MICA: Supporting Older People into Employment (SOPIE): Identifying factors influencing return to work in the over 50s.

This research will be undertaken by a unique partnership between Ingeus, a welfare-to-work provider, and an academic team led by the University of Glasgow and will study the Ingeus workless clients including those with health problems, who participate in interventions to help them return to work (RTW) and sustain employment and there will be a particular focus on those over 50.

In the UK there has been a steady increase during the past 40 years in the number of people (now 2.6 million) on long term health related benefits despite work becoming much safer and less physically demanding. We know that generally work is good for our health. Life expectancy has also improved. However health problems are inevitable with age and over the age of 45 years an increasing number of people leave work through ill health. Sometimes this may have been precipitated by closure of industries and lack of suitable alternative work, and sometimes by a lack of skills in the individual. There may be very little difference in the health of some of those who fall out of work due to ill health, and those with health problems who stay in work, and we know that many of those who are long term workless can be rehabilitated to work. Those that leave work and go onto benefits tend to experience more rapid deterioration in their health and die younger than those who are able to stay in work and it has also has been shown that people who RTW become healthier and generally live longer.

In the past these individuals have not had enough help in improving their health, nor have they had enough support in terms of retraining, building their confidence, and helping them find work. The Work Programme (WP) introduced in 2011 across the UK is intended to provide this help and in Scotland Ingeus is one of two providers. Ingeus estimate referrals of 17,000 per year for 2013-2015 with around 15% over 50.

This partnership between academics and Ingeus provides a unique opportunity to establish a long term study of older people going through the WP and comparison of those who succeed in returning to and staying in work with those who do not. In the past this has been a population who have been hard to reach and this research will identify what are the needs of people over 50 and, what needs to be done to help them improve their health and RTW. By studying the other age groups the research will also provide information on the lifecourse of this population and may provide information on which interventions could be introduced in future to prevent people falling out of work. All of this will require the consent of the people involved to use their data in a completely anonymised way and also to link information to other records on economic factors, deprivation, employment opportunities in different parts of the country and health usage.

The research will gather data on the numbers going through the different interventions and the results of these interventions, including if they RTW and what happens subsequently. Clients of the WP will also be interviewed so that we can gather information on how they feel about the WP and understand their perspectives. Ingeus staff and advisors will also be interviewed separately.

The research will provide new information on the interventions, support, and individual factors which assist the over 50s RTW and sustain work and the academic research will not only help to inform how the Ingeus interventions can be improved, but may also provide new information on how to prevent people having to leave work and extend working lives of this most disadvantaged group. The benefits to these individuals are clear as it is well established that safe work improves the health of those who are long term workless. This research will inform current and future welfare-to-work and job retention initiatives and improve their effectiveness in helping working age people extend their healthy working lives, which will benefit them and society.

The objectives are: 1. To understand the different work and health trajectories experienced by clients during their engagement with the Ingeus WP and how these differ by stage of the lifecourse and multiple dimensions of socio-economic position; 2. To establish a large-scale cohort of WP clients to enable long term analysis of the relationships between health, worklessness and the RTW process, and sustainability of employment, in the over 50s. We intend to use a mixed-methods observational methodology consisting of embedded fieldwork, and longitudinal qualitative and quantitative components. The embedded stage will establish administrative data collection procedures and map the detailed processes clients pass through in Ingeus WP. The qualitative study will involve interviews with purposively sampled WP clients to focus on experiences of: the WP; the interaction between age, health and employability across the lifecourse; and barriers or facilitators to RTW. Staff will be interviewed to give an understanding of the referral, assessment and intervention processes. The quantitative component will study a cohort of clients engaging in the WP from April 2013 to March 2014. We will quantify the relative frequencies of various patterns of RTW (or not), and the various intervention components provided, cross-classified by client characteristics relevant to programme success and explore those individual and area characteristics (such as unemployment measures and job densities), associated with sustainable RTW with a particular focus on how these vary by age. Analyses will use logistic regression and Cox regression models for time to event (RTW or length in work following return). We will also link the pilot sample (5,000 individuals) to routine health data (e.g. deaths, hospital discharges, prescriptions). The findings will help Ingeus to improve their services, and the research findings will provide important policy learning about how to support older people's RTW.

Benefits of this research

People who are workless
The main beneficiary of this research will be those people who are out of work. These individuals not only have poorer health but their health deteriorates further once they become workless; deprivation and inequalities increase and their life expectancy goes down. This group have been relatively neglected; previous national interventions have not always been evidence based and have evidentially failed. This research will identify what these citizens need and how to provide them with more effective support and services so that those that have the potential to work, will be rehabilitated to work and assisted to stay in employment with all the considerable benefits to their health and wellbeing that this will provide.

Children of workless households
The health of children in workless households is poorer and those who are reared in workless households and communities are at increased risk of long term worklessness themselves. Helping older people stay in employment will improve the life chances of their children.

Benefits to society
The number of the population on long term health related benefits is now in excess of 2.6 million and a large proportion of these are over fifty when the risk of falling out of work due to health reasons is highest. The costs of health related disability and worklessness in the UK is £100 billion p.a. There is evidence that many of these individuals do have the potential to work but need effective interventions to achieve this and this research will provide evidence on what are the effective interventions for the ageing population, inform existing and future programmes and help more people extend their working lives. This will improve social inclusion, reduce health and other inequalities, and improve prosperity.

Benefits to Work Programme providers
The academic output of this partnership will inform how existing and future intervention programmes can be made more effective and will contribute to the success of these organisations that are paid by results.

Benefits to policy makers
Policy makers in government such as in the Treasury, DWP, NHS, Education and Skills will have more and better evidence to inform how future programmes could enable the population to maintain their functional abilities and extend their working lives. We will aim to produce briefing material for MPs, MSPs and key civil servants to improve understanding of the perspectives of Work Programme clients.

Benefits to the NHS
The health of the those who are long term workless deteriorates faster than if they had stayed in safe employment. By enabling older workers to extend their working lives their health care usage will relatively reduce.

Benefits to the economy and national prosperity
The population is ageing and it has been estimated that by 2035 there will be 15.6 million people over the existing state pension age. Already many older people are taking advantage of the ability to remain in work beyond 65 and this will increase. The demographic changes make this necessary and extension of working lives will benefit the economy by increasing the proportion of the population who are productive and reduce the proportion dependent on state support.

Academic-developing knowledge of what works
This study will be one of the most comprehensive undertaken of the ageing workless population undergoing interventions, and will provide new information on the interventions being provided, what is effective and what is needed to assist the over fifties return to and sustain work. It will also provide new information on the lifecourse of those with health problems who become workless and on the earlier interventions which may be successful in preventing worklessness in this relatively disadvantaged group. It will also raise more questions which will need answered by further research.