Benefits and Return to Work

Paul Watson gives a simple update of what has happened and how successful it has been

How to return those on long term sickness benefit to work has been a significant problem over the last 20 years. In the late 1980s through to the mid 1990s the number of Incapacity Benefit days paid to people who were unable to work increased dramatically. Chronic pain was one of the key reasons for claiming. This led to a number of Government initiatives, as well as changes in the terms of qualification for benefits.

The Pathways to Work Initiative

The pathways to work initiative is part of a Government aim to reduce the large numbers on Incapacity Benefit from 2.74 million people in 2005 to 1.74 million or fewer in 2015. The main aims of this initiative were:

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• To provide skilled adviser support and action planning within 6 weeks of a person initially starting to claim incapacity benefit
• Easier access to a range of specialist employment and vocational rehabilitation programmes
• Improved financial benefits to encourage Incapacity Benefit recipients to move into employment
• Tailored support for recipients to come off benefits
• Engagement of employers and GPs.

Pilot sites were set up in the England, Wales and Scotland in late 2003 and early 2004.

Following the pilot programme introduction in six sites there was a commitment by the Government to extend the service to more areas of the UK. 15 sites became eligible for Pathways as it commonly became known. But this was done without any evaluation of the success of the Pathways programme. A progressive roll-out of Pathways resulted in the programme becoming available in all areas by April 2008. This, in theory, means that all Incapacity Benefit recipients in the UK should be able to access the service now. So if you are entitled to Incapacity Benefit you should be able to access them through their local Job Centre via the Pathways Personal Advisors

The current key features are :

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• A Personal Capability Assessment that determines if you are entitled to the benefit claimed. A Capability Report is also undertaken, which should focus on the type of things you might reasonably be expected to do. This is different from a report on your ability to do your current or usual job or on what you cannot do. It may not be conducted for sometime after you have been signed on to incapacity benefit by your GP.
• Mandatory work-focused interview. Eight weeks after making an initial claim, you will be invited for an interview to identify your needs with respect to return to work. This may be put back in the case of serious illness or incapacity.
• Access to a range of programmes to support preparation for work. The "Choices" packages as they are known vary between areas but include skills development, job seeking training and a Condition Management Programme. The latter aims to help you manage your health condition.
• A return to work credit where if you enter employment you can qualify for a weekly payment of £40 per week if you earn less than £15,000 per annum
• A Personal Advisors discretionary fund of up to £300 annually per person to support activities or purchases to increase your chances of finding work.

If you get a job but find you are unable to sustain it, you can move back onto benefits within 52 weeks (this could be extended to 104 weeks) without having to reapply and without a qualification period. This provides a safety net for when a job does not work out, so that you will not be left without income.

The interviews and the development of the personal return to work package is provided by Personal Advisors located in local Jobcentres. They are your first port of call if you are on Incapacity Benefit and are looking to return to work.

Future changes

The Government wants to replace Incapacity Benefit by 2013 with the Employment Support Allowance. The medical criteria for Employment Support Allowance will be more stringent and based on what the claimant can do. Additional support along the lines of Pathway would be given to help them find work. The small number of severely disabled claimants will receive more money and will not be required to seek work. The expectation is that Employment Support Allowance will be temporary and claimants will be required to seek work according to their ability.

Does it Work?

Pathways to Work is now available through the local Jobcentre. The Government has repeatedly announced its commitment to Pathways to Work. The main effect for Pathways seems to be through the early referral to a Personal Advisor for advice in returning to work rather than allow people to settle into long-term unemployment. There does seem to be a small effect for returning people to work in the short term.

Professor Paul J Watson is President-Elect of the British Pain Society and author of Pain Concern’s leaflet Back To Work. Incapacity Benefit is based on an article published in the British Pain Society’s Newsletter.