Getting in, staying in and getting on
Disability employment support fit for the future	

Presented to Parliament by the Secretary of State 
for Work and Pensions by Command of Her Majesty
June 2011 

Cm 8081	£28.50	

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Contents
Foreword
Executive summary	
Chapter 1 – The challenge ahead	
Chapter 2 – Opportunities and drivers
Chapter 3 – Foundations for support
Chapter 4 – Specialist support
Chapter 5 – An enabling state
Appendices	

Notes
Language used in the report
Disabled people	Used to describe anyone living with an impairment that has a long-term effect on day-to-day activities. People are ‘disabled’ by barriers to participation – from low expectations to inaccessible IT or the built environment. The term ‘people living with disability or long-term health conditions’ is used to reflect the diversity of experience: including hearing or visual impairments, mental health conditions, learning disabilities, long-term health conditions and mobility impairments; and including people with impairments that are acquired or long-standing, fluctuating or stable. This review respects the many different ways individuals define their own experience.	
Specialist disability employment programmes	Used to describe employment programmes and support designed to help people with complex or severe disability-elated barriers to work. Access to Work, Residential Training Colleges, Remploy and Work Choice are specialist disability employment programmes funded by the Department for Work and Pensions.	
Mainstream employment programmes	Used to denote the Work Programme, Pathways to Work or Flexible New Deal, whether these are provided by Jobcentre Plus or commissioned from provider organisations.	
The Department	In this report the ‘Department’ refers to the Department for Work and Pensions unless otherwise stated.	
Quotations used in the report
•	Unless otherwise indicated, quotes appearing in this review are from disabled people.
•	Personal stories appearing in the text have been shortened because of space constraints but the words used are those of the people relating their experiences.

Foreword
Three things were in my mind when I agreed to lead this independent review. First, the types of support that today’s young disabled people will want in tomorrow’s economy, and the support people who acquire impairments in their future working lives will value most. I wanted to recommend employment support that would meet our future aspirations as disabled people in the context of a changing economy and the big changes in the way we all work.
Second, I focused on the right to work, enshrined in the UN Convention on the Rights of Persons with Disabilities, which is supported by the UK Government. This includes:
“The right to work on an equal basis with others in a labour market and work environment that is open, inclusive and accessible.”
I saw an opportunity to make recommendations that could take us closer to making that right real.
Finally, I thought about the review’s independence and the opportunities to offer constructive challenge – to make the case for cross-Government work to unlock the big enablers of employment:
•	raising aspirations of what disabled people can achieve across our education, health and social care services; and
•	developing more equitable ways to:
o	‘get in’ – more disabled people doing apprenticeships, work experience, work placements, and on-the-job learning;
o	‘stay in’ – better promotion of Access to Work for retention; and
o	‘get on’ – whether setting up your own business or mutual, or gaining skills for career development.
I was therefore very grateful to the Secretary of State for inviting me to conduct this important review, geared to ensuring that disabled people have the opportunities and support needed to meet their employment aspirations.
The review offered me the chance to challenge everyone (employers, Government, providers, and disabled people ourselves) to play our roles so we can achieve greater rights in practice, and disabled people can contribute more to economic recovery.
I did the review during a period of significant change and anxiety among disabled people and our organisations about the impact on our lives of new assessments and local and national budget cuts. I make recommendations with a very important proviso: that any changes made in employment programmes must result in the money being used for effective employment support for disabled people, and not to be taken as savings.
I set up a Scrutiny Group to challenge my thinking as it developed, and the challenges disabled people and all members of that group made to me were invaluable. For instance, making recommendations just on employment could run the risk of seeming to support an agenda of reducing benefits: I support improved employment support as a positive incentive to meet disabled people’s employment aspirations. Media headlines that stigmatise benefit claimants are not helpful. In previous recessions, disabled people lost jobs and never got back in. If we can improve the system now, we stand a chance of stopping history from repeating itself. We could enable many more disabled people to get and keep jobs and careers.
Although my main recommendations focus on what can be done within the current Spending Review, I also set out longer-term plans. When Government spends around 20 times as much on out-of-work benefits for disabled people as on specialist disability employment support (£7 billion compared with just £330 million) something is wrong: we need to invest more in a menu of disability employment support that individuals can control if they wish (Access to Work, peer support and mentoring, support to get and keep employment). This makes economic sense: for every £1 spent on Access to Work the Exchequer recoups £1.48, and the social return on the investment is even higher. This would (with other measures) help reduce some of the need for out-of-work benefits, which would make the whole change self-sustaining.
A lot of people have been extraordinarily generous with their time and thinking: the Scrutiny Group (Mike Adams, Rachel Perkins, Kay Allen and Lord Tom Sawyer), disabled people’s organisations, charities, trade unions, employers, academics, providers, colleges, businesses, disability employment advisors and so many more. The Scrutiny Group’s key role was to challenge my thinking: they have been invaluable in informing the findings, but the recommendations are my own and the group were not asked to give them their collective endorsement.
I have received great pieces of analysis and very helpful advice. I am hugely grateful to you for sharing your insights and experience; and also to the team who worked together on the review, very ably led by Mike Jones: Laura Webster, Bahadir Ustaoglu, Matthew Willis, Roger Morgan and Simon Francis.
Liz Sayce
Liz Sayce is the Chief Executive of RADAR, the UK’s leading pan-disability organisation. She is a Commissioner at the UK Commission for Employment and Skills. From 2000 to 2007 she was Director, Policy and Communications, for the Disability Rights Commission, where she led on creating a new Disability Agenda for policy for the next two decades, covering skills, employment, housing, health, social care and more. She also directed a formal investigation into physical health inequalities experienced by people with mental health problems and/or learning disabilities. Previously she was Director of Lambeth, Southwark and Lewisham Health Action Zone. She spent eight years as Policy Director of Mind, and one year as a Harkness Fellow in the United States, studying the impact of the Americans with Disabilities Act and related policy initiatives. She was a member of the UK Government’s Disability Rights Task Force (1997 to 1999). With personal experience and knowledge of mental health issues, she has published widely on mental health, disability and social inclusion, including From Psychiatric Patient to Citizen (Macmillan-Palgrave 2000). 

Liz Sayce OBE

Executive summary
Getting in, staying in and getting on: Disability employment support fit for the future
“I want the same choices as anyone else – to have the career I want.”
“Disabled people can help contribute to growth, to taking the country out of the economic downturn.”
At the age of 16, young disabled people hold the same aspirations to stay in education and find fulfilling careers as their non-disabled classmates.
This review recommends changes to government policy to support disabled people to work in any role in any sector by doubling the numbers of people able to use Access to Work support, and raising the overall numbers securing specialist disability employment support to 100,000 within existing resources. In a tight economic environment this would be achieved by ensuring government funding is spent where it can have most impact, by better partnership working to maximise the contribution of government, employers, service providers and disabled people themselves; and by reducing the costs of assessments, driving down costs of services and equipment, encouraging suppliers to compete, empowering employees and employers to have far easier access to information, peer support and cost-effective solutions. This review was commissioned to identify ways to use funding for specialist disability employment support more effectively. It finds significant scope to increase the number of people who can benefit from this support to get in, stay in and get on at work; and to improve the system for people with the greatest support needs and labour market disadvantage.
Government-funded support would be focused on the person and their employer, not the facility, so disabled people can use that support in whatever type of employment they pursue. Longer term there is a strong case for still greater expansion of Access to Work as a passport to successful employment by using benefit savings to fund more support for more people through Access to Work (the AME-DEL switch). And the big enablers of employment – from apprenticeships to aspirations at school and in health and social care services – would be pursued through a cross-Government ministerial group and strategy.
What people told us
We live in challenging times. Disabled people are twice as likely to live in poverty as non-disabled people. We listened to people’s fears and where they come from – the fear of poverty, the fear of reduced support, the experience of being disrespected as someone who claims benefits (viewed as a scrounger). The commissioning of this review is timely in seeking evidence to ensure that money spent on employment support is accurately targeted and helps as many people as possible in the most effective way, to help more families living in poverty and support the wider goals of social justice. 
Some people argued that improving support to get and keep employment is fruitless at a time when jobs are in short supply. Yet as young disabled people spoke about their employment aspirations; as we saw how good support could help people experiencing disability for the first time to keep (rather than lose) their job; as we heard from those employers who spot and develop disabled talent as a bottom line business issue; it was clear that getting support right mattered, enormously, to huge numbers of disabled people, their families and to employers. It was also clear that expectations on the part of disabled people have changed.
“The last generation of disabled people campaigned for rights and legislation. For young disabled people today the ground is already built and our experience is different. They want boyfriends and girlfriends who are non-disabled as well as disabled. Some want a lifestyle nothing to do with disability. The mass of young disabled people want a mainstream lifestyle and that’s what we need to give them.”
(Young person with significant physical impairment)
Whereas soldiers returning injured from the Second World War had the opportunity to work in specially designed Remploy factories, those returning from Afghanistan today are being supported into civilian roles from airport security or administration to setting up their own businesses (in one case, a business run by amputees to help emergency services respond to mass injuries). 
Again and again disabled people – especially young disabled people – said they wanted the same chance of getting the full range of roles in the economy as everyone else, in every sector from hairdressing to engineering, from apprenticeships to work experience, from self-employment to mutuals and co-operatives, from employee to director. 
Some talked eloquently about what had enabled them to make the transition from stacking shelves to being on the till (for one person with a learning disability), from intern to employee; or what helped them keep a job following catastrophic spinal injury or a diagnosis of multiple sclerosis or bi-polar disorder.
What works – personalised support
One of the key factors is personalised support – available in whatever work the individual is in – so they can pursue opportunities in the labour market as it is now and in the future, with its increase in short-term contracts, portfolio careers and varying working practices. Young people today do not expect a job for life. This challenges us to look at resources not in terms of the facilities that should be funded (the businesses, colleges, or workshops) – but the people who need funding for the support that they can use, whether in a social enterprise, working for themselves at home or working in the local pub.

Evidence from across learning disability, mental health, physical rehabilitation and beyond shows consistently that support that is flexible, personalised, long lasting when needed, with a rapid focus on job search, is more effective than a series of stepping stones to employment. It also shows support must be available to the employer. 
The chance of securing roles across the economy is not just an aspiration – it is a right, recognised in the UN Convention on the Rights of Persons with Disabilities: the right of disabled people to: ‘work on an equal basis with others in a labour market and work environment that is open, inclusive and accessible’. For that right to be made real, support needs to be focused on the person, be portable across different jobs or contracts, and offer choice and control in how it is used to achieve agreed outcomes (as is now being trialled under the Right to Control).
Supporting growth, encouraging independence
“There is a deeper tragedy. Almost 1.5 million people have been on out-of-work benefits for nine of the past ten years – during the longest sustained period of economic growth this group of people never worked at all … we want them to be able to seize the opportunities of work as the economy grows.” 
(The Right Honourable Iain Duncan Smith MP, Secretary of State for Work and Pensions, 2010)
Moving towards this vision even in hard times is important. In past recessions hundreds of thousands of people living with disability or health conditions lost employment, never got back in and lived in worklessness and poverty for many years. Planning did not start early enough to enable disabled people to keep their jobs as redundancies happened nor to take up opportunities as the recovery began. When jobs may be lost, ensuring support is in place to enable people to stay in work is crucial. And now is the time to enable employers to create jobs and easily take on disabled people; and to enable disabled people to seize opportunities, securing the jobs that come through or setting up their own businesses. This could help work towards a future in which we, as disabled people, can use our capabilities to the full – bringing greater equality of outcome, with smaller employment and pay gaps between disabled and non-disabled people, and between people with different impairment experiences.
At a time when the Government aspires to enable more disabled people than ever before to gain sustainable employment – with 1.5 million people on benefit being re-assessed to explore whether they can work – it is imperative that effective disability employment programmes are ready and waiting to help. It would not be fair to expect job seeking without employment support. Government is aware of this, and has introduced early access and differential pricing in the Work Programme, and this review was commissioned to recommend the best approach to providing specialist disability employment support.

More effective support means that some changes to existing programmes will be necessary. Changes should be made only with two rock-solid caveats: that resources released from reform are used to grow the numbers of disabled people who can be supported, not taken as savings; and that the rights and support needs of current users of programmes are met through a comprehensive package of support, with their full involvement at every stage.
The ‘big enablers’
We have identified three ‘big enablers’ – factors that, taken together, are essential if disabled people are to gain equal access to labour market opportunities:
•	Confident, well-informed disabled people who can actively pursue jobs and careers and make choices about the support and adjustments that work for them. It should be easy for people who want to work to get information on the success rate of different providers, the range of support and technology available, the rights to adjustments, and peer advice and support from those who have trodden a similar path. This would empower individuals to take up their role and to find the approaches that work for them.
•	Confident, well-informed employers, able easily to access information on employment practices, adjustments, technologies, able to seek advice at the time it is needed and to experience business benefits. As the default retirement age is scrapped, employers will benefit from understanding how to make adjustments to retain talented older workers. “It is important to us to retain and manage talent. It’s a business issue. The cost of making reasonable adjustments stacks up well against the cost of people going off sick or leaving. We want to retain experience.” (Lloyds Banking Group).
•	An enabling State, empowering individuals to seize employment opportunities and supporting employers to tap into all available talent; and developing the key drivers of employment, from skills to portable social care and housing. And setting the bar for good employment practice, through the public sector’s own employment of disabled people, through levers in procurement to encourage good practice among contractors, and through tracking progress – in line with the Equality Act 2010.
Government has a wider role in stimulating and incentivising change on the big enablers of employment. The rise in apprenticeships, work experience and internships could make a major difference to disabled people’s opportunities, provided disability equality is built into plans from the outset. Health service staff can make the difference between someone with a traumatic injury getting back into employment, or giving up hope for good. Schools and colleges can raise disabled people’s aspirations, or they can leave people believing there is nothing in store for them. Enterprise zones and support for entrepreneurs can build in support for disabled entrepreneurs, or leave them out. Equalities law is important in setting out clearly what is expected of employers. 

This report therefore includes comments on the actions of different government departments, devolved administrations, employers, health professionals and other key players, which impact on employment prospects for disabled people. We propose a cross-Government ministerial group to lead a new strategy on disability and employment, incorporating the Government response to this review, and to track progress on implementation of that strategy.
Government employment programmes
By far the largest proportion of funding for employment support lies in Jobcentre Plus and with Work Programme providers. The Work Programme has been designed to streamline the number of programmes and give people support for their individual needs. It is vital that those with greatest labour market disadvantage benefit fully from the new programme, and tracking will be important to ensure this. It is crucial that there is monitoring of outcomes and transparency by impairment group, qualification level and the length of time people have been out of work. It is important to know whether the Work Programme is working for everyone. 
This review focuses on existing specialist disability employment programmes. We found little logic in the range of programmes that have been developed over the years in terms of what or who they were for. It seems that those with the highest support needs and those who are most disadvantaged in the labour market are not necessarily those using the most specialist programmes: indeed some specialist programmes in effect exclude them, explicitly or implicitly. The programmes are not necessarily based on available evidence (for instance, not all take a work-focused approach). To deliver a strategic set of support this report proposes simplification and improved targeting of the entire system. Long term it would make sense to have just one specialist disability employment programme offering a personal budget to individuals which they could use to purchase employment support, building on the Right to Control. This would run alongside and complement a generalist programme, for example, the Work Programme.
Access to Work – Government’s best-kept secret
“I would never have got to where I am today had it not been for Access to Work.”
(Disabled person)
On specific programmes, there was overwhelming support throughout this review for the Access to Work programme, and the recommendations seek to transform it from Government’s best-kept secret to a recognised passport to successful employment. Access to Work at its best boosts the confidence of both employees and employers. It helped 37,300 people in 2009/10, at an average cost per person of around £2,600. Historically, Access to Work has been rationed by lack of publicity. It is a matter of accident whether an individual or employer has heard of it – and it is under-used by people working in small businesses (who probably need it most) and by those with mental health problems and learning disabilities. This means people needlessly lose their jobs or miss out on getting them.
“I used to run pubs, then I lost my sight. If I’d known about Access to Work I’d have kept my £40,000 job”
(Disabled person)
Experiences like this are often hidden – but must be heard. It is a shocking waste of talent – and money – for individuals to lose employment for lack of knowledge of straightforward support available. The programme needs to be opened up through innovation: by establishing a web portal promoting best practice (especially to those under-using Access to Work), comparing experiences, rating products and services, driving down costs through market scale and reducing assessment costs, supporting independence, boosting peer support and offering expert (including face-to-face) advice where really needed. The Government has acted upon the Coalition Agreement commitment to reform Access to Work so that people can apply for jobs with greater knowledge of their likely entitlement by introducing the pre-employment eligibility letter. This review recommends strengthening this to further increase employee and employer confidence. Medium term, greater investment is needed in Access to Work, as it reaps net benefits to the Exchequer – an estimated return to the Treasury of £1.48 for every £1 invested, with even higher returns to society overall (including improved health and well-being).
Remploy
“I want a proper job. I don’t want to work in a special place for disabled people.”
(Disabled person)
“It would give an odd message if Government were saying disabled people have a great deal to contribute, can work in the mainstream – but we are propping up non-viable businesses to employ them.”
(Disabled person)
In relation to Remploy factories there was a total consensus among disabled people’s organisations and charities that the factories were not the model for the 21st Century, and that Government funding should be invested in effective support for individuals, rather than subsidising factory businesses. The factories employ around 2,800 disabled people, at an annual cost of around £22,700 per person (a total of around £63 million in 2009/10). Workers in the factories and the trade unions representing them strongly supported the employment opportunities they offer and could offer. The cost arises because all factory businesses make a loss, and there is not enough work to go round – around half of factory employees have no work to do. Everyone wanted to suggest ways that change could be taken forward to enable those businesses with real prospects of viability to thrive (potentially as mutuals, owned by the workers, or as social enterprises or co-operatives) and give greater say and empowerment to employees; and where factories are not viable, and cannot continue, to offer very strong protection and support, with effective opportunities for individuals’ employment, wider lives, families and communities. 
Some feared that, without properly planned change, the factories might just wither and die without the time and opportunity to invest in a planned transition; much better to plan ahead to give strong support and protection for individuals in their communities and for those businesses that could be viable, through a big emphasis on partnerships with local businesses, local authorities, community organisations, social enterprises and others. The recommendations include vital protections and support that should be in place to enable a fair and effective transition. The precise details of a transition plan will need to be decided, but this review recommends that employees and management of Enterprise Businesses should be given sufficient time to put forward a business plan to an expert panel. This panel would judge whether the business is capable of being self-supporting, with entrepreneurial support, within a realistic period, with a tapering level of subsidy over that period. Any individuals in businesses not deemed viable should have strong support in place well before transition and continuing afterwards. 
In contrast, Remploy Employment Services are supporting much larger – and increasing – numbers of disabled people, many significantly disabled, into a wide range of jobs. They should be freed from Government control and bid for all DWP funding through commercial contracts, as they already do for a growing proportion of their business. Once this transition is complete, Remploy’s future should be as an organisation independent of Government, focused on supporting disabled people to find and sustain work across the range of roles in the economy. Government funding would be of individuals, not a direct grant to Remploy. In time, after the costs of reform are accounted for (and these are likely, rightly, to be substantial), the resources released can be used to increase funding for Access to Work.
Residential Training Colleges
“It should be available locally.”
(Disabled person)
Residential Training Colleges provide a range of services including adapting to impairment (independent living skills) and vocational courses. Independent living programmes feature multi-disciplinary input and sometimes state of the art facilities. They are highly valued by those attending. The vocational courses, between them, supported 230 people into jobs in 2009-10 at an average cost per job of around £78,000. Views were mixed about the relative value of the employment related provision, and whether this should be directly and separately funded by the Department as a stand-alone programme. Provision tends to focus on longer, residential courses, which for some can create dislocation from employment opportunities at home; and does not demonstrably meet the needs of a broad range of disabled people facing disadvantage – for example, eighty percent of those attending are men. The recommendation is that colleges should offer a more flexible service and, in doing so, broaden their funding base. Rather than receiving funding directly from the Department, colleges should be encouraged to explore funding models from sources in learning, employment, independent living and adaptation to impairment (as some are already doing to good effect). Colleges could subcontract their high-value services to mainstream programmes such as Work Choice and the Work Programme, seek resources from the Skills Funding Agency (which has an obligation to secure reasonable facilities for learners with learning difficulties and/or disabilities) and the health and social care sectors. They could partner mainstream further education providers and diversify and personalise the types and length of course on offer. Colleges should be supported by the Department to make this transition.
Conclusions and core principles
The views of disabled people, other organisations and evidence gathered led to the development of five core principles which drive the recommendations made in this report:
1. 	Employment matters. Work is positive for health, for income, for social status and for relationships. Employment is a core plank of independent living and for many people work is a key part of their identity.
2. 	Public money should be used to deliver the best outcomes – for as many people as possible, on the most equitable basis possible.
3. 	There should be a clear recognition of the role of the individual, the employer and the State in achieving equality for disabled people.
4. 	Disabled people should have choice and control over the support we need to work. Resources and power should be allocated to individuals who, where they wish, have the right to control that resource to achieve agreed outcomes.
5. 	There is a clear role for specialist disability employment expertise – as a resource not a world apart from mainstream support – available to those who demonstrably have the greatest support needs and/or labour market disadvantage, and also to those who support or employ them.
Change is tough and some recommendations in this report will pose real challenges to individuals and organisations. This review specifies at every point that change should happen only with full involvement of everyone affected, offering opportunities for disabled people to have maximum control and leadership. 
The model of employment support needs to change so that it meets disabled people’s aspirations, is based on evidence, is fit for the future and serves far more people than it does today. It is vital to think about what will best meet the aspirations of young disabled people, and people who will become disabled over years to come. Otherwise the next generation of disabled people will still be out of work for lack of good cost effective support and they, their families and the British economy will be the losers.
Summary of recommendations
A new direction
Recommendation 1 
The Department’s disability employment funding should be focused on supporting aspirations for sustainable work and career choices across all types of employment, as for other citizens, in every sector:
•	whether as an employee, entrepreneur, self-employed, or working for a social enterprise, mutual or co-operative;
•	with support to ‘get in’ work – through apprenticeships, internships, work experience, learning on the job programmes and work placements, to ‘stay in’ and to ‘get on’. 
Money should follow the individual so they can work where they choose, rather than the Department funding disability-specific workplaces or facilities. Over time all specialist disability employment support should be made available through individual budgets so individuals can select the support that best meets their needs.
Support should be evidence based which means:
•	a focus on supporting people into and in open employment, with ongoing and flexible support for employee (and employer) where needed to get in, stay in and get on;
•	rapid job search rather than assuming a series of stepping stones are needed first; and
•	rapid support and adjustments to aid job retention.	
	
Access to Work
Recommendation 2 
Access to Work should be transformed from being the best kept secret in Government to being a recognised passport to successful employment, doubling the number of people helped. Government should improve equity of access, use innovation to create efficiencies, remove unnecessary waste and mobilise the power of peer support.	
	
Recommendation 2a 
The Department should make Access to Work available through an internet-based portal that opens up knowledge of support, technology, services and “what works” to employees and employers. Suppliers could compete through the website thereby driving down unit costs and developing the market for disability employment support. The Department should investigate options for the website to operate independently – perhaps being opened up beyond Access to Work users – so that market forces push costs down further. This could work alongside a core advice and assessment service for Access to Work.
Further work will be required to develop the specification, but the portal should deliver:
•	increased choice;
•	improved customer experience; and
•	reduced costs.
The portal might also offer:
•	information on the range of supports, adjustments, and adaptations;
•	on-line peer support, discussion forums and reviews of products and services; and 
•	information on rights and duties of employees and employers.	

Recommendation 2b 
The Department should undertake a targeted information-sharing campaign about Access to Work, concentrated on:
•	growth sectors, to enable disabled people to have a fair chance of securing new jobs as the economy grows;
•	small- and medium-sized enterprises;
•	the professional groups and trade unions who have most contact with disabled people – in particular health and social care staff;
•	BME, learning disability, mental health, neuro-diversity and multiple impairment networks – to reach people who are under-served and/or have low employment rates.
The Department should be transparent about the limited budget and manage it in the most equitable way possible. The campaign should utilise existing structures such as Direct Gov and work in partnership with trade unions, professionals and user-led organisations.	

Recommendation 2c 
The Department should increase employer confidence in employing people with fluctuating conditions by making Access to Work available to part-fund temporary cover for an employee of a small business who is off sick for a significant period of time. Funding might only be available for smaller employers, for prolonged condition-related absences. Individuals should be able to draw down support when required.	

Recommendation 2d 
The Department should increase employer and employee confidence by strengthening the indicative pre-employment Access to Work eligibility, based on work likely to be undertaken, to be finalised once the exact role is known.	

Recommendation 2e 
The Department should train Jobcentre Plus advisers to support and, where necessary, constructively challenge employers, where they are not willing or confident to make adjustments or introduce accessibility features to enable an individual to work successfully. This would help avoid placing the onus for negotiation wholly on the newly employed individual.	

Recommendation 2f 
The Department should strengthen the role Access to Work plays in supporting independent travel where appropriate, engaging with individuals to take advantage of training and confidence-building in public transport or driving. It should then consider time-limiting – in some cases – payments for taxis. However, adequate protections must be in place for people who do need taxis long term to ensure they are not forced to stop using taxis where this would put them at significant disadvantage.	

Recommendation 2g 
The Department should work with user-led organisations to provide services and peer support for people using Access to Work. This could include assessment and delivery – so the process is fully informed by what others have found most helpful.	

Recommendation 2h 
Over the long term the Department should significantly expand funding for Access to Work. This could be achieved by applying the AME-DEL switch principle to release money to invest in the programme in recognition of the benefit savings it generates.	

Recommendation 2i 
The Department should introduce a stronger triage system for Access to Work applicants. People who understand their support needs should not have to go through detailed assessment unless what is asked for is disputed.	

Recommendation 2j 
The Department should ensure Access to Work awards are transferable from one employer to another. Reassessments should be avoided unless necessary, and should take place only if requested by the disabled person or the type of work changes significantly.	

Recommendation 2k 
Government should, longer term, radically simplify assessment, thereby saving time, money and bureaucracy. There should be an aspiration to a single, portable assessment covering employment, health and social support needs as well as benefit entitlement.	

Recommendation 2l 
Government should act as an exemplar in making adjustments. As Access to Work is not available for central Government:
•	government departments should move towards centralising the budget for adjustments to ensure there is no disincentive to employing people with complex adjustment needs;
•	Access to Work advice and assessments should continue to be available to employees and employers in government departments; and
•	government departments should continue to fund adjustments for their employees to a level equivalent to that provided by Access to Work.	

Recommendation 2m 
Government should ensure adjustments are funded for internships, work experience, learning on the job programmes and work placements. This can be through ring-fenced budgets within programmes, plus a ring-fenced budget within Access to Work.	

Remploy
Recommendation 3 
The Department should, by the end of the current Spending Review, have introduced a new model for Remploy, and Government funding should be invested in effective support for individuals, rather than subsidising factory businesses: 
•	Remploy Enterprise Businesses should be given the opportunity – with expert support – to become successful businesses free from Government control.
•	Where this is not an option, and businesses cannot continue, individual employees should be offered guaranteed and active support to secure employment, training, or other community activity.
•	Remploy Employment Services should in future secure Government funds only by competing for contracts like other providers.
(For further details on how the transition process should support businesses and individuals see Chapter 4).	

Recommendation 3a 
The Department should ensure resources released from Remploy reform (after accounting for the costs of reform) are spent on employment support that fits disabled people’s aspirations for work in all types of employment settings.
(For further details on how the transition process should support businesses and individuals see Chapter 4).	

Recommendation 3b 
The Department should ensure existing employees in Remploy Enterprise Businesses are offered the opportunity and expert entrepreneurial and business support over a decent time period to develop businesses into independent enterprises, where viable – whether mutuals, social enterprises, companies limited by guarantee or other models. The Department should actively pursue partnership working between Remploy, local authorities, businesses, disabled people’s organisations and others to achieve this. Trade unions should be fully involved.	

Recommendation 3c 
The Department must ensure disabled individuals working in Remploy Enterprise Businesses which are not potentially financially viable, or who wish to seek open employment, are offered comprehensive support, to be agreed between Remploy, Government, trade unions and employees, to include individual resources for a guaranteed place in Work Choice, Remploy Employment Services or alternative employment support of their choice. Remploy should ensure that practical support for wider family and community life is on offer. There should be support and life planning actively offered at least six months prior to any business change and the package should recognise people’s long-standing work with Remploy. The Department and Remploy should actively pursue links with employers to provide alternative employment opportunities.
(For further details on how the transition process should support businesses and individuals see Chapter 4).	

Recommendation 3d 
The Department should ensure Remploy employees’ accrued pension rights are fully protected.	

Recommendation 3e 
Remploy Employment Services should be freed to operate as a social enterprise, mutual, co-operative or other structure. Taken together with the recommendation for a new model for Remploy Enterprise Businesses, this recommendation envisages that Remploy’s future should be as an organisation independent of Government, focused on supporting disabled people to find and sustain work across the range of roles in the economy.	

Residential Training Colleges
Recommendation 4 
The Department should not directly fund Residential Training as a distinct facilities-based programme. RTCs should be encouraged to seek funding from a range of sources including the Skills Funding Agency, and Work Choice and Work Programme providers funded by the Department. Colleges should be supported by the Department to make this transition.	

Recommendation 4a 
The Department should encourage RTCs to explore options for:
•	developing as centres of excellence and sharing their expertise on accessibility, learning, employment, independent living skills, and adaptation to impairment through partnership working with FE and training providers, the NHS commissioning board and local authorities; and
•	adapting their provision and seeking new opportunities to operate directly in provider markets including:
o	education and training;
o	welfare-to-work;
o	independent living and adaptation to acquired impairments;
o	advising on accessibility; and
o	diversity training and workforce development.	

Recommendation 4b 
The Department should use the budget currently allocated to funding Residential Training to open-up opportunities for work experience, including internships, work placements and on-the-job learning. This could be through ring-fenced funding under Access to Work.	

Work Choice/Work Programme
Recommendation 5 
The Department should commit to ongoing monitoring and continuous review of Work Choice and the Work Programme. This should include:
•	publication of key performance information, including a breakdown by impairment type, qualification level and length of time out of work systematically collected across all the Department’s programmes. It is also important to gain a better understanding of disabled people’s career progression. This should help ensure all disabled people are well served, including people facing greatest labour market disadvantage; 
•	groundwork, using this information, for improved gatekeeping and pricing of different types and levels of support, so that those with the greatest support needs or disadvantage secure greater support. The Department should keep the differential pricing model under continuous review to ensure providers are encouraged to work with the full range of people; 
•	close monitoring of supply chains of prime providers to ensure that specialist organisations are being used effectively; and
•	reviews to ensure that Work Choice meets disabled people’s aspirations and is evidence-based. 
This monitoring will provide information in support of the Public Sector Equality Duty to advance equality of opportunity for disabled people.	

Recommendation 5a 
The Department should, when existing Work Choice contracts expire, cease any specific guarantee of funding to supported business places, so that funding follows people rather than facilities. Learning and evidence should be used to help a transformation to support in viable enterprises or mainstream employment. Any savings should be used to support more individuals through evidence-based support.	

Recommendation 5b 
When existing Work Choice contracts expire, the Department should consider rolling Work Choice funding into individual budgets with Access to Work. This would simplify the system into one general Work Programme and one individual budget-based programme so individuals have a choice over the support that they most need. This would build on learning from the Right to Control trailblazers.	

An enabling state
Recommendation 6 
The Department should make employment of disabled people a cross-government objective with joint ministerial responsibility. A cross-departmental ministerial group, including all departments with responsibilities that impact on employment outcomes, should drive a new cross-Government strategy on disabled people’s employment, incorporating the Government’s response to this review. There should be regular reporting and tracking progress externally on the Cross-Government Strategy. The cross-Government group should work closely with business and disability leaders.	

This review has identified the following as foundations for success for an enabling state:
•	Education, health and social care systems that raise the aspirations of disabled people and their families, and prepare people from day one for a successful transition (or retention) into sustainable employment and career paths. This report encourages Dame Carol Black and David Frost in their Sickness and Absence Review to look at increasing the use of Access to Work to reduce time away from work for people acquiring an impairment.
•	Fair access to all routes into work, including work experience, internships, apprenticeships, university, learning on the job schemes, and support for setting up a business. For example, this review encourages the move towards a portfolio of evidence for apprenticeships to improve accessibility for talented people who have missed out on earlier qualifications.
•	A fair and simple benefits system that means disabled people can be confident that they are always better off in work, including self-employment, and an end to stigmatisation of benefit claimants. 
•	A public sector that leads the way as an exemplar employer of disabled people, and as a major buyer to drive wider improvements through procurement.
•	A robust legal framework to promote equality and prevent unlawful discrimination. 
•	Effective employer engagement (led by employers and employer organisations) that demonstrates the business case, identifies and promotes levers to incentivise employers, and makes it easy to employ disabled people.
•	An accessible transport system which empowers disabled people to access opportunities in the labour market. 
•	Portable social care packages that allow disabled people to move easily into and between jobs without fear of losing care and support.
•	Accessible housing that enables disabled people to have choice over where they live and work – so people can move areas for a job and secure accessible housing with ease.
•	Accessible information and digital inclusion that enables disabled people to make fully informed choices – including accessible on-line recruitment.
•	Recognition of the role and influence of families and those supporting disabled people.	

Chapter 1
The challenge ahead
Aspirations
1.1	Introduction
1.2	The vision
1.3	The principles
1.4	Histories and futures 
1.5	It’s not unusual 
1.6	Government programmes 
1.7	Equality and inequality
1.8	Equality within
1.9	Key messages – Chapter 1

Aspirations
“Disabled people used to be shut away – it used to be like the old psychiatric hospitals – disabled people only working in separate workshops doing mundane work.”
(Health professional)
“I want the same choices as anyone else – to have the career I want.”
(Young disabled person)
1.1	Introduction
In the period after the Second World War many disabled people still lived in large institutions. They worked – if at all – in industrial therapy units inside institutions for little or even no pay. Even in the new post-war therapeutic communities set up by Maxwell Jones “the patients themselves came to see the workshops as part of treatment and will no more expect payment for the work as they would for attending one of the doctor’s groups”.
Where disabled people did hold mainstream jobs they often started their careers before their impairment took significant hold and then hid the impairment where they could: witness Roosevelt’s ‘splendid deception’ in concealing his polio from American voters and Churchill’s reticence about his ‘black dog’ (depression).
Support for wider employment opportunities was in its infancy and included Remploy factories, designed to give returning injured soldiers the opportunity of work experience to equip them for manufacturing jobs. Since then:
•	Large institutions have closed: “Few ought to be in great isolated institutions or clumps of institutions…” (Enoch Powell, 1961). 
•	Disabled people’s employment has gradually increased, from 40.9 per cent at the end of 1998 to 46.8 per cent at the end of 2010.
•	Public attitudes to disabled people have altered. The British Social Attitudes Survey shows that attitudes towards disabled people have improved since 2005 – in 2009 people were more likely to think of disabled people as the same as everybody else (85 per cent compared with 77 per cent in 2005). It is no longer acceptable to society that disabled people should be shut away and assumed automatically incapable of work.
•	More people living with disability or health conditions and in work are open about their impairment, even those in prominent positions – witness Frank Gardner, David Blunkett or Stephen Fry.
This transformation is of course partial. If less than 50 per cent of disabled people of working age are working, then more than 50 per cent are out of work. Those in work often work far below their potential. Young disabled people are twice as likely as young non-disabled people to be not in education, employment or training: 56 per cent of disabled 16–24 year olds, compared with 23 per cent of non-disabled people aged 16–24. Disabled people report that others routinely under-estimate what they can do: 38 per cent of people view disabled people as less productive. 
“They [careers advisers] just talk about what I couldn’t do.”
(Young disabled person)
It is still the case that some disabled people work in sheltered workshops for pay that is far below the minimum wage – even though the work is contracted by companies and forms part of the UK economy. And some people with hidden experiences of disability (especially mental health conditions) still – like Roosevelt – choose to hide their experience where they can, often for fear that if people knew it would affect their career chances. 
The transformation has been sufficient, though, to generate strong aspirations among young disabled people. Disabled children’s aspirations about future employment reflect those of non-disabled children. In this review young disabled people said:
“I want to feel normal – I want to do the same job that anyone else could.”
(Young disabled person)
There are also strong aspirations among people acquiring impairments. People do not want to be consigned to a life of worklessness. This review makes recommendations that could help both young disabled people – and those acquiring impairments at any age – to better meet their employment aspirations.
A number of factors have driven improvements in disabled people’s employment:
•	Disabled people and our organisations have driven a seismic shift in policy and practice, campaigning successfully for anti-discrimination law and pioneering new models of independent living support based on self-determination.
•	Leading employers have recognised the benefits of retaining staff who become disabled and of recruiting talent from the widest pool.
•	Anti-discrimination law and test cases have begun to set out what disabled people should expect: reasonable adjustments at work, and fair chances to work and progress.
•	Developments in technology and knowledge have supported disabled people’s employment opportunities: from the power of voice recognition software or flexible working practices to new evidence showing the types of support that are effective in enabling disabled people to get in, stay in and get on at work.
•	The start of spreading expertise about disability and employment: from a small number of separate disability-specific workplaces to the workplace in general.
•	Employment support has developed. Personalised, tailored support in mainstream employment has helped transform the lives of larger numbers of disabled people.
Further discussion of these factors is in Chapter 5.
This review is concerned with how best to stimulate the next phase of development: a growing transformation of disabled people’s employment opportunities. 
Taking disabled people’s aspirations as its base, the vision below has been tested with disabled people, disabled people’s organisations, charities, providers and a range of other individuals and organisations. The vision is one of equality: a future where having an impairment or health condition is not in itself a barrier to employment.
1.2	The vision
Everyone living with disability or health conditions is able to use their capabilities to the full. 
•	This means equality of opportunity:
o	an equal opportunity to access the full range of roles in the economy;
o	an equal chance to secure new roles as they come on stream through economic growth;
o	the opportunity to keep working when you acquire an impairment or when your impairment changes; and
o	disabled people experiencing fewer barriers to getting in, staying in and getting on in employment, with reduced reports of low expectations, discrimination and fear of discrimination.
•	Leading to greater equality of outcome:
o	a steadily reducing employment gap between disabled and non-disabled people;
o	a steadily reducing employment gap between different impairment groups; and
o	a steadily reducing pay gap between disabled and non-disabled people, and between different impairment groups. 
1.3	The principles
Based on disabled people’s aspirations, the views of different stakeholders and the vision above, five key principles have been developed:
1.	Employment matters. Work is positive for health, for income, for social status and for relationships. For many people work is a key part of their identity. The independent living movement identifies access to employment – as well as education, information and more – as a core principle if disabled people are to live as equal citizens. 
“I feel so much better now I’m working. I don’t know what I’d do if I lost my job.”
“I really enjoy it [working]. I feel like I have a real purpose now. I have choice.”
“Making a contribution is so important for self respect. We should ask – to paraphrase Kennedy – not just what our country can do for disabled people but what disabled people can do for our country.”
(Disability leader)
2.	Public money should be used to deliver the best outcomes – for as many people as possible, on the most equitable basis possible.
3.	There should be a clear recognition of the role of the individual, the employer and the State in achieving equality for disabled people. 
4.	Disabled people should have choice and control over the support we need to work. Resources and power should be allocated to individuals who, where they wish, have the right to control that resource to achieve agreed outcomes.
5.	There is a clear role for specialist disability employment expertise – as a resource not a world apart from mainstream support; available to those who demonstrably have the greatest support needs and labour market disadvantage, and also to those who support or employ them.
1.4	Histories and futures 
Huge progress has been made over the past decades in the drive towards equality for disabled people. Today we have major employers committed to spotting and developing the talents of all individuals – disabled or non-disabled. There are some key examples of good practice in Chapters 2 and 4. 
The proportion of disabled people in work has steadily risen – and has so far stood up during the recent economic downturn. Figure 1.1 shows the employment rate for disabled people (defined under the Equality Act 2010) compared with the overall population. The gap between disabled and non-disabled people’s employment rates has shrunk over the past 12 years – but a significant discrepancy remains. 
Figure 1.1: Disability employment rates

Data is also available on the employment rate for different subgroups within the broad group of disabled people, see Table 1.1.
Table 1.1: Employment rates – 16–64-year-olds Q4 2010
	Employment rate, disabled people
%	Employment rate, not disabled
%	Employment rate, overall
%	
Overall	46.8	76.7	70.8	
Men	49.2	81.6	76.1	
Women	44.7	70.7	65.6	
25–34-year-olds	53.3	82.1	79.1	
55–64-year-olds	36.8	67.7	57.0	
Highest qualification degree level or higher	72.8	86.8	85.3	
No qualifications	17.0	54.9	40.6	
White	47.6	77.9	72.2	
Mixed	49.0	66.6	64.3	
Asian or Asian British	37.2	65.4	61.1	
Black or Black British	44.8	65.2	62.5	
Chinese	51.2	55.9	55.5	
Other ethnic group	27.0	58.3	53.7	
South East	52.2–56.6	79.2	75.2	
Wales	37.2–43.4	75.9	67.6	

There is also notable variation in employment rates across different impairment experiences.
Figure 1.2: Employment rates by impairment type 

Disability is not the only characteristic which causes disadvantage in the labour market. Qualifications, age, gender and ethnicity play an important part. It is often the total effects of more than one characteristic which cause significant disadvantage: for instance, disabled people with low or no qualifications have an employment rate of 17 per cent. These wider factors will be considered in more detail in Chapter 5.
The Government spends millions of pounds in supporting people to get and keep work. It can be difficult sometimes to understand the scale of spending, when dealing with figures in the millions and billions. Figure 1.3 compares some key Government spending relating to the employment of disabled people. It is worth remembering, when looking at Figure 1.3, that disabled people make up 18 per cent of the working-age population.
Figure 1.3: Benefit and employment support expenditure 

In total, Government spends over 20 times more on disability out-of-work benefits than on disability employment support (£7 billion compared with around £330 million). Figure 1.3 shows graphically the relatively small role disability employment programmes play. This raises important questions: might it be more effective to spend more on disability employment support in order to help more disabled people into work, thereby reducing the need for out-of-work benefits? This is explored further in Chapter 4.
In an age of increasing austerity it is more important than ever that the money available is spent as effectively as possible to support those who most need help to play an active role in the labour market. The Government and all the main political parties are committed to supporting disabled people into sustainable employment:
The Organisation for Economic Co-operation and Development (OECD) has produced a number of reports looking at how disabled people fare across its member countries. 

Table 1.2: Employment rates 20–64-year-olds, late 2000s 
	Employment rate	
	Disabled
%	Non-disabled
%	Ratio	
Sweden	62.3	83.9	0.74	
Iceland	61.3	86.4	0.71	
Estonia	55.8	82.2	0.68	
Mexico	55.4	66.8	0.83	
Switzerland	54.9	85.5	0.64	
Denmark	52.3	81.6	0.64	
Luxembourg	50.4	71.3	0.71	
Germany	50.4	73.7	0.68	
Portugal	47.9	75.4	0.63	
Canada	46.9	79.0	0.59	
France	45.8	71.8	0.64	
UK	45.3	81.4	0.56	
Korea	44.7	70.3	0.64	
Norway	44.7	83.4	0.54	
Netherlands	44.5	80.5	0.55	
Austria	43.9	70.8	0.62	
Finland	43.5	76.8	0.57	
Slovenia	41.3	69.7	0.59	
Slovakia	41.1	74.0	0.56	
Italy	40.7	63.7	0.64	
Australia	39.8	79.4	0.50	
United States	38.5	83.9	0.46	
Belgium	36.3	71.5	0.51	
Spain	35.7	71.1	0.50	
Czech Republic	35.0	73.1	0.48	
Greece	34.2	67.0	0.51	
Ireland	32.9	72.7	0.45	
Hungary	31.7	71.3	0.44	
Poland	17.6	62.1	0.28	

This data suggests that the UK is in a reasonable position compared with its international counterparts – but there is further to go, both in absolute terms and compared with a number of other countries. 
1.5	It’s not unusual 
Figure 1.4: Working-age population 

The pool of talented disabled people is not a small one: over seven million people, or 18 per cent of the working-age population. Disabled people, as defined by the Equality Act 2010, include people with a wide range of impairments and challenges – from people with a visual impairment, to those with a mental health condition, cancer or learning disability. 
Disability touches everyone. The vast majority of people will, if they are not disabled themselves, have friends, colleagues or relatives who are – people who are disabled by the world around them and who may need an adjustment or support to make their full contribution to society. And most of us become disabled as we age. Around half the working-age disabled population – over 3.5 million people – are out of work – a significant waste of talent and potential productivity.
Figure 1.5 indicates the relative size of the group of people claiming health or disability-related out-of-work benefits compared with the entire Great Britain (GB) population.
Figure 1.5: Employment and Support Allowance claimant population –  mid 2009 

The majority of disabled people are not claiming an out-of-work benefit. By no means will all those claiming working-age health and disability out-of-work benefits (Employment and Support Allowance (ESA)/IB/Severe Disablement Allowance (SDA)) be disabled – many claims are due to temporary illness or injury – so the proportion of disabled people who rely on an out-of-work benefit is even smaller than suggested by Figure 1.5. 
1.6	Government programmes 
“There are lots of different programmes but seemingly little logic in what and who each one is for.” 
(A provider of employment services)
Many people expressed views such as this during the consultation for this review. The review found no clear logic in the historical spectrum of support, from the more general programmes (like Access to Work) to the more specialist, in terms of target group. This has confirmed a need for a more strategic and simplified approach to this policy area. The support on offer should be simple to understand and access – for individuals and employers.
Most disabled people who use one of the Department’s employment programmes will get existing support either from Jobcentre Plus or the Work Programme. The more specialist programmes run alongside this mainstream provision. Table 1.3 gives some idea of the relative scale of the specialist programmes which the Department currently operates. 

Table 1.3: The Department’s employment programmes
Programme	Number of disabled people entering or remaining in employment (2009/10)	
Access to Work	37,300	
Work Choice (projected)	9,000	
Remploy Employment Services	7,500	
Remploy Enterprise Business	2,800	
Residential Training Colleges	230	

Between 2010/11 and 2014/15 it is expected that Work Choice contracted provision will support 45,000 people into work at a cost of £470 million. Remploy grant-in-aid Work Choice provision is additional to this.
As shown earlier in this chapter, expenditure on employment programmes is very small compared with expenditure on benefits. The ‘per job’ expenditure varies widely across the different programmes. This is not necessarily a bad thing – there is some excellent practice in some of the more expensive provision which should be harnessed and built upon. However, the per job cost of around £78,000 for someone on the Residential Training programme compares starkly with an average spend on each Access to Work customer a year of around £2,600 – and an average award of around £1,800. This suggests a case for examining whether the total funding pot is being used in the most effective way to support disabled people on the most equitable basis.
It might be expected that the more costly programmes support people with the greatest labour market disadvantage or highest support needs. There seems to be little evidence that this is the case. 
1.7	Equality and inequality
The aspiration is a future of equality: where having an impairment is not in itself a barrier to employment and disabled people can use our capabilities to the full. It is important to specify measures of progress, in order to establish whether the action taken has affected real change.
The standard measure which the Department has used to look at the effectiveness of support provided to disabled people has been the employment rate of people who are disabled as defined by the Equality Act 2010.
This is vital. However, the vision of equality of opportunity may not be measured solely by the gap closing. Additional measures could include disabled people’s perceived restrictions on employment and their experiences and fears of discrimination. Progress could also be measured by monitoring the changing practices and policies of employers.
Further, a job – any job – is not enough. Indicators looking at the pay and seniority gaps between disabled and non-disabled people will help provide more relevant information to establish progress. 
Once in employment, disabled people are less likely to progress to senior roles. While there is a pool of senior people with significant and long-standing impairments, non-disabled people are three times more likely than disabled people to earn over £80,000 a year, and twice as likely to work at director level. There is a pronounced disability pay gap, compounded by a gender pay gap. Recent research has found that when compared to non-disabled men, disabled men have a pay gap of 11 per cent and disabled women have a pay gap of 22 per cent.
None of these inequalities is inevitable. Removing barriers and raising aspirations can result in real changes – as the rise in the disability employment rates over the last decade has demonstrated.
1.8	Equality within
We have also seen that there is significant inequality within the overall group of disabled people. People with learning disabilities or mental health problems have much lower employment rates than other disabled people, as do disabled people from Bangladeshi and some other black and minority ethnic communities. Disabled people without qualifications face particular challenges in the labour market. Young disabled people in their early 20s are twice as likely to be NEET (not in education, employment or training) as their non-disabled peers. There are also real differences in life experience between people who are disabled from birth or early childhood, and those who acquire an impairment or health condition later; and between those whose impairment is stable, or fluctuates, or gradually worsens. Employers, for example, find it more challenging to employ people with fluctuating conditions, and this review seeks to address this and other differences of experience. 
The headline measure of the different experiences of disabled and non-disabled people can sometimes distract from the inequalities within the disabled population. It is important that Government support is designed to ensure an equitable distribution of support across the various challenges that disabled people face. Figure 1.6 gives an idea of some of the variations within the current system of specialist disability employment support.

Figure 1.6: IB/SDA/ESA claimants impairment breakdown – 2009/10

Figure 1.7: Access to Work impairment breakdown – 2009/10

Figure 1.6 highlights the differences between those who might need employment support and those that receive it. Government should ensure that people facing the greatest labour market disadvantages are not further disadvantaged by the level of support from employment programmes. 
There are also disparities between the gender and ethnicity breakdowns of ESA claimants and those who are using the Department’s employment programmes, as shown in Table 1.4. 
Table 1.4: Residential Training College and Access to Work breakdowns 
	Working-age ESA/IB/SDA claimants
%	Access to Work people helped in 2009/10
%	Residential Training customers 2009/10
%	
Male	56	39	84	
Female	44	61	16	
White	94	90	95	
Ethnic minorities	6	10	5	
In order to ensure that Government policy supports the move towards equality and addresses the challenges faced by disabled people in the labour market, it is important to explore levers for change. Chapter 2 sets out key drivers that should be considered to achieve the vision.
1.9	Key messages – Chapter 1
•	Young disabled people have the same aspirations as their non-disabled peers, to work in every sector and in every type of role; and people acquiring impairments have strong aspirations to keep employment.
•	The employment position of disabled people has improved in recent years, but disabled people still face significant disadvantage. All the following groups have employment rates under 25 per cent: disabled people with no qualifications, people with serious mental health problems, and people with learning disabilities.
•	There is little logic to the current set of specialist disability employment programmes in terms of who and what they are for.
•	Government spends far more on disability out-of-work benefits than on employment support for disabled people. 
•	Funding for specialist disability employment support is vital to the ambition that more disabled people gain sustainable employment and it should be spent in the most effective way to maximise the number of disabled people who can be helped, in the most equitable way possible.	

Chapter 2
Opportunities and drivers
Achieving the vision
2.1	Looking ahead	
2.2	Jobs for the future
2.3	Equal access across the spectrum	
2.4	Harnessing talent	
2.5	Confident employees – confident employers	
2.6	Evidence-based support	
2.7 	A new direction	
2.8	Key messages – Chapter 2

Achieving the vision
At the age of 16, disabled people have the same aspirations as non-disabled young people; but by the age of 26 their aspirations have diverged, with young disabled people being less confident of the strengths they bring to the labour market, and three times more likely to agree that “Whatever I do has no real effect on what happens to me”. Morris (1999) found that young people with complex health and support needs had very similar aspirations to young people in general – they wanted to be able to choose to live independently when they felt ready, to socialise with their friends, and to do something useful. But in practice many were at risk of moving into institutional accommodation, losing contact with friends, and had low educational achievements which would put them at a significant disadvantage in the labour market.
This chapter looks at current and future opportunities and drivers that will make it possible to close the gap between aspiration and reality.
2.1	Looking ahead
A future strategy for employment support must reflect the future demands of the economy and future ways of working. In the course of this review some people have argued that support for disabled people’s employment is fruitless in the current climate when jobs are in short supply. This view must be challenged. In past recessions hundreds of thousands of disabled people living with disability or health conditions were consigned to long-term worklessness and poverty. There was a lack of preparation and planning to help people take up new opportunities as the recovery began, whether as entrepreneurs or employees. Attention must be paid to the demand for labour as well as the supply of potential employees: this is further considered below. But this is precisely the time to develop a strategy to empower disabled people to seize new opportunities when they come on stream and to enable employers to retain and take on disadvantaged people.
2.2	Jobs for the future
While the available projections suggest slower change in occupational structures than in previous decades, there is some reason to think that there will be an expansion in higher-skilled occupations. At the other end of the skills spectrum, elementary jobs are projected as falling only slowly – which resembles an international trend of higher skilled and low skilled jobs increasing at the expense of mid-range jobs. 
•	Manufacturing employment is projected as continuing to decline, along with the primary and utilities sector. 
•	Employment in distribution and transport and allied sectors will continue to grow, as will business services and non-marketed services.
•	Recent growth in the knowledge economy is set to increase, in line with expansion of higher education and a more highly educated workforce.
Some particular sectors are set to grow, including hospitality, health and social work, and retail. It is particularly important that support for disabled people and employers is available in growth sectors, where job opportunities are likely to be greatest; and that any structural barriers in the sector are removed (like over-cautious approaches to health and safety that debar disabled people unfairly from particular health and social care professions). 
The nature of the modern workplace – with increased technological advances, home working, and diverse employment patterns – could at best provide particularly fruitful opportunities for disabled people. Challenging stereotypes of traditional jobs should help to encourage more flexible working patterns and improve opportunities for everyone. At worst, inaccessible technology could lock some disabled people out of new opportunities (at the most basic, many on-line recruitment drives are completely inaccessible to people using screen readers). This could present an argument for focusing effort to employ disabled people in growth areas of the economy which are likely to make extensive use of flexible practices and technology, on the proviso that technology is designed with accessibility in mind and liberates rather than imprisons disabled people.
Contemporary careers in the modern labour market are characterised by frequent occupational changes, sometimes in the form of a succession of short-term contracts or portfolio careers. Young people of today do not expect to have a job for life.
The expected greater flexibility of the future work place could increase opportunities for some disabled people. Others, especially those who find change and multi-tasking difficult, may thrive more in a traditional longer-term job. UKCES projections suggest that part-time working among men will continue to grow across the period to 2017. Some disabled people opt to work part-time in order to manage energy or concentration levels, treatment effects, inaccessible transport or other disability-related issues. Some fulfil roles they can deliver with great flexibility to suit a fluctuating condition (for instance, door-to-door delivery, where the work can be done at different times of the day and week as long as core outcomes are achieved).
It is also important to consider the spatial dimension of future changes in the labour market, particularly in terms of the pace and consistency of the economic recovery. In the short term there is an expectation that areas heavily reliant upon public sector employment will experience tightened and highly competitive local labour markets and will require private sector growth to fill the gap. Labour mobility could be an important factor in accessing jobs for the future. This means it is important that disabled people are able to move for jobs, which will only be possible with portability of employment support and continued access to social care and accessible housing if required. 
2.3	Equal access across the spectrum
The UN Convention on the Rights of Persons with Disabilities includes the right to “the opportunity to gain a living by work freely chosen or accepted in a labour market and work environment that is open, inclusive, and accessible to persons with disabilities”. Opportunities vary significantly in terms of working patterns, location, sector, industry, occupation, and type and size of business. To reflect the full range of skills, experiences, talent and aspirations of disabled people support must be available for all types of employment in the modern economy. This must include self employment.
Table 2.1: Employment by sector – 16–64 year-olds Q4 2010 
Sector	DDA
disabled
%	Not DDA disabled
%	
Agriculture and fishing	1.4	1.5	
Energy and water	1.1	1.2	
Manufacturing	9.5	10.9	
Construction	6.4	7.6	
Distribution, hotels and restaurants	19.0	19.1	
Transport and communication	6.5	6.2	
Banking, finance and insurance etc	15.3	17.5	
Public administration, education and health	34.5	29.8	
Other services	6.3	6.2	
Total	100.0	100.0	

Figure 2.1: Disabled people working in the UK 

The vast majority of disabled people in work are in mainstream employment, and almost half of disabled employees work in workplaces with fewer than 50 people. 
Self-employment can give disabled people the opportunity to adapt their working environment in a way that best suits them. A slightly higher percentage of disabled people are self-employed than non-disabled people, 14 per cent of the disabled workforce compared to 13 per cent of the non-disabled workforce; and small businesses, including sole traders, are growth sectors. Disabled entrepreneurs have led developments in which disability is irrelevant, or central (for instance, sole traders running well-being training or developing technological innovations, like smartphone applications that could guide everything from wheelchair movement to actions in the home). They are supported by organisations such as UnLtd and require flexibilities in financing and benefit systems to support initiative. 
There are also employment opportunities for disabled people in alternative business models, such as mutuals, co-operatives, social enterprises and social firms. These models can be particularly attractive to people disadvantaged in the labour market, such as disabled people, but must be viewed as an option for disabled people to choose, rather than the default expectation or ‘solution’ for disabled people. Alternative business structures offer potentially exciting and innovative opportunities for disabled people, and can at their best offer exemplary accessibility and support, but given the scale of this sector, any future growth is unlikely to have any significant impact on disabled people’s employment overall. Social enterprises can also, like any small business, be fragile and do not always offer secure employment. 
Alternative business structures
Social enterprises – Social enterprises are socially-driven organisations which apply market-based strategies to achieve a social purpose. The movement is broad and can include both not-for-profit business models to pursue their mission and profit-making organisations whose primary purposes are social. They generally exist to solve a social problem or to correct a market failure. The word social is key: many commercial businesses consider themselves to have social objectives, but social enterprises are distinctive because of the core emphasis that is placed on social outcomes. There are 62,000 social enterprises in the UK, contributing over £24 billion to the economy, employing approximately 800,000 people.
Social firms – Social firms are one type of social enterprise. The specific purpose of social firms is to create jobs for people who find it hardest to get them. A social firm is a market-led enterprise set up specifically to create good quality jobs for people disadvantaged in the labour market. The Star quality assurance system set up by Social Firms UK requires that employees are paid at least the minimum wage. An ‘emerging social firm’ is an enterprise that is working towards becoming a social firm, usually in the early stages of trading; emerging social firms may operate by employing unpaid disabled trainees and volunteers. The number of social firms is much smaller. A recent mapping study identified 99 social firms, employing just over 1000 severely disadvantaged people in total; and 82 emerging social firms, employing just under 200 severely disadvantaged people between them. 
Co-operatives – Co-operatives are a form of social enterprise. According to the International Co-operative Alliance, a co-operative is an autonomous association of people united to meet their common economic, social, and cultural needs and aspirations through a jointly-owned and democratically-controlled enterprise. Co-operatives are based on the values of self-help, self-responsibility, democracy, equality, equity and solidarity. In the tradition of their founders, co-operative members believe in the ethical values of honesty, openness, social responsibility and caring for others.	

Supported businesses are businesses where more than 50 per cent of the workers are disabled people who by reason of the nature or severity of their disability, are thought unable to take up work in the open labour market. Sheltered work is similar, but workers are typically not paid the minimum wage: sheltered work takes place in workshops where work is considered ‘therapeutic’ and proper wages are not available. Both are often in a protected employment environment. Many – including Remploy – emerged in the 1940s to provide an opportunity for disabled people to get out of the house and gain work experience. Supported businesses are very different from supported employment, which provides support in jobs in the open labour market. A relatively small number of disabled people are in supported businesses; fewer than 6,000 disabled people are in supported business places funded by central Government. There are some places within other supported businesses that are not funded by central Government, but there exists no official estimate for the number of disabled employees. In addition to Remploy factories there are around 80 supported businesses in the UK. 
2.4	Harnessing talent
Increasing the employment rate for disabled people is important for productivity as well as equity. In 2007 a paper produced by the Social Market Foundation (SMF) presented a clear case for action to improve skills and employment for disabled people. Their analysis suggested that closing the employment rate gap between disabled and non-disabled people would boost economic growth by £13 billion. 
Businesses are increasingly concerned with high-performance working practices, given the competitive advantage of high productivity and evidence that the UK currently lags behind some countries. Employers have increasingly recognised the need to focus on wider workforce well-being to create high-performance workplaces and increase productivity. 
Research commissioned for Dame Carol Black’s review found considerable evidence that health and well-being programmes produced economic benefits in all sorts of firms. The same factors that generate well-being for all – from employee engagement to regular management feedback and flexible working – help disabled people perform to our best. Given the rising prevalence of disability in the labour force, labour productivity will clearly be enhanced if improvements in health at work, job retention and access to jobs are mainstreamed.
“The fact is that if Lloyds Banking Group is not able to attract, recruit and retain people with disabilities as employees then we are missing out on an enormous talent pool to the detriment of both our business and society as a whole. The business case is clear and we are making disability an integral aspect of our organisation by minimising barriers in recruitment and providing disabled colleagues with a simple ‘one stop shop’ process for obtaining workplace adjustments.” 
(Graeme Whippy, Group Disability Programme, Lloyds Banking Group)
There are numerous examples of businesses which have used innovative approaches and alternative structures to meet the needs and aspirations of their employees or potential employees.
BBC ‘Extend’ Scheme
The BBC run a disability work placement scheme – Extend – exclusively for disabled people, which aims to increase representation in the organisation. This scheme offers appropriately experienced and/or qualified disabled people a great opportunity to gain six months paid work placements within the BBC. In addition to developing experience and skills related to the job, participants are supported with coaching and career development workshops. Although there is no guarantee of a full-time job at the end of the placement, 70 per cent of Extendees in 2009/10 progressed into further work at the BBC. Andy Page came out of the RAF in 2007 after 22 years when he was diagnosed with multiple sclerosis. Andy went back to college to retrain in accountancy: in 2009 he completed his Extend placement and is still working in the BBC Programme Finance Team in Cardiff.
“We value Extend highly – not only does it provide a clear route into the BBC for talented and aspiring disabled people, its success rate in terms of the numbers of participants who progress into BBC jobs remains consistently high. It also serves as a clear signal, to prospective employees, of our commitment to increasing disabled staff representation.” 
(Amanda Rice, Head of Diversity – BBC)	

Holiday Inn
Holiday Inn aim to provide sustainable job opportunities for disabled people. Holiday Inn Edinburgh works in association with the Royal National Institute of Blind People, Remploy and Jobcentre Plus to organise open recruitment days to identify suitable disabled candidates who are given pre-employment training on-site, with a mixture of temporary and permanent roles on offer. 
In January 2006 Robert McPherson was recruited onto the Sustainable Work programme. Robert had very low confidence levels when he first started, which improved so much that he went to Holiday Inn Bloomsbury to meet the Senior Management team to help them learn from the Edinburgh experience and encourage them to organise a similar recruitment day. Robert has now been employed at the hotel for over five years. Holiday Inn have won a number of awards in recognition of their work in recruiting disabled people.
“Whilst winning awards is very satisfying, the changes we experienced within the team are even more satisfying. As a result of this initiative we have seen a massive improvement to the hotel profile within the local business community.” 
(Christopher Rawstron, InterContinental Hotels Group)	

Project Search 
The Project Search model has been adopted by 14 (mainly public sector) employers across England to offer people with learning disabilities the opportunity to move beyond the mundane work usually assigned to them – clearing tables, moving shopping trolleys – and instead trains them in more complex, but routine, tasks, such as assembling medical equipment. Individuals learn different roles, in rotation. The approach requires the employer to ‘carve’ jobs in new ways so the individual has one essential job, that they learn thoroughly, and offers support to both employee and employer, alongside training. 
The initiative is still young in the UK and formal evaluation evidence is not yet available, but the four sites that have been running for over one year report that they have successfully supported people into employment and are saving money in recruitment costs. The Employers’ Forum on Disability aims to involve five private sector companies in adopting the approach, so it may be set to grow.	

These positive developments show how ordinary working environments and practices can be adjusted – from active recruitment approaches to job carving – so that disabled people, including people with significant impairments and challenges, can participate. Today’s innovations in recruiting and retaining disabled people need to be encouraged and mainstreamed.
2.5	Confident employees – confident employers
For disabled people this means having the confidence to pursue your aspirations – spotting opportunities, applying for jobs, navigating your way through advice and support, finding the support or equipment that works for you, planning next career moves, seeking training and development – or simply keeping your job if you acquire an impairment or health condition. It also means being confident that fair recruitment and promotion processes will be in place, selecting on grounds of merit, with necessary adaptations and support put in place quickly. This is not just about getting into work, but having confidence in the culture at work – feeling that if you talk to an employer about a need for support or adjustments, or about a health condition that may affect you at work, that this will not result in quiet or overt prejudice, or in a well-meaning offer of early retirement when what you want is to continue at work. This is particularly important where a condition degenerates or disability is acquired while in work. The majority of people experience the onset of disability during adulthood and, within a year of becoming disabled, 35 per cent of single adults who were in employment have left employment, as have 22 per cent of individuals in two-adult households.
“I wouldn’t tell them that I have disabilities because I have no trust that I would have a chance to get through to the organisation.” 
(Individual with Asperger syndrome)
“We are really disadvantaged when going up against able bodied applicants who will not cost additional sums to employ and who will not take as much time to set up.” 
(Disabled newly qualified teacher)
For employers this means being confident that their recruitment processes are efficient in attracting the best candidates, and knowing that advice and support will be available quickly if they encounter any issues – this is a great confidence booster to taking on people with more complex challenges, including fluctuating mental and physical health conditions. Ongoing advice and support for employers and their wider workforce, and support when employees acquire impairments are also helpful. 
At present there can often be fear on both sides: fear for the disabled person – ”what if it doesn’t work out – if I fail at this?”, “will I be worse off than on benefits?” and fear for the employer – “what if I don’t know how to do this properly, I feel embarrassed”, “what if I get it wrong and it ends in a tribunal?”. Employment programmes should be geared to reducing these fears and increasing confidence.
Confidence is linked to information. Giving individuals and employers high-quality information can be incredibly empowering; better informed individuals and employers can be more confident in their choices. The recent UKCES Review of Employment and Skills identifies coherent information as the first of four priority areas for action, and the report recommended using performance information as a catalyst to empower individuals, employers and communities to hold local partners to account, enable informed decision making, and drive performance improvement. Confidence is important for individuals who are increasingly expected to take more responsibility.
“We are dealing with decades of disempowerment. We’ve created cultures where disabled people are scared to take any responsibility, for fear of losing what little power and control they’ve managed to secure.” 
(Baroness Jane Campbell)
“Most employers are still clueless about how to make adjustments in a way that maximises individual productivity.” 
(Stephen Bevan, Managing Director, The Work Foundation)
“Most SMEs are still terrified of being lumbered with additional costs if they employ a disabled person. What we need is hard facts to demonstrate that this simply isn’t true. Access to Work is there to support employers to keep disabled people at work, and take more disabled people on. We need greater awareness of Access to Work amongst SMEs, this would enable more small employers to see for themselves that disabled people are an asset, rather than a liability.” 
(Dr Nasser Siabi, Chief Executive, Microlink)
A number of stakeholders report that the existing information on adjustments, supports, and technology to enable disabled people to work is patchy and hard to access. Access to Work has been described as Government’s best kept secret – some disabled people find out by sheer chance about approaches that may help, others never do. Information and advice from people with similar experience to your own is known to be immensely powerful: this can encourage you to try work or a career direction, it can empower you to ask for the support worker or technology you really need. 
Confident employees – and job seekers – should have access to peer-based advice and experiences, and a highly accessible system enabling them to choose from a menu of support tailored to their specific requirements. One stakeholder suggested that equipping individuals to be strong self-advocates on adjustments can be a powerful determinant of whether individuals are able to get in, or stay in, work. Accurate and impartial information on the effectiveness of provision on offer – plus ratings by other users, as on many ‘compare’ websites – would empower individuals to take responsibility and make decisions about their own package of support in the context of their employment plans. Good information on whether they will be better off in work – i.e. benefits advice – is also important. With this blend of advice and support available, job seekers are more likely to ‘jump’ from benefits into employment – or from a safe job to a new opportunity. 
Employers must be seen as equal customers of all employment support programmes. Employers, like disabled people, need to access excellent information and advice when they need it, and learn from the experiences of other employers.
Employment support must make it as easy as possible for employers to employ disabled people. This means that employers must know where to go for help, and support should be delivered quickly and with as little cost to employers as possible. If programmes place heavy bureaucratic burdens on employers, this will act as a disincentive.
“The time taken to deliver reasonable adjustments was taking in excess of 87 days. A number of employment tribunals were lost on the grounds of failure to provide adequate reasonable adjustments. Disabled colleagues were not getting consistent support across the business. The process of Access to Work had to be improved.” 
(Kay Allen, Royal Mail Group)
Many disability organisations have an ambition to influence employer attitudes – to increase their willingness to take on disabled employees. Evidence suggests that the most powerful way to influence attitudes is through personal contact, on at least equal terms; and that what influences employers’ willingness most is having previously employed a disabled person. Employers do not seek generalised awareness campaigns, but the knowledge that if they need advice or support with a particular employee or a particular challenge, it is there. With that knowledge, employers are more likely to ‘jump’ – to take the risk (as they see it) of retaining or employing a disabled person. 
Enlightened employers argue that there should be no need to pressure employers to employ disabled people on corporate social responsibility grounds, but rather to simply spell out the business case for employing disabled people and dispel myths about the costs and difficulty involved.
The business case is simple: employing disabled people can lead to better business performance through accessing untapped reserves of talent, new sources of ideas, creativity and problem-solving, and new business from disabled customers, their families and friends from opening up new markets and enhanced reputation and loyalty. Although there is some evidence to back up the business case, many employers are not aware of these benefits. It is helpful to tailor the business cases to different types of employers.
Recent evidence has shown that many employers were willing but did not know how to change policies and procedures to remove barriers for disabled people, and did not have the disability competence needed to make adjustments which enable people to work. 
Support for employers is not restricted to line managers or Human Resources departments; there is a role for wider workforce support. Diversity training at work can be part of adjusting the workplace environment to increase understanding and awareness of colleagues and make disabled people more confident at work.
Support needs may vary according to the size of employer, and the nature of their business. Small- and medium-sized enterprises are unlikely to have a central HR function and may need intensive support, while larger employers may prefer to manage support themselves with little interaction with the State or providers. 
Stakeholders have made strong representations on the value of peer support which is seen as vital in instilling confidence in disabled people looking for work, disabled people in work, and to employers. A good system must seek to foster and encourage peer support throughout. The voice, knowledge and experience of other disabled people can inspire individuals living with disability and provide helpful guidance on different approaches and real examples of what has worked for others. Disabled people and Jobcentre Plus staff gave an overwhelmingly positive response when RADAR piloted the distribution of its Doing Work Differently publication which was written by disabled people, for disabled people, drawing together invaluable knowledge and experience in getting and keeping a job. 
St Giles Trust Peer Advice Project
The Peer Advice Project is a scheme run in prisons and local communities. Serving prisoners and ex-offenders are trained to advise other inmates on housing and employment issues, mental health and drug dependency problems, and to offer support and counselling.
The project was developed as a peer-led intervention focused on practical support and guidance, and the persuasiveness for offenders to fully engage with the service coming from other prisoners and ex/offenders themselves. Clients of the peer advisors gain the benefit of being supported by someone who has direct, first-hand experience of the issues they are facing. As ex-offenders themselves, peer advisors have similar life experiences that generate greater understanding and empathy.	

Recent examples of innovative social media and web developments have shown the power of on-line stories to encourage people to take the next jump in their move into or through employment. Such examples include an online resource with videos and written articles from a wide range of people talking about what they do, what it’s like, and how they got there; or horsesmouth.co.uk the on-line social network for informal mentoring.
2.6	Evidence-based support
Disabled people are not a homogenous group, and employment support must recognise: the varying needs of people with acquired or long-standing impairments, fluctuating or stable conditions; the different types of employers and business structures; and the different jobs available. To maximise the number of disabled people achieving their potential, support must reflect the best available evidence on what works.
There is considerable evidence available on the effectiveness of specific programmes, and although the evidence base does not provide definitive answers on the most effective types of support overall, it does provide some strong common themes across the needs of different groups of disabled people. There are messages on ‘what works’ that are highly relevant for Government-funded disability employment programmes.
There are certain models that have been shown to work for certain groups, based on a solid evidence base. For example, evidence suggests that supported employment is successful in placing people with learning difficulties into paid jobs and achieves better outcomes than sheltered alternatives. Evidence from Lanarkshire shows significantly improved employment rates and savings to the taxpayer. Supported employment is sometimes known as the ‘place, train and maintain’ model of vocational rehabilitation. In this model a job is considered a necessary first step rather than an end-point. The key stages of the supported employment process include: vocational profiling, job finding, job analysis and placement, and job training and follow-up.
“The research literature shows that, at many outcome levels, supported employment can deliver good jobs for disabled people and good workers for ordinary employers. Increasingly, ‘special’ in vocational rehabilitation and training should mean greater differentiation in the support we give individuals to help them fulfil their potential and to level the playing field for local economic inclusion. This is especially true of people with learning disabilities who benefit least from pre-vocational qualification training and most from skilled, time-limited training on the job.” 
(Dr Stephen Beyer, Cardiff University, Welsh Centre for Learning Disabilities)
There is substantial evidence to suggest that the Individual Placement and Support (IPS) model is more effective than traditional approaches to vocational rehabilitation for people with a mental health condition. The IPS model involves embedding employment specialists within clinical treatment teams so that clinical treatment and employment support are integrated and, importantly, simultaneous (help with employment starts from day one rather than waiting for someone to be successfully treated: the longer the wait, the less the chance of retaining or gaining employment). Similarly to supported employment for people with learning disabilities, IPS focuses on obtaining appropriate open, competitive employment from the start, then provides support as long as necessary for the individual to be successful in work. There are seven key principles of the IPS approach:
1.	Competitive employment is the primary goal.
2.	Everyone who wants it is eligible for employment support.
3.	Job search is consistent with individual preferences (in other words, people are more likely to succeed if they pursue a job that interests them).
4.	Job search is rapid: within one month.
5.	Employment specialists and clinical teams work and are located together. 
6.	Support is time-unlimited and individualised to both the employer and employee.
7.	Welfare benefits counselling supports the person through the transition from benefits to work.
“The research evidence is clear – for people of working age with severe or enduring mental ill health who want paid employment (which surveys suggest is most of them) Individual Placement and Support (IPS) is the most effective model if correctly applied.” 
(Professor Bob Grove, Centre for Mental Health)
Literature on IPS shows that with this evidence-based support, people with long-term, serious mental health problems can get and keep all kinds of roles, in many sectors. Miles Rinaldi et al. in Not Just Stacking Shelves shows how people with difficulties like schizophrenia, bi-polar disorder and serious depression have been supported with IPS to work in jobs including boatyard worker, events manager, administrator, labourer, teaching assistant, leaflet dropper, baker, interior designer, credit controller, bar worker, accountant, journalist – and many more. This fits the aspirations of disabled people described in Chapter 1 – the chance to work in every sector, every role, as other citizens. 
Through stakeholder discussions and the call for evidence for this review, there has been strong support for the importance of an early and continuing focus on ‘real jobs’, with many advocating the value of work placements and internships in overcoming barriers for both potential employees and employers (in preference to pre-employment training and preparation outside the workplace), and highlighting effective employer engagement as an important key element of successful support. Mentoring, buddying and peer support have proved particularly helpful as people start employment. Stakeholders argued that there are commonalities across groups disadvantaged in the labour market, including disabled people with different impairment experiences and also people experiencing homelessness, drug or alcohol problems, or with a history of offending. It seems that, although the specific interventions required may differ (someone with a learning disability may need systematic instruction, a deaf person usually does not; someone with a learning disability may need a job coach at work, someone with a recently acquired visual impairment might find that unnecessary and intrusive), the same principles apply. In particular, focusing quickly on searching for work and having access to learning, mentoring and buddying in the role tends to work better than prolonged preparatory activity outside the workplace. 
“The evidence is clear. Sheltered work is generally a concept of the past. It has been superseded by supported employment…Work-place training/rehabilitation is a more reliable way to help people with back pain, psychiatric problems and some other experiences to get employment than other training models.” 
(Dr Andrew Frank, Vocational Rehabilitation Association)
Some stakeholders have suggested that some disabled people may need more time or more long-lasting support to move into work. Some talk about the need for pre-employment support to help to get people ‘ready’ to think about work. This review is not convinced that it is possible, desirable, or fair to make judgments about the length of time and intensity of support required to help individuals move into work; nor that a ‘stepping stone’ approach with pre-employment support is superior to one which focuses on real work from the outset. This is because research suggests that learning and training in one setting are not easily generalised to other settings – it is most powerful to learn so-called employability skills in a real workplace, with intensive support where needed (hence the value of work placements, as described above at Holiday Inn and BBC). 
People with learning disabilities have particular difficulties in generalising learning from one setting to another, hence the value of supported open employment compared to pre-vocational training or repeat college courses. 
It is not necessarily possible to measure ‘distance from the labour market’, or accurately predict the time it will take for an individual to successfully move into paid employment. Starting with a work-first approach for everyone, but accepting that it will take longer for some than others, seems a sensible approach. A system that assumes some individuals are not job ready on the basis of their impairment goes against the evidence, goes against social inclusion and the very goals employment support aims to achieve, and could reinforce negative messages of low expectations and poor aspirations. Of course, lack of specific skills or qualifications may be a barrier to employment – but even here many employers prefer to train people themselves, and apprenticeships are a classic model of combining employment and learning in a contextualised way. It is vital that apprenticeships and internships are open to disabled people (see Chapter 5).
The system of support has to focus on the capabilities of individuals and the support they need to get a job, recognising that the support needed (and the costs of support) will differ from one individual to another. 
“The concept of ‘fitness for work’ is a nonsense, especially when concentrated in medically driven functional capacity testing. Many disabled people work already. Those who can and want to work must simply be provided with the conditions in which to do so, in a meaningful way. This requires a lot less prejudice and a little more imagination on behalf of agencies, government and employers to create conditions in which it becomes impossible to start from the position ‘this person is disabled therefore they cannot work’. But this can never be a stick with which to beat disabled people off benefits for spurious reasons either. That serves no-one’s best interests and certainly not the country’s, when so much talent is left to waste.” 
(Kevin Fitzpatrick, OBE)
“…the [IPS] literature provides no empirical justification for excluding any consumer from receiving supported employment services, based on the clinical or work history, ‘readiness’, or any other factor commonly used as screening criteria.” 
A menu of support could include work experience, internships, rapid job search, access to support workers or job coaches, or help setting up a business, for example. Training to improve skills and qualifications can play an important role, but this must be explicitly work-focused, relevant to labour market opportunities, and often delivered as part of a package of simultaneous support, rather than a sequential approach.
It is important that the system gets the right balance between demand- and supply-side measures. A system that is designed to push disabled people at work through training, CV preparation, motivation etc will only affect the supply side, which is only one part of the equation. We cannot ignore the demand side, and this means rebalancing support to give more focus on enabling employers to pull disabled people more efficiently into jobs. This includes support to employers in making more complex adjustments, job matching (matching suitable candidates with employers), job carving (tailoring jobs so that they become suitable for particular workers), or targeted recruitment programmes which link employers, intermediaries, and job seekers systematically. 
In particular, if employers are to rise to the challenge of employing disadvantaged people – from young people with few qualifications, to people with learning disabilities or people who are homeless – it is imperative that they are enabled to support each other and learn from good practice, with specific advice available when needed. Employer organisations including Business in the Community, the Federation of Small Businesses, UKCES (which has an aim to enable employers to make jobs available to disadvantaged people) and the Employers’ Forum on Disability have track records and crucial roles in stimulating and sharing good practice. The evidence base on IPS (above) shows that support must be for employer as well as employee: this has strong implications for Government-funded disability employment programmes that must support the relationship, not just the job seeker or employee. 
Employment support is not just about out-of-work support. Although there will be some individuals for whom support needs are upfront and one-off, others will require some ongoing support, and many will be in work at the time when they first need support (for example, people with fluctuating conditions, or existing employees who acquire an impairment or health condition). The support system must be flexible enough to serve people across the disability spectrum with all types of support needs.
Social enterprises and social firms can be an important part of the wider support offer, but it is important that the system does not automatically filter people with certain characteristics or impairment types down this route. Open employment must be considered a possibility for everyone. The system should support individuals to find a job that suits them in terms of their interests and aspirations and the environment they need, based on individual choice.
These core components of effective support are likely to work across people with all types of disability, and most likely other types of labour market disadvantage. 
Getting employment support right is only part of the solution to existing inequalities. In order to become confident employees, disabled people must be supported right across the system to aim high and achieve their potential. Open employment must be an aspiration for all, with support where needed to sustain it. 
“At school the support workers always think you are dumb, they say you can’t do stuff, but they never give you the chance. That really annoys me.” 
(Young disabled person)
Employment support should focus not just on employment but on helping individuals achieve their potential in sustainable and fulfilling careers. This remit is wider than the Department for Work and Pensions and relies upon a range of enablers, from portable social care packages and accessible transport to effective routes into work, through apprenticeships and work placements. Wider system enablers are discussed in Chapter 5.
2.7 	A new direction
This chapter has focused on the opportunities and drivers to achieve the new vision set out in Chapter 1. To achieve it, this review recommends a fundamental shift in the approach to funding specialist disability employment support. This recommendation underpins the more detailed recommendations of this report.
Recommendation 
The Department’s disability employment funding should be focused on supporting aspirations for sustainable work and career choices across all types of employment, as for other citizens, in every sector:
•	whether as an employee, entrepreneur, self-employed, or working for a social enterprise, mutual or co-operative;
•	with support to ‘get in’ work – through apprenticeships, internships, work experience, learning on the job programmes and work placements, to ‘stay in’ and to ‘get on’. 
Money should follow the individual so they can work where they choose, rather than the Department funding disability-specific workplaces or facilities. Over time all specialist disability employment support should be made available through individual budgets so individuals can select the support that best meets their needs.
Support should be evidence based which means:
•	a focus on supporting people into and in open employment, with ongoing and flexible support for employee (and employer) where needed to get in, stay in and get on;
•	rapid job search rather than assuming a series of stepping stones are needed first; and
•	rapid support and adjustments to aid job retention.	
2.8	Key messages – Chapter 2
•	Disabled people should be supported to contribute to the future economy: to move from job to job or contract to contract, set up new enterprises across all sectors, including growth sectors
•	Employers increasingly recognise the strong business case for retaining and attracting diverse talent and enhancing productivity through well-being and flexibility. But there is much more to do both by employers – and by Government funded employment programmes, that should support the relationship of employee and employer.
•	The future vision will be achieved through:
o	confident employees and confident employers;
o	evidence-based support – such as a simultaneous approach to employment help and other support and training, rather than a sequential approach; and
o	supportive wider-Government policy, from skills to health and more.
•	A shift in policy is needed: money should be used to support individuals to achieve their employment aspirations rather than to fund facilities.	

Chapter 3
Foundations for support
The existing system
3.1 	How it works now
3.2 	Who uses what?
3.3	The Work Programme
3.4 	Do we need specialist support?	
3.5 	Work Choice
3.6 	What more is needed?
3.7	Key messages – Chapter 3

The existing system
3.1 	How it works now
The Department runs a range of employment programmes designed to help people find work. There is huge variation in what is offered, from the basic fortnightly signing regime for new Jobseeker’s Allowance (JSA) customers, through to long-term supported employment in Remploy factories.
Disabled people could be supported in any one or more of the programmes the Department offers. Some employment programmes are attached to a particular DWP benefit – for example, the previous Government’s Flexible New Deal was only available to certain people claiming JSA. Others, such as Work Choice, are available regardless of the benefit people are claiming – or indeed whether they are claiming benefit at all. This chapter focuses on the large-scale employment programmes likely to support a relatively high number of disabled people. The programmes disabled people are most likely to use are shown in Table 3.1.
Table 3.1: Numbers helped by the Department’s programmes
Programme	 	Number of customers 
supported a year	
The Work Programme	Over 500,000 a year between 2011/12 and 2013/14 	
Work Choice	Around 13,000 new customers starting and around 9,000 getting jobs	
Access to Work	Around 37,300 people helped in 2009/10	
Remploy Enterprise Businesses		Around 2,800 disabled people employed in factories in 2009/10	
Remploy Employment Services	Around 10,600 job outcomes in 2009/10	
Residential Training Colleges	840 customers started in 2009/10 – around 230 got jobs	

Most disabled people receiving employment support from the Department will do so either through Jobcentre Plus or the Work Programme. Data suggests that around 120,000 of the 500,000 people expected to start on the Work Programme will be claiming Employment and Support Allowance (ESA) (many of whom will have previously claimed Incapacity Benefit (IB)). A large proportion of these 120,000 people – as well as some claiming JSA, will be disabled people – i.e. people living with disability or a long-term health condition.
This chapter will focus on the Work Programme and Work Choice. Detailed recommendations about the Work Programme and Work Choice are outside the scope of this report. However, it is important that their design and impact is understood, as they provide the underpinning structure for the other programmes (Access to Work, Remploy and Residential Training Colleges) – which provide far more specialised support to a smaller pool of people.
The Work Programme is the largest programme and is likely to serve more disabled people than all the specialist disability employment programmes put together. It is therefore important that it works effectively to support disabled people to get into sustainable employment. Over time it is hoped that mainstream support, like the Work Programme, and Jobcentre Plus, would become so disability competent and confident, with specialist support available through providers and their supply chains when needed, that large numbers of disabled people could be served effectively to get and keep jobs. This section also looks at how the longer term future of disability employment programmes might be aligned with a system where the majority of support would be provided through a disability confident Work Programme. 
Work Choice is the Department’s main employment programme specifically for disabled people with severe and complex barriers to employment. It was launched in October 2010, replacing three existing programmes: WorkStep, Work Preparation and the Job Introduction Scheme. It includes both pre-employment support and ongoing support in work and is expected to support around 79,000 people between 2010/11 and 2014/15.
3.2 	Who uses what?
It is not immediately clear from the description of the various programmes that disabled people might access who would be suitable for each programme or who is currently taking part in them. There is also no comprehensive data on the level of support needs or labour market disadvantage faced by individuals using the different programmes, which means it is difficult to be confident that public money is being targeted where it is most needed. 
During this review, it became clear that the existing programmes do not form a clear continuum of support; it is not necessarily the case that those with the greatest disability-related support needs or greatest labour market disadvantage are receiving the most intense support. 
There is substantial variation in primary impairment types across the Department’s programmes. This in part reflects the different foundations of these programmes, from physical ‘in work’ adaptations to post-war rehabilitation. For example:
•	In 2009/10 over 40 per cent of Workstep users, where the primary impairment was known, were individuals with learning disabilities. 
•	By contrast, in Access to Work, sensory impairment was reported as the primary condition, in around 30 per cent of the 2009/10 caseload, and problems with the limbs, back or neck taken together were reported as the primary condition in around another 33 per cent. Learning difficulties constituted less than 5 per cent and mental health conditions less than 1 per cent.
•	In Remploy Enterprise Businesses, mobility and dexterity problems form the main identified group – about a quarter – followed by those with learning disabilities, about one in five. People reporting experiences of mental health conditions make up only 6 per cent. 
•	In Remploy Employment Services, counting those funded by Remploy commercial income as well as Workstep, those with recorded mental health conditions make up almost a quarter of cases where a disability is identified, with those with learning disabilities accounting for about one in six.	

It might be expected that the most specialist and high-cost programmes – Residential Training Colleges and Remploy Enterprise Businesses – would serve the highest proportions of people with high support needs and significant labour market disadvantage. From visits and discussions carried out during this review, this does not appear to be the case. For example, they both support lower proportions of people with mental health conditions than WorkStep (Work Choice’s predecessor) or Remploy Employment Services. 
Many people said through this review process that they found the existing range of programmes the Department offers completely baffling. It was not clear who each programme was for and there appeared to be little consistency in referral processes. This in part reflects that these programmes have evolved over many years from very different starting points. Successive Governments have introduced important reforms, for example, Access to Work in 1994 and the Equality Act in 2010. But there is much more to do in order to build an effective, integrated system – if disabled people don’t understand what is on offer, they will not be able to take advantage of it. 
It is important to improve data on who is using which programmes, both for purposes of monitoring and accountability, and to ensure that the level of support needs and labour market disadvantage are accounted for in the pricing of support. For example: someone requiring British Sign Language interpretation who has qualifications and a recent employment record might have high support needs but relatively little labour market disadvantage, and would require high-level Access to Work support; whereas someone with autism, no qualifications and several years of economic inactivity might have labour market disadvantage and high support needs, and might require intensive support to get sustainable employment. 
Recommendation
•	The Department should commit to ongoing monitoring and continuous review of Work Choice and the Work Programme. This should include:
•	publication of key performance information, including a breakdown by impairment type, qualification level and length of time out of work systematically collected across all the Department’s programmes. It is also important to gain a better understanding of disabled people’s career progression. This should help ensure all disabled people are well served, including people facing greatest labour market disadvantage; 
•	groundwork, using this information, for improved gatekeeping and pricing of different types and levels of support, so that those with the greatest support needs or disadvantage secure greater support. The Department should keep the differential pricing model under continuous review to ensure providers are encouraged to work with the full range of people; 
•	close monitoring of supply chains of prime providers to ensure that specialist organisations are being used effectively; and
•	reviews to ensure that Work Choice meets disabled people’s aspirations and is evidence-based. 
This monitoring will provide information in support of the Public Sector Equality Duty to advance equality of opportunity for disabled people.	

3.3	The Work Programme
The Work Programme is one of the central planks of the coalition Government’s approach to welfare reform and to supporting people back to work. It replaces a range of employment programmes introduced by previous administrations. 
The Department’s invitation to tender documents described the programme’s purpose as to:
1.	increase off–flow rates for Work Programme customer groups (more people into work); 
2.	decrease average time on benefit for Work Programme customer groups (people into work sooner); 
3.	increase average time in employment for Work Programme customer groups (longer sustained jobs); 
4.	narrow the gap between off–flow rates and time in employment for disadvantaged groups and everyone else; and 
5.	contribute to a decrease in the numbers of workless households.
Given the relative scale of the Work Programme and existing specialist disability employment support, most disabled people receiving employment support funded by the Department will do so through the Work Programme. The Work Programme therefore forms the main backdrop against which more specialist support must sit.
The key principles behind the Work Programme are:
1.	The programme will operate under a black box model – providers will be paid by results and the Department will not specify the service they provide.
2.	The programme’s funding model is designed to reduce the payment for so-called ‘deadweight’ – employment which would have occurred even without support.
3.	Differential pricing – different customer groups will command different outcome payments, depending on the perceived challenge of supporting them into work.
4.	Sustainment – providers will be paid for keeping customers in work for up to two years.
Work Programme providers will receive a small payment upfront for taking someone on, and then a more substantial payment when that person finds work – and stays in work. Figure 3.1 below shows the basic structure of this model:
Figure 3.1: Work Programme payment model

Many of the people and organisations consulted during this review have cautiously welcomed the move the Work Programme will make towards differential pricing. A number commented that they would like to see this concept extended – to allow for more differentiation between groups based on a wider range of characteristics. 
Bidders for the Work Programme were required to explain how their supply chains will effectively serve the needs of the full range of people using their services. It is critical that the Department ensures prime contractors meet their obligations in this regard, and effectively monitors the programme to establish whether the differential pricing model performs as intended and provides an effective incentive for prime providers to work with the full range of people. 
As time passes and the experience and expertise of the large welfare-to-work providers develops, and as the Department develops its supply chain and contract management processes, it is to be hoped that mainstream employment programmes will become increasingly disability competent and able to support more people. It is also relevant that the programmes replaced by the Work Programme – like Pathways to Work – have not been proven to be effective. It will be essential for providers to draw on the evidence base outlined in Chapter 2 to develop services that are flexible and personalised enough to achieve successful employment outcomes for disabled people. 
3.4 	Do we need specialist support?
Disabled people often face barriers to work beyond those faced by their non-disabled counterparts. Many require support which goes beyond the traditional package of CV-writing, skills training and job broking used to support many job seekers. Disabled people may also require barriers to be removed; ongoing support for them and their employer at work; individualised support to manage their impairment; and help with transport. One day, providers of the Work Programme and equivalent mainstream programmes may be so disability-competent with such strong specialist supply chains that additional specialist services are gradually less needed. The Department should encourage and support this market development.
“The evidence suggests we should stop investing in different programmes and facilities. Invest in people and the support they need.” 
(Dr Stephen Beyer, Cardiff University, Welsh Centre for Learning Disabilities)
Until such a position is reached, it is important to ensure that the most specialist programmes and support are available to those with the greatest need – those who face the most demanding challenges in the labour market due to the severity of their impairment, the complexity of their adjustment needs, the interplay with other significant disadvantage (like long-term worklessness) or the intransigence of others’ attitudes to their impairment.
3.5 	Work Choice
On 25 October 2010 the Department for Work and Pensions launched Work Choice – its new disability employment programme. Work Choice replaced three existing programmes – Work Preparation, WorkStep, and the Job Introduction Scheme.
Work Choice is a modular programme and follows the prime-provider model which the Department is also using with the Work Programme whereby the Department contracts with a relatively small number of large organisations who in turn contract with smaller and more specialist providers.
Work Choice comprises three modules:
Module 1 – help finding a job and preparing to enter work, which may include activity such as:
•	individually-tailored vocational guidance and development planning to help identify and address support needs (disability-related and otherwise); 
•	personal and job-skills support, confidence building, and capacity building;
•	job-search support – advice, job matching of individuals to identified vacancies, active sourcing of suitable jobs, and advising employers on opportunities for job-carving; 
•	job application support – including managing disclosure of health and disability information, CV and interview preparation, skills development and advocacy to the employer if needed; and
•	labour market advice and support.
Module 2 – short to medium-term in-work support
•	As a minimum, providers are expected to be working with the participant, or with others on behalf of the participant, for at least 8 hours per month.
Module 3 – longer-term in-work support
The programme is expected to support 79,000 customers between 2010/11 and 2014/15 and to meet the following performance targets:
•	55 per cent of new participants get a supported employment placement; 
•	30 per cent of participants move to unsupported employment; and 
•	60 per cent of participants who have obtained unsupported employment will continue in that employment for at least 26 out of 30 weeks. 
Work Choice funds places in supported businesses, as well as support in open employment, and Government gave a guarantee to protect funding for five years for around 2,400 supported business places when Work Choice was launched.
It is too early to understand whether Work Choice is achieving its ambitions. The Department should carefully monitor those using the service to ensure that the programme is targeted, as intended, at those with the most severe and complex barriers.
Customers currently supported in Work Choice are generally positive about the programme: “I wouldn’t know what to do in an interview so it (support through Work Choice) helped me get confidence” and “(the support has) made me be a better person all round at work – it’s helped me become friendlier”.
In the course of this review some people said they wanted to see Work Choice extended to offer more places. Others wanted reassurance that the most disadvantaged disabled people had access to the programme; and reported disjunctions at local level between the planning systems and cultures of central programmes – like Work Choice – and local assessment and review (as in social care and personal health budgets).
More is known, and more systematically, about the experience of people using Work Choice’s predecessor programmes.
WorkStep provided in-work support to disabled people. Table 3.2 shows the impairment breakdown for people in supported employment through WorkStep at the end of 2009/10.
Table 3.2: WorkStep impairment breakdowns
Main disabling condition	2010/11	
All	12,970	
Learning disability	4,100	
Unknown	3,050	
Conditions restricting mobility dexterity	1,650	
Mental health	940	
Neurological conditions	740	
Visual impairment	680	
Hearing and/or speech impairment	540	
Other health conditions	500	
Long-term medical conditions	440	
Prefer not to say	330	

The complexity of having three separate programmes serving the same objective was one of the key reasons that the Department replaced these programmes with Work Choice. Work Choice was the key outcome from a consultation on disability employment programmes. 
In the course of this review some people said that the segregated nature of supported business places, funded under Work Choice, is not fully conducive to the vision, set out in the previous chapter, of people being supported in mainstream employment. It is not evidence-based. Some people advocated a properly planned transition to social enterprises and support in mainstream employment, with individualised support also for social and community living. Many went further – suggesting there should be a move toward individual budgets so that disabled people can buy the support that is right for them. Disabled people should have a choice of providers with a wide menu of support options – whether that is kit, travel to work support, a support worker, or the buddying of a colleague. Giving individuals this responsibility enables them to think creatively about how to make best use of constrained resources. It would require resource allocation according to level of support need and labour market disadvantage learning from resource allocation in the social care and other sectors. 
Longer-term these budgets could be pooled with budgets for social care, as is beginning to happen under the Right to Control – so disabled people can design a single, integrated support package that suits them. This is consistent with the messages received during this review about Remploy Enterprise Businesses – which is explored further in Chapter 4. 
Recommendation
The Department should, when existing Work Choice contracts expire, cease any specific guarantee of funding to supported business places, so that funding follows people rather than facilities. Learning and evidence should be used to help a transformation to support in viable enterprises or mainstream employment. Any savings should be used to support more individuals through evidence-based support.	

In addition to this, disabled people should have more choice and control over how they use services. The Right to Control envisages a hugely simplified resource allocation and assessment process, whereby resources for social care, Disabled Facilities Grant, Work Choice, Access to Work and more follow the individual – and the individual has the right to manage that resource, if they wish, as a direct payment. This has huge potential to stimulate more active participation of disabled people. 
Another point commented on was the number of assessments people might have over the years by different (and sometimes the same) agencies and organisations – for Disabled Students’ Allowance, Access to Work, social care, different benefits etc. Such a system seems inefficient and is clearly not joined-up. It would seem to make more sense to have one linked assessment covering a Disabled Students’ Allowance, personal health budget, Access to Work, Work Choice and perhaps benefits like the Personal Independence Payment as well. This is discussed in more detail in Chapter 4.
Recommendation
When existing Work Choice contracts expire, the Department should consider rolling Work Choice funding into individual budgets with Access to Work. This would simplify the system into one general Work Programme and one individual budget-based programme so individuals have a choice over the support that they most need. This would build on learning from the Right to Control trailblazers.	

3.6 	What more is needed?
Given the range of support provided by the Work Programme and Work Choice, what need is there for further specialist support? The Department currently operates three specialist disability employment programmes beyond the Work Programme and Work Choice – Access to Work, Remploy and Residential Training Colleges.
It is important that Government has a clear picture of who each programme it runs is for. The current position is that, in some cases, programme entitlement depends on the benefit a customer is claiming. This can cause tension – there are many people found fit for work at their Work Capability Assessment (WCA) who may have high support needs, whereas some people entitled to ESA may have lower support needs. Often it is labour market disadvantage – things like qualifications and length of time out of work – that affects support needs. Professor Harrington is exploring a ‘real world test’ to improve the WCA and take account of such factors; and the Department is making certain changes to the WCA as a result of the Harrington Review to develop the assessment so that it can more effectively determine the support needs of different groups of disabled people, including those with autistic spectrum disorders, mental health conditions and learning disabilities. 
Until the WCA or other assessment of labour market disadvantage and support needs is sufficiently developed, and the Work Programme is sufficiently disability competent, there remains a need for more specialist employment provision for disabled people. Moreover, this should take account of disabled people’s progress in pioneering independent living, whereby we decide on and manage our own support on the basis of self determination, choice and control. Peer support is vital to this process. The Access to Work programme has elements close to principles of independent living: resources are allocated to an individual, not via a block contract. The next chapter explores the role of specialist programmes including their potential to support independent living. 
3.7	Key messages – Chapter 3
•	Most disabled people receiving employment support from the Department will do so either through Jobcentre Plus or the Work Programme: therefore these general programmes must work well for disabled people.
•	The Department should monitor and review Work Choice and the Work Programme to ensure they meet the needs and aspirations of disabled people, including those most disadvantaged.
•	Data should be collected and published on users of all programmes, including numbers with high support needs or labour market disadvantage, defined in terms of broad impairment group, skills and qualifications, and time out of work. 
•	Until mainstream programmes become more disability-competent, there remains a need for more specialist employment support for disabled people. 
•	Disabled people should have more choice and control to design their own single, integrated support packages. Government should consider rolling Work Choice into an individual budget, combined with Access to Work, and offering a menu of employment support, building on the Right to Control.	

Chapter 4
Specialist support
Aspiring to the vision
4.1 	What does existing support look like?
4.2 	Access to Work
4.3	Remploy
4.4	Residential Training Colleges
4.5 	Summary
4.6	Key messages – Chapter 4

Aspiring to the vision
“I want the same chances as non-disabled people. I don’t want to work in a specialist place for disabled people.”
4.1 	What does existing support look like?
In considering what the future of specialist disability employment services might look like, this chapter begins by looking at the current system and considering how well it supports the vision laid out in earlier chapters. The core of this chapter looks at Access to Work, Remploy and Residential Training Colleges (RTCs). Below is a brief overview of the three programmes:
•	Access to Work provides practical advice and support to disabled people and their employers to help them overcome work-related obstacles resulting from disability.
•	Remploy Enterprise Businesses provide supported employment to disabled people in a network of 54 factories and managed CCTV services. Remploy Employment Services provide back-to-work and job search support to disabled and disadvantaged people through branches and offices.
•	RTCs provide vocational training for disabled people in a largely residential setting. Individuals spend up to 12 months in a college where they receive both vocational training and support with independent living skills and adapting to their impairment. Around half of participants are residential, the remainder are day students.
Table 4.1: Number of people helped and amount spent on specialist disability employment programmes in 2009/10
	Access to Work	Remploy Employment Services	Remploy Enterprise Businesses	RTCs	
Number of disabled and disadvantaged people helped to get or keep jobs in 2009/10	37,300 supported to keep their job
	10,600 people helped to get jobs (including WorkStep and other disability programme provision)	2,800 disabled people employed	230 got jobs
	
Spend in 2009/10	£98 million programme cost	£35 million	£63 million	£18 million	

Table 4.1 highlights the stark difference in cost per job across the programmes. For example, it indicates that the cost per job for RTCs is around £78,000 compared with a spend per person on Access to Work of around £2,600. Spend on each disabled employee in a Remploy factory is around £25,000 a year. It is important to keep in mind, however, that the services these programmes provide vary significantly and that direct comparisons of this type should be considered with great caution. 
4.2 	Access to Work
What happens now
Access to Work supports disabled people to take up and retain paid employment by helping with payments for aids, adaptations and support so disabled people can work effectively. Support can include specialist equipment, help with travel, support workers and communication support. It is provided where the employee requires support or adaptations beyond those “reasonable adjustments” which an employer is legally obliged to provide under the Equality Act 2010. Access to Work also provides advice to employers on reasonable adjustments. It was launched in June 1994 and is delivered by Jobcentre Plus. Access to Work is available to people in full-time work (16 or more hours a week), people undertaking permitted work (low hours work while still claiming out-of-work benefits), and to people undertaking apprenticeships or Work Trials arranged through Jobcentre Plus.
Effectiveness
During 2009/10, Access to Work supported 37,300 disabled people to keep or get employment at a cost of £98 million. The 2002 report, Evaluating the Impact of Access to Work: A Case Study Approach indicates that 45 per cent of customers would be out of work but for the support they receive through Access to Work. Secondary analysis of this data has suggested that there is a net return to the Treasury of £1.48 for every £1.00 spent on the programme. More recent analysis by the Department has backed this up by showing there is an even higher social return on investment for every £1.00 invested in the programme (the social return on investment includes savings such as healthcare costs, whereas the £1.48 net return to the Treasury is calculated on the basis of taxes paid and benefits no longer received). Access to Work is a highly effective and well-liked programme. It is well-supported by users, employers, disabled people’s organisations, and charities. The evidence suggests it provides excellent value for money – particularly when compared with Department’s other specialist disability employment programmes. This suggests the future direction of Access to Work should be one which builds on this success.
As set out in Chapter 2, the vision is that everyone living with a disability or health condition is able to use their capabilities to the full. Access to Work has a strong role in supporting this aim. In this review, there was a strong consensus from employees, employers and disability organisations that Access to Work is an important programme that should be built on for the future.
“It’s the envy of the world.” 
(Access to Work customer)
“I would never have got to where I am today had it not been for Access to Work.” 
(Access to Work customer)
“It allows you to more confidently express what you need to ensure you do your job properly, without worrying about what your employer is going to think about the costs and time needed to sort this out.” 
(Access to Work customer)
Reach
It is estimated that over 300,000 people move from work to incapacity benefits each year through ill health, when in some cases they could stay in work. The 1.5 million people currently receiving Incapacity Benefit will, over the next few years, be reassessed and it is hoped many of these people will be supported to enter sustainable employment. Of course, not all would need Access to Work to succeed at work; many disabled people need no adjustments at all – just a fair chance to work or a reasonable adjustment that employers have a legal duty to provide. However, some will only work successfully if they have those additional supports and adaptations provided through Access to Work: a British Sign Language user, for instance, cannot work in many roles without access to an interpreter; and for some employers, particularly small employers, the cost of communications support (or support workers, or travel) would go beyond their duty to offer reasonable adjustments. Most private sector workers in the UK are employed in small or medium-sized enterprises (SMEs) and encouraging more small business start-ups is a core part of the coalition Government’s economic recovery strategy. If disabled people are to have a fair chance of retaining their jobs and securing new jobs as they come on stream, including in SMEs, then Access to Work will need to be available to more than 37,300 people a year. Efficiencies must be created in the system to allow more people to benefit from this vital support.
Recommendation
Access to Work should be transformed from being the best kept secret in Government to being a recognised passport to successful employment, doubling the number of people helped. Government should improve equity of access, use innovation to create efficiencies, remove unnecessary waste and mobilise the power of peer support.	

“In spinal injury units you hear from people who have done everything from sky diving to walking to the North Pole. The message is that being disabled is fun. Employment is a faint whisper. All the volunteers with spinal injury who come in are out of work – and we get no advice and support about getting back into employment.” 
(Senior journalist with spinal injury)
“When people do not have access to rehabilitation – because it is patchy – the health service gives them no idea that getting back to work may be possible after a major diagnosis. Families then set up alternative scenarios – like the partner working more – when this may be quite unnecessary. Employment support comes too late.” 
(Vocational rehabilitation professional)
“I have found the Access to Work support as a life-changing experience for those who need the help because when I first used the service many years ago my company was relatively small and could not afford the cost of the provisions needed to prevent my condition from deteriorating hence the financial contribution was absolutely critical.”
(Access to Work user and small business owner)
A wide range of employees and employers have commented that Access to Work is Government’s best kept secret. While some large companies and public sector organisations – and some well-informed disabled people – know the scheme and use it, many others – including people working in small businesses – miss out completely because they have never heard of it. This needs to change. Access to Work is an effective programme, but it can be more effective. Improving the scope and awareness of Access to Work will be essential.
At present the budget for Access to Work is limited. Year-by-year the proportion of the budget going on existing claimants has increased – i.e. more of the pot of money is used by the same group of people. It is important that new customers can also benefit. Of the 37,290 customers who benefited from Access to Work in 2009/10, only around 16,400 were new customers – the rest were continuing to receive support which had started in earlier years.
There are also large variations in the use of Access to Work by people with different impairments. Use of Access to Work is disproportionately low among people with mental health conditions and learning disabilities. This is partly because Access to Work started out as a programme to support physical adaptations and the image that it is about ‘kit’ has, to some degree, persisted. It can be used for other support, such as support workers. The term ‘disability’ programme can reinforce this view: it is important to make clear that it exists for people living with health conditions or disability – that is, anyone who would be considered disabled under the Equality Act 2010, whether or not they fit the lay stereotype of a disabled person (such as someone using a wheelchair or with a sensory impairment).
Table 4.2: Access to Work by impairment type 
Primary impairment	2009/10	
All	37,290	
Back or neck	7,050	
Difficulty in hearing	5,460	
Difficulty in seeing	5,290	
Other	4,830	
Dyslexia	2,820	
Legs or feet	2,570	
Progressive illness	2,350	
Arms or hands	2,330	
Learning disability	1,710	
Epilepsy	1,130	
Mental health condition	400	
Cerebral palsy	380	
Heart, blood, blood pressure or circulation	280	
Diabetes	180	
Chest or breathing	160	
Spina bifida	120	
Stomach, liver, kidney or digestion	110	
Difficulty in speaking	90	
Missing/unknown	20	
Skin conditions and severe disfigurement	20	

It has been encouraging, through this review, to hear the interest expressed by organisations in working with Government to promote the scheme: trade unions interested in sharing messages with health and social care staff in their membership; small business umbrella bodies and trade associations sharing knowledge with local small businesses; learning disability, mental health and black and minority ethnic (BME) organisations sharing knowledge with their members; companies promoting good practice. This must be a partnership in which Government supports promotion directly. There is, of course, a likely effect of such a campaign: that the demand for the programme would increase, with a corresponding pressure on the budget. The Department would therefore need to ensure a fair and transparent system is in place to manage the overall budget: many people have said they would prefer the Department to manage the spend in a transparent way rather than for demand to be depressed through lack of publicity. 
Recommendation
The Department should undertake a targeted information-sharing campaign about Access to Work, concentrated on:
•	growth sectors, to enable disabled people to have a fair chance of securing new jobs as the economy grows;
•	small- and medium-sized enterprises;
•	the professional groups and trade unions who have most contact with disabled people – in particular health and social care staff;
•	BME, learning disability, mental health, neuro-diversity and multiple impairment networks – to reach people who are under-served and/or have low employment rates.
The Department should be transparent about the limited budget and manage it in the most equitable way possible. The campaign should utilise existing structures such as Direct Gov and work in partnership with trade unions, professionals and user-led organisations.	

By focusing any marketing on SMEs and organisations who work with groups with historically low use of Access to Work, the gains from the programme should be maximised: helping those who truly would not be in work without Access to Work support. 
It is important that the Department continues its work to ensure Access to Work is not just about kit. Support workers are a key part of what Access to Work provides. The language used in promotion should talk of support for people with health conditions – not only of disabled people.
Appropriate provision for differing needs
Access to Work needs to improve its offer to the full range of people living with health conditions or disability. A particular issue raised throughout this review is the availability of Access to Work for fluctuating conditions. This is relevant to mental health conditions (among others) and a recommendation on this was made in the 2009 report Realising Ambitions: Better employment support for people with a mental health condition, which said:
“The review recommends that Government investigates the use of Access to Work to fund temporary cover for an employee of a small business who is off sick for a longer period of time. Such funding should only be available for condition-related absences that are likely to be prolonged and to smaller employers.”
This recommendation was not implemented at the time, and people with a fluctuating mental (or physical) health condition still often find it difficult to secure or retain work, since employers (especially small employers) fear they will be unable to cope if the person has disability-related time off work. Part-funding for employees in SMEs for temporary absence, for a time-limited period, would build confidence in both employer and employee. This report, therefore, reiterates the recommendation made in Realising Ambitions:
Recommendation
The Department should increase employer confidence in employing people with fluctuating conditions by making Access to Work available to part-fund temporary cover for an employee of a small business who is off sick for a significant period of time. Funding might only be available for smaller employers, for prolonged condition-related absences. Individuals should be able to draw down support when required.	
Building confidence of job seekers and employers
A consistent message received during this review is that disabled people should know before they get a job that they are likely to get Access to Work. This would mean they could approach employers with the confidence that Access to Work would, in principle, be available – thereby giving the employer confidence that supports or necessary equipment will be easily obtained and making them more likely to employ the individual. In December 2010 the Government introduced a pre employment eligibility letter which potential employees could show to an employer and which indicated potential eligibility for Access to Work. Numerous employers, organisations and disabled people have said, as part of this review, that this is a welcome step in the right direction but there is scope to strengthen this letter to reassure employers that they will not incur excessive costs as a result of taking on a disabled person. 
There are difficulties in making a definite Access to Work award before a job offer is made, since the support needed will depend on the nature of the job as much as on the person’s impairment. However, an indicative entitlement could be offered – letting individuals know in principle what they would be likely to be entitled to in line with their job preferences, stating that the level of support available would depend on the size of the employer and the exact role. This would offer crucial confidence and still allow the entitlement to be finalised once the job role is known. 
Recommendation
The Department should increase employer and employee confidence by strengthening the indicative pre-employment Access to Work eligibility, based on work likely to be undertaken, to be finalised once the exact role is known.	
Squaring the circle: moving forward cost effectively
This report sets out a strong vision of equal opportunities, confident employees and employers, and ever-closing employment and pay gaps between disabled and non-disabled people and between different impairment groups. If this is to be realised, further changes must be made to the way Access to Work currently operates. 
To spread impact beyond the 37,300 people in receipt of Access to Work and to achieve the recommendations above requires a different model, that both improves customer experience and makes public money go further.
A shared responsibility
In the course of the review we heard from employers that had developed their own models of assessment and delivery of adjustments, either with or without the involvement of Access to Work – and had benefited in terms of retaining valued employees and recruiting and developing new talent. 
Lloyds
Lloyds Banking Group have well-developed systems and policies for supporting disabled employees. A senior executive sponsor provides leadership to the core business objective; the business benefits of equality are well-promoted, and advice and support for managers and staff is centralised. Lloyds decided, given some delays in delivering Access to Work solutions and variation in assessments by region, to contract their own assessors, operating a partnership with Access to Work. They are able to offer an end-to-end solution for in-work disability support, from assessment to implementation and training. This has enabled them to reduce waiting times and to ensure solutions fit the requirements of both employee and the business. They have formed partnerships with support organisations and have their own quality-assurance processes in place. There is clear guidance on best practice in phased returns to work, travel, time off, and wider workplace adjustments.
Royal Mail
Royal Mail conducted a comprehensive review of the support given to disabled employees in 2008. The average time taken to deliver reasonable adjustments was in excess of 87 days and disabled colleagues were not getting consistent support across the business. A new Disability Helpline service was launched in 2009 to provide full pro-active case management service for implementation of reasonable adjustments. The timescales have been improved and are on average implemented within 34 days. There is now a central point for collating data on reasonable adjustments, and costs can be claimed back through Access to Work. Royal Mail has an ambition to reduce the implementation of reasonable adjustments to within 30 days and improve the process further for claiming back costs from Access to Work.	

Large companies told us that what they most wanted from Access to Work was simplicity, reduced form-filling, and advice when needed. In many cases they were prepared to go beyond their legal responsibilities and make adjustments that would otherwise be provided by Access to Work; and understood the expectation that, as a large employer with substantial resources, they would do so. Some shared their experience of mainstreaming good practice: for example, ensuring that all IT systems are accessible and easily integrated with voice recognition software, thereby removing the need for often costly bespoke solutions. 
“We need an Access to Work service that provides timely support when it’s needed most; one that swiftly removes barriers to enable our people to get on with doing what they do best for BT and our customers. We need a service with a strong customer focus; one that is easy to access, swift and responsive, straightforward and transparent. We need absolute clarity on what we can expect as customers, and by when.” 
(Helen Chipchase, Head of Disability Policy, BT Group) 
Disabled people told us that many Access to Work allocations would not be necessary if employers would make relatively straightforward adjustments. For example: 
“As a wheelchair user I can travel on public transport in London – but not in the rush hour. Because my employer was not prepared to let me work flexible hours I had to get Access to Work to provide me with daily taxis long term, at considerable cost to the public purse.” 
(Access to Work user)
Inaccessible IT is a major problem. Increasingly employers recruit on-line: but if the on-line processes are not accessible (for instance cannot be used with screen readers) then disabled people are literally barred from applying. The Canadian Supreme Court recently required the Government to fix its inaccessible recruitment within 15 months.
The case of Donna Jodhan v Attorney General of Canada on 29 November 2010
The Canadian Supreme Court determined that Ms Jodhan was denied equal access to, and benefit from, Government information and services provided on-line to the public, including access to jobs available on-line. The court ruled that this constituted discrimination against her on the basis of her disability, as she is blind. The ruling also went to on say that this was a system-wide failure to make websites accessible, affecting many of the 146 Government departments and agencies in Canada. The Government has been given 15 months by the court to make their websites accessible to disabled users.	

To encourage employer good practice and challenge those that place obstacles in disabled people’s paths, employers should be encouraged to learn from the successful business practices of organisations that remove barriers; and Jobcentre Plus staff should be trained to support them to do so – so the onus is not placed wholly on disabled employees.
Recommendation
The Department should train Jobcentre Plus advisers to support and, where necessary, constructively challenge employers, where they are not willing or confident to make adjustments or introduce accessibility features to enable an individual to work successfully. This would help avoid placing the onus for negotiation wholly on the newly employed individual.	

Disabled people also have a huge role to play, exercising initiative to use Access to Work to achieve maximum independence – often supporting each other to do so. While some disabled people need Access to Work long term, others may not. For example, 35 per cent of Access to Work awards are for travel costs – often taxis. 
Where public or private transport is an option (and it is not always), support to achieve this should be offered by Access to Work rather than long-term taxi use. This would mean that as more disabled people ceased using Access to Work, resources would be freed for new people – like the numerous people with mental health conditions, or learning disabilities, or those working in SMEs, who could work far more successfully if only more were able to access to the programme.
Recommendation
The Department should strengthen the role Access to Work plays in supporting independent travel where appropriate, engaging with individuals to take advantage of training and confidence-building in public transport or driving. It should then consider time-limiting – in some cases – payments for taxis. However, adequate protections must be in place for people who do need taxis long term to ensure they are not forced to stop using taxis where this would put them at significant disadvantage.	

It is vital that Access to Work responds flexibly and positively to both employers and individuals who propose innovative and cost-effective solutions. But stakeholders reported that the response is not always flexible enough.
“I contacted Access to Work as I wanted a cycle attachment for my wheelchair. I was planning on cycling to the House of Lords and between meetings. At a one-off cost of £2,000 I thought this cost effective and with great benefits to my health. Access to Work said they could not provide this, but they were happy to fund taxis daily, at a much higher cost.” 
(Baroness Tanni Grey-Thompson, DBE)
Sharing power and information
It should be possible to expand the number of people who can be supported through the programme – even within the same funding package – if Government, individuals and employers used their buying power to drive down costs. The review has taken evidence from experts in web-based solutions, which could potentially dramatically open up information and choice to individuals and employers. If everyone could search and compare the range of adjustments (support worker services; voice recognition software; training to implement software, technology and equipment; adjustable desks; interpreters – and more) then employers could more easily put in place adjustments themselves, and individuals could view how other disabled people have rated products and services and exercise their own choices – at least for relatively standard solutions. 
This would not replace the important role of assessments and more personalised advice (including peer advice) for more complex issues – but over time it might reduce the need for them. 
Recommendation 
The Department should make Access to Work available through an internet-based portal that opens up knowledge of support, technology, services and what works to employees and employers. Suppliers could compete through the website thereby driving down unit costs and developing the market for disability employment support. The Department should investigate options for the website to operate independently – perhaps being opened up beyond Access to Work users – so that market forces push costs down further. This could work alongside a core advice and assessment service for Access to Work.
Further work will be required to develop the specification, but the portal should deliver:
•	increased choice;
•	improved customer experience; and
•	reduced costs.
The portal might also offer:
•	information on the range of supports, adjustments, and adaptations available;
•	on-line peer support, discussion forums and reviews of products and services; and 
•	information on the rights and duties of employees and employers.	

“Finding quotes for equipment was time consuming – surely the Government can have a list of approved suppliers users can search through to select their desired product (if they know it)?” 
(Access to Work user)
It is difficult to specify the extent to which these changes would drive down unit costs. However if, for example, they reduced the annual spend for each person – for the same level of support – by 20 per cent, the Department might see an extra 7,400 people benefiting from the programme each year for the same expenditure.
Many disabled people commented on how useful they found hearing about the experiences of others who had utilised effective support to enable them to work. The vital role peer support can play is discussed in Chapter 2 – but has particular relevance for Access to Work.
Recommendation
The Department should work with user-led organisations to provide services and peer support for people using Access to Work. This could include assessment and delivery – so the process is fully informed by what others have found most helpful.	

It is important that in any move to place services on-line, the needs of those who are not internet users are taken into account, and that face-to-face assessments and advice are sustained where needed. The existing Access to Work assessor role would continue in parallel with the portal, for individuals requiring either a bespoke approach, an ergonomic assessment, or simply for people not on-line. It would be hoped that usage of the existing assessment approach would decline over time as both individuals and employers took more power into their own hands. This could empower both individuals (as consumers – not Government programme recipients) and employers to get solutions in quickly and easily through on-line purchase. Individuals could rate products and services and share experiences – thereby enhancing choice and making individuals less dependent on State-funded assessors. It might even be possible to generate some income by allowing advertising on such a site. The site could include an eBay-style area for resale of equipment/technology. 
Work experience
Work experience or internships are keys routes into work for many people. Both the current and previous Government have developed initiatives to encourage employers to offer work placements. It is imperative that disabled people have equal access to these opportunities. Further, Alison Wolf’s recent report to Government on vocational training says: “… there is a wealth of evidence indicating that they [employers] value work experience, and that the best way to obtain a job is to have one…”
Recommendation
Government should ensure adjustments are funded for internships, work experience, learning on the job programmes and work placements. This can be through ring-fenced budgets within programmes, plus a ring-fenced budget within Access to Work.	
Streamlining assessments
A significant part of the existing Access to Work process is the assessment phase. Advisers in Jobcentre Plus carry out an initial assessment and can then refer to external assessors where they think this is needed. The cost of this assessment process is around £6 million a year. Those with straightforward requirements should have their equipment or support approved without a complex assessment process. This does not, however, appear to be the experience of many customers who have taken part in this review. 
Many have had multiple assessments by different – or sometimes the same – part of Government (as students, as recipients of individual budgets in social care, and personal health care, as previous Access to Work users and more) and will already be aware of the adaptations they require to secure and sustain employment. Despite this, people said that too often they are required to undertake further assessment as part of their application to Access to Work. This, again, is because the support received through Access to Work is attached to both the individual and the job. 
“I know what my condition is. I know what piece of kit I need. Why do I need to go through this assessment only for someone to tell me what I already know.” 
(Access to Work customer)
“I found it bizarre that I had to apply again considering I asked for the same support three years ago. Surely you just need your name, NI [National Insurance] number and details, they ask if your support needs or disabilities had changed then go from there?” 
(Access to Work customer)
“I moved to Newcastle from London and had to be assessed all over again. The person assessing me was another wheelchair user as it happened, who I happened to know quite well – and we both just laughed at the process. I knew what I needed, he knew that I knew – but the forms just had to be filled in.” 
(Access to Work customer) 
A number of people reported that assessments sometimes led to getting more kit than you either wanted or needed, and were told that some assessors had links with companies and therefore had conflicts of interest in recommending particular equipment. 
“I wanted a chair – but I ended up with a whole set of things – a desk that goes up and down and all sorts of things. I don’t use them.” 
(Access to Work customer)
This suggests some waste in the system. The experience of individual budgets in social care shows that where individuals have more power in the process, they can come up with very cost-effective solutions. 
Disabled people get very frustrated by the experience of multiple assessments. The 2011 Special Educational Needs and Disabilities Green Paper proposes simplifying assessments for young disabled people. The same applies to adults. The emphasis in the Right to Control trailblazer areas on pooling individual budgets – so individuals have fewer assessments and more control over how they use the resources they are entitled to – is the right direction of travel. 
Recommendation
The Department should introduce a stronger triage system for Access to Work applicants. People who understand their support needs should not have to go through detailed assessment unless what is asked for is disputed.	

People have talked of their frustration at not being able to take their equipment from one employer to another, or from an educational establishment into work. 
“I had to leave the Braille printer behind. Now it’s just gathering dust and I have had to have a new assessment and receive a new award. It’s such a waste of my time and of taxpayers’ money.” 
(Access to Work customer)
There are some circumstances in which transferring equipment between employers is not possible: for example, where an adjustment has been incorporated into an employer’s IT system. However, it appears some of the difficulties arise from confusion about ownership of equipment purchased through Access to Work. Ensuring equipment is transferable and moves with the disabled individual, where appropriate, will increase the cost-effectiveness of Access to Work on two fronts. It will ensure that equipment purchased through the scheme continues to be used, as opposed to becoming obsolete with an employer who no longer has any use for it, and it will stop individuals from being required to make unnecessary applications and receive further grants for adjustments they have previously secured. This will in turn reduce the administrative burden on the Access to Work scheme.
Recommendation
The Department should ensure Access to Work awards are transferable from one employer to another. Reassessments should be avoided unless necessary, and should take place only if requested by the disabled person or the type of work changes significantly.	

Many people suggested there was scope to go even further in reducing administrative burdens on individuals, employers and Government, by streamlining assessment processes in different parts of the system. For example, university students in receipt of Disabled Students Allowance questioned the logic of reassessment, and new replacement equipment when their support needs were the same at university as in employment. Individuals with agreed social care packages wondered why they needed separate assessments when their needs had already been identified and well documented in other parts of the system. Some raised the gaps that open up between different assessment regimes: for instance, in some areas someone in work can get an electric wheelchair but a job seeker cannot, due to disjunctions in planning between health and employment agencies. The Right to Control trailblazer areas are testing approaches to bringing budgets together, enabling individuals to use them to best effect. 
Recommendation
Government should, longer term, radically simplify assessment, thereby saving time, money and bureaucracy. There should be an aspiration to a single, portable assessment covering employment, health and social support needs as well as benefit entitlement.	
Government’s role
There is a key role for Government – to act as an exemplar in its own employment of disabled people. Access to Work is not available to people working in government departments – but there is an expectation that government departments will provide disability support at least equivalent to Access to Work. There are concerns among disabled staff that the absence of Access to Work creates a disincentive to employing people with higher-cost adjustment needs, particularly in departments where budgets are not centralised, as this leaves small teams responsible for the funding. There are also fears that disabled people could disproportionately face redundancy in restructuring. Results from the 2009 Civil Service People Survey found that disabled people working in the Civil Service were three times more likely to encounter some form or bullying, harassment or discrimination. In response to these findings a Civil Service Disability Task Group was established, and the Understanding Staff Issues on Disability project was set up to understand these negative results and make recommendations for improvements. One action that Government could take, which would convey a positive message of commitment and ‘nudge’ departments to improve their employment practices, would be to centralise budgets for adjustments within each department, thereby removing a disincentive. This is in line with good practice in the private sector: organisations including Barclays, Royal Mail, Lloyds and others all centralise their budgets for adjustments. It is also important that Access to Work assessments and advice should be available to government departments, even if financial resources come from the department itself.
Recommendation
Government should act as an exemplar in making adjustments. As Access to Work is not available for central Government:
•	government departments should move towards centralising the budget for adjustments to ensure there is no disincentive to employing people with complex adjustment needs;
•	Access to Work advice and assessments should continue to be available to employees and employers in government departments; and
•	government departments should continue to fund adjustments for their employees to a level equivalent to that provided by Access to Work.	
Longer term
Access to Work can also help people keep their jobs if they acquire an impairment or their condition worsens. Many people leave employment each year due to ill health (around 300,000 people each year leave work and move on to incapacity benefits through ill health or disability). In many cases they – and their health professionals, and their employers – are unaware of the support and adjustments that could help them keep their job. Promoting Access to Work more strongly in this context is a win-win, enabling employers to retain skilled talent, enabling newly disabled people to keep their jobs, and saving the State money in out-of-work benefits. We encourage the review of Sickness Absence led by Dame Carol Black and David Frost to explore how Access to Work can become a stronger part of the menu of support on offer to help people retain their jobs if they develop long-term health conditions or if they worsen (see Chapter 5). 
Recommendation
Over the long term the Department should significantly expand funding for Access to Work. This could be achieved by applying the AME-DEL switch principle to release money to invest in the programme in recognition of the benefit savings it generates.	

The above recommendation is particularly relevant when the Department spends around £7 billion a year on out-of-work sickness and disability benefits, but just £330 million on specialist disability employment support. It is also important to consider the strength of Access to Work – studies consistently suggest a strong positive return from the programme to both the Exchequer (£1.48 for every £1) and society overall. The key argument used to secure Treasury funding for the Work Programme has been the use of benefit savings to pay for the programme. Access to Work produces real benefit savings – perhaps even more so than some of the mainstream programmes that the Work Programme is replacing. There is a real case for greater investment in Access to Work over the longer term.
4.3	Remploy
What happens now
Remploy’s mission is: “to significantly increase the employment opportunities of disabled people and those who experience complex barriers to work.” It offers support to disabled people through the two separate arms of its organisation. Enterprise Businesses, otherwise known as the Remploy factory network, currently operate in 15 business sectors including furniture, logistics and recycling industries, as well as extended supply chain management and higher added-value manufacturing. Types of work are wide-ranging: from highly-skilled work (like making protective clothing for the Ministry of Defence or furniture and textiles manufacture) to lower-skilled work, such as packing or bar-coding publications. Work is carried out in a network of 54 local business sites spread across Great Britain which employed around 2,800 disabled people in 2010/11. The other arm of Remploy is the Employment Services network, which operates through a network of branches and offices, and supports disabled people into work with mainstream employers. In 2009/10 it supported around 10,600 people into mainstream employment. 
Remploy: History
Remploy Ltd is a non-departmental public body and public corporation limited by guarantee, which has been sponsored by the Department for Work and Pensions and its predecessors since its creation in 1945. 
Remploy was set up to provide sheltered employment, rehabilitation and training for disabled ex-servicemen returned from the Second World War. The goal was to help disabled people to secure open employment and lead full lives.
The first factory opened in Bridgend in Wales in 1946 and within seven years 91 factories had opened across Great Britain. The total number of factories open today stands at 54.
Remploy Employment Services was set up (under its original name – Interwork) in 1989 and supports disabled people into mainstream employment through a network of branches and offices.	
Effectiveness
Remploy Employment Services are supporting increasing numbers of people each year into mainstream employment at a cost of around £3,300 for each person (from 4,600 people in 2007/08, to 9,800 in 2010/11 and an expected 14,800 by 2012/13). The jobs people go into cover the full range of industries. Disabled people using Remploy  Employment Services who were consulted in the course of the review appeared satisfied with the service. For instance:
“They were really helpful. I don’t think I’d be in work without Remploy’s help.” 
(User of Remploy Employment Services)
The Employers’ Forum on Disability told us that the approach was working well with companies in their membership. Some charities thought Remploy had improved their capability in supporting people facing more complex barriers (like autism and mental health conditions).
The 54 factories provide employment for 2,800 disabled people at an average cost of around £25,000 a year for each person. Although some factory employees move into mainstream employment, the rate of movement is slow, with a large proportion of employees having been employed in the factories for many years, even decades. 
It was clear from this review that the best factories offer job satisfaction, a supportive and accessible environment and a reasonable income for those they employ. The factories have provided employment opportunities – sometimes for many years – to disabled individuals. They have also provided a sense of community for their employees. Some have pioneered learning and development, often led by Union Learner Representatives, through which individuals have (for instance) learnt to read for the first time, or worked towards qualifications. While some sheltered workshop environments pay staff less than the minimum wage, Remploy factories pay above the minimum wage and offer good terms and conditions.
The working environments Remploy factories offer vary. Some have strong marketing and business development models, with busy workloads – others are short of work for significant periods, which is clearly demoralising. As a result, a substantial proportion of the Enterprise Businesses’ workforce is currently in an environment where they are unable to fulfil their potential or realise their aspirations. All of the Remploy Enterprise Businesses are loss-making, requiring subsidy of between £0.5m and £9.4m in 2009/11. Around half of employees at any time have no work. In five sites, where only around 25 per cent of staff had work, Remploy moved to a social enterprise model, capitalising on local markets. They asked staff at the outset what they liked and did not like about working at Remploy; unsurprisingly, the greatest dissatisfaction was having little or nothing to do. As part of the review we talked with employees from factories and comments included:
“I love coming to work [here]. I’ve got lots of friends here. The work is good.” 
(Factory employee)
“We sometimes don’t have enough to do. Sometimes it’s boring.” 
(Factory employee)
Previous reviews have commented on the cost effectiveness of Remploy provision. For instance, in 2005 a National Audit Office report concluded that the Employment Services part of Remploy’s business “appears to offer a more cost-effective service at around £3,400 per person and accounts for three quarters of progressions to unsupported employment … compared to the Enterprise Business aspect which, given the decline of manufacturing across the UK has meant many … Remploy businesses are not really sustainable in purely economic terms despite the supportive environment which they offer their employees”. 
Several people said in the course of the review that the Remploy factories require the level of investment they attract because they employ the most disadvantaged disabled people, furthest from the labour market. There seems to be little evidence for this view. They clearly employ disabled people who face barriers to employment, but the distinction between people using other programmes like Remploy’s Employment Services and those employed in the factories is not clear. 
For example, the factories do not employ large numbers of people requiring support workers at work, or people with serious long-term mental health problems – in fact only 6 per cent of employees have mental health conditions, as compared to almost a quarter of people using Remploy Employment Services. The largest group employed in the factories are people with manual or dexterity difficulties. Some factory employees entered this employment several decades ago, at a time when there were fewer opportunities for disabled people in mainstream employment.
In 2007 the Remploy Board agreed to a modernisation plan with the previous Government. The company’s costs were continuing to rise and this was increasing pressure on funding available for the remaining specialist disability employment programmes. 
The most important question raised by this discussion of effectiveness and cost-effectiveness is how Remploy employees can be part of viable, positive businesses. 
A large number of organisations have commented on this:
“Several valid concerns about the segregation of workplaces have been raised and there is no clear evidence that they are necessary for the employment of disabled people with the most significant impairments or greatest support needs. However, whilst full integration in the workplace is an aspiration, many disabled people within supported businesses have indicated that they feel they would not be able to gain/sustain mainstream employment and greatly value the supported environment in which they work.” 
(Centre for Economic and Social Inclusion)
An historical perspective
Many of Remploy’s Enterprise Businesses are in traditional manufacturing industries which have experienced increasing difficulty in competing on price with other countries, including China and India. Manufacturing has been in decline in the UK for many years. There is, therefore, a question to be asked about the extent to which skills developed in Remploy factories are relevant to the modern labour market across Great Britain; and perhaps about why Government invests such a proportion of its disability employment budget in manufacturing opportunities for disabled people. In the 1940s – when Remploy was set up:
•	manufacturing was at the heart of British employment;
•	society’s views toward disabled people were very different from today. Disability was something to be hidden away, disabled people were considered to be limited by their condition and it was up to them to adapt to the world in which they lived; and
•	the State played a much more interventionist role across the whole of society. In the aftermath of the Second World War, with the development of the National Health Service (NHS) and the welfare state, and nationalised industries from telecommunications to steel and rail, it seemed natural to have Government involved in the direct running of factories.
The decline in manufacturing has coincided with a shift in policy towards supporting disabled people to get in, stay in and get on in competitive open employment. These changes have been driven by disabled people and disabled people’s aspirations, and are underpinned by the Equality Act 2010 which has given a legal framework to the rights of disabled people in mainstream employment. 
Remploy was originally created to offer returning armed-services personnel supported work for a short period, so that they could return to mainstream employment. Over time this approach has changed and some people now working in Remploy have been there for decades. There is therefore a question about the extent to which Remploy’s Enterprise Businesses arm has been able to provide the ‘stepping stone’ originally envisaged to help disabled people realise mainstream employment. The experience of a soldier returning home today and accessing Remploy services contrasts strongly with the experiences in the early days of Remploy.
“Stan Pedrick lost an arm in the Second World War, he walked the streets looking for work only to be repeatedly turned down. In 1946 he started working at the first Remploy factory in Bridgend making violins which were bought by school orchestras throughout the country. Stan retired in 1988.”
“After nearly ten years in the army, Graham Sorley was medically discharged in 2010 because of debilitating arthritis in his left arm. Remploy Employment Services supported Graham with updating his CV and interview technique and he successfully applied for a job as a security guard at Edinburgh airport.”
(Remploy)
The employees of Remploy factories have in some ways been let down over a period of years by a failure to adapt to current markets and by the limitations imposed by direct Government control. Trade unionists have rightly pointed out there is a glass ceiling in Remploy, with non-disabled people largely running the organisation and disabled people working in it. It is the aspiration of this review to enable those businesses that can become viable enterprises to do so, to enable disabled employees to have genuinely sustainable employment and to enable disabled people to have more power and engagement in leading and running businesses where possible. There seem to be a number of problems with the business model of the Remploy factories:
•	Lack of focus. The lines of business are so diverse (from the automotive industry to textiles; from packing to distribution) that there are challenges in reaching the numerous relevant markets effectively. More commonly, businesses of the size of Remploy are much more focused – it is only very large companies, with the investment and capacity to penetrate a range of markets that diversify to the extent that Remploy has done.
•	Central costs. This issue has been highlighted by trade unions. Some lines of business are more likely to be viable without the super-structure and related central costs. 
“Remploy has to change … a slimmed-down corporate structure is needed.”
(Unite)
•	Limitations of Government control. Government is not best placed to operate commercial businesses and its controls and ways of working sometimes do not allow operational flexibility that businesses need. Some factory managers commenting during this review felt hampered by limitations imposed by Government, including tight controls on recruitment and marketing which they felt risked reducing sales. 
This is not the way to run a successful business. This review would like to give those enterprises that have the potential to succeed as businesses a much stronger chance of success than is possible with the level of central control currently in place.
Remploy is currently a large and diverse organisation mostly led by non-disabled people, employing disabled people (the vast majority of factory employees are disabled, compared with around one in five managers):
“There is a glass ceiling in Remploy and other supported workplaces for disabled employees – there is a lack of employee engagement. Disabled people’s skills are not harnessed.”
(GMB Union)
“From the start Remploy should have had a plan for disabled people to move on and move up.”
(GMB Union)
The approach may have reflected society’s values in the 1940s, but not in 2011. A more positive approach would involve disabled people having the chance to run those businesses that are potentially viable.
“I think we recognise we have some considerable way to go, certainly in terms of giving disabled people the opportunities and encouragement to move right to the top of the organisation. Last year, as part of that, we put in place a management development programme specifically aimed at some of our higher-potential disabled junior and middle managers to give them accelerated opportunities to rise through the management.” 
(Tim Matthews, Chief Executive, Remploy)
Such changes are needed in order to gain real equality for disabled people – so they are not confined to lower-level roles in separate workplaces but can utilise their full potential and have the same employment opportunities as non-disabled people.
The model of supported businesses
During the course of this review individuals working in Remploy factories, and the trade unions that represent them, have spoken eloquently of the value of the supported business model, emphasising the supportive environment, the accessibility that is often lacking in mainstream employment, the peer support and sense of community, and the value of skilled work and reasonable pay. From others we talked with there has been a consistent message that ‘we would not start from here’ – that the current Enterprise Business model is not the model of choice for disabled people today. In fact – there has been a unanimous view that it is not the model for the 21st century from both disabled people’s organisations and from disability charities that have submitted evidence to the review. In addition, many stakeholders consulted during the course of the review thought it odd that Government was directly involved in the running of factories. These messages have been relayed consistently during this review by disabled individuals, leaders from disabled people’s organisations, charities and academics. To give a flavour of comments:
“It’s just wrong. It’s 50 years out-of-date. [To have separate factories for disabled people].”
(Disabled people’s organisation)
“I want a proper job. I don’t want to work in a special place for disabled people.”
(Young disabled person)
“We believe that employment in the mainstream market place is key to the inclusion of people with a learning disability in all parts of society. While we believe that these factories have been of real benefit in the past, disabled people are far more likely to have fulfilling lives, and to reach their potential, by working in the inclusive environment which the rest of us take for granted … We agree that by focusing its limited resources on supporting people into mainstream employment, Remploy can help larger numbers of people to get and keep jobs and can offer a wider choice of job.”
(Mencap)
“The currently ring-fenced Remploy factory subsidy should be made available to fund other targeted employment initiatives … This must be conditional upon specific support being provided to the current Remploy workforce that enables them to take up other meaningful opportunities.” 
(Disability Charities Consortium) 
“Remploy factories need to be substantially reformed in order for work places to grow more inclusive and to help disabled people enjoy the same employment opportunities as non-disabled people. They represent an outdated model, cost significantly more per head than traditional employment support models and do not provide any progression as part of a career. However, given the harsh economic climate, we recognise the need for transitional protection for the 3,000 employees currently located in the Remploy factories and suggest that full closure is deferred until the employment environment has recovered.”
(Scope) 
“RNID [Royal National Institute for Deaf People] has long supported Remploy’s move away from the provision of supported employment to helping people into sustainable long-term work. We believe that the subsidies that currently support people in Remploy factories could be better used in providing people with the training and support to enable them to enter the open employment market.” 
(RNID) 
Although this was a unanimous view from organisations led by disabled people and from disability charities, there have been voices strongly opposing fundamental change; from many existing factory employees and from some – but not all – trade unions.
“Remploy is a required and valuable plank in the Government strategy and the factories are the perfect solution for plans to take disabled people off benefits into supported employment.” 
(Trade union representative)
“The factory is so important. I really enjoy it here.” 
(Remploy employee)
“Working in a Remploy factory can help a disabled person become orientated towards the workplace, to establish or re-establish a rhythm of work, build confidence of working alongside others, can teach disabled people skills which can be certificated and then applied in wider work environments, can help people manage interpersonal relationships with other colleagues, and can assist them becoming work ready, to engage in open employment environments.” 
(Unite)
The future 
Many people told the review that equality of opportunity in the full range of employment opportunities – from self-employment to employee or social enterprise – should be the focus of Government policy and that disabled people should have the right support available to them to ensure they are able to work and progress in all types of employment. Chapter 2 discussed how models like Individual Placement with Support enable people with significant impairments to work in every role from boatyard worker to credit controller, from leaflet distributor to accountant. This means Government needs to ensure disabled people experience fewer barriers to employment and progression and to improve access to new roles through economic growth, self-employment, social enterprises and business development. Apprenticeships, work experience, internships and work placements are crucial. Only through opening up all these opportunities, with support, can Government ensure that everyone living with a health condition or disability is able to use their capabilities to the full.
The Trades Union Congress position that there is no need to choose between either support in open employment or supported businesses is sensible and there needs to be a range of choices for disabled individuals as for everyone else, including working in social enterprises, social firms, mutuals, co-operatives and supported businesses. There is one significant caveat that should be added to this: businesses must have a market and must have the potential, with business support, to be viable. As one disabled person put it:
“It would give an odd message if Government were saying disabled people have a great deal to contribute, can work in the mainstream – but we are propping up non-viable businesses to employ them.”
Others said it was unacceptable for Government to put its money into non-viable businesses when such huge numbers of disabled people need individualised support to keep or get jobs and were out of work purely because they were not getting it. This lack of support is a crisis, including for young disabled people not in education, employment or training and for those becoming disabled. People said that their voices are not always heard but need to be. People are losing – or not securing – work for lack of support. 
For example. 
“I used to run pubs, then I lost my sight. If I’d known about Access to Work I’d have kept my £40,000 job.” 
(Disabled person)
This is why it is recommended below that employees and individual businesses within the Remploy umbrella should be able to make proposals to become independent businesses – including co-operatives or mutuals, owned and run by the disabled employees – if they have the potential to be viable. There should be serious business and enterprise support to enable potentially viable businesses to succeed (outlined in the recommendations below). A number of interesting initiatives are in development, for example the York Disabled Workers Cooperative, supported by the GMB, and the Remploy Social Enterprise Sites. These are not currently self-supporting, but illustrate that employees, unions and management are keen to work together to explore alternative models. Also, in areas including Stoke, Wigan, Hull, and the south west of England, transitions have been made or are in development from supported businesses to new enterprise models; and Glasgow Blindcraft has shown how a supported business can move to viability. The five Remploy social enterprise sites have enabled disabled employees to connect with local customers and markets, to have more say and engagement, and to develop new roles and skills, for example, going from answering phones to book-keeping and wider responsibilities. Devolving control to the local level helps secure buy-in of the workforce. Early progress reports suggest that losses are reducing in the social enterprise sites, there is potential to deliver increased sales and margins, and that some may be able to move to viability. Some employees have expressed interest in taking on and running the enterprises themselves. 
The purpose is to enable more disabled people today and in the future to have genuinely sustainable employment, in viable businesses, with opportunities for greater engagement and leadership than currently. 
Many partners could assist – from local businesses (as has happened with the York co-operative, where a local business has offered business expertise) to local authorities, devolved governments, MPs, trade unions, other social enterprises and more.
It is crucial to remember that the existing factory network provides not only work to disabled individuals, often in areas with high unemployment and poor employment opportunities, but also a sense of community. 
“They [Remploy factories] provide a real sense of community. That mustn’t be underestimated.” 
(Disabled people’s organisation)
Local authorities, devolved governments and other partners could play a significant role at local level in supporting proposals to turn individual businesses into viable enterprises, perhaps making use of existing facilities as community or enterprise resources. For example, learning centres within Remploy could be opened up for wider use. 
The current factory businesses are all loss-making to some degree, as shown in Table 4.3.

Table 4.3: Remploy Enterprise Businesses: 2009/10 operating result by business 
Enterprise Businesses (EB)	No of 
factories	Operating result (loss) £,000	
Automotive	4	-3,536	
Building products	2	-4,709	
CCTV	-	-575	
EB central and business offices	-	-3,175	
Commercial furniture	8	-9,487	
E-cycle	3	-5,522	
Electronics	3	-3,421	
Filters	1	-646	
Textiles	6	- 1,895	
Furniture	3	-7,225	
Healthcare	2	-3,646	
Office fulfilment	6	-6,346	
Packaging	5	-5,754	
Social enterprises	5	-2,293	
Supply chain	6	-4,949	
Total	54	-63,179	

The modernisation plan which started in 2007, led by the last Government, envisaged more use of Government procurement (under Article 19 of the Public Service Procurement Directive which exempts sheltered businesses from full competitive tendering). While there are examples of this being used, it has not been as successful as hoped. Some people have said that this procurement model is limited, for a variety of reasons:
•	Overly ambitious targets.
•	Directors of procurement have become used to social benefit clauses covering everything from environmental to community benefit and commissioning. It would be useful to link procurement from disabled people’s organisations, including Remploy businesses, to social benefit clauses, in order to be more influential with procurement departments.
•	There is not always a clear fit between what Remploy businesses provide and what Government buys.
•	Some people think businesses should compete on the basis of merit: in any event, the product must have a real value in the market.
•	It is important that public sector procurement delivers value for money.
It is likely, looking at the loss-making figures, that some businesses might not be able to become viable, even with the most active involvement of business expertise and partnerships – and even with increased procurement from Government. All, however, must be given the chance to submit proposals for viable business plans: groups of employees or local managers may have strong ideas for viability and potential partnerships to help make it happen. Where this is not possible, it is critical that there is very strong support in place to help employees find alternative employment and other support they and their families may require (see Transitions section below). The individuals working in Remploy factories deserve to be supported. In many cases they have worked for Remploy for years, which in itself may make it hard for them to secure alternative employment. Positive support, planned by Remploy with trade unions and with the full involvement of employees, is essential. 
Employment Services
In addition to the factory network, Remploy receives grant-in-aid each year in exchange for delivering a range of employment and development opportunities for disabled people in line with the Government’s Work Choice programme. These are delivered by Remploy’s Employment Services business. Many of the stakeholders consulted during the course of this review felt that there was an anomaly in Remploy’s delivering Work Choice provision through their core State-funded offer, while other providers are bidding to deliver similar provision through open competition.
Future funding
The core recommendation of this report – set out at the end of Chapter 2 – is that the Department should, in general, be funding individuals’ support costs – so that disabled people can participate in every type of employment, from working for a mainstream employer to setting up their own business or working in a social enterprise or mutual – rather than funding disability-specific facilities, like Remploy factories. 
“I want to feel normal – I want to do the same job that anyone else could.”
(Young disabled person)
Funding should therefore follow the individual and not the institution. This would mean disabled people would have support to access the maximum range of career choices. Disabled people should have choice and control over the support they receive, and disabled people’s organisations, charities, providers and other organisations should be encouraged to respond to their demands.
Remploy currently receives direct funding from the Department; funding which accounts for over a third of the Department’s spending on specialist disability employment support. Much of this directly funds facilities – the factory businesses (£63 million) – rather than individuals. The use of funding in this way limits the number of disabled people who can be supported into employment.
The current use of resource in the factory network seems unsustainable – £25,000 spent on each person is high when factories do not appear to employ people who are more disadvantaged than those using other employment support services and when few people progress to wider employment (and this may be unlikely to change given that stepping stones are not evidence-based and people too often ‘stop there’, see Chapter 2).The businesses themselves are making significant losses, in manufacturing sectors that in some cases do not prepare disabled people well for the economy of today and tomorrow. That is why it is imperative to give those business lines with the potential to become viable enterprises the support they need to do so, as soon as possible; and to give individual employees excellent support for transition so they can make choices with strong support. Employees should be engaged and asked for their ideas as a central part of this process. 
The Access to Work recommendations set out earlier in this chapter make the case for scaling back the administrative and controlling role of Government and moving toward individuals having control over the services they access. The same principle applies here.
Government money spent on disability employment support should be spent as effectively as possible. Support for transition to viable enterprises and businesses plus Access to Work support in mainstream employment could, over the longer term, help many more people than the current set of programmes. The Department’s spending on disability-specific workplaces – with their relatively high unit costs – could be reduced, once business support is offered to enable all those that are able to do so, to be transformed into viable businesses and co-operatives. This could mean both that those enterprises that were viable could offer disabled employees the opportunity to develop and take on new roles and that resources could be freed to support more disabled people who are needlessly out of work for lack of support. It will be crucial to undertake an equality impact assessment of proposed changes.
The current situation is not sustainable or equitable. The alternative to a managed reform programme is that the growing gap between aspiration and reality will force Remploy Enterprise Businesses to crisis point. There is a real danger that factories might just decline, and/or close in circumstances that do not allow the kind of phased and planned support for employees that would give them the best opportunity of finding new roles in viable employment. This must not be allowed to happen. 
Recommendation
The Department should, by the end of the current Spending Review, have introduced a new model for Remploy, and Government funding should be invested in effective support for individuals, rather than subsidising factory businesses: 
•	Remploy Enterprise Businesses should be given the opportunity – with expert support – to become successful businesses free from Government control.
•	Where this is not an option, and businesses cannot continue, individual employees should be offered guaranteed and active support to secure employment, training, or other community activity.
•	Remploy Employment Services should in future secure Government funds only by competing for contracts like other providers.	

This chapter has already recognised the huge contribution Remploy has made – and still makes – to disabled people’s lives. It is, however, time to reassess the current structure and funding of the organisation – and it is important this is done in a way which builds on the positives that Remploy has delivered (support, training and development), and in a way which offers excellent, active support to individual employees and maximises funding to be released to enable larger numbers of disabled people to work, more equitably. The following recommendations, if implemented, should allow many more disabled people than before to benefit from effective employment support, including people facing greatest disadvantage.
Recommendation
The Department should ensure resources released from Remploy reform (after accounting for the costs of reform) are spent on employment support that fits disabled people’s aspirations for work in all types of employment settings.	
Transitions
Transition must be managed positively with full involvement of employees and trade unions, and must offer strong protection of the rights and interests of individuals. Change is difficult for everyone and often the way change is managed is as important as the change itself. In particular this review wants to see two protections: trade unions involved in the process for assessing potential viability of businesses and in planning the support for those businesses, over a sensible timescale to give every opportunity for success; and a package of support for individual employees – ideally this would be through an individual budget, so that individuals can begin to plan six months before any change and use the budget for training and support for employment. Remploy should ensure that practical support for wider family and community life is on offer. 
It is for Government, Remploy and the trade unions to discuss the detail of this package but it needs to recognise that many employees have worked for a long time in the factories and be sufficient to address the challenges people may face in working in different settings, and to offer support and advice on issues such as benefits and transport that can be so crucial to employment and community opportunities. The Remploy Board has a key role in ensuring that these protections are in place and followed through properly. 
In the course of this review views were gathered from people who have managed all kinds of transitions – closures of large psychiatric and learning disability institutions, transformation of sheltered workshops into enterprises and more. Social Firms UK have pulled together learning on transitions from supported businesses to social firms. This highlights the importance of a planned approach, with an agreed strategy; the need for strong change management; and the difference that can be made by having a ‘social firm champion’. Evidence was also gathered about the lessons from Remploy modernisation, which it seems did not offer everyone active support with career planning and resulted in some people being without activity. Some of the key principles of transition are: full and early involvement of those affected, enabling people to feel in control, to take leadership roles if they wish; strong and frequent communication; changing practices – for instance not employing people afresh in factories that may be about to change. In implementing any change, it is absolutely imperative that the Department respects the rights of current Remploy employees. They must be supported in making the best use of their talents. They must have real choice about the support they receive. And they must have every opportunity to use their potential.
There are implications of this review for other supported businesses. Well-planned transformation of supported business places in receipt of guaranteed support under Work Choice, along the lines discussed here with respect to Remploy, will also be needed to ensure individual disabled people have the option of running independent businesses or a choice of all other types of work and career, and the personalised support to go with it. 
In summary, this report recommends that Government implements the following recommendation to maximise the employment support disabled people receive.
Recommendation
The Department should ensure existing employees in Remploy Enterprise Businesses are offered the opportunity and expert entrepreneurial and business support over a decent time period to develop businesses into independent enterprises, where viable – whether mutuals, social enterprises, companies limited by guarantee or other models. The Department should actively pursue partnership working between Remploy, local authorities, businesses, disabled people’s organisations and others to achieve this. Trade unions should be fully involved.	

It may be that some of the larger business lines would require national sales strategies and lend themselves to mutualised structures without being fully owned, whereas smaller, localised business lines might become co-operatives. The following text sets out a suggestion for the way the above recommendations on Remploy might be implemented. The detail should be agreed between Remploy, trade unions and Government who could work from the following suggestions.
If the Department accepts the core recommendation set out above, then any current Remploy Enterprise Businesses which may have a future as a viable business should be supported in the transition to such a structure. The following sets out the process by which this might happen:
•	The Department announces its intention to invite interest in new models and to taper direct funding of Enterprise Businesses.
•	The Department establishes a small independent panel of business and enterprise experts, with trade union involvement, to consider the viability of both existing Remploy Enterprise Businesses and proposals that will be invited from employees and managers.
Employees and management of Enterprise Businesses should be given a sufficient window (for instance, six months) to put forward a business plan to this expert panel setting out how the business will become viable without Government subsidy. Proposals will be welcome from partnerships, for instance involving local authorities or local employers; and Remploy is encouraged to open discussions with devolved administrations and local authorities to see whether innovative ways can be found to build a viable business. This panel will have the discretion to decide whether or not a business has a viable future. A business might be: the whole of one of Remploy’s Enterprise Businesses, or a part thereof; or several factories with a similar focus banding together; or a new strong idea, with a clear market. 
In order for the panel to declare a business to be viable, the business should:
•	be capable of being self-supporting within a realistic period (for instance, 24 months) of starting to implement its business plan; and
•	be able to operate with a tapering level of subsidy over that period. This subsidy will start at the equivalent of the current level of subsidy and reduce to nil at (say) the 24-month point.
Of course, individuals requiring support should be able to secure it (under Access to Work, Work Choice or other). 
If the expert panel approves a business’s plan then the Department should:
•	provide the tapered subsidy as detailed above;
•	link each potentially viable business to the business advice and support it needs, from a menu including mentoring by a social entrepreneur, support from a social enterprise infrastructure organisation (such as the Social Enterprise Coalition), with business planning expertise contracted in;
•	fund support from a social entrepreneur expert to provide advice on transition to social enterprise (or other appropriate structure); and
•	give the group of employees or management who have put forward the business proposal the option of buying the business at the end the 24-month period. The business would then be independent, operating outside Remploy control.
It is difficult to predict in advance how many of the current Remploy businesses could become successful social enterprises. Some Enterprise Businesses may be unlikely, given their business models, to meet the viability tests set out above. In this case there should be guaranteed, proactive, substantial support for employment and wider social support. Government should channel any savings into Access to Work and consider options for use of the assets, including exploring options for community or other social use.	

There will rightly be some costs associated with the changes above, particularly to support transition. As money becomes freed to recycle into Access to Work, this recommendation is likely to result in many more people benefiting from disability employment support. In 2009/10 £63 million was spent on Remploy Enterprise Businesses – which supported 2,800 disabled people. Had the same amount of money been spent on Access to Work, around 24,000 people might have been helped for the same money.
It is critically important that any employees leaving Remploy Enterprise Businesses receive strong support to help them find alternative employment.
Recommendation
The Department must ensure disabled individuals working in Remploy Enterprise Businesses which are not potentially financially viable, or who wish to seek open employment, are offered comprehensive support, to be agreed between Remploy, Government, trade unions and employees, to include individual resources for a guaranteed place in Work Choice, Remploy Employment Services or alternative employment support of their choice. Remploy should ensure that practical support for wider family and community life is on offer. There should be support and life planning actively offered at least six months prior to any business change and the package should recognise people’s long-standing work with Remploy. The Department and Remploy should actively pursue links with employers to provide alternative employment opportunities.	

Recommendation
The Department should ensure Remploy employees’ accrued pension rights are fully protected.	

The Remploy board and local management have a key role to play in any transition process in ensuring Remploy employees receive the necessary support.
Views on Employment Services have not been as strong or consistent as views expressed on Remploy Enterprise Businesses. Most users seem relatively content with the service, but many people and organisations have commented that the current funding model – with Employment Services funded through grant-in-aid (rather than through contracts) – is an anomaly.
Recommendation 
Remploy Employment Services should be freed to operate as a social enterprise, mutual, co-operative or other structure. Taken together with the recommendation for a new model for Remploy Enterprise Businesses, this recommendation envisages that Remploy’s future should be as an organisation independent of Government, focused on supporting disabled people to find and sustain work across the range of roles in the economy.	
4.4	Residential Training Colleges 
RTCs provide vocational training to help disabled adults move into employment, often combined with intensive multi-disciplinary support and independent living skills.
Residential Training is a specialist programme, delivered by nine Residential Training Colleges (all of which are registered charities) concentrated in the East and South of England. Traditionally the colleges have had no representation in the North West of England, Scotland or Wales; however, one of the colleges has recently established two satellites – one in the North West and one in South Wales.
Courses vary between colleges but typically offer qualifications in anything from massage to fork-lift truck driving, joinery, accountancy and IT. The duration of courses available through the college network varies, though no course should run for longer than 52 weeks. The average length of courses in 2009/10 was 35 weeks.
While the remainder of this chapter contains recommendations for Government to consider, the future strategy of the RTC network is for the colleges themselves to determine. RTCs are independent organisations. Unlike Access to Work and Remploy, the colleges do not fall under the direct control of Government. Consequently, the colleges have the freedom to develop their services outside of the recommendations of this review.
It should be noted that there are over 70 independent specialist colleges offering further education (FE) or training for learners with disabilities across the UK. The Association of National Specialist Colleges (Natspec) reported that almost 4,000 young people per year attend independent specialist colleges funded by the Young Person’s Learning Agency. Six of the RTCs are also members of Natspec.
According to the Labour Force Survey (LFS), around 110,000 disabled people aged 16 or over are in FE (local college, tertiary college, specialist FE college or sixth form).
With around 840 starts in 2009/10, the number of people supported by Residential Training is very small compared with the number of people attending specialist colleges, and even smaller compared with the 110,000 disabled people in FE. Residential Training is also small in comparison to the number of disabled people who receive specialist disability employment support. 
RTCs: A short history
The origin of the RTC network is varied. Some were established for the purpose of rehabilitating disabled war veterans, some set up as charitable foundations before the Second World War, and others established as schools for disabled children and subsequently developed into training centres for disabled adults.
Of the nine colleges, five are pan-disability, three focus on visual impairment and one focuses on hearing impairment.	

During the course of this review, all nine RTCs were visited. 
Effectiveness
Each college is different, so it is hard to generalise the provision.
The college visits and evidence submitted to this review highlight two main strengths of Residential Training. Firstly, the provision includes some impressive practices in supporting independent living skills and adaptation to impairment. Colleges often have state-of-the-art specialist equipment, technology and facilities – from football pitches designed with acoustic features to enable blind people to play, to hydrotherapy pools and fully accessible gyms – combined with teams of expert staff. They offer highly accessible environments and often give disabled people the opportunity to learn to use the latest specialist equipment and technology for the first time.
Secondly, most colleges adopt strong multi-disciplinary approaches that offer people the chance to tackle their full range of challenges in a concerted way – from adaptation to impairment to family problems, debt, anxiety and more – alongside peer support and vocational training. At best this enables people to tackle the issues that prevent them from moving on in their lives. Finchale College recently won awards for its approach to health and well-being at work. 
However, this review is concerned specifically with employment support. The Department currently funds around 840 places across the nine RTCs, which, in 2009/10, led to 230 job outcomes, of which two thirds were sustained at six months, at a cost of £18 million a year. There is little systematic information on longer-term outcomes – although some colleges keep in touch with former trainees informally.
Figure 4.1: Summary of total Residential Training assessments, starts, early leavers, completions, jobs and sustained jobs

In terms of both unit cost for each job and cost for each sustained job, Residential Training is the most expensive specialist disability employment programme. It costs around £78,000 for each job and £120,000 for each sustained job. Around two-thirds of people who get a job sustain it. It is not possible to directly compare effectiveness or value for money of Residential Training with other employment programmes, but the large disparity in unit costs across employment programmes cannot be ignored. This review has attempted to identify a clear rationale for direct investment in Residential Training as a preferred approach to employment support.
It is important to note that RTC principals have usefully looked in 2010/11 at how to deliver ‘more for less’, with some encouraging innovative suggestions. Some colleges are already moving towards shorter courses and new partnerships. However, even if price for each sustainable job could be significantly reduced, questions about the approach of this model should be explored.
It was clear from visiting the RTCs that some take more of a ‘work first’ approach than others, displaying impressive links with local employers to help deliver highly work-focused training programmes involving work experience placements with employers, and a strong focus on job search from day one. Some liaise with employers from the individual’s home area, organise work placements in that area where possible, and liaise with local employment support agencies to continue support after the course is completed. Others are more focused on training, with job outcomes being considered as the course nears its end. 
The recent report by Alison Wolf suggests that vocational training is more effective when it includes genuine work experience and close links with employers because employers continue to value and reward work experience, not just formal credentials, and skills are best acquired in the context of the reality of working life. The Wolf Report argues that: “work experiences still offer an alternative progression route, while many formal qualifications are not worth having at all”, and that: “there is a wealth of evidence indicating that [employers] value work experience, and that the best way to obtain a job is to have one … partly because a genuine workplace teaches both general and specific work skills more effectively than any education-based simulation can, however hard it tries”. Although the more work-focused provision in some RTCs is an effective model for vocational training, there is a question over whether a traditional vocational training model in itself is the best approach for employment support.
Many stakeholders consulted during this review argued that vocational training is not the most effective form of employment support, preferring a more personalised package with an early and continuing focus on real jobs.
In addition to concerns over the cost-effectiveness of Residential Training, and an evidence base which suggests that vocational training may not always be the best model of employment support, some stakeholders have raised further issues in relation to the appropriateness of this model for the future.
Given the geographical spread and residential nature of this provision, there are understandably some concerns about the dislocation between college provision and continuity of family and social networks, local agency support, and lack of contact with local employers.
In their response to the call for evidence, the Foundation for People with Learning Disabilities raised a number of concerns over RTC provision, including: 
•	“Residential placements are too often the default option for people who are seen as ‘too difficult’ to support locally, for lack of investment in strong local services;
•	People who are sent away to college can find it hard to return, as they are still seen as ‘too difficult’;
•	It is hard for families, friends and local services to keep in touch with someone who is in a distant placement. Social networks dwindle, links between the residential college and local employers are inevitably less well developed, and it is not always clear that the skills being developed at college truly reflect those required by an employer;
•	And people with learning disabilities often find it hard to transfer skills learned in one location and apply them in another, which is why supported employment techniques have been developed to teach ‘on the job’.”
If ‘dislocation’ from the local labour market and networks is an issue, there is a question about whether regular FE can offer vocational training to disabled people when needed. The answer appears to be that it can do, but practice is patchy around the country. 
Case study – Lewisham College 
Lewisham College aims to be an inclusive community for all learners, including people with a wide range of experiences of disability. In 2009/10 30 per cent of learners in mainstream courses were disabled or had additional learning needs. There is a centralised budget for additional learning support so learners can get their adjustment needs met. In addition there are specific programmes enabling people with learning disabilities to develop a portfolio of skills, including the Pathways to Employment programme through which learners do work placements and volunteering and secure paid work with support from the college, Jobcentre Plus, local Mencap and other agencies. Former learners include the founder of Heart N Soul (a performance group) – the first person with a learning disability to be awarded an MBE. Strong links with local agencies are fostered so that the range of learners’ needs can be addressed holistically: for instance, speech and language therapists, sexual health and social services.	

The Skills Funding Agency has a legal responsibility to secure reasonable facilities for learners with learning difficulties and/or disabilities aged 19 or over, except those aged under 25 who are subject to a Learning Disability Assessment (who receive funding from the Young People’s Learning Agency).
“My parents thought I would need to operate in a mainstream world, so I attended a mainstream college.” 
(Young deaf man who uses British Sign Language, in employment) 
The integrated support offered in RTCs can be offered locally – without the disadvantage of dislocation when the learner returns to their home area. The fact that many local FE colleges are not as inclusive suggests a potential role for RTCs in partnering these colleges, supporting both students and staff through distance learning, short modules in the RTC or other approaches, thereby potentially spreading expertise to larger numbers of disabled people. Some RTCs have developed or are developing such links. 
Some stakeholders expressed fears that attendance at RTCs might result in disabled people becoming institutionalised. The visits to RTCs suggested that these fears may be valid in some (but by no means all) cases, while others revealed excellent practices, enabling people to develop greater independence than ever before.
“My daughter went to an RTC. She has significant impairments, had gone through mainstream school, was about to go on a gap year on Greyhound buses (which are accessible) – and the people at the RTC just couldn’t believe she was going on a gap year. She had more significant impairments – but they [RTC staff] just couldn’t imagine a life [for her] outside institutions.”
(Parent of a disabled young person) 
Several staff members in RTCs talked about the need to reduce people’s aspirations when they arrived. Research suggests that disabled people generally already have reduced confidence and aspirations. While the context of a difficult labour market, in which sometimes only entry-level jobs are available, is a real one, it seemed that some staff members were not in touch with the more aspirational thinking of the disability movement and more forward-thinking disability employment programmes. 
Some RTCs had taken steps to practice what they preached, by employing significant numbers of disabled people themselves as tutors and managers. In others, this had not happened and the culture seemed more one in which the non-disabled staff provided for the disabled trainees. 
There were some examples of RTCs developing links with local colleges and universities. St Loye’s Foundation in Exeter has developed satellite centres in Warrington and Cardiff – allowing them to start to break down geographical limitations to their services. The Royal National Institute of Blind People’s college in Loughborough is co-located with a mainstream FE college and supports students within it.
It is important to consider the views and experiences of disabled people – and these were carefully explored in the course of the review. The majority of disabled people in RTCs who were consulted spoke highly of the provision. Many had tried accessing vocational training through mainstream FE, but had not been given the necessary support to succeed. One former student described Residential Training as an: “… important experience not too dissimilar to going to university.” While many individuals thought that Residential Training was superior to mainstream provision because of the peer support, multi-disciplinary approach, and the opportunities to learn to use new technologies and independent living skills, others seemed to value the provision because they felt it was their only option, and there was a feeling that ideally this provision should be available locally, and that disabled people should be adequately catered for through mainstream support.
“The whole experience (of mainstream FE) terrified me.”
“They (FE colleges) say they’ll give you the support. Then you turn up and there’s nothing.”
“I’d prefer to be in a mainstream college. Then I’d feel normal.”
“You’re still human. You still have to get on with normal people.”
(RTC students)
The comments suggest high value placed on what the colleges offer; but also a sense from some people that it would be preferable if holistic support were available locally in FE colleges, with Access to Work support for work experience and more opportunities for peer engagement not only with other disabled people but with non-disabled peers as well. Some suggested that some of the strengths of RTCs could be offered locally, for instance:
•	peer support, or 
•	through short residential modules for people with ‘low incidence’ impairments, like complete sight loss, to work with others residentially on independent living, with peer support etc. 
This provision is only available to around 840 disabled adults each year, which represents a very small proportion of the disabled population. While it is important to consult those who use this provision, it would be wrong to ignore the needs of the overwhelming number who do not use it.
Disabled people were asked to give their views of RTCs. Young disabled people said:
“Some people want separate colleges – either because that’s all they can imagine, it’s low expectations – or because there is no alternative.”
“It should be available locally.”
There was a lack of clear consensus among disability leaders, disabled people’s organisations and professional groups, with a range of different views put forward to this review. Many thought RTCs were not the model for the future and support should be phased out in favour of investing in individual support for disabled people to access mainstream vocational training, FE, work placements and employment. Some saw a clear role for RTCs – for instance, in enabling young disabled people to get away from home for the first time and establish independence, or enabling people with acquired impairments to gain independent living skills. Some thought 24-hour provision was needed to support rehabilitation and social functioning only for people with the most complex challenges (and even then not for vocational training) – for instance, people with significant brain injury unable to think sequentially, or people with significant learning disabilities combined with major physical impairments.
In summary, while RTCs clearly offer benefit to people’s lives, there is not a clear, strong evidence base or strong consensus in support of the current RTC model of vocational training as the most effective way specifically of enabling employment. Many of the arguments put forward in favour of this approach seem to use wider system failures to justify a need for the longer-term vocational courses offered by RTCs. 
The people served 
The aim of RTCs is to serve disabled people facing the most complex or significant barriers to employment. From the visits undertaken during this review, and through discussions with staff at the colleges, it is hard to conclude that this is the case in practice. In general, groups with the lowest employment rates – people with learning disabilities or serious long-term mental health problems – are under-represented. 
The colleges cover a significant age range (offering places to people who have recently acquired impairments – at whatever age – and to people with long-standing impairments who, for whatever reason, have not succeeded through other programmes). There is much less equitable coverage by gender and ethnicity – as shown in Figure 4.2. A move away from the existing Residential Training programme to more mainstream provision might help address such imbalances.
Figure 4.2: Breakdown of Residential Training customers by gender and ethnicity 2009/10

Explanations offered by RTCs for the gender and ethnicity imbalances included the family responsibilities of some women, which made it harder for them to leave their home and variations in the referrals from Disability Employment Advisers (DEAs).
This review has attempted to understand the process through which disabled people are judged to be eligible for this very limited and costly provision. All referrals to Residential Training must be made by a DEA. The evidence submitted to this review suggests that knowledge and awareness of this provision is inconsistent, and that DEAs themselves have varying views on whether this provision is effective in helping disabled people move into work. A lack of consistency in awareness is perhaps not surprising given the geographical concentration of colleges. However, this raises important questions about equity of access to provision which is either not known about by DEAs, or not deemed accessible by individuals living far away from one of the colleges. 
DEAs were asked who they referred and why. Some had a clear sense of who might benefit, in line with Jobcentre Plus guidance and their own experience – for instance, people who needed a break from their home environment to learn and progress. Others had concerns about RTCs:
“I referred a man with physical impairments who did benefit.” 
(DEA)
“I stopped referring because the RTCs cherry pick.” 
(DEA)
“I was very surprised that I had the power as a DEA to refer to this very expensive provision. I didn’t see it leading to jobs. Now I know what can be done locally to support people into real colleges and workplaces I don’t see the point of that expenditure.” 
(Former DEA)
“A young man wanted to do a particular course – it cost £800 at the local college, but the DEA did not have any budget to allow her to refer him to the course. She did have the power to refer to a Residential Training College to do the course. So that is what she did – at the cost of around £56,000.” 
(DEA)
Each college carries out its own assessment process before accepting referrals onto the provision. One college suggested that as many as 40 per cent of people referred to Residential Training might be turned down at the assessment stage, in order to ensure people most likely to benefit and secure employment were taken on. A range of implicit and explicit selection criteria used became apparent during this review, such as potential clients needing to have or be working towards a Level 2 qualification, being free of alcohol and drugs over the last six months and needing to have a fixed abode. Some said people with injuries or mental health problems needed to have gone through rehabilitation or recovery first before they would be ready for the course. Such criteria lead to questions about whether the programme is serving the most disadvantaged.
It is clear that some of the RTCs can support people with, for instance, a physical impairment and family or debt problems; but the people who are most disadvantaged in the labour market are, in reality, people with more serious challenges: drug problems, homelessness, serious mental health problems and learning disabilities. These experiences do not seem to be so readily catered for, despite the aspiration to help those most disadvantaged. 
Waiting until people with mental health problems or injuries have been fully treated or rehabilitated is inconsistent with best practice: the longer someone is away from employment or education or vocational activity the harder it becomes to get back into work. The process of recovery or rehabilitation needs to focus on employment from the outset – so people with current mental health problems can benefit from employment programmes. Requiring a Level 2 qualification excludes many people with learning disabilities and others who may have missed out on education, for instance, young people growing up in care or with complex medical conditions.
Despite this, it is important to recognise the excellent service RTCs provide for individuals, with high levels of satisfaction, excellent facilities and committed staff. The individuals in some cases would not have been able to secure the support they wanted or needed at local level as things currently stand, and some people found the programmes life-changing. RTCs have expertise that can be used in a range of ways in future. 
The future
There is no clear message that vocational courses lasting an average of 35 weeks in a residential setting specifically for disabled people have high value for employment outcomes for people facing significant disadvantage. There would appear to be greater value in:
•	increasing access to internships, work experience, apprenticeships, work placements and on-the-job learning. These opportunities are growing. This requires Government action to support and incentivise employers and individuals – so that the full range of adjustments and supports needed by disabled people are in place to allow them to participate in all these programmes. RTCs may have a role in this;
•	improving employment prospects of people most disadvantaged in mainstream FE provision through support (potentially from RTCs, as centres of excellence) to FE colleges, enabling them to become better equipped to support disabled students. This could potentially include encouraging disabled people to attend short courses, as part of their mainstream learning, in RTCs, or through distance learning;
•	independent living programmes which support disabled people to adapt to impairment – adapting to the huge change in their life through peer support as well as learning to use technology. For low incidence impairments this could take place in residential settings (from university campuses to existing RTCs), or alternatively through disabled people’s organisations and other expertise at local level;
•	multi-faceted local input for people facing the most significant disadvantage, for instance, people with intersecting mental health, drug, homelessness, ex-offender histories, as well as family or financial problems. Again RTCs may be able to share expertise in multi-disciplinary work. 
Under these priorities, the role of RTCs might change – from direct provision of relatively long courses for a very small number of disabled people, to sharing of expertise more widely as centres of excellence (with FE colleges, Work Choice/Work Programme providers and employers taking on apprentices or interns). They might deliver modular programme elements as part of an individual’s journey, for instance adaptation to impairment programmes, plus – potentially – certain vocational programmes as part of Work Choice or the Work Programme. 
Given the core recommendation in Chapter 2 that the Department’s funding should follow individuals not institutions, and the evidence which suggests that RTCs offer more than simply vocational training, it is time for the Department’s direct funding to RTCs to change. 
It should not be possible for a DEA to refer someone to a £56,000 programme for want of £800 in the right budget to spend locally. Instead, funding should follow the individual and be spent to best effect either by the individual (if they hold the budget) or on their behalf, so their needs are being addressed in the round. 
Some stakeholders did question why this provision was funded separately, outside of the wider FE system, referring to current funding arrangements as “an accident of history”. The colleges themselves recognise that their provision has value to other government departments. Indeed, it is hard to see the difference between the vocational training element of residential training and mainstream FE provision, which in some cases is bought in by the RTCs through sub-contracting arrangements and seems to be based on a stock syllabus. 
On balance, there would appear not to be a compelling case for supporting 840 people a year through this particular vocational provision as a separate direct-funded programme. Where there are aspects of the vocational programmes that are effective in achieving job outcomes for people facing complex challenges, then these could be purchased under the Work Programme or Work Choice; or through Skills Funding Agency contracts, which increasingly support courses and qualifications leading to employment outcomes. The Skills Funding Agency has an obligation to secure reasonable facilities for learners with learning difficulties and/or disabilities. Chapter 3 discusses improvements to resource allocation overall, which are important to enable people with the greatest challenges and support needs to secure the resource they need through Work Choice and the Work Programme. Independent living programmes – which seem a particular strength of some RTCs, especially training in use of state of the art adaptive technology – could be bought through NHS commissioning or individual health or social care budgets. Some of the colleges are already delivering programmes focused on vocational rehabilitation of armed forces personnel with injuries or impairments.
It is also important to consider the equality dimensions of any changes. The shift envisaged here – with more emphasis on supporting local skills and employment – has the potential to support more women and more people from BME communities across the whole of the UK than RTCs have achieved. 
The following recommendations set out how the Department might make changes to the Residential Training programme to improve the overall offer of employment support to disabled people. It is important that RTCs have the opportunity to explore with different government departments and funding agencies the potential ways that their expertise can become part of disabled people’s skills and employment development in future. We suggest some approaches below but encourage funders and departments to work with RTCs to enable successful transitions. The Skills Funding Agency has introduced the Approved College and Training Organisation Register (ACTOR). Anyone (including RTCs) wishing to receive funding through the agency for delivery of FE provision can apply to be registered on ACTOR. ACTOR tests the providers’ quality, capacity and capability to deliver and meet minimum standards. It is important to note that being on ACTOR does not guarantee funding. It does, however, simplify the previous processes for being considered by the Agency when awarding contracts. 
Recommendation
The Department should not directly fund Residential Training as a distinct facilities-based programme. RTCs should be encouraged to seek funding from a range of sources including the Skills Funding Agency, and Work Choice and Work Programme providers funded by the Department. Colleges should be supported by the Department to make this transition.	

Recommendation
The Department should encourage RTCs to explore options for:
•	developing as centres of excellence and sharing their expertise on accessibility, learning, employment, independent living skills, and adaptation to impairment through partnership working with FE and training providers, the NHS commissioning board and local authorities; and
•	adapting their provision and seeking new opportunities to operate directly in provider markets including:
o	education and training;
o	welfare-to-work;
o	independent living and adaptation to acquired impairments;
o	advising on accessibility; and
o	diversity training and workforce development.	

Recommendation
The Department should use the budget currently allocated to funding Residential Training to open-up opportunities for work experience, including internships, work placements and on-the-job learning. This could be through ring-fenced funding under Access to Work.	

Releasing Residential Training funding and investing the money in Access to Work will allow more disabled people to benefit from support (and see Chapter 3 for suggested improvements to resource allocation to meet the needs of people facing complex challenges under Work Choice and the Work Programme). The Department spent £18 million on Residential Training in 2009/10. With the average annual spend for each person on Access to Work at around £2,600 – around 6,800 extra people could have been supported with the same level of funding in Access to Work. Such an increase would be significant – and be on top of the increased numbers which could be helped as a result of the efficiency changes recommended in the section on Access to Work.
4.5 	Summary 
This chapter has set out details of how specialist disability employment programmes might be reformed to provide a more coherent and more effective set of services. Having set these out, it is important to clarify the roles that individuals, employers and the State should play in supporting this vision.
•	The State – should offer a spectrum of support and resource allocation to meet a spectrum of need. It should support and stimulate a range of models in addition to its employment programmes: self-employment, social enterprises. It should champion support and partnerships with employers.
•	Employers – should take a leadership role in breaking down barriers to career development and progression, identifying and promoting incentives to do so.
•	Individuals – should exercise their control over the services on offer. They should seize opportunities and work to develop their personal capability.
Transition
It is recognised that there will be uncertainty and concern during any transition period from the existing Remploy and RTC structures. The recommendations in this chapter set out some vital protections and supports that should be put in place to enable this transition to be fair and effective. If the Government is to build an effective system of employment support for disabled people, it is crucial that there is a strong vision and a fair process for getting there. Through all of these changes, the Department does not and should not act in isolation. There are key roles for other departments and organisations to play. Such roles are discussed in more detail in the next chapter.
4.6	Key messages – Chapter 4
•	For every £1 spent on Access to Work the Exchequer recoups £1.48, and the social return on investment is even higher. It is vital, popular and should be built upon through a new portal with peer support, that radically opens-up knowledge, drives-down costs and improves access including to people in SMEs, groups who are under-served, people needing support to retain their jobs, and people seeking a job or work placement.
•	Remploy Enterprise Businesses would not be the model of choice for disabled people today: support across all roles in the open labour market should be the focus of Government policy. Individual Remploy’s Enterprise Businesses should be given strong expert support to become viable enterprises or mutuals, to give sustainable employment to disabled workers, where possible, with partners. Where this is not possible, individuals should receive excellent protection and support for their employment and wider lives.
•	RTCs should seek funding from a range of sources for their expertise in learning, independent living and employment, and no longer be funded as a distinct employment programme directly by the Department.
•	Funding freed from changes to Remploy and RTCs should be used to open up opportunities for work experience, including internships, work placements and on-the-job learning, via Access to Work. Doing this (once transition costs were complete) could double the number of people receiving Access to Work and take the number of people receiving specialist disability employment support from around 65,000 a year to 100,000.	

Chapter 5
An enabling state
Working with wider support services
5.1 	Foundations for success
5.2 	Raising aspirations
5.3 	Skills and qualifications
5.4 	Accessing labour market opportunities
5.5 	Summary
5.6	Key messages – Chapter 5

Working with wider support services
The vision for equality set out at the beginning of this report cannot be achieved without the support of wider Government policy and from a range of other players, from employers to schools, recruitment agencies to health professionals and disabled people’s organisations. It is a joint agenda. It is vital that other parts of the system do their bit to facilitate greater equality of opportunity for disabled people by removing barriers to employment.
5.1 	Foundations for success
Employment must be a cross-Government objective, so that the Department’s services work in conjunction with wider policy and are part of the answer (prevention), rather than having to pick up the pieces of wider policy failure (cure).
The messages from stakeholders are clear – equality in employment will not be achieved without the following foundations for success:
•	Education, health and social care systems that raise the aspirations of disabled people and their families, and prepare people from day one for a successful transition (or retention) into sustainable employment and career paths. This report encourages Dame Carol Black and David Frost in their Sickness and Absence Review to look at increasing the use of Access to Work to reduce time away from work for people acquiring an impairment.
•	Fair access to all routes into work, including work experience, internships, apprenticeships, university, learning on the job schemes, and support for setting up a business. For example, this review encourages the move towards a portfolio of evidence for apprenticeships to improve accessibility for talented people who have missed out on earlier qualifications.
•	A fair and simple benefits system that means disabled people can be confident that they are always better off in work, including self-employment, and an end to stigmatisation of benefit claimants. 
•	A public sector that leads the way as an exemplar employer of disabled people, and as a major buyer to drive wider improvements through procurement.
•	A robust legal framework to promote equality and prevent unlawful discrimination. 
•	Effective employer engagement (led by employers and employer organisations) that demonstrates the business case, identifies and promotes levers to incentivise employers, and makes it easy to employ disabled people.
•	An accessible transport system which empowers disabled people to access opportunities in the labour market. 
•	Portable social care packages that allow disabled people to move easily into and between jobs without fear of losing care and support.
•	Accessible housing that enables disabled people to have choice over where they live and work – so people can move areas for a job and secure accessible housing with ease.
•	Accessible information and digital inclusion that enables disabled people to make fully informed choices – including accessible on-line recruitment.
•	Recognition of the role and influence of families and those supporting disabled people.  
Underpinning all of these is an emphasis on personalisation, choice and control. The more that disabled people can plan for our own support needs, pulling together support for social care, employment, education and long-term health needs, the more individuals can find innovative solutions, fulfil responsibilities and contribute socially and economically. The Right to Control trailblazers are testing approaches to achieve this which should bring learning across policy areas. 
It is in the interests of government departments to address the disability dimension of their policies – without doing so, policies are, quite simply, less likely to be effective. For example:
•	the Social Market Foundation estimated that if disabled people’s skill levels rose to the level of the population as a whole by 2020, this could add an average of £1 billion a year to national income over the period to 2030; 
•	health services that adopt a work-first approach, enabling people with injuries or new diagnoses of impairment quickly to get into or back into employment, will reap benefits in terms of improved health outcomes and reduced hospital usage. The Fit for Work scheme is envisaged to save costs for the National Health Service (NHS) in the longer term;
•	in the Life Opportunities Survey, difficulty with transport was the second most common barrier to employment identified by adults with impairments (31 per cent); 
•	evidence from the Valuing Employment Now programme shows that disabled people’s lives are often blighted by low aspirations and expectations, leading to people repeating college courses without an employment outcome, or spending their days in day services. Supporting disabled people into employment would be more cost effective than these services and lead to more fulfilled lives.
Disabled people are already major contributors to society and the economy – but there is still untapped potential. With an ageing society, and removal of the default retirement age, more and more people will be working with health conditions and impairments – so the more that government departments encourage adaptations at work and effective retention, the less likely people are to become net benefit claimants and the more likely they are to enjoy good health.
The Equality Act 2010 (and in particular the Equality Duty) offers a useful framework which government departments can use to assess the disability equality dimensions of a whole range of policies and programmes to ensure that they are pulling in the direction of greater opportunities for disabled people, including in employment. 
Stakeholders report frustrations with a system that often feels disjointed at the point of access. Individuals want different parts of the system to work together, including the opportunity to link funding through pooled budgets. This includes recognising that the actions of one government department may reap positive benefits (or incur negative costs) on another.
Recommendation
The Department should make employment of disabled people a cross-government objective with joint ministerial responsibility. A cross-departmental ministerial group, including all departments with responsibilities that impact on employment outcomes, should drive a new cross-Government strategy on disabled people’s employment, incorporating the Government’s response to this review. There should be regular reporting and tracking progress externally on the Cross-Government Strategy. The cross-Government group should work closely with business and disability leaders.	

It will be vital that employers take a leadership role in retaining, recruiting and developing disadvantaged and disabled people, including through positive employment practices for all, apprenticeships, internships, talent development and adjusting processes to suit people with little previous work experience or qualifications. The cross-Government Strategy should involve business leaders from organisations and networks such as the UK Commission for Employment and Skills (UKCES), Employers’ Forum on Disability and small business networks. Employers are well placed to identify the levers that would incentivise more action to employ disadvantaged people.
The devolved administrations have responsibilities in many of the areas discussed above, and there will be differences in the extent to which policies link up and facilitate disabled people’s employment across Great Britain (GB). All GB nations have their own significant strategies to take forward policies to promote employment and should be consulted as necessary in the development of a new cross-Government GB-wide strategy. While specific policies differ between nations, the broad conclusions in this chapter are likely to be relevant to all nations.
5.2 	Raising aspirations
“Promote employment opportunities and career advancement for persons with disabilities in the labour market, as well as assistance in finding, obtaining, maintaining and returning to employment.”
(UN Convention on the Rights of Persons with Disabilities, Article 27(e))
Aspiration is an issue from birth, or from the time at which a person becomes disabled. The so-called ‘bad news room’ in maternity wards sends messages of chronically low expectations for people born disabled. These low expectations can be reinforced at every interaction with the system throughout a person’s life.
Evidence shows that aspirations have an important influence on educational outcomes, which in turn affect employment opportunities. 
“Disability is often viewed as incompetence, an inability to do a job.” 
(Young disabled person)
“My initial dream was to be a primary school teacher, after meeting a successful deaf teacher, yet the universities explained that they would not be able to provide me with the support I needed on work placements at schools (having someone to be my hands and ears!).”
(Young disabled person)
It is important that all parts of publicly- and indeed privately-funded services deliver the message that the vast majority of disabled people can work and have successful careers, given the right support and opportunities. This means: school-business partnerships that mentor disabled young people or introduce disabled role models; teachers and careers advisers talking about career options based on individual capabilities and ambitions from an early age (and inviting disabled young adults to share their experiences); health and social care professionals helping people to plan to move into or return to work from day one; parents and families being involved at the earliest stage and receiving support to have high aspirations; more disabled people in work to act as role models; and employers receiving appropriate support to recognise and value the potential of disabled people.
In March 2011 the Department for Education (England only) published a Green Paper, Support and aspiration: A new approach to special educational needs and disability – A consultation. This document acknowledges a culture of low expectations and sets out a vision for reforms to support better life outcomes for young disabled people and those with special educational needs. Proposals aim to challenge low expectations and to support as many people as possible to obtain paid employment through early integrated support and advice, access to better quality vocational and work-related learning options, good opportunities and support for employment, and a well co-ordinated transition to adulthood. The Green Paper also considers introducing supported internships and how to ensure high-quality work experience placements for disabled young people. This review is supportive of these aims. It is also important to recognise the support needs of disabled people without a statement of special educational need. The education system must support all disabled people to achieve their potential and make successful transitions into adulthood. 
In order to maximise their potential, disabled people need equal access to high-quality impartial information, advice and guidance that supports long-term career planning from a young age and continues to support people throughout adulthood. Careers guidance should support everyone, including disabled people, to make choices that enable them to achieve their potential and fulfil their aspirations for sustainable careers. This includes advice to young people at school, those making the transition from education to employment, and adults with acquired disability. The move towards a single all-age careers service with a single assessment has the potential to overcome problems for young people making the transition into adulthood. The all-age careers service must be disability competent: careers advisers are another important group of professionals who have the opportunity to raise aspirations, or risk reinforcing low expectations.
Stakeholders report that historically there has been little join-up between health care and social welfare, and not enough done in terms of early intervention to help prevent people from dropping out of the labour market in the first place. There are a number of recent reviews and reports that are relevant in terms of raising aspirations for disabled people’s employment. These include:
•	In 2008, Dame Carol Black set out her agenda for a new approach to health and work in Britain which explicitly set out how healthcare professionals needed to adapt their advice to patients to reflect the importance of remaining in or returning to work wherever possible. Her review highlighted that working-age ill health was costing England £100 billion a year. Key issues identified include early intervention and prevention, and proactive responses such as health-promoting workplaces, better mental health and employment outcomes, building young people’s resilience and lengthening healthy working lives. Since then, significant progress has been made but there is further to go to ensure: that employment support is embedded system-wide from first contact in health services; that vocational rehabilitation is made available as part of a wider emphasis on rehabilitation across community and hospital services; and that the occupational health profession takes a lead in promoting the numerous ways that disabled people can be enabled to work (rather than taking a risk averse approach, advising against employing people experiencing health conditions or disability).
•	The 2010 Public Health White Paper, Healthy Lives, Healthy People (England only), acknowledges that being in work leads to better physical and mental health. The Government has committed to working in partnership with business to safeguard and improve health at work, and support disabled people, people with health conditions or people with caring responsibilities to stay in or return to work. 
•	The recent cross-Government mental health strategy, No health without mental health (England only), calls for better employment rates for people with mental health conditions. This strategy stresses the importance of employment as part of the recovery process, and identifies employment as a critical priority area. The Government has committed to helping people with mental health problems to enter, stay in and return to employment, and supporting employers to promote the well-being, resilience and mental health of their staff.
•	In February 2011, the Prime Minister announced a review into sickness absence in England jointly chaired by David Frost and Dame Carol Black to explore radical new ways to change the system to help more people stay in work and reduce costs. 
•	In March 2011, Government published How to guide: learning from the Valuing People Now employment demonstration sites (England only), which highlights the importance of raising aspirations and expectations among people with learning disabilities and their families, professionals, and local employers. 
This review welcomes the recent attention given to this important area, but there is still a huge cultural shift needed for health and social care services to support aspiration and employment opportunities from day one. 
“If I had support after diagnosis maybe I would be in work now.” 
(Individual diagnosed with Asperger syndrome)
The following suggested developments have been raised by stakeholders:
•	Renewed emphasis on employment support in secondary health services, drawing on vocational rehabilitation expertise and building on the work already done in primary care – for example the coronary heart disease service, the stroke unit, the spinal injury unit, the community mental health team etc. 
•	Inclusion of employment outcomes as standard in performance frameworks for health funding streams, and in person-centred planning and personal budgets.
•	The review of sickness absence should consider enhancing Access to Work support (and promotion) through health services, to encourage job retention, perhaps 
re-channelling resources into this from pure sickness benefits.
•	Modules on employment should be included as standard in the training of all teachers, health and social care professionals, and other professionals providing support services to disabled people.
•	Further culture change to move away from the notion that individuals must be 100 per cent fit before they can return to work.
Employers also need higher aspirations of disabled people, and support to overcome attitudinal barriers and assumptions about what people can and cannot do. In the course of this review there were numerous reports of the damage done by describing benefit claimants as scroungers. People with hidden impairments, who may be suspected of ripping-off the system, can face bullying and even hate crime. Employers can pick up the impression that anyone claiming benefits is work-shy. Opinion-formers, Government and the media have a shared responsibility not to use inflammatory language about people who claim benefits. 
A number of stakeholders suggested much greater scope for local school and business partnerships as a means of raising aspirations by giving disabled people the chance to explore possibilities for employment, and giving employers contact with disabled people to help break down negative assumptions and stereotypes. 
5.3 	Skills and qualifications
Skills and qualifications are a key driver of employability; the employment rate for disabled people with no qualifications is just 17 per cent. Failure in the education system will result in disabled people entering the labour market without the skills they need for sustainable, productive employment. Increasingly, there has been a shift in the UK economy towards high-value-added service sectors and knowledge. There is also evidence of a reduction in demand for low-skilled employees and growth in demand for highly-skilled workers. A recent UKCES report concluded that: “the proportion of jobs requiring higher levels of qualifications has been rising while the proportion requiring low or no qualifications has been declining.” If disabled people are to have fair access to the jobs of the future, they must have the relevant skills. Data from the Labour Force Survey (LFS) show that in comparison to non-disabled people, a smaller proportion of disabled people have a degree or equivalent qualification, and a larger proportion have no qualifications at all.
Table 5.1: Highest qualification reported by 25–34-year-olds 
	DDA 
disabled 
%	Not DDA disabled 
%	
Degree or equivalent	18	34	
Higher education	8	7	
GCE, A-level or equivalent	19	20	
GCSE grades A*-C or equivalent	25	18	
Other qualifications	14	13	
No qualification	15	6	
Don’t know	–	–	
Total	100	100	
Note: ‘–’ indicates sample is too small to give figure.
Latest available data show that 10 per cent of apprentices starting in 2008/09 had learning difficulties and/or disabilities and among university students 9 per cent of full-time, first degree students reported having a learning difficulty and/or disability in 2009/10. There has been a slight fall in the proportion of apprenticeship starts recorded as having learning difficulties and/or disabilities since 2007/08, and stakeholders raised this as something they were worried about. These concerns should be taken seriously, and there should be an expectation that disabled people will be better represented among apprenticeship starts in the future.
LFS data is not directly comparable with administrative data on apprentices and university students, but the LFS shows that disabled 18–21-year-olds are less likely to be studying for a degree than those without a disability. This, combined with the higher likelihood of those with low qualifications becoming disabled, contributes to the lower proportion of disabled people with degrees. 
Stakeholders raised specific concerns about accessibility of apprenticeships for disabled people. Government has signalled an intention for disabled people to be able to present alternative evidence to establish their suitability for an apprenticeship, and a group of external disability experts is advising officials on implementation of this flexibility. This is a positive development to be encouraged. The minimum entry requirements for apprenticeships assume that apprentices need a Level 2 qualification as a pre-requisite, but in reality in many work settings people do not necessarily need a Level 2 qualification. This requirement may not, therefore, be justified and can act as a barrier for disabled people. It has also been suggested that there is a lack of reasonable adjustments for disabled people within the apprenticeship frameworks. For example, inflexible time limits for completing apprenticeships can act as a barrier to disabled people, particularly people with fluctuating conditions who may not finish a course within permitted deadlines, and creates disincentives to providers measured by completion and success rate to take disabled people on. 
A lack of qualifications is an additional labour market disadvantage for too many disabled people. Some stakeholders have reported that historically the further education system has been a ‘revolving door’ for disabled young people and adults, with too much focus on the acquisition of low-level qualifications, at the expense of genuine progression. Others have reported that some groups of disabled people are only directed to certain types of job. Support is required to level the playing field in the education and skills system to enable disabled people to compete more effectively in the open labour market. Closing the gap in educational attainment should help to close the employment gap.
There have been different estimates of the earnings reduction associated with different types of disability from different sources. Despite the earnings penalty identified among higher-qualified disabled employees, average hourly earnings increase with highest qualification in a broadly similar fashion among disabled people as among those who are not disabled. It is the combination of disability and lower educational attainment that disadvantages disabled people in terms of pay. 
Equality in employment means more than just the overall employment rate – a labour market where the majority of disabled people are employed in low-paid, unskilled employment is not equal. To achieve true equality in the labour market, disabled people must be supported to aim high, get the skills and qualifications they need to reach their potential, and have fair access to jobs across the whole economy.
This must include self-employment. Disabled people need equal access to advice and support for setting up a business, particularly given the assumption that new business growth is needed to drive the economic recovery. New initiatives designed to increase entrepreneurship must be available and accessible to disabled people. This includes the New Enterprise Allowance and the StartUp Britain campaign. Entrepreneurship organisations such as UnLtd have supported a number of disabled entrepreneurs and identified both successes, for instance, people drawing on their experience of disability to establish new technologies and new services, and barriers, from difficulties in accessing bank loans to rigidities in the benefits system. The UN Convention on the Rights of Persons with Disabilities includes: “promoting opportunities for self-employment, entrepreneurship, the development of co-operatives and starting one’s own business.”
Skills and qualifications act as a passport for the majority of professions, and disabled people are significantly under-represented within the professions. The system needs to be fairer to ensure the most talented have access to opportunities which will help them build their skills and progress in work, and that the economy is as productive as possible.
In 2007 the Disability Rights Commission (DRC) reported findings from their formal investigation into barriers disabled people face in pursuing careers in teaching, nursing and social work. Their report concluded that the complex array of primary and secondary legislation and statutory guidance governing requirements for physical and mental fitness failed to protect the public and acted as a deterrent to people applying to or remaining in these professions – thus undermining disability equality and leading to discriminatory attitudes, policies and practices. The Equality and Human Rights Commission facilitates a network of professional bodies committed to promoting equality and diversity in and through their memberships, and thereby widening access to opportunity. 
The Government recently published its social mobility agenda, and the Department for Business, Innovation and Skills operates several initiatives targeted at widening access to the professions, including the Equality and Diversity Tool Kit and the Gateways to the Professions Collaborative Forum. Widening access to the professions is vital for delivering equality in the labour market for disabled people and increasing the number of role models.
Skills and qualifications are equally important for disabled adults who may need to re-train or up-skill to get in and get on at work. Therefore it is important that Government skills initiatives and re-training programmes provide equal opportunities for disabled people. Government training programmes must be work-focused, and linked to genuine employment opportunities.
The recent Skills Strategy sets out entitlements to government subsidies for learning. Fully-funded learning is available for individuals out of work on ‘active’ benefits (Jobseeker’s Allowance and the Employment and Support Allowance (ESA) Work Related Activity Group) for basic skills and first foundation learning, Level 2 and Level 3 qualifications for those under 25. Disabled people should be given support to access this provision for skills development where necessary as part of their plan to return to work. It is important that Government monitors the equality impact of recent changes to entitlements to skills training. Removing entitlements to people out of work who are not required to seek work as a condition of their benefit (for example – the ESA Support Group) may disproportionately affect disabled people.
In her recent review of vocational education in England, Professor Alison Wolf recommended that the Department for Education should review current policies for the lowest-attaining pupils, and remove incentives for schools to divert low-attaining pupils onto courses and qualifications which are not recognised by employers or accepted by colleges for progression purposes. This is especially important for young disabled people, who are disproportionately likely to be among the lowest-attaining pupils.
The Wolf Report also recommends that programmes for the lowest-attaining learners should concentrate on the core academic skills of English and Maths, and on work experience; and that funding and performance measures should be amended to promote a focus on these core areas and on employment outcomes rather than on the accrual of qualifications.
This review fully endorses the Wolf Report recommendations and urges Government to take them forward. 
The importance of work experience (including through apprenticeships, work placements, internships, learning on the job etc) has been raised again and again throughout this review. The importance of work experience is also recognised in the UN Convention on the Rights of Persons with Disabilities: “promote the acquisition by persons with disabilities of work experience in the open labour market.” 
It is crucial that disabled people are actively encouraged and supported to take up relevant work experience opportunities and that inequality between disabled and non-disabled people is reduced through positive action. There is: a key role for schools to ensure that young disabled people are offered genuine work experience opportunities; a key role for the education system more widely to ensure vocational qualifications include genuine work experience of value to future employers; a key role for employers to ensure disabled people have equal access to work experience opportunities and that work experience is considered as part of a portfolio of evidence alongside formal qualifications in recruitment; and a key role for the Department to ensure that the new Work Experience programme for benefit claimants is fully accessible to disabled people. 
This is vital for young disabled people and it is also crucial for people who acquire an impairment, for whom work experience or a new apprenticeship may be the key to opening up employment opportunities in changed circumstances. 
5.4 	Accessing labour market opportunities
The system as a whole needs to support sustainable employment outcomes for disabled people. Higher aspirations, skills and qualifications are important but there are still barriers that can act to prevent disabled people from accessing jobs in the labour market. In a dynamic economy, local labour markets can decline while others grow and flourish. Disabled people must be set free to access all jobs across the economy, including the option of moving around the country to get the jobs they really want.
Through consultation and evidence gathering, this review has identified a number of 
•	key barriers and opportunities to facilitate better access to real jobs:
•	Complexities and disincentives in the benefits system.
•	Portability of social care.
•	Accessible housing.
•	Transport.
•	Public Sector leading by example.
•	Support for employers.
•	Robust legal framework.
•	Accessible information and digital inclusion.
The existing benefits system is complex. Financial security can understandably be the most significant factor in decisions about returning to work, particularly for those in low-income families. Disabled benefit claimants may fear, correctly or incorrectly, that they may not always be financially better off in work. Although better-off calculations can help demonstrate the financial benefits of work to disabled claimants, there may be residual concerns about potential difficulties returning to benefits if a job doesn’t work out; and real difficulties for people who are self-employed who work highly variable hours each week, for whom securing entitlement is complex and time-consuming. This insecurity can be particularly important for people with fluctuating conditions, and in the current climate where disabled people feel that their entitlements to benefits are under threat. Changes to the benefits system that would better enable a partial or phased return to work, and flexible patterns of working, could be of particular benefit to disabled people. This review is supportive of the direction of travel towards a simplified welfare state and the introduction of a new Universal Credit, and recognises the importance of communicating the financial benefits of work to disabled people, and better communication and information sharing to address real and perceived fears about losing benefits such as Housing Benefit when moving into work. 
Benefits simplification must go hand in hand with efforts to reduce stigmatisation of benefit claimants, which can affect the aspirations of disabled benefit claimants themselves, and the attitudes of employers. 
Portability of social care can be a major barrier to labour mobility for disabled people who have gone through complex assessment processes to get personalised care packages that meet their need. The fear of losing a personal care package can prevent disabled people from relocating from one local authority to another. In areas of high deprivation and few job opportunities this can act to restrict choice for disabled people who feel unable to move. This represents injustice for disabled people who are not able to enjoy the same social and economic mobility and freedom of movement as their non-disabled counterparts. This review supports portability of care entitlement, including moves to ease the process of disabled people moving from one local authority to another, ensuring that councils work together to provide a seamless transition to an equivalent level of support when a person who receives a care package or direct payments moves to a new local authority. 
Similarly, a lack of accessible housing can restrict labour mobility for disabled people. Although the situation has improved in recent years, one in three households with a disabled person still live in accommodation that fails to meet the definition of a ‘decent home’. One in five disabled people requiring adaptations to their home believe that their accommodation is not suitable and 8 per cent of adults with impairments interviewed as part of the Life Opportunities Survey experienced difficulty getting into at least one room within their own home. Government schemes such as the Disabled Facilities Grant, which helps to fund provision of adaptations to people’s homes, and Supporting People, which provides practical support to people to live independently in their own homes, are welcomed by this review. 
Transport can be a key barrier to employment for disabled people – either because existing public transport is not accessible, welcoming or safe for disabled people, or where public transport is simply not available or not affordable locally to connect people to jobs. It is therefore important that the Department for Transport continues to improve personal mobility and promote greater accessibility to enhance access to jobs. Only 31 per cent of all rail vehicles in public transport and 61 per cent of buses nationally meet modern accessibility standards: this must be improved.
Lack of mobility can be related to confidence. Disabled people can be encouraged to take up existing support available through local travel training schemes to develop skills and confidence to use public transport independently. This could have positive knock-on effects for the Access to Work budget.
Since 35 per cent of Access to Work awards are made in respect of travel to work, improved availability and accessibility of transport, and increased use of travel training to help more disabled people use public transport, could free up some of the over-stretched Access to Work budget to provide support for more disabled people.
This review has set out the role of the State as enabler. There is scope for Government to capitalise on its position as a large employer and major buyer of goods and services. Government should lead the way in making adjustments that support more disabled people to get in, stay in, and get on at work. The UN Convention on the Rights of Persons with Disabilities requires parties to: “employ persons with disabilities in the public sector”. There is a role for Government to learn and share best practice through existing employer networks such as the Employers’ Forum on Disability.
As a major buyer of goods and services, Government should use procurement to drive change which enables more disabled people to access employment. Accessibility and employment of disabled people should be considered as part of key criteria, ideally those scored in decision-making, in assessing bids for Government contracts. The purchasing power of Government has the potential to be a transformative lever in areas from accessible ICT to rail travel.
Chapter 2 set out the importance of support for employers, and the recommendations of this review are intended to remove barriers and increase support for employers: by making the system more efficient and flexible to make it easier for employers to employ disabled people; and by increasing the amount and quality of information and advice available to employers through Government and peer support. It is vital to get the support for employers right so that there can be no excuses for inequality in recruitment, retention, or redundancy.
This review would support moves in the occupational health profession to become less risk averse and move away from the older default position of not employing disabled people in case of risk.
Excellent support for employers must go hand in hand with a strong legal framework to promote equality and prevent unlawful discrimination. For employers who refuse to accept their responsibility under the Equality Act 2010, there is an important role for the Equality and Human Rights Commission to take action in strategic cases as its new remit is clarified.
Finally, it is important to recognise that a lack of accessible information can act as a barrier to employment. There is scope for: increased transparency, for example in Access to Work guidance; more widespread and considered dissemination of information; and due regard for accessible formats as standard. 
Digital inclusion is increasingly important as more and more recruitment – and the networking that links people to job opportunities – takes place on-line. There is work to be done to improve digital inclusion for disabled people, and communication strategies must provide suitable alternatives for people without on-line access. 
5.5 	Summary
Although the main focus of this review is on specialist disability employment support funded by the Department, it must be recognised that employment is a wider Government issue and that policies across Government have the power to facilitate or hinder the Department’s efforts to improve disabled people’s employment.
It is vital that the whole publicly-funded system works together with other partners – employers, disabled people’s organisations, health and social care professionals, transport providers, housing professionals, recruitment agencies and more – to raise aspirations for disabled people themselves, their families, and the professionals who serve them; that disabled people are equipped with relevant skills and qualifications to achieve their potential and give them every opportunity to succeed in the labour market; and to remove barriers and increase incentives for disabled people to access real opportunities in the labour market now and in the future.
This chapter has included suggestions for positive actions to improve the wider landscape and contribute to greater equality for disabled people in the labour market. This review urges Government to consider these suggestions in the context of a renewed Cross-Government Strategy.
5.6	Key messages – Chapter 5
•	Employment must be a cross-Government objective.
•	Policies in areas from health to skills will simply be more effective if disability is considered from the outset, especially in growing areas such as apprenticeships and well-being at work. 
•	This review strongly urges the whole of Government to work together to support the vision that everyone living with disability or health conditions is able to use their capabilities to the full.	

Appendices
Appendix 1: Terms of reference 
Appendix 2: Definitions
Appendix 3: The call for evidence and acknowledgements

Appendix 1: Terms of reference 
Since taking office in May 2010, the coalition Government has set out an ambitious programme of employment support to ensure that people disadvantaged in the labour market will get the help they need to find and keep jobs. Our aim is that Government programmes should support more disabled people than ever before into employment.
The Department will introduce the Work Programme – an integrated package of support providing personalised help to a broad range of customers. The Work Programme will cater for a wide range of disabled people. The Government recognises than many customers have complex disability-related barriers and may require more specialist support. In October 2010, the Government launched Work Choice – a new programme of support designed to help customers with more complex disability-related barriers find and sustain work. The Work Programme and Work Choice are an important stride forward in providing simple, effective customer service that draws on the best evidence about what works. A range of other, specialist programmes currently sit alongside the Work Programme and Work Choice – Remploy, Residential Training Colleges and Access to Work.
In the current fiscal climate it is more important than ever that the funding available for employment support is used effectively. Decisions on the use of the available funding should draw on robust evidence about what works in the modern labour market and on how the support meets the needs of individual disabled people. In this context, the review will examine the Department’s current employment support for people with severe disability-related barriers to work, and make recommendations about how this can be further improved to provide better value for money over the life of this Parliament. 
In particular:
•	The review should provide the Secretary of State for Work and Pensions with an independent report evaluating the current specialist disability employment programmes and suggesting what direction the strategy in this area should take.
•	Recommendations should build on the foundation provided by the Work Programme and Work Choice. While a fundamental review of these two programmes is beyond the scope of this review, the Department would welcome suggestions on improvements that could be made to their delivery.
•	The review should focus on the work of the Department for Work and Pensions, but make links with, and seek to facilitate and support, the work of other government departments as appropriate.
•	Recommendations must be deliverable within the existing funding envelope as set out in the Spending Review settlement.
•	The review should seek to involve and consult a wide range of external stakeholders, including disabled people themselves.

Appendix 2: Definitions
The Equality Act 2010 says a disabled person is someone with: “a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities”.
Examples include: long-term health conditions like cancer, AIDS, diabetes, multiple sclerosis and heart conditions; hearing or sight impairments; mobility difficulties; mental health conditions; autistic spectrum conditions and learning disabilities. People in these circumstances and some others (such as people with a facial disfigurement) are likely to have rights under the Equality Act 2010 to protect them from discrimination. However, only the courts can say if a particular individual is defined as disabled under the legislation.
The definition of disability includes an effect on the ability of an individual to carry out normal day-to-day activities. Disability is therefore a result of the interaction between an impairment or health condition and the environment in which people live. 
The social model of disability says that disability is created by barriers in society.
These barriers generally fall into three categories: 
•	the environment – including inaccessible buildings and services;
•	people’s attitudes – stereotyping, discrimination and prejudice; and
•	organisations – inflexible policies, practices and procedures.
Considering disability this way is referred to as the social model of disability. It contrasts with the more individualised medical model where an individual’s disability is determined by a medical condition or diagnosis. Using the social model helps identify solutions to the barriers disabled people experience. It encourages the removal of these barriers within society, or the reduction of their effects, rather than just trying to fix an individual’s impairment or health condition. 
In this report the social model is used to focus on the way employment can be designed to be inclusive to all and to consider the individual adjustments and supports that can enable people to work. The report also touches on the importance of health service interventions: the role that early intervention and peer support can play to help people manage and reduce the impact of a condition; and the importance of vocational rehabilitation as part of wider recovery services. 
‘Disabled people’ are very diverse: the experience of growing up with a significant impairment is different from acquiring one in working or older life (and most disabled people do become disabled as adults); a stable impairment is different from one that fluctuates or one that is degenerative. These differences pose different challenges and barriers – and potential solutions – for both individuals and employers. 

There are over seven million working-age people in Great Britain who would meet the definition of disability under the Equality Act 2010.
Evidence suggests that a significant proportion of those who would be considered to have a disability under the Equality Act 2010 definition do not consider themselves disabled. A DWP survey in 2001 suggested that only around 48 per cent of people who have a disability (as defined by the Disability Discrimination Act (DDA) – now superceded by the Equality Act 2010) saw themselves as disabled. The way individuals view their disability can impact on the type of support they are likely to seek (for instance, some see themselves as having a health condition, not being disabled, and therefore do not respond to promotion of disability support programmes). This has implications for marketing of supports and benefits: language used must enable people to understand that support may be available to them. In this report the term ‘people living with disability or health conditions’ is used alongside ‘disabled people’ to make it clear that it relates to all these experiences, however people define themselves.
Rates of disability in the population vary by a number of other characteristics. The tables below show proportions of various subgroups of the population who have a disability as defined under the Equality Act 2010.
Table A.1: Prevalence of disability
Group	 	Estimated proportion DDA disabled%	
Males aged 16–64	17	
Females aged 16–64	20	
Aged 16–17	7	
Aged 18–24		8	
Aged 25–34	10	
Aged 35–44	16	
Aged 45–54	23	
Aged 55–64		37	
What do we mean by employment?
For the purposes of this report, employment is defined as work for which the person undertaking the work is paid. Work may be unpaid – in the case, for example, of voluntary work or unpaid internships.
Employment, the structures in which work occurs, can take many forms:
•	Employment is work for which the person undertaking the work is paid.
•	Self-employment is employment where an individual runs their own business, taking responsibility for its success or failure. People in self-employment have freedom to decide how, when and where their work is done.
Employment can take place within a number of structures:
•	Limited companies are companies where the business owners have limited personal liability for the businesses’ liabilities.
•	Partnerships are businesses owned by two or more individuals, often where the business owners – unlike in a limited company – retain personal liability for the business’ liabilities.
•	Supported businesses are services where more than 50 per cent of the workers are disabled persons who by reason of the nature or severity of their impairment are thought unable to take up work in the open labour market.
•	Supported employment is employment within the open labour market where a person receives a range of types of support to enable them to fulfil their role.
•	Mutuals are businesses owned by a group of members and which distribute income in proportion to the amount of business that members do with the company.
•	Social enterprises are socially-driven organisations which apply market-based strategies to achieve a social purpose.
•	Co-operatives are business organisation owned and operated by a group of individuals for their mutual benefit.

Appendix 3: The call for evidence and acknowledgements
The review team are indebted to the many people who shared their experiences, thoughts and ideas during the course of the review. We would also like to thank the numerous government officials across England, Scotland and Wales who have contributed to the review.
The review team received a fantastic response to the call for evidence which was published in December 2010. While acknowledging it would be impossible to fully articulate the extent of the material received, this section attempts to provide a feel for the evidence received and of the range of individuals and organisations who have contributed to this process.
The team received over 200 responses to the call for evidence. This is in addition to the wide range of evidence gathered during meetings and consultation events.
The responses the review team received via the call for evidence came from a wide range of organisations (including charities, providers, local government, disabled people’s organisations, social firms and trade unions) and individuals (including disabled people working in Remploy factories, attending Residential Training Colleges (RTCs) and using Access to Work), Jobcentre Plus staff, and individuals who work with disabled people).
The following organisations submitted evidence to the review:
1.	104 films Limited	
2.	A4e	
3.	Acquired Brain Injury Forum for London	
4.	Action Group	
5.	Asperger’s Inc	
6.	Barnsley Metropolitan Borough Council	
7.	BASE	
8.	Birmingham City Council	
9.	British Assistive Technology Association	
10.	Bradford Council	
11.	Bristol and South Gloucestershire People First 	
12.	Bristol City Council	
13.	British Psychological Society	
14.	Camden Society	
15.	Cardiff and Vale Coalition of Disabled People	
16.	Centre for Mental Health	
17.	Centre Point	
18.	Changing Faces	
19.	Cheshire East Council	
20.	Choices and Rights Disability Coalition	
21.	Elcena Jeffers Foundation	
22.	Employment Services at Westminster Centre for Independent Living	
23.	Enham College (RTC)	
24.	ERSA	
25.	Finchdale RTC	
26.	Foundation for People with Learning Disabilities	
27.	Hands Free Computing Ltd	
28.	Hao2.eu Ltd	
29.	Headway	
30.	Hertfordshire Action on Disability	
31.	Hillcrest Branch	
32.	Hudson Interpreting Services	
33.	Inclusion	
34.	Indigo Dyslexia	
35.	Ingeus	
36.	Kent County Council	
37.	Key Ring	
38.	KM Furniture Ltd	
39.	Lancashire County Council	
40.	Leicestershire Centre for Integrated Living	
41.	Low Incomes Tax Reform Group	
42.	Mencap	
43.	Mental Illness	
44.	Mind	
45.	Monmouth People First	
46.	National Association of Deafened People	
47.	NASUWT (teachers union)	
48.	Newco Employment and Training	
49.	North Bank Forum	
50.	Nottinghamshire Deaf Society	
51.	Papworth Trust	
52.	People First	
53.	Pluss	
54.	Queen Alexandra College (RTC)	
55.	Queen Elizabeth’s Foundation (RTC)	
56.	Reed in Partnership	
57.	Rethink	
58.	Royal British Legion Industries	
59.	Royal College of Nursing	
60.	Royal College of Psychiatrists	
61.	Royal National College for the Blind (RTC)	
62.	RNIB	
63.	RNID	
64.	Scope	
65.	Scottish Association for Mental Health	
66.	Scottish Autism Service	
67.	Scottish Independent Advocacy Alliance	
68.	Sense	
69.	Shout Out	
70.	Signature	
71.	Slough Council	
72.	Social Firms FRC Group	
73.	St. Annes (social firm)	
74.	St Loye’s (RTC)	
75.	St Mungo’s	
76.	Sustainable Hub of Innovative Employment for People with Complex Needs (SHIEC)	
77.	The Association of National Specialist Colleges	
78.	The Coalition of RTC Providers (covers all nine residential colleges)	
79.	The Small Business Consultancy	
80.	Transition Information Network	
81.	Travel Matters UK	
82.	UNITE	
83.	UNUM	
84.	Vangent	
85.	Visibility	
86.	Vocational Rehabilitation Association	
87.	Welsh Assembly Government	
88.	Woman at Wish	
89.	Work Fit 	

Liz and the review team met with people from a wide range of other organisations including, among others, People First, National Centre for Independent Living, Disability Wales, Inclusion Scotland, the Employers’ Forum on Disability, Remploy, the TUC, GMB, Social Policy Research Unit, Centre for Mental Health, Disability Alliance, Sense, UNITE, RNIB, Mencap, the Scottish Union for Supported Employment, a range of central government departments, Essex Coalition of Disabled People and many more.
Some key themes which ran through the responses to the call for evidence are detailed below.
Through the call for evidence, and various consultation events, many individuals and organisations raised concerns about wider issues – the reform of Disability Living Allowance, the Work Capability Assessment and the Work Programme. While these are beyond the scope of this review, it is critical that the role they play in determining disabled people’s employment opportunities is recognised and that the Department manages change with care and through consultation with those affected.
The most common topic individuals and organisations commented on was Access to Work – around half of responses included comments on this programme. There was universal agreement that Access to Work provides vital support to disabled people, although there were a number of common criticisms and suggestions for improvement. All respondents suggested that this programme should be strengthened to support more disabled people. There were a number of comments that the service is not consistent and is not sufficiently advertised. More than one person said that “It [Access to Work] is the envy of the world”, while another said “the standard of service given to disabled people and employers varies greatly depending on the individual adviser”. People want Access to Work to be more efficient, more person-centred and more consistent.
Many respondents to the call for evidence commented on Remploy. The majority of responses focused on Remploy Enterprise Businesses and highlighted the need for significant change to Remploy (the need for a move away from separate workplaces was unanimous among disabled people’s organisations and charities). Some felt that there was no place in the future for supported businesses directly funded by Government and that there should be a shift in focus towards supporting disabled people into open employment – others felt that there was still a role for Government to support Remploy, but there was scope to reduce the cost of each worker and improve the viability of the businesses. Most comments on the Enterprise Businesses suggested a move away from the current model: “I believe that the ‘workhouse’ style employment should stop as it’s degrading, humiliating and an outdated approach to the prejudice and barriers we face as disabled people.” Others spoke in favour of the community support within Remploy factories. Views on Remploy Employment Services were generally positive with no overriding voice for any reform – comments included: “Remploy [Employment Services] has been effective in securing employment for many thousands of people each year.” 
There were a good number of responses relating to RTCs – many from current students. There was no clear consensus on this programme. Some stakeholders, especially RTCs themselves and individuals who were trained there felt that this provision was highly valuable for disabled people and should be strengthened, while others felt that it was too expensive, ineffective and fundamentally wrong to have separate institutions for disabled people. Comments included: “Loughborough RNIB College gave me the confidence through the acquisition of new skills and a work placement … the support mechanisms are simply not well established in mainstream institutions.” and “Residential training college provision involves separating disabled customers from mainstream provision … the geographical location of colleges which does not provide equality of access may discourage and provide barriers to others.”
The overwhelming view on the future of all these programmes was that they should empower disabled people to find work in open employment and should give disabled people choice and control over the support they receive.

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June 2011
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