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Getting employment specialists established in clinical teams, Lynne Miller


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Lynne Miller, Vocational Services Manager, Central and North West London NHS Foundation Trust

Lynne Miller, Vocational Services Manager, Central and North West London NHS Foundation Trust

Published in: Health & Medicine

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  • 1.
    • Getting Employment Specialists established within clinical teams
    • Lynne Miller, Vocational Services Manager, CNWL
    • Katherine Dawson, Vocational Team Leader Brent
  • 2. Introduction:
    • Introduction to CNWL
    • Setting up vocational services from scratch – where to you start!
    • Keys to successful implementation of IPS and UEP
    • Integration - an Employment Specialist’s Perspective
    • Feedback from service users, clinical teams
    • Monitoring/Recovery stories
  • 3. Introduction to CNWL:
    • 5 Mental health boroughs – Westminster, Brent, Kensington and Chelsea, Harrow and Hillingdon
    • 7 Addictions boroughs – Westminster, K&C, Hammersmith and Fulham, Brent, Hillingdon, Hounslow and Ealing.
    • Vocational Services Manager, 4 Vocational Team Leaders (16 ES)
    • Now delivering IPS in a range of teams including CMHTs, EIPT, Addictions and Forensic Services
  • 4. The road to evidence based services:
    • Start with a User Employment Programme:
    • Getting your own house in order within the Trust/partner agencies.
    • Success of UEP was an important factor in adoption of IPS within CNWL.
    • Two elements – direct access to paid posts within the Trust, and time limited work placements as a step towards paid work
  • 5. Getting started - UEP:
    • Selling the vision to key people – top down, top up
    • Gaining commitment from CEO, Directors, HR, Occupational Health
    • Staffing / partnerships
    • Employment Charter / Launch
    • Encouraging other providers to develop a similar commitment eg LA
  • 6. IPS – getting started:
    • VSM – selling the vision – evidence base
    • Sponsorship from Snr Management
    • Implementation plan
    • Working in an opportunistic way
    • Start small, communicate successes
  • 7. Keys to success:
    • ROLES :
    • CMHT Mgr/Snr Practitioner– shared vision/clear expectations
    • OT Role
    • Joint supervision/joint induction/joint meetings
    • Consultants
    • Team presentation – emphasis around it being a team model
    • ES role in selling the idea that anyone can work with the right support.
  • 8. Keys to success :
    • ES – recruiting the right staff
    • ES is clear about their role/purpose
    • Someone who is not afraid of employer engagement
    • Fidelity to IPS: Focus on service user strengths/ early job seeking/ job development / effective in work support / MDT approach
    • Staff supervision/training/local leadership
    • Effective monitoring and evaluation
    • Communicating successes
  • 9. Integration: an ES/Voc Team Leader Perspective
    • Into the CMHT
    • Building trust within the team
    • Integration within Vocational Services
    • Training staff
    • Advisory groups
    • Effective Supervision
    • Job clubs
  • 10. Challenges:
    • Not recruiting the right ES
    • Lack of a multi-disciplinary approach – person seen as an add on
    • Team chemistry
    • Lack of commitment from team mgt or low expectations around what an ES can achieve
    • Confusion over performance mgt issues
  • 11. Common IPS fidelity issues:
    • Zero exclusion
    • Early job seeking
    • Lack of employer engagement
    • Lack of a Team approach
    • Not providing effective in work support hence the job retention rate is low
    • ES is not confident about supporting service users to manage personal information, hence employer engagement is limited
  • 12. Monitoring:
    • Clear monthly and bi-annual monitoring systems in place
    • Making sure ES are part of integrated files
    • Use of recovery stories
    • Fidelity Reviews
  • 13. Feedback from clinical teams:
    • Clinical teams have identified that having an effective ES immediately raises the profile of employment
    • Raises expectations – especially when they can see results
    • The clinical team are more aware of local employment resources
    • ES can assist in engaging service users with the team.
  • 14. Feedback from service users:
    • “ My name is R.M. I am 44, and have had schizophrenia and a physical illness for over 21 years. I have been to the Job Centre many times over the years, but they did not seem interested in helping me. Staff at my community mental health team put me in contact with their Employment Specialist.
    • After a few sessions with the ES she invited me to the job club every Friday between 3-5pm. I quickly became motivated and eager to look for a job. They explained to me how to draw up a CV and write correct application forms. Within months I had an interview with B&Q but didn’t get the job. Then I had an interview with Homebase but didn’t get the job! The ES suggested some pointers and we did more interview practice and I got a job – 14hrs a week at B&Q. I couldn’t have done this without the constant support from the ES, she kept motivating me even when I felt low after not getting the first two jobs. I considered taking a break but she encouraged me to keep trying. I know have my dream job.
  • 15. Results:
    • UEP – since it started in Sept 05, 200 people have accessed the programme, 168 placements have taken place, 80 people have gone into jobs, 30 into educ, and 11 into volunteering.
    • When IPS was first introduced within an Early Intervention Team. In Yr 1 80% of those referred were inactive. Within 9 months 77% were involved in paid employment or education. Year 2 37 people accessed the service of which 1 was in employment (78% were unoccupied) and none were in education. By the end of the year 15 were in paid work and 8 were in education.
    • In Brent in first 10 months of this financial year – 2.5 posts (one of has been in post just 10 months), 125 people accessed the service 35 have been supported into paid work and 25 into education.
  • 16. Conclusion
    • Support from Snr and local Management to move the agenda forward and free resources.
    • Joint work with OTs
    • Leadership/Support for ES / Ensuring high fidelity to the model
    • Getting the monitoring and evaluation right
    • Increasing access to external partnerships to increase capacity
    • Fidelity reviews and a culture of continuous improvement
  • 17. For Further information
    • [email_address]
    • [email_address]