Commissioning IPS: the role of local partnerships, Jonathan Allan


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Jonathan Allan, Disability Services Manager, Shropshire Council

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Commissioning IPS: the role of local partnerships, Jonathan Allan

  1. 1.   Commissioning IPS: the role of local partnerships Jonathan Allan Disability Services Manager Shropshire Council
  2. 2. Shropshire IPS partnership <ul><li>Enable supported employment service, Shropshire Council </li></ul><ul><li>Shropshire PCT </li></ul><ul><li>South Staffordshire and Shropshire Foundation Trust </li></ul><ul><li>In various forms since 1995 </li></ul>
  3. 3. Full Partner in Centre of Excellence <ul><li>Shropshire has had 2 Fidelity Reviews: moved from “Fair” to “Good” </li></ul><ul><li>Regional role in developing IPS in the West Midlands </li></ul>
  4. 4. Current funding partners <ul><li>Shropshire Council ,Shropshire PCT, Shropshire SSS FT, Workstep </li></ul><ul><li>Elsewhere: Mental Health Trusts </li></ul><ul><li>Mix of in – house and voluntary providers </li></ul>
  5. 5. “ No health without mental health” <ul><li>Early intervention </li></ul><ul><li>Joint work between health and employment providers </li></ul><ul><li>Welfare to Work reform </li></ul><ul><li>Work Choice, Access to Work </li></ul><ul><li>Fit for Work pilots and “fit notes” </li></ul><ul><li>IAPT commitment: employment coordinator, employment advice </li></ul>
  6. 6. Healthy Lives, Healthy people consultation on outcomes <ul><li>Costs of working age ill health in UK= £100 billion p.a. </li></ul><ul><li>Local Health and Wellbeing Boards driving improvements in public health </li></ul><ul><li>“ Proportion of people with mental illness and or disability in employment” </li></ul><ul><li>Is there a better formulation? </li></ul>
  7. 7. The business case: Quality <ul><li>The evidence: Employment is good for health, unemployment is bad for health </li></ul><ul><li>Increased employment improves quality of life, self esteem, relationships </li></ul><ul><li>Unemployed have more GP consultations and hospital admissions </li></ul><ul><li>16 international randomised controlled trials demonstrates IPS is best vocational approach </li></ul><ul><li>IPS Fidelity scale provides only audit tool </li></ul>
  8. 8. The business case: innovation & productivity <ul><li>People accessing IPS based services twice as likely to achieve employment </li></ul><ul><li>Cost benefit analysis Perkins suggests a save to spend ration of £1 for every £1.51 spent </li></ul><ul><li>Centre for MH estimate in – patient savings of £6000 per person. </li></ul><ul><li>Further evidence Bush, 2009) that long term savings can be realised for high support service users. </li></ul><ul><li>IAPT / primary care: employment specialists accelerate by 7 months </li></ul>
  9. 9. Commissioning 1: Is the service effective? <ul><li>IPS is twice as effective as other vocational approaches </li></ul><ul><li>Best validated both internationally and in this country </li></ul>
  10. 10. Commissioning 2: Is it good value for money? <ul><li>No thorough cost benefit analysis: difficult as some savings locally, some to government </li></ul><ul><li>IPS “relatively inexpensive…and is cost effective” (Drake & Bond 2008) against other vocational services </li></ul><ul><li>Info from elsewhere indicates cost savings </li></ul>
  11. 11. Commissioning 3: Is it affordable? <ul><li>about £2000 per place – argument for investment as opposed to other services </li></ul><ul><li>current economic climate </li></ul><ul><li>does it save money elsewhere? Is it a good investment? Do employment outcomes lower health care costs? </li></ul>
  12. 12. What’s the link? <ul><li>“ If recovery is to become a reality, employment must become one of its key priorities.” </li></ul><ul><ul><ul><li>Centre for Mental Health (2008) Making Recovery a Reality - Policy Paper </li></ul></ul></ul>
  13. 13. Hope <ul><li>Recovery is about the hope that things can change for the better </li></ul><ul><li>Hope is the catalyst of the recovery process </li></ul><ul><li>Employment is key means of obtaining hope in all our lives </li></ul><ul><li>Integrated strategies and closely aligned services </li></ul>
  14. 14. questions……. <ul><li>How does employment survive the next 2 years before GP commissioning? </li></ul><ul><li>How do we engage with GP commissioning? </li></ul><ul><li>Can we link health commissioning (GP primary / secondary, LA led Public Health) with DWP and other programmes and approaches? </li></ul><ul><li>What do we want measuring in terms of mental health employment outcomes? </li></ul>
  15. 15. <ul><li>Jonathan Allan </li></ul><ul><li>Shropshire Council </li></ul><ul><li>[email_address] </li></ul><ul><li>01743 276900 </li></ul>