supporting older people into employment (sopie): barriers ... · employment (sopie): barriers and...

Supporting Older People into Employment (SOPIE): Barriers and Facilitators to Extending Working Lives

5th December 2017

• Demographic shift to ageing population

• The “ageing worker” is an emerging priority group for policy makers

• DWP noted that 2016 employment rates for 50-64 year olds at highest levels since 1984 – 8.3 million individuals in employment

(69.4%)– Decreases in unemployment and

economic inactivity– Also increases in >65s employment

• However, still significant drop-off of workplace engagement after age of 50 (most prevalent trend with women and those with disabilities)

• Policy challenge: how can we best support over 50s who are unemployed to re-enter the workforce?

• SOPIE team awarded MRC Life Long Health and Wellbeing Extending Working Lives Partnership Award, started Dec 2014, for 3 years– Partnership between Academic and Industry spheres– Glasgow University (Ewan Macdonald, Judith Brown, Jo Neary, Alastair

Leyland, Hilary Thomson, Vittal Katikireddi), University of Stirling (Ron McQuaid), and University of Edinburgh (John Frank)

– Ingeus (Paul de Pellette, Luke Jeavons, John Campbell, Cem Zobu)

– DWP

• A mixed method approach utilising data from Ingeus clients, participating in the Work Programme, to understand relationships between health, worklessness, and the return to work process with a particular focus on the over 50s

SOPIE

• The Work Programme is the government’s welfare-to-work scheme to help long-term unemployed people to find and keep jobs with referrals from 2011 to April 2017

• Delivered by a range of private, public and voluntary sector organisations

• DWP pays prime contractors to provide support using a payment-by-results approach

• A ‘black box’ approach to support

• Clients stay on the Work Programme for two years

• Mainly for Jobseeker’s Allowance (JSA - for people who are unemployed but capable of work) and Employment and Support allowance (ESA - for people who have an illness, health condition or disability that makes it more difficult to work) clients

The Work Programme

• Embedded fieldwork

• Longitudinal quantitative study

• Longitudinal qualitative study

Protocol for a mixed-methods longitudinal study to identify factors influencing return to work in the over 50s participating in the UK Work Programme: Supporting Older People into Employment (SOPIE). BMJ Open 2015;5:12 e010525

Study Design

• Analyse Ingeus’ routinely collected data to investigate factors (age, health, socio-economic, personal and external factors) associated with return to work

• Characterise the employment undertaken and further explore the unemployment-to-employment transitions made by clients

• Benefit type and age groupJSA clients under 50JSA clients over 50ESA clients under 50ESA clients over 50

Research Objectivesof Quantitative study

March

2015

SOPIE quantitative

cohort n=~14,000

clients, 20% 50+

First cohort client

finishes WP

Last cohort client

finishes WP

Project

ends

Project

starts

Dec 14July

2014

July

2016

Timescales for SOPIE quantitative cohort

Nov 17April

2013

2 years in WP

Transfer 2

All follow up data

Transfer 1

Baseline data

Oct

2016

Oct

2015

• Referrals/Baseline dataDemographic – age, genderSocio-economic – length of unemployment, highest qualification, ethnicityPersonal – caring, housing & parental statusPerceptions – client perception of when they think they will start workDatazones – match to Scottish Index of Multiple Deprivation (SIMD) deciles and SG 8-fold urban rural classificationHealth- Self-disclosed health condition(s), Having health concerns that affects ability to work• Jobs dataStart and end date of each job, Standard Occupational Code, hours• Interventions dataActivities clients engage with during the WP

Data

Benefit type & Age Group

SOPIE cohort – Number of health conditions disclosed

SOPIE cohort – Health conditions disclosed

Health conditions disclosed by benefit type & age group

• Job start, Yes/No• Time to first job start (Poisson modelling approach using fractional

polynomials to model age as a continuous variable)

For each client we have calculated all the unemployed and employed spells between referral date and leave programme date• Sequence analysis to visually show clients’ employment status over the

two years • Accumulated employment index

Accumulated employment during clients’ engagement in the two year Work Programme

Accumulated employment after first job start

Employment outcomes

Job start

Return to Work by Age

25 year old 50 year old 55 year old 60 year old

JSA female 69% 53% 48% 41%JSA male 76% 60% 54% 47%ESA female 29% 17% 14% 11%ESA male 28% 17% 14% 10%

Job start in 3 month period across 2 years in WP

Models

Variables includedNull Age as continuous variable stratified by benefit type

GenderSocio-economic factors

Length of unemployment Highest qualificationEthnicity

Personal factors Caring responsibilities Housing situation Parental status

Perceptions/attitudes Client perception of starting work

External factors Scottish Index of Multiple Deprivation decile 8-fold urban rural classification

Health Number of health condition(s) disclosed Having a health concern which clients believes will affect ability to work

Full All variables in models 1 to 5

• JSA clientsAge

Length of unemployment

Highest qualification

Caring responsibility

Housing status

Client perception of job start

SIMD decile

Urban rural location

Health concerns affecting ability to work

Number of health conditions disclosed

• ESA clientsAge

Length of unemployment

Ethnicity

Housing status

Parental status

Client perception of job start

SIMD decile

Urban rural location

Health concerns affecting ability to work

Number of health conditions disclosed

Factors associated with having a job start

Predicted probability of job start - age & unemployment

history

• Clients with the following health conditions more likely to have a job startCardiovascularDiabetesLearning DisabilityRespiratorySensory conditions

• Clients with the following health conditions less likely to have a job startAddictionsAnxietyFibromyalgia/CFSGastrointestinalNeurologicalSevere mental health

Job start and health conditions

Jobs undertaken

Number (%) of jobs undertaken

Sequence index plot

0

20

40

60

80

100

0 200 400 600 800Time in programme, days

UnemployedEmployedOut of Program

65% of JSA clients under 50 have a job start, n=4919

JSA clients under 50

Sequence index plots JSA & ESA clients under & over 50

0

20

40

60

80

100



65% of JSA clients under 50 have a job start, n=4919

JSA clients under 500

20

40

60

80

100



49% of JSA clients over 50 have a job start, n=693

JSA clients over 50

0

20

40

60

80

100



23% of ESA clients under 50 have a job start, n=685

ESA clients under 500

20

40

60

80

100



14% of ESA clients over 50 have a job start, n=182

ESA clients over 50

Accumulated Employment Index

1. Accumulated employment during clients’ engagement in the two year Work Programme

expresses the proportion of time client spent in employment

2. Accumulated employment after first job start

reflects how well clients did after first job start

• Helps us interpret the sequence analysis

Accumulated Employment Index

Full-time/Part-time employment

Full-time work was defined as 30 hours+, part-time work was defined as 29 hours and less.

Employment undertaken

Interventions

Type of intervention

A, content B, Form of delivery

C, Where client is in terms of labour market

Advisor appointment

Usually 30 minutes Individual Either

Health & Wellbeing workshops

e.g. anxiety & depression management, relaxation & walking groups, assertiveness skills & confidence building

Group Far but not as far as HWB appointments

Health & Wellbeing appointments

Specialised appointments with Health & Wellbeing Services and Health advisor. Clients need to be triaged and assessed

Individual Far

Basic employability

More theory skills & practical skills e.g. Assert yourself, Dream Board, CV writing

Group Far

Applied employability

Job finding activity, Pre-candidate pool, candidate pool assessment, workshops for specific employers, cold calling, retail walks, spec calls

Group Near

Specialised external interventions

Delivered by external experts e.g. Phoenix futures, SAMH, Apex

Individual Far

Interventions ‘used’ by younger older JSA & ESA

clients

Interventions associated with job success

• All clients attended advisor appointments

• Those ESA clients (young and old) who did attended HWB workshops and HWB appointments had relatively more success (in terms of job start) than other ESA clients

• JSA interventions usually reflected low job success

• Exception is Applied Employability interventions for JSA clients, which is positively associated with job success

• Relatively few ESA used Applied Employability, but those that did had relatively high job success

• Intervention versus selection of the clients for intervention

Summary

• There is a strong relationship between age and having a job start for both JSA and ESA clients

• Interaction of socio-economic factors, personal factors, perceptions/attitudes, clients health and external factors on RTW

• Sustainability of employment – novel sequence index plots

• JSA clients are more likely to return to work (and sooner) than the ESA clients

• ESA clients were as likely to sustain employment as JSA clients

• Quite high proportion of this work is full-time work

Data Linkage

• To investigate potential health impacts, including longer term benefits, of engaging with the Work Programme and return to work

• Explore the feasibility of linkage of Ingeus data to ISD health data

• Electronic Data Research & Innovation Service (eDRIS) & Administrative Data Research Network (ADRN)

• Prescribing data, outpatients data

• June 2017 ADRN panel board approval for the project

RA1 To determine if the Work Programme impacts on healthcare utilisation

RA2 To investigate the impact of return to work (or not) on healthcare utilisation

Breakdown of SOPIE cohort by payment groups

PG1 JSA 18-24PG2 JSA 25+PG3 JSA Early accessPG4 JSA Ex-IBPG5 ESA volunteerPG6 ESA FlowPG7 ESA Ex-IBPG9 JSA Ex-prisoner

Job start by payment groups

supporting older people into employment (sopie): barriers ... · employment (sopie): barriers and...

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