We led the design and supported the implementation of the Finance for Jobs development impact bond, delivering job outcomes for young Palestinians.
Building England’s IPS sector to help more people into jobs
Individual Placement and Support (IPS) is a form of supported employment developed to help people recovering from mental health issues. It offers intensive, individually tailored support to help people choose and find the right job, with ongoing support – for employer and employee – to help them keep it.
IPS is now being adapted for people with physical health problems and people in treatment for drug and alcohol issues.
Why are we doing this?
Good quality employment is good for health and wellbeing. Research increasingly shows that being out of work can lead to negative health effects and socio-economic issues for people and their families. This has an impact on the health system and other services.
Most people accessing mental health services say they see getting a job as key to their recovery, wellbeing and life opportunities. And there is evidence that employment can support recovery from drug and alcohol use.
Yet unemployment rates remain high for people with mental health conditions and people who use drugs and/or alcohol or have other health conditions. We wanted to help change this.
In 2015, there were several large, well established and effective IPS services operating around England. There was strong evidence from these and from the US and Europe that the IPS approach was much more effective at helping people in a mental health treatment setting than traditional forms of employment support, such as ‘train then place’ or volunteering as an entry into paid employment.
IPS was included in some policies. And the NHS five year forward view, published in 2014, included a goal of better investment in mental health services with a focus on reducing unemployment.
However, IPS hadn’t really taken off. We felt there was a huge opportunity to develop and scale it across England and ensure that all people with severe and enduring mental illness gained access to a quality IPS service. To do so, we needed to build momentum behind IPS and collect compelling data to convince funders at local and national level of the benefits.
When people are recovering from mental health problems and want to seek work, they’re introduced to an Employment Specialist. Employment Specialists are based in mental health services and work with clients to help them choose and find a job using a personalised and strength-based approach. If they are successful, the Employment Specialist then provides ongoing in-work support for both the client and employer to help their client keep their job. This support is provided as long as the client wants and needs it.
What did we do?
We helped commission several IPS services across England, created a national IPS community to share knowledge and skills, further built the evidence base for IPS in England and engaged with key stakeholders.
This enabled us to make the case to decision makers for widespread adoption of IPS and to secure funding to build a national support infrastructure to drive the roll out and scaling of IPS.
We continue to lead the development, delivery and quality assurance of IPS services across the health system in England through an organisation we host called IPS Grow.
1. Building momentum and the evidence base for IPS in England
In 2015 we set up a new arm of Social Finance – the Mental Health Employment Partnership. Through this we:
Commissioned several pilot IPS services using social impact bonds as a funding tool – the first time they’d been used in health and employment
Supported the largest randomised control trial of IPS in primary care in the world
Provided support for fidelity reviews with our partner, The Centre for Mental Health, in the randomised control trial of IPS in drug and alcohol treatment teams
Created a community of experts, built stakeholder links and organised round table discussions, sharing our data, findings and client personal stories
Set up technical advice, support and monitoring and became a respected source of expertise, advice and guidance.
2. Making the case for adoption and roll out of IPS
Using the compelling data and evidence we’d gathered, we set up conversations with government and local commissioners and built propositions for wider introduction of IPS. Through this, we secured external funding to create an organisation to support the development and quality assurance of IPS services, called IPS Grow.
3. Rolling out and scaling IPS in England
Off the back of the NHS five year forward view on investment in mental health services, we formed a coalition of experts, created the first phase of IPS Grow and developed resources and a website to support high-quality IPS provision.
This and the momentum and public conversations we’d created helped IPS become a key focus of the NHS Long Term Plan – a 10-year strategy for targeting and improving services delivered by the NHS.
NHS England then commissioned IPS Grow to develop and manage a large scale IPS support system to enable the extended national roll out and quality assurance of IPS services across England.
My Employment Specialist has made a huge difference. She picks one up from the dark corners of low self-esteem and despair and makes one begin to feel like a human being again with something to offer in the world.
Person using IPS services
Impact and insights
We’ve taken IPS provision in England from a handful of services in 2015 to hundreds and helped to build a new workforce of more than 1,000 people to support this.
By 2023 there will be more than 300 IPS services across England. As well the huge expansion of IPS in mental health services backed by NHS England, this also includes:
IPS provision in drug and alcohol treatment services in every local authority area in England, funded by the Office for Health Improvement and Disparities.
IPS provision in primary care locations, funded by the Department for Work and Pensions.
IPS may also be adapted for prison leavers and military veterans.
A growing body of evidence shows that, on average, people recovering from mental health problems who receive IPS keep their jobs longer, earn more, and spend less time in hospital.
An independent evaluation of IPS Grow’s impact on supporting providers concluded that we:
Helped with faster implementation of IPS across funded services.
Improved the consistency of IPS implementation.
Contributed to improving the quality of IPS offered by these services.
Provide support through our Regional Leads that IPS providers find extremely helpful in enabling them to deliver quality services.
The evaluation is available to read on the IPS Grow website.
IPS Grow helped us build our confidence so we can create solid foundations for an excellent IPS service offer that is embedded within clinical services and has strong partnerships with the local DWP and other supported employment initiatives.
NHS IPS service manager
The IPS approach is now being adapted and expanded beyond mental health. We’re supporting trials looking into how effective and suitable IPS is for people with physical health problems or addiction problems. It is also being adapted for prison leavers and veterans.