Evaluation of the Innovation Fund Health-led Trials

What is the issue?

Despite the rate of sickness absence falling in recent years, the cost to the state, employers and the wider economy is estimated to exceed £22 billion. Reducing the extent of sickness absence and the disability employment gap in the UK has been a policy priority for years as the benefits from even a small reduction would be significant.

There are two main conditions that disproportionally lead to people struggling to maintain or gain employment: mental health and musculoskeletal disorders. Innovation Fund Health-led Trials test new ways of addressing these conditions. They work across health and work to improve individual economic, social and clinical outcomes within the objective of halving the disability employment gap.

How did we help?

The Department for Work and Pensions commissioned a consortium, of which RAND Europe is part, to evaluate the trials implemented in Sheffield and West Midlands. Overall, the evaluation aimed to:

• determine the impact of the new interventions on health and employment outcomes
• understand what works, for whom and under what conditions.

The evaluation was rooted in a realist approach and relies on mixed methods. It included Randomised Control Trials, cost-benefit analysis, and qualitative research methods, such as interviews, workshop and site visits.

What did we find?

The employment outcome measure for the trials, which covered the probability of being employed for 13+ weeks over the year following randomisation, was aligned to public employment programmes in contrast to many Individual Placement and Support (IPS) studies which assess impact on a single additional day in work over the control group. This measure was selected in order that results could be compared with other public employment programmes for similar target groups.

Economic benefits arising from improvements in health were worth more to society and the exchequer than financial benefits from improvements in employment, particularly as the trials did not generate an earnings impact.

What can be done?

• Staff training is key and should be provided to new employment specialists joining IPS services to maintain fidelity in delivery.
• Continuous efforts to build relationships and to support links between health and employment systems are important.
• Co-location of health and employment specialists (or regular presence of employment specialists with local teams) could strengthen the integration between employment and health systems.
• Rapid enrolment to the IPS service, managing caseload size (and mix) and employer engagement should help improve outcomes in future.