including from young people, parents, and education providers.
- Attendees felt that discussions about careers should begin from a very young age: this would help to acclimatise young people and parents to the idea that they may get a job later on.
- Lack of data to demonstrate efficacy and securing funding (see below).
Data
Reliable success data was noted as being critical to demonstrating efficacy and securing funding for programmes like this to expand. Some success data was available from DFN:
- Approximately 4% of people with learning disabilities have jobs.
- However, 70% of Project Search interns get a job, and 60% get full-time jobs.
- These jobs are often paid well above minimum wage.
National data on the outcomes of people with learning disabilities was described as very limited. The Committee was told that General Data Protection Regulations (GDPR) present a challenge in analysing individual outcomes. However, a projected simulation could contrast outcomes for populations who benefit from supported internship/employment programmes, and corresponding populations which do not. Data could also be collected from employers, for example on the retention and progression rates of people employed through the programme.
Requirements for the scheme
DFN Project Search was clear that buy-in from the top of the employing organisation/host business was essential, including to ensure that the interns were fully integrated. It also required a large employer, one with a range of possible placements. Hospitals were a good example of a ‘skills lab’ because there are many different types of roles for individuals to trial; hotels and potentially local authorities were noted as being good examples of possible employers.
Business to business advocacy had been helpful in the past to encourage other organisations to adopt the model: there were examples of private sector employers running the scheme.
Tour
Members visited:
- the pathology department, where they met a young man processing blood samples;
- a nursing ward where two young women were engaged in ward clerking and serving food to patients;
- the patient experience room, where interns were engaged in processing patients’ feedback and comments; and
- the medical devices room, where interns were taught to keep track of devices and to repair equipment.
Possible concerns
One attendee suggested that increased digitisation could remove some admin-heavy jobs. This would potentially make it more difficult to employ people with disabilities.
The programme requires ongoing support throughout an individual’s journey, even once they have secured a job. This is resource intensive.
There were concerns raised about how the quality of transition to work programmes can be ensured: attendees felt that a kitemark certification would be helpful here.
There were concerns about how many people would be able to access the schemes: all present wanted a funding formula which gave all learners with special educational needs and disabilities access to a job coach.