Fair Start Scotland - individual placement and support review: Scottish Government response

Recommendation 2

Existing IPS delivery within FSS could be improved through capacity building support and future contractual changes.

In considering recommendations around capacity building, and in line with our 'test and learn' approach, we have, since this review was conducted, worked with colleagues in Health Improvement to deliver National Institute of Disability Management and Research (NIDMAR) training for frontline staff from each Fair Start Scotland service provider, to drive improvements in the service offer. NHS staff (including clinicians and a range of Health and Social Care staff who provide vocational rehabilitation) from the respective areas also attend the training to support partnership building. The training enhances participants' understanding of work as a health outcome, offers practical skills in completing the Allied Health Professionals' health and work report, and provides a deeper understanding of mental health and reasonable adjustments in the workplace.

To date, over 90% of the staff have successfully passed the Certified Disability Management Professional exam and have gained their Professional Registration Certificate. Through attendance on the course, professional relationships have developed and, as a result, Service Providers are now engaging with Community Mental Health teams in their respective areas and have been invited to attend the Scottish IPS peer support group.

Additionally, three out of the five FSS providers have obtained fair, or above, IPS Fidelity Review results from an independent assessor, with the remaining two confident of achieving at least a fair rating in their upcoming reviews. We will continue to closely monitor IPS delivery over the remaining lifetime of the FSS contracts, with all learning shared across providers and used to inform the future delivery models of IPS as we move towards further implementation of No One Left Behind.

We have listened to the views of disabled people's organisations and feedback from disabled participants, who indicate that finding and maintaining a job of 16 hours per week is unachievable for some disabled people. As a result, we will be implementing changes to the Fair Start Scotland contracts to allow providers to claim job outcomes for participants who work at least 8 hours per week, in specific circumstances, which will allow more people to benefit from the service offer.

Early discussions are already underway on how to increase the wider reach of the IPS offer to straddle both Employability and health and work holistically with individuals who do not interact with current referral routes, with advice being sought from the Scottish Government's Mental Health Professional Advisors.

We have also commissioned a Disabled People's Organisation (DPO) delivery contract, which was awarded to a consortium led by Inclusion Scotland and supported by Glasgow Disability Alliance and Glasgow Centre for Inclusive Living. The purpose of this work is to help enable provision of better support to disabled people during their time with the Fair Start Scotland service. Drawing on disabled people's lived experience and underpinned by the social model of disability, this contract supports Employability providers and employers to develop their disability equality capability and knowledge across all stages of the employment process, including in-work support. Key learning from this will help to shape further improvements to Employability provision in Scotland.

Ensuring that access to IPS within FSS was not linked to conditionality and sanctions removed a barrier that there is evidence can cause hardship, including potential emotional and mental distress. In consideration of the review recommendation regarding the need to develop both capacity and capability, we recognise that this extends beyond individual skills and knowledge to include organisational processes and approaches.

The Scottish Government has worked closely with the Department for Work and Pensions (DWP) to ensure that, where appropriate and dependent on the individual, the referral process encourages effective working between Job Centre Plus and FSS service providers.

A key theme which emerged from the review was the need to strengthen cross-policy working, including between employability and health in particular. Through collaboration with service providers and other stakeholders, and building on the implementation of A Fairer Scotland for Disabled People: Employment Action Plan,

we will focus on promoting collaboration and alignment of our respective services. To achieve shared outcomes will call for closer partnership arrangements, aligning plans, strategies, and spending decisions towards improving outcomes. Cross-policy collaboration around quality standards for secondary mental health services, linked to the national outcomes, will provide an opportunity to link this to cross-cutting policy issues, including Employability.

This is part of a wider ambition to develop a suite of standards for mental health services. This will allow us to address transitions between inpatient and community services which has been identified as a key area for improvement. The aim of these standards is to improve the quality and safety of mental health services. We want to ensure that individuals, their families and carers know what they can expect from mental health services, ensuring our approach is person-centred. The standards should reduce scope of unwanted variation of quality of care and therefore reduce inequalities in experiences and outcomes. In addition, they should provide an opportunity to build a collective understanding of performance and enable effective benchmarking to drive improvements in quality of care. This should provide a basis for continual improvement through enabling greater scrutiny and assurance of services against the standards.

The Scottish Government is confident that the current Fair Start Scotland delivery model is flexible enough to ensure that providers can commission any bespoke support needed to help overcome a wide range of barriers to accessing employment, whether that be through IPS, supported employment, or another combination of specialist support services.

The success of this model is very much dependent on effective partnerships at a local level with other support organisations (e.g., the Scottish Prison Service, drug and alcohol rehabilitation services, and those that support people with complex health conditions). We are committed to continuous improvement of Fair Start Scotland and will explore all opportunities to enhance the local integration of services and 'test and learn' about what works best to support those with more complex barriers towards and into work. IPS forms an important part of the FSS offer to help participants find sustainable, competitive jobs that fit their needs and interests, and we know that from the Year 3 Evaluation report that 82% of participants felt that the support received while on the service helped improve their general quality of life and wellbeing.

We will consider the remaining elements of this recommendation in the future development of devolved employability services.