30 March 2006 - Publication of DWP Research Reports 339 and 342: Experiences of the Job Retention and Rehabilitation Pilot and Impacts of the Job Retention and Rehabilitation Pilot
Research published today by the Department for Work and Pensions provides final results from the Job Retention and Rehabilitation Pilot (JRRP), a trial which looked to test out boosting the usual help for those off work due to sickness and ill health to return to and retain their job.
Two reports published today provide information about the experience of participating in the trial and a quantitative assessment of the impacts of the trial on return-to-work rates, health, and other measures.
JRRP was designed as a 4-way Randomised Controlled Trial. Volunteers were screened to ensure that they were eligible, then randomised into either a health intervention group, a work-based intervention group, a combined intervention including any elements of the health and work provision, or a control group.
The trial aimed to test the net impact of each intervention compared to the control group, (who received no services additional to that already available elsewhere), and the impacts of intervention groups relative to each other.
Key Findings
Impacts of the Job Retention and Rehabilitation Pilot reports on the quantitative results of the Randomised Controlled Trial. It shows that this particular method of recruiting and assisting people to retain employment was not effective. Overall, the interventions had no significant impact on the group of people recruited into the trial across key return-to-work measures. Similar rates of return to work were observed in the intervention groups as in the control group. There were however some minor impacts, both positive and negative, on certain subgroups: specifically, improved return-to-work rates for those off work because of an injury; and lower return-to-work rates for those with mental health issues.
Possible reasons for the overall lack of impact are:
- Being randomised into a JRRP intervention group may have introduced an element of passivity for participants. There is some evidence to suggest that those in the control group tended to take responsibility for their own return to work, while those randomised into an intervention group tended to relinquish responsibility to the providers, possibly as a result of poor communication channels with providers
- The intensity of contact between providers and participants was sometimes low, with participants sometimes reluctant to contact providers
- GPs and employers provided key routes into JRRP but would need to be engaged more to encourage a greater range of people to participate. Service providers also faced barriers from GPs and employers that reduced the probability of their being able to achieve a successful return to work for those participants they did work with.
Experiences of the Job Retention and Rehabilitation Pilot reports on the reasons for and experience of sickness absence, and gives further detail about the pathways through JRRP and information about the types of interventions received. Finally, the report describes participant and staff perspectives on what was successful, and identifies the barriers and constraints to its success. Key findings are as follows:
- Absences from work were generally unplanned, with people sometimes reluctant to take time off. Being off work made people frustrated, and people reported that longer-term absence had a negative effect on their mental health
- There was a common feeling amongst interviewees that it was not their GP’s role to advise them on when they might be ready to return to work: people instead relied on their own assessments of their fitness for work
- Knowledge of what JRRP could offer varied but a number of interviewees hoped to be able to access certain health services more quickly than they otherwise could. People tended to find it more difficult to envisage how the Workplace intervention could help them
- The case manager role was on the whole highly valued, but contact was not always maintained
- Health interventions such as psychological therapies, interventions to support mobility, referrals to specialists, surgical treatment and complementary therapies were thought by staff and clients to be useful
- Workplace interventions such as negotiations for graded returns to work, mediation and the provision of equipment was seen as useful for both clients and employers, and key to these was having contact with the workplace in order to understand cultures and processes and to try to work in partnership
- Employers were perceived as being resistant to JRRP staff being in contact with them, and did not always allow access to workplaces. A lack of knowledge about sickness absence management and vocational rehabilitation amongst employers was thought to be a major constraint
- Whilst many GPs were found to be supportive, staff felt that some GPs had a lack of awareness and knowledge of vocational rehabilitation. Medical opinion was seen as very influential for patients so staff felt that people had been held back when GPs agreed that they could not work or issued sick notes for long periods with limited enquiry.
Notes to Editors
- Experiences of the Job Retention and Rehabilitation Pilot and Impacts of the Job Retention and Rehabilitation Pilot are published today in the DWP Research Report Series, as report numbers 339 and 342. A summary and copy of the reports are available on the DWP website at http://www.dwp.gov.uk/asd/asd5
- The research was carried out by the National Centre for Social Research (NatCen) with the Social Policy Research Unit (SPRU) at the University of York and the Urban Institute in Washington.
- Background. The Job Retention and Rehabilitation Pilot was a four-way Randomised Controlled Trial designed to test the relative and net impacts of a boosted health, workplace-based and combined intervention for people who are off work sick for between six and 26 weeks and are screened as being unlikely to return to work without some additional help. The pilot was run by four providers in six areas, and ran from April 2003 to March 2005. 2845 people took part.
- Workplace interventions included ergonomic assessment, employer mediation and advice about graded returns to work. Health interventions included physiotherapy complementary therapy, psychotherapy and referral to medical specialists.
- Methodology. This is one of the first uses of the Randomised Controlled Trial methodology in a voluntary UK labour market context. Eligible volunteers were placed at random into one of four groups, and were interviewed after participation so that various work and health-related outcomes could be measured. The outcomes of each intervention group were compared against each other and against the control group.
- The report on experiences of JRRP is based on three qualitative research studies which ran alongside the Randomised Control Trial. The first, with service users, involved a panel of 36 people who were interviewed six times – initially face-to-face and then by telephone at monthly intervals. The second, with members of the control group study involved 46 participants, interviewed once. Finally, research with provider staff involved interviews with five people in a management capacity, and six group events with case managers.
Press enquiries: 0207238 0866
Out of hours press enquiries: 07659 108 883
Public enquiries: 020 7712 2171
Website: http://www.dwp.gov.uk/asd/asd5