Paying more for people who need more support
What do you think about paying providers different rates to aim support towards harder to help customers?
We will develop a payment system that aims to take account of increased costs in supporting harder to help customers. This will help ensure that there will always be an incentive for a provider to help someone into work.
Do you think it is appropriate that we pay providers more for supporting people back into work who need more support?
This discussion is now closed. Thank you to all of you who contributed.
We welcome a system that pays more for those that need more support but to achieve truely sustainable employment for the hardest to reach customers, like people with autism spectrum disorders, delivery methods need to reflect the barriers these customers face. Therefore, in paying more for people who need more support, it should be recognised that disability is dynamic not static. For people on the autistic spectrum, this means that their condition and ability to cope fluctuates; consequently support must be flexible. Autism is a hidden disability, which means that the needs of individuals on the spectrum often go undetected and incorrect assumptions are made about their ability to cope. This often leads to employment becoming unsustainable as support breaks down. Thus, to ensure employment is sustainable for people with autism, a system which pays more for those who need more support, must create specialist assessment tools to effectively assess the individual’s needs and those conducting assessments must have training about understanding the dynamic nature of disability and the complex nature of hidden disabilities like autism.
Papworth Trust supports the move towards a differential payments system, believing this recognises that more hours of support are required to help those hardest to reach into work. We believe the Work Programme structure needs to reflect the support required in reaching the desired outcome.
Differential payments go some way to helping the hardest to reach, but what is the definition of sustainable employment and will part-time working be recognised as an outcome?
We urge the DWP to move to a model of ‘off benefits’ check to verify a person’s employment rather than rely on the provider, employer and client to collate and provide this information. Not only will this provide a more realistic picture, but as a provider we have experienced problems in the past whereby a customer does not wish to connect with the provider to verify support given some time previously.
The point about customers failing to confirm that they have received support is a good one, especially if they’re failing to confirm that they are now in work and/or failing to confirm their new wage (for wage-related payments to the Work Programme provider).
However, not all claimants come off benefits in order to enter work. For example, someone who starts on JSA might later find themselves unable to work due to illness or disability. Others might decide to voluntarily declare themselves unavailable for work (women having children come to mind). Please note that this sort of information can be collected by the DWP when the claimant ends their claim.
Any system which included an “off-benefit” check should therefore cover the following cases:
1. A minimal payment for claimants who come off benefit, but do not enter work. This payment would only cover the Work Programme provider’s basic costs in dealing with that claimant.
2. A full payment for claimants who come off benefit to take up a verifiably sustainable, permanent post. This would be staged over the first year or two of employment, include a variable component that increased in proportion to the claimant’s new wage, and include a bonus for claimants who were considered hard to place.
The Government’s new real-time PAYE system will contain the information that would be required as input to this kind of payment structure, since it will have to keep an ongoing record of wages and employer details anyway.
I think that it is time it is recognised by the Government/DWP/ATOS that very many are totally unable to work.
Many physically handicapped are in Care Homes, some as permanent residents, some for Respite, the charges for these places are assessed financially on the patients (not customers) income, time limiting any benefit would be horrendous and the idiocy in anyone thinking they could have a return to work in the future is beyond belief.
many of these patients are in the younger age range as well and I look forward to the furore there will be created by many families when ATOS or the DWP decide to try to test those residents, as they certainly will such is the stupidity of the powers that be at present.
Now what bullying tactics could be used by providers on those people…..
Support for people furthest from the workplace, particularly through targeted support from specialist providers, needs to be financially viable: if services are not receiving appropriate funding they will ultimately not succeed. We welcome the emphasis that has been placed on using differential pricing mechanisms. There is a significant challenge in identifying how much support an individual will need from the outset as the needs of people with autism vary considerably from person to person. Some people will need intensive, long-term support whilst others will need less intensive support for a shorter period of time. The difficulties faced by an individual with autism in entering the workplace may only become apparent over time and so providers must be supported to provide financially sustainable services, for example through supplemental funding or a percentage of the payment paid upfront.
I’m grateful for the placement I had from certain well-known organisation, because that gave me my first employment, as they paid for some of my wages. This was in the last recession, and was probably seen as a “carrot” to my employer.
The problem with this is if disabled people who are capable of doing another job within the firm away from the placement get stuck, on comparatively low wages, and don’t get encouraged to move on if they wish to.
This is fundamental to any programme. We currently deliver a DWP/ESF (Convergence) funded programme as a sub-contractor. As a ‘ball park figure’ we are paid £1200 for each client who goes into work (+16 hrs, likely to last 13+ weeks – the usual thing). Eligibility for our programme is quite straightforward (anyone of working age, living in Cornwall and actively seeking work). Essentially, we can meet a client on a Monday with a ‘job start’ the following week who claims to need a pair of safety boots before they can start work. A £25 pair of safety boots later and on the following Monday we are £1200 the richer. On the other hand we can invest vast amounts of staff time (and money) in supporting a particularly challenging (but deserving) client who after considerable effort MAY become ‘job ready’ and MAY find work – only then earning us the same £1200. Where is the incentive (apart from the fact that we are a charity and have our charitable objectives at the heart of what we do rather than profit) to devote time and resources to the clients who really need the support?
Just to keep these figures in proportion;
16 hours at minimum wage (£5.93) gives £94.88 for 13 weeks, gives the client £33.44 more than you receive.
Then you can place them again…
Please dont hide behind the smoke screen of being a charity. You may be a fantastic charity, but are all the service providers as altruistic as you wish to be perceived?
“Where is the incentive to devote time and resources to the clients who really need the support?
The fact that you are a charity and have your charitable objectives at the heart of what you do, maybe?
Or the fact that you should be commited to assist all, not just “park and cream”?
The parking and creaming issue has been recognised for a long time, though strenuously denied by service providers (see Hansard), but you have actually shown the true reality with the phrase “Where is the incentive…”.
I dont know who I feel more sorry for – yourselves feeling a lack of incentive (actually a lack of quick financial gain), or those who will be placed in inappropriate employment situations in order for you to gain a “satisfactory” financial reward.
Why are you attacking the work we do – we don’t ‘cherry pick’ clients and the ‘incentive’ we get is the satisfaction of changing people’s lives for the better! However, we are not averse to the occasional ‘quick win’ as that enables us to devote more time to other clients with significant barriers to overcome. My point is that not all providers devote as much time as they could to the more challenging clients and clearly for some ‘profit’ is a more tempting driving factor. If future contracts can recognise ‘distance travelled’ by the client in the payment schedule, I believe it will lead to a more appropriate service being delivered to all.
As a charity we don’t make a ‘profit’ but will use any ‘surplus’ to support our other work so I guess in some ways charities can still be tempted to ‘cherry pick’ clients, although there are different ‘checks and balances’ in place for us. We have trustees who wish to see that we are covering our costs and meeting the charities wider objectives, possibly by generating a small surplus. A commercial organisation will have Directors keen to see that shareholders get their dividend. That isn’t to say ‘charity good, commercial bad’; there are plenty of poor charities who for reasons of inefficiency are force to ‘cherry pick’ more than they need to in order to break even. There are also some excellent ‘commercial’ providers who manage to satisfy shareholders whilst providing a fair balance to their caseloads.
I do apologise if you felt that I was attacking you, or the work you do, personally.
The worry is that some charities will not behave charitably, some providers will not have as their mission statement “Changing People’s lives for the Better”.
From this side of the fence we feel we are being “thrown to the lions” and we have no idea if that lion is starving or not.
At the end of the day, how we are received and treated by Service Providers, the rules regulating our involvement, and the rules regulating how and why and for what you are paid, are somewhat badly thought out.
And I am unsure how Service Providers will be “policed” to prevent abusive behaviours.
From this section alone there is a huge disparity in terms of what Service Providers want, how they “grade” their clients, etc.
At the moment Service Providers are looking for the “carrot”, whilst the service users will only be receiving the “stick” of financial sanctions, so excuse us if we are sceptical.
“From this side of the fence we feel we are being “thrown to the lions” and we have no idea if that lion is starving or not.”
A great analogy and one with which I can wholeheartedly agree. You as a client may well have little if any choice in the matter of which provider supports you. Some of us are very good (we like to think) but others not so. This is for a variety of reasons, not just linked to profitability. Providers are (and will continue to be) ‘policed’, primarily by OFSTED got ‘quality’ of service and the DWP for ‘audit’ (i.e. financial and contract compliance). If I were to be critical, in the past there has been too much emphasis on the ‘audit’ and too little on the ‘quality’. I’m sure that you as a client are more concerned that you have had a good experience with us than we have ‘dotted the ‘I’s and crossed the ‘T’s on our paperwork!
It is so important for clients to complain when they believe they are receiving a poor service, but also ‘compliment’ good service. When you are trying to get someone into work, who simply doesn’t want to work you can expect complaints. However, we also get many plaudits from our clients.
“At the end of the day, how we are received and treated by Service Providers, the rules regulating our involvement, and the rules regulating how and why and for what you are paid, are somewhat badly thought out.”
I think the rules assume that more people are ‘cheats’ than really are, however, there is a large number in the middle who perhaps ‘want’ to work, but don’t necessarily go the best way about it. I agree that payment schedules need more thought, one of the real dangers being that without care you will lose the ‘small’ providers who tend to give the best service, leaving you with the ‘big boys’. Not unlike supermarkets really – you tend to get better service but a more specialist product from a small shop. At the moment, we ‘small shop’ providers are being put out of business by the ‘supermarkets’ of the Welfare to Work business.
I am wondering what you, and other contributors to this consultation, think of the Shaw Trust and ATOS partnership?
ATOS, who use LIMA software, who work in close association with the discredited US company Unum, who sponsored the “research” that has been twisted by this government and the previous to “prove” that work-is-good-for-you.
Internet searches will confirm this.
Internet searches will reveal the multiple alliances that exist, advisors in one organisation being a CEO in another, major share holders, sponsors etc.
Now Shaw Trust, a charity, have become partners with ATOS and Pinnacle People to be service providers.
Imagine how sick and disabled people now feel.
Unum were discredited as their tests for disability were considered too tough.
ATOS bases their tests on Unum tests, only made even tougher.
This is not about employment, it is about reducing benefits, about using a bio-psychosocial model that denies real illnesses exist.
Its about money.
Its about actively changing the public perception of sick, ill and disabled people.
It is about creating an underclass that can be vilified and then treated appallingly without public outcry.
Shaw Trust should be considering their “charitable” status.
However it leaves many thousands of people who will be “tested” by ATOS, be found “fit” by ATOS, and then ATOS get paid to conduct work related activity with these people.
I’m not sure many people will appreciate that situation.
ATOS will be creating through their “medical” testing more opportunities for financial gain in the Welfare to Work business.
ATOS create a “need” then fill that “need”, and get paid twice.
There is no supermarket, we cannot shop around. There will be no choices. And I cannot believe that the ATOS-Shaw partnership will be succesfull from a clients point of view.
Complain about ATOS? Many have tried, but few succeed.
Many win their appeals, but will there be an appeal procedure when ATOS act appallingly in their new role?
No, there will just be financial sanctions for the “customer”.
OFSTED will not police ATOS too hard, they employ their services too.
The ATOS client list is huge, and influential. It is a parasite gradually permeating every part of government,public and private sectors.
There are posters on here who have been found too ill to work by ATOS as their occupational health advisors, only to be told they are fit and well by ATOS at their ESA medical.
ATOS are…[truncated by the system]
I agree with you that the ATOS assessment is flawed, we see a number of clients who are clearly not ‘fit’ to work and should have the right to ‘opt out’ of a pressurised job search regime in order to qualify for their benefits. Nonetheless, we do also see people who should be considering work. As a organisation focussing on volunteering, we have seen clients initially start with a teneative few hours of voluntary work and then gradually ramp up the hours. They then start active job search and ‘don’t look back’. They literally get a new focus in their lives.
But, and this is a big but, this must be a ‘choice’ and not done under threat of benefit sanctions. For some ‘work’ does make the life changing difference, but for many others it is a further concern in an already stress filled life. The other problem of course is distinguishing between those who are sick and the small minority who do play the system. In short, a better means of assessment is needed – one that is trusted by the customers who rely on its integrity.
As for Shaw Trust, we have not had much to do with them down here, however, I believe they are certainly at risk of coming unstuck as a ‘charity’. In order to compete with the commercial ‘big boys’ thay have lost sight of their core values. A prime example of what will certainly happen elsewhere as we head down this ‘Prime Contractor’ route.
until the issue of employers not taking on disabled people is addressed squarely then paying providers more to get us into work is pointless… a waste of money….
you can throw as much money as you like at trying to get people into work but with only 27% of employers saying theyd employ a disabled person then the odds are against getting disabled people into acceptable and realistic employment.
Sort the employers out maybe offer THEM some cash to part pay the wage of a disabled person so they have an incentive to employ someone with an impairment rather than throw cash at providers who are going to find it impossible to place someclients.
Given the rampant disability discrimination in the job market, as illustrated by the IOSH figures (bizarrely trumpeted as in some twisted fashion positive) showing that only 27% of employers would be willing to employ a disabled person, no matter that discrimination in recruitment on the grounds of disability is illegal under DDA/EA, it would seem that the problem isn’t whether providers should be paid more, but whether there is any point in trying to place disabled people in employment in a job market which is not prepared to consider them on equal terms.
A programme which does not challenge the discrimination disabled people face in the job market will ultimately fail them and perpetuate the discrimination against then by channelling them into lower wage and other positions which fail to provide them with the opportunities to recognise their potential. It is highly doubtful that such a programme meets the demands of DWP’s Disability Equality Duty. Paying more for placing disabled people isn’t a reflection of ‘difficulty’, it is a nod and a wink to the discrimination that makes it difficult. Do we want to fix the symptom, or fix the problem?
Well said.
When I became unemployed, I was considered an ‘easy’ customer – I was well qualified with many transferable skills and able and willing to work for 40 hours a week. I am also a wheelchair user. Two years later, the JCP advisers were very surprised I hadn’t yet got a job, in spite of attending countless interviews under the Two Ticks scheme, but I encountered many barriers, both access-related and attitudinally related.
Shortly after that, I secured a job with an employer who valued my skills and made the adjustments I required, which was excellent. I am not a permanent member of staff, though, so I fear becoming unemployed again and facing sanctions, because it may take me longer than a year to find another employer with a similar positive attitude as I am disabled.
The above comment describes the situation pretty well. I find it disturbing that most of the focus seems to have been placed on making disabled people employable. I’v never heard any politicians speaking out about the blatant bias there is against employing disabled people.
Doesn’t it say something if the employers don’t even want to deal with us and would rather use middle-men?
The employment of those with disability has taken a huge set back with the DWP’s decision to no long help towards the cost of essential equipment. This has long been provided and has helped so many people stay in work or to be taken on following injury or an accident. To cut back in this area is nothing short of criminal, particularly as the cut occured on the 1st October 2010, the same day as the new Equality Act became law. People like myself who provide advise and solutions for employees with disability can not believe how these changes have been implimated and how nobody seems to have a clue what is going on!
Employees have a right to be able to carry out their duties in comfort and without having to ask for help every 5 minutes. These cut backs will make it almost impossible for the majority of businesses to fund any necessary work area changes. Particularly small and medium sized companies! Somebody please recognise that a big mistake has been made and sort it out!
It is appropriate to pay more for people who are considered hard to place, but the premium should be structured to ensure that those people will not be pressurised into taking an unsuitable job so that the Work Programme provider can collect a payment.
No premium should be paid to a Work Programme provider for hard-to-place workers (for example, disabled people) until those people have held their new posts for at least a year. Such a premium should be kept under cost control by making it a small percentage of total salary (perhaps 2%), with a minimum premium of perhaps £250 to maintain the incentive for lower earners.
There’s a part of my psyche that wonders if we have spent too much helping disadvantaged and recent immigrants at the expense of the majority of hard-working well-meaning folk. As a result too many of us are disenchanted, fed-up with jumping through meaningless hoops designed to target funding to specific groups.
It may be appropriate to pay providers more, but only if those they have helped into employment are still in work after a year – no payments for short-term contracts, or for getting people into work that they can’t maintain long-term (perhaps a provider that made more than a certain number of failed placements could be paid less or simply lose the contract?).
Providers would need to continue to support people once they are in work, to ensure that the placements are working out well for employer and employee.
My preference would be for ‘harder to help’ people to be outside the ‘payment by results’ framework. DWP studies have shown that outcome based contracting tends to exclude the harder to help – paying higher rates is clearly a response to this, but it raises other difficulties. It is hard to decide who will be hardest to help for the purpose of allocating the premium. Severity of health condition and length of time on benefit are not entirely reliable indicators. Services block funded for this group, or paid at cost would be better at removing the very difficult conflict for providers of balancing business outcome versus clinical need. I feel that outcome based funding has yet to prove itself with harder to help people. Having said that I am fully supportive of evidence based, outcome focused approaches, and of the importance of value for money.
It is absolutely vital that if the government wants to place chronically ill, disabled and perhaps much older people into the workplace, they are going to have to put aside a very large budget to be able to do so.
They will have to pay providers to travel to people’s homes, to pay for good-quality and meaningful retraining (especially to people who have been out of work for a long time, and perhaps who have to change career because of their illness or disability), and the government will have to pay to “incentivise” employers to take-on sick and/or disabled people as employees.
What I am saying is that the government will have to pay a lot more than they do in current welfare rates to get older, disabled and chronically ill people into employment.
As for other groups, people who are young, and who do not have any sort of illness or disability, then providers should get a commission for finding people in that group employment that lasts for longer than 12 months, and I suspect that this group would be the only group that would save the government money rather than cost it a lot more.
I would like to know how long will service providers receive money for people who need more support.
The chronically sick may never be well enough for work.
Will they be “clients” for ever?
And will the service provider be paid forever?
Just how many times in one lifetime can a chronically sick person write their CV, have mock interviews and do activities to raise self-esteem?
Regardless, they will still be too ill to work.
And then there is the scenario of there being no jobs to apply for.
If the service providers are successful then all available posts will be filled.
What will their role be then (apart from a drain on the public purse)?
Service Providers on this consultation alone have indicated how “hard” it will be, and how “long” it will take to deal with some categories of clients (each category is different according to the Service Providers speciality subject or client group).
And how they need more money for not fulfilling the position they are employed to fill…
So they want money if they find jobs, money if they dont, extra for every person they see as disadvantaged, coupled with a caveat that they wont be able to find them work… but if they do, they want more money.
Yes Kate, I can forsee this situation will cost the Government a lot more than it saves.
And the saddest truth is that some people will get the same amount of benefits, if not more, when they enter the workplace. (the benefits will just have different names).
I believe that companies should be rewarded accordingly if they decide to take on longterm ill/disabled, partime & uk citizens this will encourage them to employ the thousands who are classed as long term unemployed and in the long run reduce the welfare bill.
Why reward someone for meeting the minumum standard required of them by law?
What message does that send to people about my equality if the only way an employer will consider me is to be paid to take me on?
One of the concerns of the former Work Support Programme is that those furthest from the job market, i.e. disabled, would/were “parked” by firms. The payment process didn’t incentivise companies to use resources as they was not inherent benefit to them for dealing with the most difficult therefore to realise the most profit from the least cost. Companies were perversely incentivised to place the easiest cases, in volume.
As this is increasing a commercial arrangement. It has to financially worthwhile for companies to expect a return on the investment and resource it uses.
We support more incentives for companies as it relates to placing and supporting those furthest from the workplace back into work. A “tariff” system that would pay at various levels depending on certain criteria such as those out of work for many years, those with ill health/disabilities etc..
Without the paying providers more for supporting people back into work who need more support our main critisim of the older schemes would continue. Simply because it will not be financially viable nor profitable to expend resources that may incur a high cost and loss to the provider.