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A comparison of routine and case-managed pathways for recovery from musculoskeletal disorders in people in employment

BERGMAN, Beverly P
DEMOU, Evangelia
LEWSEY, James
MACDONALD, Ewan
2021

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Purpose: To compare outcomes in employed people from an enhanced routine management pathway for musculoskeletal disorders within National Health Service Scotland with an existing active case-management system, Working Health Services Scotland.


Materials and methods: The study comprised a service evaluation using anonymised routinely collected data from all currently employed callers presenting with musculoskeletal disorder to the two services. Baseline demographic and clinical data were collected. EuroQol EQ-5DTM scores at the start and end of treatment were compared for both groups, overall and by age, sex, socio-economic status, and anatomical site, and the impact of mental health status at baseline was evaluated.

 

Results: Active case-management resulted in greater improvement than enhanced routine care. Case-managed service users entered the programme earlier in the recovery pathway; there was evidence of spontaneous improvement during the longer waiting time of routine service clients but only if they had good baseline mental health. Those most disadvantaged through mental health co-morbidity showed the greatest benefit.

 

Conclusions: People with musculoskeletal disorders who have poor baseline mental health status derive greatest benefit from active case-management. Case-management therefore contributes to reducing health inequalities and can help to minimise long-term sickness absence. Shorter waiting times contrib- uted to better outcomes in the case-managed service.

The impact of COVID-19 on disabled people in Northern Ireland

FITZSIMONS, Sean
O'NEILL, Emma
CRAWFORD, Alison
September 2020

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Key findings and recommendations are reported from an online survey published in April 2020 to gather the experiences of disabled people, their families and carers during the COVID-19 outbreak in Northern Ireland. The survey went live on April 1st 2020 and closed on April 30th 2020.  Over 400 survey responses were received, including over 1300 written statements. 

Key findings are reported in the areas of: social care; physical health; mental health and emotional wellbeing; carers; accessing food and medicine; accessing information; employment and training; social security benefits and community support

Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory

SENGERS, Johan H
AMBA, Femke I
BROUWER, Sandra
STAHL, Christian
2020

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Purpose: Many high-income countries are witnessing a shift of focus on eligibility for disability benefits towards promotion of work reintegration. However, little is known about how countries assess work cap- acity, and how a job match is then obtained. The current study aims to compare work capacity assess- ments and available efforts to achieve a job match in eight high-income OECD countries.

 

Methods: A survey was conducted among key stakeholders concerning organization of work capacity assessments in social security settings, and efforts made to obtain a job, across eight OECD countries: Australia, Denmark, Finland, Iceland, Sweden, the Netherlands, the United Kingdom and the United States. 

 

Results: In most countries, work capacity is assessed at several time points, with variations in moments and in information used for job matching. In countries obtaining information on personal and work levels, the search to find a job match usually begins with the persons who have disabilities.

 

Conclusion: Although a shift towards a holistic focus in work capacity assessment has been recognized, medical factors still prevail. Limited emphasis is placed on the implications of functional limitations for the possibilities of work. A holistic approach to assessment needs to be coupled with holistic support measures through provision of coordinated and high quality job matching services.

Reimagining the workplace: disability and inclusive employment

LEONARD CHESHIRE
February 2019

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This UK based report examines the challenges and barriers facing disabled people throughout their working journey, as well as considering solutions to some of the key issues. Through our own research survey and interviews we look at the impact on disabled people where they cannot access adequate support as well as what works in improving their employment prospects

 

Topics discussed include: conditions of employment; preparing for work; falling out of work; and the performance of government based programmes.

 

ComRes interviewed in 2018 online 1,647 disabled adults in the UK, aged between 18 and 65, and in 2017 they interviewed 1,609 disabled adults. ComRes interviewed 503 UK line managers responsible for or involved in the recruitment process in 2018 and in 2017.  Between 1 December 2018 – 20 January 2019, Leonard Cheshire conducted in-depth telephone interviews with seven disabled people of working age about their experiences of employment. 

 

Recommendations are made throughout.

Disability and vocational rehabilitation in rural settings

HARLEY, Debra
et al
2018

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A graduate student textbook offered in 39 chapters, each with different authors and subjects. Abstracts, test questions and citations are freely available on-line. Full text is charged for. The book surveys rehabilitation and vocational programs aiding persons with disabilities in remote and developing areas in the U.S. and abroad. Contributors discuss longstanding challenges to these communities, most notably economic and environmental obstacles and ongoing barriers to service delivery, as well as their resilience and strengths. Considerations are largely of the US but there is a chapter on each of Asia and Pacific region, Australasia, Canada, Mexico, India, Turkey, Colombia and the UK. 

 

Disability and conditional social security benefits : Journal of Poverty and Social Justice, special issue, vol. 25, no.2, June 2017

GEIGER, Ben Baumberg
Ed
July 2017

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This special issue of the Journal of Poverty & Social Justice has two aims. Firstly to provide new evidence on the implementation and impacts of conditionality for disabled benefits claimants in order to provide an empirical foundation for the contested claims on both sides of this debate and secondly to prompt further research in this area. 

Article titles in this issue are:

  • Benefits conditionality for disabled people: stylised facts from a review of international evidence and practice
  • Does sanctioning disabled claimants of unemployment insurance increase labour market inactivity? An analysis of 346 British local authorities between 2009 and 2014 
  • Consequences of activation policy targeting young adults with health-related problems in Sweden and Denmark
  • Assessment of work ability in competing strands of social insurance: the German case 
  • Welfare conditionality and disabled people in the UK: claimants' perspectives
  • The bedroom tax in the Supreme Court: implications of the judgment 

Being disabled in Britain: a journey less equal

EQUALITY AND HUMAN RIGHTS COMMISSION
April 2017

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"Being disabled in Britain is a review into disability inequality in Great Britain. It builds on the Equality and Human Rights Commission’s statutory five-yearly report on equality and human rights progress in England, Scotland and Wales, Is Britain Fairer?.

We want this report to be used by UK and devolved governments to make improvements to law and policies, by local government to ensure services meet the needs of disabled people, and by disability groups to strengthen their case for change.

The report includes chapters on six areas of life, including education, work, health, justice and participation in politics, looking at where there has been progress and where there are still serious issues to be tackled. It also looks the experiences of those with different impairments and how these impact on people’s life chances"

Precarious lives and resistant possibilities: the labour of people with learning disabilities in times of austerity

BATES, Keith
GOODLEY, Dan
RUNSWICK-COLE, Katherine
2017

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This paper draws on feminist and queer philosophers? discussions of precarity and employment, too often absent from disability studies, to explore the working lives of people with learning disabilities in England in a time of austerity. Recent policy shifts from welfare to work welcome more disabled people into the job market. The reality is that disabled people remain under-represented in labour statistics and are conspicuously absent in cultures of work. We live in neoliberal- able times where we all find ourselves precarious. But, people with learning disabilities experience high levels of uncertainty in every aspect of their lives, including work, relationships and community living. Our research reveals an important analytical finding: that when people with learning disabilities are supported in imaginative and novel ways they are able to work effectively and cohesively participate in their local communities (even in a time of cuts to welfare). We conclude by acknowledging that we are witnessing a global politics of precarity and austerity. Our urgent task is to redress the unequal spread of precaritization across our society that risks leaving people with learning disabilities experiencing disproportionately perilous lives. One of our key recommendations is that it makes no economic sense (never mind moral sense) to pull funding from organisations that support people with intellectual disabilities to work.

Improving lives. The work, health and disability Green Paper

October 2016

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Employment rates amongst disabled people reveal one of the most significant inequalities in the UK today: less than half (48%) of disabled people are in employment compared to 80% of the non-disabled population. Despite a record-breaking labour market, 4.6 million disabled people and people with long-term health conditions are out of work leaving individuals, and some large parts of communities, disconnected from the benefits that work brings. People who are unemployed have higher rates of mortality and a lower quality of life. This green paper sets out the nature of the problem and why change is needed by employers, the welfare system, health and care providers, and all of us. Proposed solutions are set out  and views requested. (Consultation now closed)

04101608 10/16 

The autism employment gap report

The National Autistic Society
September 2016

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For nearly a decade, the full-time employment rate of autistic adults has stagnated. A survey we carried out in 2007 indicated that just 15% of autistic people were in full-time paid work. Shockingly, in this year’s survey, the figure was just 16%.

 

A similar number are in part-time employment, giving an overall employment rate of 32%. And while full-time work won’t be right for everyone on the autism spectrum, four in 10 of those working part-time feel under-employed. Others feel they are in low-skilled work and employers don’t see their abilities. They see their autism. They see a problem.

 

Meanwhile, employers have told us that they are worried about getting things wrong for autistic employees and that they don’t know where to go for advice. Autistic people are overloaded by too much information at work, and employers don’t have enough.

 

The UK Government has made a very welcome pledge to halve the disability employment gap by the end of this Parliament, meaning that they have to shift the disability employment rate from 47% to 64%. But the autism employment gap is even wider. For the number of autistic people in work to reach 64%, the Government will need to commit to doubling the number of autistic people in employment by 2020.

 

Both Government and employers need to take specific action to make this happen – without it, recent history tells us that autistic people will continue to be left behind

Rethinking the work capability assessment

BAUMBERG, Ben
et al
March 2015

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This report outlines the key research findings about the Work Capability Assessment (WCA) criteria of the Employment Support Allowance (ESA), a means tested benefit for those who are unable to find work in Britain. It presents the state of the UK’s existing assessment and then describes how seven key countries systematically assess incapacity, and the lessons these countries provide for reforming the WCA in the UK

Human Rights

www.macao-tz.org
December 2014

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Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania.  Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods.  In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.

Nonparametric estimation of a compensating variation : the cost of disability

HANCOCK, Ruth
MORCIANO, Marcello
PUDNEY, Stephen
December 2013

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This paper proposes a nonparametric matching approach to estimation of implicit costs based on the compensating variation (CV) principle. The paper aims to introduce the matching approach, compare its properties with those of the conventional indirect parametric approach, and demonstrate its application in an important policy area. The authors apply the method to estimate the additional personal costs experienced by disabled older people in Great Britain, finding that those costs are substantial, averaging in the range £48-61 a week, compared with the mean level of state disability benefit (£28) or total public support (£47) received. Estimated costs rise strongly with the severity of disability. The authors compare the nonparametric approach with the standard parametric method, finding that the latter tends to generate large overestimates unless conditions are ideal, and recommend the nonparametric approach

ISER Working Paper Series, No. 2013-26

Post-2015 development goals : eighth report of session 2012-2013|Volume I : report, together with formal minutes, oral and written evidence

INTERNATIONAL DEVELOPMENT COMMITTEE
January 2013

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The UK International Development committee "report begins (Chapter 2) with a more detailed exploration of the processes by which the post-2015 development goals are being developed and the consultations which are being undertaken. In Chapter 3, we consider what the overarching purpose of the new goals should be, including consideration of the extent to which development should be integrated with issues of environmental sustainability. In Chapter 4, we assess the potential content of the post-2015 framework. In doing so, our intention is not to be prescriptive, but to set out some broad issues to be borne in mind when the framework is being developed. Finally, in Chapter 5, we assess the potential structure of the new framework, including a consideration of the role of targets and indicators"
HC 657
Note: Additional written evidence is contained in Volume II, available on the Committee website

Benefits stigma in Britain

BAUMBERG, Ben
et al
November 2012

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This report presents the results of a research study assessing the impact of stigma and other social influences on applying for benefits in the UK

Good governance handbook

BULLIVANT, Dr. John
et al
March 2012

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"This document has been designed to provide some key principles of good governance that can aid decision making at board level in healthcare providers. The guide builds on previous best practice guidance whilst recognising the major impact of the current changes to the NHS architecture. It is intended to be of interest to existing NHS boards, emerging Clinical Commissioning Groups and Health and Wellbeing Boards and those responsible for managing governance systems and processes within healthcare"

Enabling equality : furthering disability equality for staff in higher education

EWENS, David
et al
2011

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Informed by in-depth interviews and a widely distributed survey of disabled staff in higher education institutions, this research identifies ten areas that are influential in shaping the experiences of disabled staff in the workplace, and offers recommendations for best practice
Note: This report is available in both pdf and word format

Independence, choice and control : DLA and personal mobility in state-funded residential care|Volume 1 : report

THE LOW REVIEW
2011

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This report focuses upon: how the mobility component of DLA is being used by care home residents and the impact of the loss of this benefit; funding arrangements for meeting personal mobility needs between local authorities and care home providers; and responsibilities of care home providers in relation to the mobility needs of residents. Over 800 submissions from individuals, local authorities and providers were provided , and six oral evidence sessions were held for the compilation of this report
The executive summary and report are available in both word and pdf formats
Oral and written evidence is contained in volume 2 available on the website

Disabled children : a legal handbook

BROACH, Steve
CLEMENTS, Luke
READ, Janet
2010

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This handbook aims to empower disabled children and their families through a greater understanding of their rights and entitlements in England and Wales. It is useful reading for the families of disabled children, their advocates and lawyers, voluntary and statutory sector advisers, commissioners, managers and lawyers working for public authorities, education, social and health care professionals, students and academics

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