Health, Disability and Employment (Early Interventions) Project Third Sector Employability Forum 23 rd March 2016
Project Governance Internal SG structures bring together key policy and delivery areas at different levels, e.g. health, fair work, social security, economic development, equalities, SDS and others. Collaborative Group involving academics, disabled people s organisations, GPs, nurses, TSEF, local authorities, employers and trades unions. Coordinating with other key pieces of work.
The strategic challenge A significant proportion of Scotland s working age population has a disability or limiting long term condition Disabled/ LLTC Not disabled/ No LLTC Disabled (Labour Force Survey definitions) 19.4 80.6 Limiting Long Term Conditions (Scottish Health Survey definitions) 25.6 74.4 3
Percentage of population The strategic challenge 40.0 35.0 Prevalence of limiting long term conditions in the working age population is higher in areas of deprivation 38.0 30.0 25.0 20.0 28.8 23.4 21.1 25.6 15.0 17.9 10.0 5.0 0.0 1st - most deprived area 2nd 3rd 4th 5th - least deprived area Scotland Level of deprivation (Scottish Index of Multiple Deprivation) (SHeS) 4
Age Group The strategic challenge The prevalence of disability and limiting health conditions increases with age % of adults in each age group with health conditions 0% 10% 20% 30% 40% 16 to 30 17% 10% Limiting long-term condition Non-limiting long-term condition 31 to 45 22% 13% 46 to 64 35% 16% Long-term limiting and non-limiting health conditions by age group, Scotland 2014 (SHeS) 5
The strategic challenge In Scotland there will be more older working age people in the next 25 years. 6
The strategic challenge Under current levels of disability, Scotland s performance on disabled employment could be improved. Employment rate aged 16-64 disabled vs non-disabled 7
The strategic challenge The disabled employment rate varies across local authority areas Shetland Islands Orkney Islands Aberdeenshire Highland Eilean Siar Scottish Borders Perth and Kinross Argyll and Bute East Renfrewshire East Dunbartonshire East Lothian South Lanarkshire Edinburgh, City of Midlothian Stirling South Ayrshire Renfrewshire Aberdeen City Moray Fife Angus Scotland West Lothian North Lanarkshire Falkirk North Ayrshire Inverclyde West Dunbartonshire East Ayrshire Dumfries and Galloway Dundee City Clackmannanshire Glasgow City 0 10 20 30 40 50 60 70 80 EA core and work-limiting disabled employment rate, 16-64 (%) (to March 2015) 8
The strategic challenge Shetland Islands Orkney Islands Aberdeenshire Highland Eilean Siar Scottish Borders Perth and Kinross Argyll and Bute East Renfrewshire East Dunbartonshire East Lothian South Lanarkshire Edinburgh, City of Midlothian Stirling South Ayrshire Renfrewshire Aberdeen City Moray Fife Angus Scotland West Lothian North Lanarkshire Falkirk North Ayrshire Inverclyde West Dunbartonshire East Ayrshire Dumfries and Galloway Dundee City Clackmannanshire Glasgow City as does the size of the disabled employment gap 0 10 20 30 40 50 60 70 80 Disabled employment gap (percentage points) 9
The strategic challenge 10
The strategic challenge The personal and financial costs of this are significant. E.g. Benefit expenditure in Scotland, 2012/13 (selected benefits) 11
The response An effective response to this strategic challenge requires better employment outcomes for disabled people and those with health problems who are: transitioning from the education system into employment long-term unemployed at risk of falling out of work due to health/disability recently unemployed due to health/disability
Why focus on early interventions? Around half of those moving onto ESA arrive from employment c.40,000 per year. Many still want to work. Strong evidence that keeping people in fair work is better for their health and wellbeing. The longer someone is out of work, the less likely they are to return. Figures vary, but as an example: After 6 months sickness absence, probability of return to work within 6-12 months falls to 2.3% (NICE) Potential benefits for public finances and economy
A Potential Way Forward? (Draft) Draft core recommendations A unified Scottish Health and Work Service, with an improved focus on mental health Strengthened focus on disability and health in economic development work Prioritise at an early stage monitoring and evaluation in order to improve triage/services, and support the spread of good practice Improvement work (draft) Programme of work focused on improving knowledge, attitudes and behaviours, early identification, early action/early referral.