Change that leads to better lives

Employment support for disabled people – the evidence

NDTi has completed the most comprehensive research ever into the cost effectiveness of local authority and NHS commissioned employment supports for people with learning disabilities and people with mental health conditions. Funded by the National Institute for Health Research’s School of Social Care Research (SSCR), this shows that most current spending is on types of employment support that are unlikely to lead to people ever getting a paid job. More people can be supported into work simply by re-investing that money in the type of employment supports where there is an evidence that they work.

Rob Greig, Chief Executive of NDTi, said

“For the first time we know how much commissioners are investing in what kinds of support for disabled people to get or keep work.

“Unfortunately, only a third of the money is currently invested in approaches we know will make an effective difference. At the same time, it looks like commissioners are starting to disinvest in employment support because of the financial pressures they are under.

“Far from being a reason to continue to disinvest, though, our findings show that far better employment outcomes can be achieved for disabled people if money is used wisely. Not only this, but supporting disabled people to work also results in an overall positive effect on the public purse because of a reduced reliance on care services.

“We encourage everyone with a stake in good employment outcomes for disabled people to look at the research and use its practical findings to make things better in their local area."

The study has identified a significant variability in the cost of employment support services and costs per job outcome achieved that cannot be explained by factors such as complexity of people’s disability or size of service. The study therefore concludes that variable cost and outcomes is primarily explained by one or both of:

  1. Service model being used (right model)
  2. Strategic organisational actions taken (right conditions)

In a time of tight public finances, the NDTi study shows existing investment in employment support could be used to deliver much higher numbers of new or retained jobs for disabled people at significantly lower average costs than is being achieved presently.

Have you got 5 minutes?

If so, you could read NDTi insights 20 – Employment support for disabled people: the relationship between investment and outcomes

If you have a few minutes more, you could also read the handy 4 page summary – research findings that highlights the key points from the research and provides background information, our findings and implications for practice.

Looking for more detail?

You can download a copy of the full report here The Cost Effectiveness of Employment Support for People with Disabilities

NDTi have developed a practical resource for social care and NHS commissioners to use to help ensure that the employment supports they commission for disabled people (most likely for people with learning disabilities and people with mental health problems) achieve good outcomes at a cost effective price. To read more about this tool, please follow the link: Employment Support Tool for Commissioners

The background

Using a mix of methods to investigate the relationship between health and social services investment in employment support for disabled people and the resulting outcomes (i.e. people getting or retaining paid work), the study entailed:

  • Collecting national data on investment in employment support and breakdown of type of support purchased and outcomes generated
  • Collecting further local in–depth data from 70 services in 43 LA areas
  • Fieldwork visits to six sites to understand strategy implementation and outcomes for people
  • Learning Networks (in conjunction with ADASS) for commissioners of employment support in three parts of the country to share the learning from this research

Ethics approval for the fieldwork component of this study was successfully sought from the Social Care Research Ethics Committee

Additional Resources

Phase 1: A review of economic evidence around employment support

Phase 2: The cost effectiveness of employment support for disabled people

Phase 3 – Bringing it all together

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