PEER SUPPORT FOR EMPLOYMENT

A PRACTICE REVIEW

EXECUTIVE SUMMARY

May 2016

Written by Liz Sayce and Natasha Fagelman

PEER SUPPORT FOR EMPLOYMENT

A PRACTICE REVIEW

EXECUTIVE SUMMARY

This report is based on a survey and interviews initiated to identify practice examples of peer support to help people secure, retain or progress in employment. It is a companion report to The Work Foundation’s review of research evidence on the same subject.

We conclude that the time is right to scale up and further test peer support for employment:

  • There is high demand for peer support from disabled people. Disabled people involved report that peer support for employment offers hope, new belief in possibilities, encouragement, role models, relationships of trust, a new balance of power,holistic support with connected life issues and a sustainable support network
  • There is an appetite to facilitate it from Disabled People’s Organisations and organisations in other sectors
  • Government is seeking new approaches to support employment of disabled people/people with long-term health conditions, to fulfil its commitment to halve the disability employment gap. Previous programmes like the Work Programme have had poor results with these groups. In health, the 5-year Forward View cites the importance of evidence-based patient-led initiatives, including peer support, for the future NHS
  • Peer support goes with the grain of wider social and economic trends. Forbes’ top business trends for 2016 include a connecting economy, in which successful business leaders create value by connecting customers (as with Airbnb or Facebook). It may be possible to create human value by mobilising the expertise of lived experience
  • The Practice Examples in this report show promising practice. There is some evidence for peer support generally demonstrating a positive Return on Investment: for instance, Self Management UK have found that for every £1 spent on self-management courses, £2.24 is saved in reduced health service usage[1]. Research finds positive outcomes from peer support generally: for instance, The Work Foundation cite one randomised control trial[2]showing significantly improved employment for people accessing peer support. A literature review by Repper and Carter (2011) [3] found evidence that peer support workers in mental health services could lead to reduced admissions, an increased sense of independence and empowerment, and higher self-esteem, confidence, social connectedness and community integration. Peer support reviewson employment specifically show a range of positive results in terms of securing employment, self-employment and promotions, sometimes (as with Journey to Employment and the DR UK Leadership Academy Programme) with emerging evidence of cost-effectiveness

‘The most obvious trend is that outcomes tend to last longer because support, networks and strategies don’t just disappear on discharge – they can endure’

We identified over 50 practice examples (47 from our survey, plus examples shared outside the survey). Many were from Disabled People’s Organisations, which are founded on peer support; it is in their DNA. They are led by people with lived experience and include centres for inclusive living and impairment-specific, user-led groups. In addition we identified employment-related peer support offered by large charities, the NHS and Community Interest Companies.

The Practice Review discusses different approaches under the following headings:

  • Who is involved and benefiting?Peer support today is taking place both between people with very similar impairment experiences – and, seemingly more commonly, between disabled people whatever their impairment. We found examples of positive outcomes from both approaches, in terms of hard evidence of employment destinations and reports of increased confidence, feeling safe and encouragement to grow and develop. These programmes take place both in DPOs and other sectors.
  • Why? What is the purpose or purposes?We found promising practices of peer support focused specifically on securing employment (eg Job Clubs), retaining employment (eg support with Access to Work) and progression (eg Leadership Academy). Other examples focus on wider life outcomes of which employment is just one. Promising outcomes include jobs obtained and career progression, with some evidence of promising return on investment, as well as improved confidence and resolution of independent living issues
  • What?We identified one to one and group approaches, based either on pure mutuality or on ‘peer mentors or peer support workers’ supporting recipients. ‘It takes place physically, by phone or on-line, over different time periods. Investment in facilitation and training was thought crucial by participants.’

Survey response

Peer support is not a single magic bullet: it may be one component of someone’s employment support (for instance, going alongside Individual Placement with Support).

The field of peer support for employment is still under-developed and under-evaluated, with a lot of activity being small scale and discrete. Below, we make 3 key proposals to ramp up effective activity so that the clear potential of peer support for employment is more fully realised. All could be led or co-led by Disabled People’s Organisations. DPOs have been particularly influential in developing peer support and are in a position to connect employment peer support to a range of other life issues, enabling people to overcome barriers (from debt to housing problems) that need to be addressed for the person to turn their life around.

  1. Create a national Peer Support for Employment Network to share expertise, evidence and practice – involving DPOs, academics, commissioners and other providers. We suggest that this should be jointly convened by Disability Rights UK and The Work Foundation. Its first task should be to create a framework for practice and evaluation to help generate improved evidence.
  1. To complement DWP’s Journey to Employment project, which is showing positive results from group-based approaches, we propose that government could next invest in testing peer mentoring delivered by disabled people in work to those out of (or in) work – to offer individual encouragement and role modelling
  1. There is an opportunity with the Joint Work and Health Unit to encourage approaches that bring together objectives for health gain and employment gain. This would not be in the traditional sense of providing treatment so that people can work; often what people with permanent or fluctuating conditions need are strategies to manage work and workplace adjustments in the context of life challenges more broadly, from transport to social care. The purpose would be to encourage joint commissioning at local/regional level of peer support for both employment and health/well-being.

The time is right to build good practice and evidence on peer support to enable people living with health conditions or impairments to work to their full potential.

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[1] Self Management UK (2016) Cost effective for commissioners, better outcomes for patients

[2] Kaufman, C L (1995) The self help employment center: some outcomes from the first year Psychosocial Rehabilitation Journal 18, 4, pp 145-162

[3] Repper J and Carter T (2011) A review of the literature on peer support in mental health services. Journal of Mental Health 20 (4) 392-411