Health and Employment Bulletin November 2013
-3.4%
-5.2%
ANNUAL CHANGE IN HEALTH – RELATED BENEFIT CLAIMANTS
ANNUAL CHANGE IN OUT-OFWORK BENEFIT CLAIMANTS
More jobseekers are currently being supported into work than people with health conditions.
Health and Employment Bulletin: Health and economic activity
Introduction This edition of the Health and Employment Bulletin provides an update on health and employment statistics across Greater Manchester. The information is designed to help health practitioners understand the links between employment, worklessness and health. This month considers the newly released Work Programme statistics – a programme led by the Department for Work and Pensions to support individuals out of work to find a job. The statistics show that those with the most significant barriers to employment – invariably health conditions – are finding it difficult to gain employment and stay in work. The bulletin also shows how, over the past year, unemployment and economic inactivity have fallen – by 6.4% and 1.9% respectively – across Greater Manchester. There are now 17,100 fewer out of work individuals than a year ago. Employment has also increased, with 23,400 more individuals employed than a year ago in Greater Manchester. Coupled with a fall in out-of-work benefits of 5.2%, the news is positive for Greater Manchester. However, whilst numbers have fallen a great proportion of this is down to changes in benefit eligibility. Changes to lone parent benefits, for example, have meant that fewer individuals are eligible for income support. Simultaneously, incapacity benefit claimants have been reassessed for the new Employment and Support Allowance. Roughly one-third of re-assessed individuals have been found ‘fit for work’ and transferred to Jobseeker’s Allowance. In addition to other welfare reforms, this has placed additional pressure on benefit claimants. The impact on health and wellbeing can be seen through many of the national metrics. Greater Manchester’s healthy life expectancy – influenced by an individual’s employment status – is below the national average in almost all areas. Stockport and Trafford are the only authorities with a greater healthy life expectancy than the national average for males, while only Stockport has a higher than average healthy life expectancy for females. Simultaneously, the Office of National Statistics’ annual report on personal wellbeing noted that Greater Manchester was below the national average for life satisfaction, happiness and a meaningful life, and above the national average for levels of anxiety. Therefore, the role for health practitioners in employment support – and in supporting good health for work – continues to be vitally important.
Health and Employment News Post-Work Programme ‘Help to Work’ scheme announced The government has announced a new scheme to help JSA claimants who have not found work within two years on the Work Programme. From April 2014, JSA claimants will return to support from Jobcentre Plus (JCP), as part of a programme called ‘Help to Work’. Claimants reaching this level will have been out of work for a minimum of two years, and potentially significantly longer. Claimants who have previously claimed incapacity benefits (IB) may have been out of work for several years before being reassessed as fit for work and mandated to join the Work Programme. The Help to Work scheme has three proposed streams:
Community Work Placements (CWPs), which are unpaid work experience placements that are designed for claimants who are unmotivated or who have not had recent work experience. A Mandatory Intervention Regime (MIR), which is an intensive support programme to help those with several barriers to employment, for example literacy or numeracy problems. Daily sign-ins at JCP.
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Health and Employment Bulletin: Health and economic activity
Claimants will be assigned to one of these streams, dependent on an assessment of their need. The first workstream – CWPs – are expected to be delivered by similar prime contractors to those delivering the Work Programme. A current invitation to tender has been put out by government to deliver this across the same areas as the Work Programme. Greater Manchester – part of a wider contract package area that also includes Cheshire and Warrington – is expected to have one provider of the CWPs. This is in comparison to the three Work Programme providers. Providers will be looking for partners to deliver work experience placements for their clients – with an emphasis that these are not in charity shops. Due to the nature of work experience suggested by government (e.g. cleaning graffiti, picking up litter) local authorities are expected to be the main focus for providers to work with, especially as they offer a range of job opportunities. The second workstream will focus on reducing some of the more significant barriers to employment, including skills needs. However, these barriers could be more extensive and include other local authority or commissioned services such as health needs, childcare support or travel. The last workstream has the least available information. Currently, JSA claimants have to attend JCP usually every two weeks to show they have been looking for work. As part of ‘Help to Work’, JSA claimants will be expected to attend a JCP office daily to prove they have been looking for work.
Work Programme benefit claimant switch The Work Programme splits the country into several contract package areas (CPAs) – as mentioned above Greater Manchester is part of a CPA that also includes Cheshire and Warrington. In each of these areas, usually two or three providers support benefit claimants towards employment. The reason for this is to promote competition and service delivery amongst the contractors in each CPA. As the providers don’t compete on price, the incentive is for them to compete on outputs – in this case, getting a claimant into work. Benefit claimants are assigned randomly to Work Programme providers. However, the government has now instigated a ‘market share shift’. This shift means that the providers with less job outcomes are assigned less claimants, and those with more job outcomes are assigned more claimants. The aim of this is to get better results for claimants, and to support more claimants towards work. The changes in Greater Manchester, Cheshire and Warrington are presented below: Increase of 5% in the number of claimants referred
No change in the number of claimants referred
Decrease of 5% in the number of claimants referred
G4S
Seetec
Avanta
This change in claimant referrals only affects individuals on JSA who are aged 18-24. This is because G4S have seen a larger proportion of its referrals in this group gaining employment – 38.8% in 2012/13, compared to 34.4% for Avanta. It is expected that further market share shifts will occur to ensure continued pressure on providers to better support clients into work. G4S also outperforms Seetec and Avanta for older JSA claimants and ESA claimants.
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Health and Employment Bulletin: Health and economic activity
Health and economic activity Nearly one in three people of working age in Greater Manchester is either unemployed or economically inactive – that is, they do not work. With the links between worklessness and poor health well established, this represents a significant problem for Greater Manchester and translates into poorer healthy life expectancies. Healthy life expectancy in Greater Manchester varies between 55.0 years and 65.5 years for males (63.2 years nationally); and between 55.4 years and 64.7 years for females (64.2 years nationally). Both are skewed towards levels lower than the national average. Research in March 2013 from the Department for Work and Pensions looked at how much cycling there was amongst unemployment benefit claimants. The research suggests that two in every five jobseekers aged 32-34 has never claimed an unemployment benefit before – indicating that a significant number of jobseekers at this age may be falling into a group associated with poorer health. It also suggests that, for this age group, there is substantial movement between employment and unemployment. This may be into low-paid or low-skilled jobs, which lead to a cycle where the individual quickly returns to benefits. Around 17% of 32-34 year old JSA claimants had made a benefit claim three or more times in the past four years, and spent over a year in total on benefit. Naturally, for younger individuals the cycling was even greater – rising to 28% for 22-24 year olds. Getting people into work –and into sustained work at that – is therefore important for improving an individual’s healthy life expectancy. Importantly, it also affects the life expectancies of children. As a result, the outcomes of the government’s Work Programme is important for the health and wellbeing of Greater Manchester residents. The Work Programme supports individuals on benefits to enter employment. Private and voluntary sector organisations are paid by DWP to provide support on a ‘payment-by-results’ basis. When an individual is ‘attached’ to a Work Programme provider, the provider receives a small fee. Then, the provider can only receive further payments if their client enters and remains in work. Payments are based on the benefit the individual is currently receiving. Those claiming Jobseeker’s Allowance (JSA) attract the lowest payments, as they are more likely to find work and have fewer barriers to employment. Those with health conditions – i.e. those on Employment and Support Allowance (ESA) – attract higher payments. This means that providers should be more incentivised to help individuals furthest from the labour market – and with significant barriers to work – into employment. The payments received for support are significantly higher – up to £13,720 – for ESA claimants. Comparatively, providers would only receive a maximum of £6,600 for JSA claimants.
Yet recent figures suggest this is not the case. Individuals on JSA are easier to support into work, and as such can provide a quicker return on investment. Comparatively, those with more serious health barriers can take a long time to support towards work. For example, those with alcohol or drugs issues may require support for many years to abstain from or limit substance abuse. This costs money and reduces the profit providers can make. As a result, the figures show that ESA claimant job outcomes are significantly lower than JSA job outcomes. Just 1.2% of new ESA claimant referrals to the Work Programme resulted in a job outcome. Comparatively, 19.0% of 18-24 year old JSA referrals and 13.0% of age 25 or above referrals have secured a job outcome. Looking at just the past year, the rates are 2.0% for new ESA claimants compared to 54.3% and 28.9% for JSA claimants aged 1824 and 25 or above, respectively. All this suggests that there is a significant role for health to play in supporting individuals with health conditions. Reducing health barriers – through an integrated and coordinated approach to health and work – can support an individual’s journey to employment. For benefit claimants, this can significantly improve their life chances and wellbeing, and raise their healthy life expectancy. For health practitioners, being in work can also reduce the amount of capacity used on supporting and treating individuals in the long-run.
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Health and Employment Bulletin: Economic activity
ECONOMIC ACTIVITY AS OF JUNE 2013: ECONOMICALLY INACTIVE: 443,800 (-1.9%)
ECONOMICALLY ACTIVE: 1,297,400 (+1.2%)
UNEMPLOYED: 122,800 (-6.4%)
IN EMPLOYMENT: 1,174,700 (+2.0%)
SELF-EMPLOYED: 132,500 (-0.8%)
EMPLOYEES: 1,030,700 (+1.9%)
1,741,200 WORKING AGE POPULATION IN GREATER MANCHESTER
The number of individuals in work has increased by
+2.0%
Nearly 1 in 3 people in Greater Manchester (32.5%) are unemployed or economically inactive
The number of unemployed individuals has fallen by
-6.4% 5
Health and Employment Bulletin: Economic activity
Economically active The number of individuals who are both willing and able to work. This includes those in work (employed) and those who are looking for work (unemployed). The employment rate is calculated as those in employment as a proportion of all the working age population. The unemployment rate is the number of unemployed people as a proportion of all economically active people.
Employment rate
67.5%
Annual change
+2.0%
Over 23,400 more people are in employment now than one year ago. While self-employed figures have fallen by 1,100 (0.8%), the number of employees has risen by 19,100 (1.9%).
Unemployment rate
9.5%
Annual change
-6.4%
Unemployment has fallen by around 8,400 in the past year across Greater Manchester, a drop of 6.4% and 0.7 percentage points. Yet out-of-work benefit claimant numbers have fallen by a greater amount, suggesting there are large numbers of individuals out of work and not being supported. Greater Manchester’s unemployment rate (9.5%) continues to remain higher than the national average (8.0%).
Economic activity over time United Kingdom North West Greater Manchester This quarter has seen a slight dip in economic activity rates in Greater Manchester – in contrast to a continued rise nationally. This is largely down to significant increases in the number of temporarily sick and student residents.
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Health and Employment Bulletin: Economic activity
Economically inactive The number of individuals who are either unwilling or unable to work. The majority of individuals in this group are unable to work, mainly due to a health condition, but students, stay-at-home carers and the retired are also inactive. However, some do want to work.
Economically inactive and want a job
25.0%
Annual change
+0.2%
Around 111,100 people in Greater Manchester are economically inactive but want a job – a quarter of the economically inactive population. This is slightly above the national average of 24.4%, and represents a marginal increase on the past year. This is against a background of falling economic inactivity, suggesting more people are becoming economically active and searching for employment.
Economically inactive due to illness
2.5% Inactive with a temporary illness Annual change: +41.8% UK average: 2.0%
25.5% Inactive with a long-term illness Annual change: -4.5% UK average: 22.0%
The number of individuals with a temporary illness has significantly increased over the last year, with a further 3,300 on temporary sickness than in June 2012, compared to a fall in long-term sickness of 5,300. This may be due to changes in benefit rules, and many of those with long-term health conditions previously could have been assessed as having a short-term health condition.
Economic inactivity over time United Kingdom North West Greater Manchester Manchester has largely driven the increase in the number of economically inactive GM residents, seeing a rise of 5,000 this quarter.
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Health and Employment Bulletin: Benefit claimants
Benefit claimants The Government’s stated aim is to help people to find and stay in work. This policy is in the light of the need to reduce government spending. In 2001-12, £159bn was spent on benefits. The largest proportion of benefit spending was on pensions – accounting for £74.2bn. Yet payments for health-related benefits (then Employment and Support Allowance, Disability Living Allowance and Incapacity Benefit) are still a significant proportion, around £21.1bn across the UK. ESA and IB make up £8.5bn of this spending. It is estimated that across Greater Manchester £21bn of public money is spent, while just £17bn is received in tax income. This suggests that we need to do more to be a net contributor to the UK economy. Part of that is in helping to move people from benefits into work – changing people from a net receiver of public money to a net contributor. Universal Credit roll out Government has recognised that one of the main barriers to employment for individuals is the ‘poverty trap’. As individuals move off benefits and into work, the amount of support they currently receive drops off significantly. This acts as a disincentive for individuals to enter low-level work, as their overall takehome pay is less than what they received on benefits. Universal Credit (UC) aims to smooth the transition into employment by ensuring that an individual’s benefits taper off as they increase their hours in work. It does this through bringing together payments for six different benefits into one single payment. The benefits are: income-based Jobseeker’s Allowance; income-related Employment and Support Allowance; Income Support; Working Tax Credit; Child Tax Credit; and Housing Benefit. Over £67bn was spent on these benefits and tax credits by HM Revenue and Customs and the Department for Work and Pensions in 2012/13. The Government estimates that 3 million households will be better off under UC. What does this mean for Greater Manchester residents and patients?
move from a fortnightly to a monthly payment system. Budgeting and planning will become important skills for new and existing claimants as the system is rolled out. In addition, the system looks to make the claim process easier. It aims to do this through ensuring that all claims can be made (where possible) online. Individuals should be able to access the online claim forms at libraries and other areas where free internet access is provided. Who does this affect? It will affect large numbers of individuals across the conurbation: as of February 2013, 71,600 claim income based JSA; 62,290 claim income based ESA; and in 2011/12 almost 282,000 claimed Working Tax Credit or Child Tax Credit. In addition, individuals claiming housing benefit are currently subject to changes in how they receive housing benefit. A recent report by the National Federation of ALMOs suggests that in the period March to June 2013 alone, the number of council housing tenants across the country falling into arrears with rent rose by 21%.
UC has not yet been rolled out across England, but is being trialled in several places across Greater Manchester, especially in Tameside, Wigan and Oldham.
All of this can have a potentially serious affect on a patient’s health and wellbeing. With longer periods of worklessness linked with poor mental health, it is important that patients are supported holistically in terms of their health and worklessness.
Patients claiming any of the above benefits or tax credits will receive one single, monthly payment that brings together all of their benefit claims. This means that some patients – especially those claiming JSA – may find the change in responsibilities demanding, as they
Manchester City Council is now piloting a support service for individuals claiming ESA to support them towards work by reducing their health barriers. As findings emerge from the Programme, they will be shared across the conurbation.
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Health and Employment Bulletin: Benefit claimants
BENEFIT CLAIMANTS AS OF NOVEMBER 2012: ESA AND IB CLAIMANTS: 142,720 (-4.9%) JSA CLAIMANTS: 84,280 (-2.4%) LONE PARENT INCOME SUPPORT: 27,930 (-12.6%)
OTHER INCOME-RELATED BENEFITS: 7,670 (-10.8%) DISABLED BENEFITS: 21,830 (+7.8%) OTHER BENEFITS: 29,910 (+7.2%)
314,340 BENEFIT CLAIMANTS IN GREATER MANCHESTER 17.9% CLAIMANT RATE -3.3% ANNUAL CHANGE
Change in out-of-work benefit claimants in the past year:
5.2%
Change in health-related benefit claimants in the past year:
3.4% 9
Health and Employment Bulletin: Benefit claimants
Out of work benefits The number of people claiming Jobseeker’s Allowance (JSA); Employment and Support Allowance (ESA) or Incapacity Benefits (IB); Income Support (IS), especially for lone parents; and other out of work benefits. JSA claimants are economically active and mainly unemployed, though some do work part-time. ESA claimants have a health condition that limits their ability to work, and may be in work, unemployed or economically inactive. Lone parents may be in work, unemployed or economically inactive.
Out of work benefits rate
Out of work benefit claimants
5.2% ESA claimants
4.9%
JSA claimants
2.4%
Lone parent income support claimants
Others on income related benefit
12.6%
10.8%
The greatest fall in terms of claimant numbers this year came from the ESA and IB group, which saw a decrease of 7,290 over the past year. Yet lone parent income support claimant numbers have also seen a reduction over the past year of 4,040 across Greater Manchester. This is due to benefit changes introduced in March 2012, which mean that lone parents with children of school age or above cannot claim lone parent income support, and must instead claim JSA.
Out of work benefits activity over time United Kingdom North West Greater Manchester Nationally, the claimant rate stood at 11.7%, compared to 14.9% in Greater Manchester and 14.3% in the North West. This difference has changed little in the past two years. The greatest fall in claimant rates, though, has come in the past year.
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Health and Employment Bulletin: Benefit claimants
Employment and Support Allowance Individuals with a health condition can claim Employment and Support Allowance (ESA). Claimants are assessed through a Work Capabilities Assessment (WCA) as to how much their health condition affects their ability to work. There are two ESA groups – those who cannot work (economically inactive) and therefore receive a larger benefit payment (support group); and those who are able to work, but require some support and are expected to complete some work-related activity (work-related activity group, or WRAG).
Health conditions and ESA
As shown in the chart above, the three highest claimant health conditions in Greater Manchester continue to be mental and behavioural disorders, musculoskeletal disorders and non-classified health conditions. Constituting the largest proportion – and at a greater rate (47.7%)
than nationally (45.5%) – mental and behavioural disorders continue to be the largest primary health condition experienced by ESA claimants. However, anecdotal evidence from Work Programme providers suggests that this figure may be significantly higher.
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Health and Employment Bulletin: Wellbeing and happiness
Personal Well-being Across the UK In October 2013, the Office of National Statistics released its second annual report on personal wellbeing. The report is part of a larger piece of work by the ONS on understanding and measuring national wellbeing. The report is split into four sections, focusing on four key measures of personal wellbeing: an individual’s life satisfaction; the extent to which individuals feel that what they do is worthwhile; an individual’s level of happiness; and the levels of anxiety experienced by individuals. This is closely linked to some of the statements about mental wellbeing used in the Warwick-Edinburgh Mental Wellbeing Scale. Overall, the results – which are based on a survey of individuals – shows that Greater Manchester on the whole experiences lower levels of personal wellbeing than nationally, albeit marginally lower. It experiences lower average levels of life satisfaction, happiness and a feeling that what is done is worthwhile. Simultaneously, it also experiences higher than average levels of anxiety. Of the local authorities, only Stockport scores consistently higher than the national average across all four questions. Data is available by clicking here.
LIFE SATISFACTION
GM
UK
Question: Overall, how satisfied are you with your life nowadays? 10
0
WORTHWHILE Question: Overall, to what extent do you feel the things you do in your life are worthwhile?
GM
HAPPINESS
UK
GM
UK
Question: Overall, how happy did you feel yesterday? 0
10
0
10
ANXIETY UK
GM
Question: Overall, how anxious did you feel yesterday?
The final question on anxiety indicates that a smaller number is more positive for personal wellbeing, in contrast to the other indicators where a higher number is more positive.
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Health and Employment Bulletin: More information
For more information, please contact: Christopher Pope Health and Worklessness Coordinator, New Economy T: 0161 237 4052 E: christopher.pope@neweconomymanchester.com
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