Health and work support pilot: final evaluation

Quantitative findings

Analysis of management and performance data

It should be noted that there were a number of issues related to data held by the HWS pilot which impact on our capacity to draw definitive conclusions about the service.

Firstly, the management and performance data held by the Health and Work Support Pilot (HWS) service was contained within two datasets. The first database comprised client and progression information from the start of the Pilot (approximately June 2018) through to the end of May 2019. The second database held client and progression information from the end of May 2019 onwards, until the closure of the HWS service. The two databases were a result of changes to the monitoring of the service, and the introduction of a revised questionnaire for data capture. The revised questionnaire aimed to remove inconsistencies in data capture across the service area. The two datasets were combined, and data cleansed by the Scottish Government statistics team prior to being provided to the consultancy team for analysis.

The change in approach to monitoring the delivery of the HWS pilot and the revised questionnaire meant that there were considerable differences between the 'old' and 'new' datasets, prior to them being combined. This presented challenges for the analysis; for example, mapping between variables in the 'first' and 'second' datasets has not been straightforward.

The second significant issue is that there is large amounts of incomplete or missing data, particularly data on outcomes and progression and therefore caution should be used in interpreting results which are best regarded as indicative as opposed to definitive. The analysis presented here has used the data to best effect to inform the evaluation and within the limitations described. It is also important to note that the data analysis here is only one strand of evaluation activity with other forms of supplementary fieldwork including a client survey offering alternative and more complete sources of evidence.

Summary of HWS pilot client profile and outcomes

The following diagrams provide a summary of the client profile and outcomes of the HWS pilot in numbers.

Telephone survey with clients

The telephone survey findings represent the views of a sample of HWS pilot clients. Only differences which are statistically significant are reported. This section summarises the main findings from the telephone surveys.

The research was conducted using a quantitative survey approach, comprising telephone interviews with 600 Health and Work Support (HWS) Pilot clients.

The survey fieldwork took place over two waves between November 2019 and July 2020. Each wave comprised the following:

• Wave 1 (November 2019 to February 2020):
  • An 'initial' survey of 484 HWS clients
• Wave 2 (June and July 2020):
  • An initial survey of 116 HWS clients (same as the Wave 1 survey questionnaire)
    • a further outcomes survey^[6] was conducted with 38 Wave 1 participants (who agreed to be re-contacted for further research) who were still using the service at the time of the first survey but had now finished using the service.
  • A follow-up survey of 144 Wave 1 survey participants who agreed to re-contact (this survey comprised new questions to gauge if/how participants' health and work outcomes had changed over time)

Key telephone survey findings

Overall levels of satisfaction with the support received through the Health and Work Support Pilot were found to be very high:

• 94% of participants were satisfied with the support they had received overall;
• 93% were satisfied their initial enrolment phone call with a member of the HWS team;
• 92% were satisfied with the assessment meeting with their case manager; and,
• 93% were satisfied with the clinical support they received from a physical or mental health specialist.

The main reasons clients described for registering with the service were to access specialist support from a health professional or to get advice / guidance on how to manage or treat a health condition.

The service was found to have made a positive difference to participants' health and employment outcomes. The majority (76%) said the service made a difference in enabling them to: remain in work and/or return to work from absence; change their working pattern; or find employment. The service also made a positive difference in relation to:

• Clients' concerns about losing their job due to their health condition: Of those that finished using the service the proportion of participants concerned about losing their jobs as result of their health condition was 12% (at the time of this survey), at the time of enrolment this was 34% (all participants ),
• Absence from work: Of those that finished using the service the proportion of participants who were absent from work (due to sickness or other reasons) was 10% (at the time of the survey), at the time of enrolment this was 27% (all participants).

Three quarters (78%) of survey respondents said that their health had improved since first contact with the service and of these a high proportion (91%) said that the service had contributed to this improvement.

The services that made the most difference in helping participants to remain in or find work were:

• Specialist support to address a physical health condition
• Support received from a case manager.

Just over a third of all participants (36%) were found to have dropped out of the service before they had finished receiving support. The main reasons for this were:

• They felt they had got all the support they needed.
• The appointment times with a specialist were inconvenient.
• Their circumstances had changed.