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IAPT Employment Support Services in London

Assessment of the Economic Impact

How a dedicated employment support service can generate £2.79 in benefits for every £1 spent, add value to psychological services and improve the quality of outcomes for people affected by common mental health problems.

2011March 18 of 1Page http://www.workingforwellness.org.uk

benefits the state.of which £0.84 benefits the individual and £1.95generates £2.79 of benefits,

every £1 spent by the state on IAPT employment services The data suggests that

with the service. that other benefits accrue for people who remain in contact service. It is expected

It has only been possible to claim outcomes for those people who have exited the

.previously unemployedwere supported to move into education and training having been people 41

;were supported to move into workpeople 59;mploymentwere supported to retain their epeople 260

. Of these:s included in this studyServiceWorking for Wellness Employment Support 5 people entered the 865In 2010,

Impact summary

IAPT programme.individuals are receiving as part of the therapeutic treatmentsemployment. The service is designed to compliment the

issues in order to support them into employment or to retain their current people affected by mild to moderate mental health motivational support and advice to

e of individually tailored, practical and ervice is to offer a rangThe purpose of the s

.1return to workimpact. This is true for reducing the incidence of job loss and for promoting people’s

greater work related support achieves health andtargetedevidence that indicates s now a growing body of contribution to beneficial employment outcomes, there i

element in the recovery process. Whilst health interventions alone can make a care services for individuals experiencing mental health problems is viewed as a key

ployment support and advice in health Therapies (IAPT) programme. Embedding em part of London’s Improving Access to Psychological asservicesupport smployment e

out of integrated clinical and -championed the rollWorking for Wellness In 2010,

Service summary


The positive link between employment and mental health is firmly established1. Research demonstrates that work is good for people and being unemployed is damaging to physical and mental health2. The proportion of unemployed people in need of psychological treatment is more than double that of those who are employed3. There is also a strong correlation between unemployment and higher mortality, higher medical consultation, higher healthcare consumption and higher hospital admission rates4 5. After an individual has been absent from work for six months, there is only a 50% likelihood of the employee returning to work; this falls to 25% after a 12-month absence and after 2 years it is virtually nil 6.

Experts have used this evidence to demonstrate that significant economic and wider societal cost savings can be achieved through targeted interventions. Recent estimates suggest that the cost of mental health problems in England increased from £77.4 billion in 2002/03 to £105.2billion in 2009/10 in terms of health and social care costs; output losses in the economy; and an imputed monetary valuation of the human cost of mental illness7. The London School of Economics calculated that ‘the total loss of output due to depression and chronic anxiety is some £12 billion a year – 1% of our total national income. Of this the cost to the taxpayer is some £7 billion – including incapacity benefits and lost tax receipts’ 8.

By articulating the links between mental illness and deprivation and the economic costs of untreated illness, the ‘Depression Report’ in 2006 helped to secure a three-year Government commitment of £173 million in 2008/09 to deliver the Improving Access to Psychological Therapy (IAPT) programme 9. Central to IAPT is the recruitment and training of a therapist workforce to new services delivering NICE compliant cognitive behavioural therapy and other treatments for anxiety and depression within primary care.

Against the backdrop of the economic downturn, Working for Wellness has led the development of integrated psychological therapy and employment support pathways which are available in 15 of London’s 31 PCTs. In 2009 Working for Wellness championed an investment fund of almost £4.5million10 to offer all London PCTs the opportunity to bid for additional resources. A total of 27 PCTs were successful in their application with most investment directed towards the 15 IAPT services that were already live. Unique to London, Working for Wellness’ approach is to support commissioners with the service design and development of local delivery models that feature appropriate provision for job retention and back to work support.

The Coalition Government has made clear that mental health and employment is a priority. The new national mental health strategy ‘No Health without Mental Health’ published in February 2011 and the NHS Outcomes Framework for 2011/12 both emphasise the importance of

and other Local Strategic Partner agencies.for London and Department of Health funding, which was matched by £1,936,720 from PCTs Commissioning Support

A total of £4,401,720 was allocated in 2009/10. The London investment fund comprised £2,465,000 joint 10

guidelines for regional delivery. London: DH.. (2008). Improving Access to Psychological Therapies Implementation Plan: National Department of Health

9

The Centre for Economic Performance's Mental Health Policy Group. London: LSE.The Depression Report: A New Deal for Depression and Anxiety Disorders.London School of Economics. (2006).

8

Centre for Mental Health. London: n 2009/10.The economic and social costs of mental health problems iCentre for Mental Health. (2010).

7

London: BSRM.Vocational rehabilitation: the way forward.British Society of Rehabilitation Medicine. (2001). 6

1214.- , 1212Medical JournalBritish practitioner. Yuen, P., & Balarajan, R. (1989). Unemployment and patterns of consultation with the general

5 Norwich: TSO.Is Work Good for your Health and Wellbeing.Waddell, G., & Burton, K. (2006).

4

282.- 264,Journal of Vocational Behaviouranalyses. - health: MetaPaul, K., & Moser, K. (2009). Unemployment impairs mental

3

Norwich: TSO.Is Work Good for your Health and Wellbeing.Waddell, G., & Burton, K. (2006). 2

Norwich: TSO.Working our way to better health.Health Work and Wellbeing. (2009). 1

Background


employment for people with mental illness. Accompanying the national mental health strategy is the supporting document ‘Talking Therapies: a four year plan’. This paper builds on the Government’s Comprehensive Spending Review announcement to continue to fund the IAPT programme – under its new name Talking Therapies – and complete its intended seven year rollout through a £400million allocation up until March 2015. The expansion of the programme aims to achieve full geographical coverage as well as to extend provision to meet a range of needs. Employment support is also recognised as a vital part of the service model and there is an expectation that PCTs will fund this work out of baseline budgets to build on their achievements to date.


Project aims and purposeAs discussed, the Working for Wellness Employment Support Service was introduced as part of London’s Improving Access to Psychological Therapies (IAPT) programme. Embedding employment support and advice in health care services for individuals experiencing mental health problems is viewed as a key element in the recovery process. Whilst health interventions alone can make a contribution to beneficial employment outcomes, there is now a growing body of evidence that indicates integrated health and work related support achieves a greater impact. This is true for reducing the incidence of job loss and for promoting people’s return to work11.

The purpose of the service is to offer a range of individually tailored, practical and motivational support and advice to people affected by mild to moderate mental health issues in order to either get them into employment or to retain their current employment. The service is designed to compliment the therapy individuals are receiving as part of the IAPT programme.

Sites included in this evaluationFive IAPT sites in London offering an Employment Support Service have been included in this economic evaluation. Each site has a slightly different service model as described in Table 1 below.

Table 1: Service information for sites included in this evaluationLocation Service model Staffing

Tower Hamlets The Employment Support Service is not co-located with the IAPT Service and the staff have different employers. Clinicalstaff are employed by Tower Hamlets Community Health Service and the Employment Support Workers are employed by a voluntary sector organisation called the Working Well Trust. The Employment Support Service is located in a premises owned by the Working Well Trust in Whitechapel, Tower Hamlets.

1 x full-time Senior Employment Advisor

2 x full time Employment Advisors

2 hours support per month from a more experienced employment retention worker from within the Working Well Trust

Southwark The Vocational Service (Southwark’s Employment Support Service) is co-located with the IAPT Service and the staff have the same employer. Both Clinical and Vocational Service staff are employed by the South London and Maudsley NHS Foundation Trust. The IAPT service operates an outreach style of service in different localities - 2 in the south of the borough and 2 in the north of the borough and a vocational specialistworks with the IAPT team in each locality.

1 x 0.5 FTE Team Leader 1 x full- time Lead

Vocational Specialist (12 months)

3 x full-time Vocational Specialist (12 months)

1 x full-time Vocational Specialist (7 months)

1x 0.3 FTE Administrator (12 months)

Lambeth The Employment Support Service is co-located with the IAPT Service although the staff have different employers.Clinical staff are employed by Lambeth

1 x full-time senior employment advisor

1 x full-time employment support coordinator

London: Royal College of Psychiatrists. Director for Work and Health.the NationalMental Health and Work. A report for (2008). Lelliott P, Boardman J, Harvey S, Henderson M, Knapp M, Tulloch S

11

ServiceThe


PCT and the Employment Support Workers are employed by a voluntary sector organisation called StatusEmployment. The service operates in three locations across the borough: a community centre in Brixton, a GP surgery in Streatham and St. Thomas hospital in the north of the borough.

2 x full-time employment advisors

Islington The Employment Support Service is not co-located with the IAPT Service and the staff have different employers. Clinicalstaff are employed by NHS Islington and the Employment Support Workers are employed by a voluntary sector organisation called Mind Islington. The IAPT service in Islington is run on a geographical basis in North, South and Central Islington. Although the Employment support service is not co-located it is based next door to the North and Central Islington IAPT teams.

3 x full-time job retention workers

1 x full-time employment support advisor

Hackney The Employment Support Service is co-located with the IAPT Service although the staff have different employers. Clinical staff are employed by City and Hackney PCT and the Employment Support Workers are employed by a voluntary sector organisation called City and Hackney Mind. The service is co-located at St Leonards CommunityHospital, Hackney.

2 x full-time employment support advisors

Services offered and intended outcomesThe IAPT Employment Support Service offers a comprehensive package of interventions, according to an individual’s needs, to help people to gain or regain work or to retain their current employment.

Key interventions offered to help people to gain or regain employment include: Basic advice and career guidance; Post-placement in-work support to maximise job retention; Vocational information and advice, including CV writing, job search and interviewing skills; Individual support for motivation, confidence building and assertiveness skills; Signposting to Job Centre Plus (JCP) support; Access to expert advice, benefits counselling and debt counselling.

Key interventions offered to help people to retain employment include: Management of employment and employer-related issues; Individual support for motivation, confidence building and assertiveness skills; Adjustments in the work place to help maintain attendance at work; Help to return to work after sick leave; Access to occupational health support; Careers guidance; Help to look for more suitable jobs whilst still employed; Sign-posting to legal advice and legal aid.


A more detailed overview of the services provided (outputs and activities) is illustrated in Appendix A. The outcomes the Employment Service is seeking to achieve are also outlined in Appendix A.

Delivery volume: referrals and patients/clientsOverall in 2010 across all five IAPT sites, 1319 individuals were referred for employment support. All referrals came from IAPT clinical teams.

As outlined in table 2 below of the 1319 individuals who were referred, 865 actually entered the Employment Support Service.

Table 2: Breakdown of referrals and numbers actually entering the service across the five sitesLocation No. of referrals No. actually entering the service

Tower Hamlets 211 130

Southwark 351 212

Lambeth 250 177

Islington 265 170

Hackney 242 176

Methods of deliveryEach individual who enters the Employment Support Service after referral is given an initial assessment to understand their specific employment needs. One of the advisors then works with the individual to develop an action plan of work-focused solutions which will be a combination of the interventions described above. The advisor then works with individuals on a one to one basis to offer a range of practical and motivational support and advice.


Standardised IAPT Employment Data collected locally indicate that the Employment Support Service is delivering a range of outcomes for the state, employers and for people affected by common mental health problems. These can be grouped as per Appendix A.

Employment Outcomes As shown in Table 3 (over), of the 865 people who entered the employment support serviceacross the five sites: 260 people were supported to retain their employment; 95 people were supported to move into work; 41 people were supported to move into education and training having been previously

unemployed.

Table 3: Employment outcomes achieved across the five sites

Entered employment (previously unemployed and claiming JSA or income support)

6 14 3 1 13 37

Entered employment (previously unemployed and claiming IB)

3 0 1 0 3 7

Entered employment (previously claiming sick pay)

3 9 5 10 8 35

Entered employment (previously unemployed and claiming no benefits or not known)

0 6 6 0 0 12

Entered employment (previously a full-time student)

0 1 3 0 0 4

Entered education or training (previously unemployed)

4 28 1 0 8 41

Supported to stay in work (either full-time or part-time)

26 93 68 30 43 260

Became unemployed having been employed either full or part time

3 9 11 3 3 29

To

tal

Hackn

ey

Islin

gto

n

Lam

beth

So

uth

wark

Ham

lets

To

wer

Impact Evidence


Economic modelThe economic evaluation approach adopts a top down perspective that takes into account the total budget for an Employment Support Service and outcomes for all individuals seen over one year. The operational budgets of each service were used to calculate costs. Benefits were claimed only for individuals who exited the service during the 12 month period. A number of financial components were used to value three types of outcome.

Individuals who gained employment Income for the individual;12

Tax and national insurance to the state;13

Reduction in welfare benefit costs to the state.14

Individuals who retained their employment Avoidance of welfare benefit costs to the state.15

Individuals who lost (failed to retain) their employment16

Income lost to the individual; Tax and national insurance lost to the state; Welfare benefit costs to the state.

The cost model assumes that the benefits or outcomes that individuals achieve will last for at least 12 months. This is a conservative estimate. The model therefore includes a further calculation that assumes the outcomes will last for up to 24 months. This is a more optimistic upper limit for which there is less certainty. However, it is not unusual for economic calculations of this type to use such upper limits e.g. DWPs 2008 analysis of Pathways to Work for incapacity benefit claimants, which reported outcomes with a confidence interval of 70 to 150 weeks17.

Twenty four month results need to be treated with some caution. However, given this evaluation applies monetary values to outcomes achieved only by people who exited the service, the use of a 24 month interval may still generate a conservative overall estimate of any return on investment. The cost model therefore provides a confidence interval for results based on 12 and 24 month time periods across which the outcomes are predicted to continue. The study also reports the mid point, or 18 month figure, which provides a balanced estimate that is in line with the Coalition Government’s move toward achieving longer term, sustainable outcomes.

Approximately 30% of benefits accrue to the individual and 70% to the state. The cost model therefore reports an overall return on investment dividend as well as describing in monetary terms what proportion benefits the individual and what proportion benefits the state.

Working for Wellness data indicates that employment support input results in approximately 2.2more people returning to work than would have done with clinical input only. This means that 45% of the benefit achieved for people returning to work would have accrued anyway with clinical input only. The model subtracts this proportion from the monetised benefits attributed to this group of individuals.

. London: HMSONo. 525

Pathways to Work for new and repeat incapacity benefits claimants: Evaluation synthesis report Dorset R. (2008)17

Costs calculated and subtracted from the benefit total.16

Anchored to SSP for all15

see Table 3– Anchored to individual SSP, IB or JSA costs 14

Based on lower quartile median London salary13

ONS lower quartile median London salary £14,74212

lationalcuCost C and ModelEconomic


Cost calculationTable 4, Appendix B, provides indicative figures for the costs and benefits to both the state and those individuals using the service based on 2010 data. This does not include the non-monetisable, categorical benefits summarised in Appendix A.

Monetising costs and benefits at the highest-level shows:

an annual service cost across the five sites of £745,117 in 2010

the benefits accrued as a result of the employment support service reducing both the actual and potential number of people out of work at a number of intervals over a 24 month period as follows:

12 months 18 months 24 months

Benefits accrued by service users in terms of the income gained by returning to work (this figure takes account of those who would have returned to work without support and those who moved from being employed to unemployed whilst being supported)

£342,752 £514,128 £685,503

Benefits accrued by the state including the tax and national insurance gained from those returning to work and the income saved by a reduction in those actually or potentially claiming social security benefits (this figure takes account of those who would have returned to work without support and those who moved from being employed to unemployed whilst being supported)

£1,160,505 £1,568,189 £2,212,102

Total monetary benefits accrued £1,503,257 £2,082,317 £2,897,605

1. Possible return on investment dividend

Applying a ROI calculation to the high-level data (total service costs) and total money accruedby the reduction in the actual and potential number of people out of work we see that:

After 12 months After 18 months After 24 months

Every £1 spent by the stateon IAPT employment services generates £2.02 of benefits, of which £0.61 benefits the individual and £1.41 benefits the state

Every £1 spent by the stateon IAPT employment services generates £2.79 of benefits,of which £0.84 benefits the individual and £1.95 benefits the state

Every £1 spent by the stateon IAPT employment services generates £3.89 of benefits,of which £1.17 benefits the individual and £2.72 benefits the state

As discussed above we have only claimed outcomes for those people who have exited the service. We would expect these returns to improve as more people exit the service. For example, a proportion of service users may exit the service with positive outcomes between years 1 and 2 for which their first year of contact with the employment service would have been a necessary foundation. This type of benefit is not monetised in the calculations.


2. Additional indirect benefitsMonetary values could be assigned to some other benefits that will gradually increase the return on investment dividend. For example, evidence indicates that by improving people’s employment status and their health and well-being there is a corresponding reduction in their use of health services. This is an important wider benefit that warrants closer scrutiny. For example, the average consultation rate per person of working age per year is 4.49, where as the average rate for a patient with depression is twice that at 8.89 GP consultations18 19. It isreasonable to deduce that employment support would reduce participants’ use of their GP to average levels. If we apply an average consultation rate to these efficiency savings the return on investment increases further:

Applying a ROI calculation to the high-level data (total service costs) and total money saved by the reduction in the actual and potential number of people out of work and the reduction in the use of health services we see that:

After 12 months After 18 months After 24 months

Every £1 spent by the stateon IAPT employment services generates £2.08 of benefits for both the state and individuals



Other benefits were also realised for which it has not been possible to assign monetary values. For example, council tax and housing benefit are adjusted as individuals regain or lose employment. The benefit status of individuals included in this analysis in these respects was not known. However, if included in the calculation these adjustments would be expected to further increase any return on investment. In a similar vein, prescription use and costs would likely change as employment brings health and well being benefits to people with mental health problems. These anticipated cost reductions are not included in the calculation.

It is also important to note that a large proportion of users across the five sites are referred to other services including:

Citizen’s Advice Bureau (i.e. for in-depth benefits advice, debt counselling etc.) The local legal advice and legal aid service Dress for Success (a charity that provides clothing to women for interviews) Physiotherapy project (funded to provide physiotherapy to those who have a physical

condition that is impacting on their ability to work) Skills for Life (NHS funded employment support project for those who speak English as a

second language)

However it is not possible to include any costs or benefits associated with these services as no data were available to indicate whether people received the services they were referred to and for how long. It is important to remember that the services levered in would be provided even in the absence of the IAPT employment service and the costs would generally be out weighed, over time, by the benefits to an individual of regaining or retaining their employment.

Potential costs incurred in the absence of the serviceIn the absence of a dedicated employment support service as part of the IAPT service there are a number of other employment initiatives that people could be referred to. However, thesealternative initiatives are often not suitable for IAPT clients for a number of reasons:

519-183, 514Psychiatry, The British Journal of Thomas, C. & Morris S. (2003). Cost of depression among adults in England 2000.

19

NHS Information Centre .2008: Analysis of Q Research (r) database.-1995ends in Consultation Rates in General Practice ). TrNHS Information Centre for Health and Social Care. (2009

18


Alternative employment initiatives are generally only available to people who are claiming a social security benefit. The IAPT employment service is available to those who are not claiming any benefits.

The majority of alternative employment initiatives are not specifically tailored to those with mild to moderate mental health problems.

Alternative employment initiatives do not generally offer support to people to retain their current employment. People with severe and enduring mental health problems can generally access retention support but there is a definite gap in retention support for those with mild to moderate mental health problems like anxiety and depression, which have significantly higher prevalence rates.


or Unemployed

Employment at risk

clientsTracking the progress of

Support to employers.

people with MH issuesmarket provision for

labourMapping local

Service development.

community.service in the local

the Employment Support Promote awareness of

Other:

information).interventions (sharing case providing low/high intensity IAPT practitioners who are Work in partnership with

services.training providers, and health

benefits advisors, JCP,with: services for clients by liaising

Gain info, advice and

Liaising with partners

talking to GP, managing anxiety.paying bills, getting spectacles,

barriers e.g. help with sorting out Practical help to overcome

representatives.Support to trade union

practice interview skills.Providing opportunities to

training courses.Arranging places on suitable

return to workredesign/adjustments/ phased

employers and with job Helping clients to negotiate with

and preparing CV.with job searching, applications Support (including advocacy)

Practical support

work)(for those that move into/return to/remain in

Track progress Ongoing case managementfocused solutions-Development of Action Plan with work

negotiate with employers.communicate and

strategies to Help with developing

.and everyday activitiescoping strategies for work

physical and mental Education and training on

.vocational supporttheir strengths through

Helping clients to realise

servicesMotivational support

activities.employment -Suggestions about non

employment and potential aspirations.about employment options, barriers to Careers guidance: helping clients think

training.including info about vacancies and

Signposting to other relevant support,

MH conditions.solutions and provision for people with

and their recruitment practices, workplace services, labour market, local employers Provision of info about: Benefits and JCP

Dissemination of materials.

rights, responsibilities and representationInfo about corporate and individual legal

Information and advice services

supportPackage of

Not eligible

E.g. debt counsellingother servicesSignposting to

(Employment needs)

Initial Assessment

OU

TP

UT

S (

ac

tivit

ies

)

(IAPT) service

Psychological Therapies

the Improving Access to

Referral from

INPUTS (routes in)

Support Service: Pathways to outcomes for IAPT Employment AAppendix


Appendix B: Economic Evidence

Table 4: Available cost and benefit data for all five sites, 2010

Cost/benefit type Measure/s Costs Total

Direct costs

1. Fixed operational budget

Value in £ Tower Hamlets = £129,588 Southwark = £185,856 Lambeth = £150,000 Islington = £194,673 Hackney = £85,000

£745,117

Direct benefits

2. Number of people regaining employment, returning to work or entering education or training following completion of the intervention

(Working for Wellness data indicates that employment support input results in 2.2 more people returning to work than would have done with clinical input only. The number of people who would have returned to work without employment support has been taken into account when calculating the overall benefits accrued)

Cost/benefit type Measure/s Confidence interval

Costs Total

Income gained by individual returning

Number of people x

Benefits accrued over

95 x £14,74220 £1,400,490

http://www.statistics.gov.uk available at : , 2010 Annual Survey of Hours and Earnings,ice for National Statistics Off20

service) works service and employment support model (i.e. between a therapeutic Evidence that a collaborative care

Freeing up clinician time

employment related issues recognising and responding to intensity IAPT practitioners in

Skills development for high and low

core component of IAPT servicesAn embedded employment focus as a

with mental health difficultiesImproved social inclusion of people

contributionsIncreased tax and national insurance

unemployedReduced cost to individual of being

sickness absence takenReduction in the number of days

hourswork, or increase their employed problems to remain at work, gain

enabling people with mental health Increased working population by

employer sick payReduced number of people on

Reduced use of state benefits

mental and wider health services)Reduced use of health services (both

due to unemploymentPrevent deterioration of mental health

adjustment scores (WS&S)Improvement in work and social

poverty)Reduced poverty (including child

term incapacity-Reduced risk of long

motivation for service usersIncreased self confidence and

for service usersImproved or increased social contact

usersImproved quality of life for service

usersImproved mental wellbeing of service

and skills developmentmarket through volunteering, learning

Moving people closer to the labour

employment commitmentsLondon achieves its regional

exchange to more suitable job rolesPeople with mental health problems

employmentPeople move off benefits and into

absencePeople return to work from sickness

employment)health problems (access to

barriers to employment due to mental Recruitment of individuals who face

problems (job retention)workforce due to mental health Prevention of dropout from the

outcomesWider

outcomesEconomic

outcomesEmployment

outcomesbeing -Health and well

Outcomes (why doing it)


to work Lower quartile median London

salary (net per annum)

12 months

accrued over 95 x £22,113 £2,100,735


Benefits

18 months

95 x £29, 484 £2,800,980

Income gained by the state in income

24 months

tax and national insurance from those returning to work

Number of people x tax and national insurance

from lower quartile median London

salary (per annum)

Benefits accrued over 12 months

95 x £5,480 £520,600


95 x £8,220 £780, 900

accrued over 24 months

95 x £10,960

18 monthsBenefits

number of people receiving welfare

£1,041,200

Reduction in the

benefits

Number of people x cost

of social security

benefits per person


37 people x £3,354 (Based on Job seekers allowance £64.50 x 52 weeks)

7 people x £3,585 (Based on Incapacity Benefit (lower rate) £68.95 x 52 weeks)

35 people x £3,754 (Based on Statutory sick pay £79.15 x 28 weeks and Job seekers allowance £64.50 x 24 weeks)

£280,583


37 people x £5,031 (Based on Job seekers allowance £64.50 x18 months

78 weeks)

7 people x £5,378 (Based on Incapacity Benefit (lower rate) £68.95 x 78 weeks)

35 people x £5,441 (Based on Statutory sick pay £79.15 x 28 weeks and Job seekers allowance £64.50 x 50 weeks )

£414,228


37 people x £6,708 (Based on Job seekers allowance £64.50 x 24 months

104 weeks) 7 people x £7,170

(Based on Incapacity Benefit (lower rate) £68.95 x 104 weeks)

35 people x £7,118 (Based on Statutory

£547,516


sick pay £79.15 x 28 weeks and Job seekers allowance £64.50 x 76 weeks )

3. Number of people retaining employment following completion of the intervention

Savings made by the state of people not claiming social security benefits

Number of people x

cost of social security

benefits per person


260 people x £3,754 (Based on Statutory sick pay £79.15 x 28 weeks and Job seekers allowance £64.50 x 24 weeks)

£976,040


260 people x £5,441 (Based on Statutory sick pay £79.15 x 28 18 months

weeks and Job seekers allowance £64.50 x 50 weeks )

£1,414,660

accrued over 260 people x £7,118 (Based on Statutory sick pay £79.15 x 28 weeks

Benefits

24 monthsand Job seekers allowance £64.50 x 76 weeks)

£1,850,680


Indirect costs

4. Number of people not retaining employment following completion of the intervention

Income lost by individual not retaining employment

Number of people x

lower quartile median London

salary (net per annum)

Costs accrued over 12 months

29 x £14,74221 £427,518

accrued over 29 x £22,113 £641,277

Costs

Costs

18 months

accrued over 29 x £29,484 £855,036

Income lost by the 24 months

state in income tax and national insurance from those not retaining employment

Number of people x tax and national insurance

from median London

salary (perannum)


29 x £5,480 £158,920

accrued over 29 x £8,220

accrued over 29 x £10,960 £317,840

Costs

18 months

£238,380

Cost to the state of people claimingsocial security

Costs

24 months

benefits

Number of people x

annual cost of social security

benefits per person


29 people x £3,354 (Based on Job seekers allowance £64.50 x 52 weeks)

£97,266


29 people x £5,031 (Based on Job seekers

Costs

allowance £64.50 x 78 weeks)

£145,899


29 people x £6,708 (Based on Job seekers

Costs

allowance £64.50 x 104 weeks)

£194,532

Indirect benefits

Reduced use of health services

Number of people with a

positive employment outcome x

average cost of reduced

GP consultations


396 people x £99.27 (Based on a reduction in GP consultations from 8.98 to 4.49 per year at a cost of £22.11 per consultation22)

£39,311

Benefits

18 months

396 people x £148.91 (Based on a reduction accrued over in GP consultations from 8.98 to 4.49 per year at a cost of £22.11 per consultation23)

£58,968

NHS Information Centre .2008: Analysis of Q Research (r) database.-1995Trends in Consultation Rates in General Practice NHS Information Centre for Health and Social Care. (2009).

23

2008: Analysis of Q Research (r) database. NHS Information Centre.-1995NHS Information Centre for Health and Social Care. (2009). Trends in Consultation Rates in General Practice

22http://www.statistics.gov.uk available at : , 2010 Annual Survey of Hours and Earnings, Office for National Statistics

21


Benefits

24 months

396 people x £198.54 (Based on a reduction accrued over

in GP consultations from 8.98 to 4.49 per year at a cost of £22.11 per consultation24)

£78,622

NHS Information Centre .2008: Analysis of Q Research (r) database.-1995nsultation Rates in General Practice Trends in CoNHS Information Centre for Health and Social Care. (2009).

24


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