This report for the National Institute for Health Research’s School of Social Care Research (SSCR) is the final report from the two year study on employment support for disabled people investigating the relationship between investment and outcomes.
It is based on the work undertaken across both an earlier scoping review1 and the three stages of the main cost effectiveness study by the National Development Team for Inclusion (NDTi).
It is clear from the research that much money being spent on employment related services by both local Government and the NHS in not achieving value for money. Substantial proportions are being spent on service models that do not evidence real job outcomes. For some, where money is being spent on evidence based activity, the strategic and commissioning activity is such that the potential for good outcomes is being undermined. However, this negative picture demonstrates the potential for improving outcomes without further financial investment at this difficult economic time. This research clearly indicates that if local authorities and the NHS aim to achieve change by following the five theories of change identified and then commission the evidence based models, they should be able (in time) to achieve the type of outcomes and cost effectiveness indicated by the best practice sites in this study. This will not be a ‘quick fix’ as it will require investment in factors such as local knowledge, new partnerships, staff skills and market development. It is, though, equally clear from this study that some of the ‘quick fix’ approaches to the current financial challenges will not deliver improved outcomes and value for money i.e. simply specifying costed outcomes without investing in strategic change and exploring evidence based models. The full report is available to download here