Clara Mascaro and Hamish Linehan discuss good work, health and “employerability”

Our work commonly sits within the intersections of different areas including health, employability, housing, and poverty. Considering issues at the point that they intersect with others can often shed light into ways to approach some of the more intractable challenges in policy and service provision. In the spirit of intersection, we have teamed up with Clara Mascaro, a former Rocket Scientist and current PhD student at the University of Edinburgh, to explore how considering employment and health alongside each other makes it clear that the quality of the job is paramount.

For me, this interest stems from our work with those who are unemployed and the services that offer support to them. People I’ve talked to have often commented on how their unemployment has contributed to their poor health, reduced life satisfaction and feelings of social exclusion. Their experiences are supported by an increasing body of literature that demonstrates how being in good employment can improve individual health and wellbeing and a growing understanding of ill health’s hidden economic cost.

In 2019, the UK government reported that 131 million working days were lost to sickness absences, and it was estimated that sickness and worklessness costs the UK economy approximately £100 billion annually. These findings are pertinent given that nearly a third (31%) of all working age people in the UK report a long-term health condition.

In addition, there is currently a significant gap between employment rates for those with disabilities (51.7%) and those without (81.7%).

As people live and work for longer, the number of those with a long-term health condition or disability both in and out of work is likely to increase. 

Helping people with long-term conditions and disabilities stay in work for longer or find employment can have a significant positive impact on both individuals and the wider economy. So far, the challenge seems simple: “there are a number of people who aren’t in work who would benefit from employment, so let’s get them into jobs!”.

However, we see the challenge as more nuanced than this. Evidence has shown that “bad work”  (low-paid, insecure, with low autonomy over tasks, resulting in low satisfaction) can actually have negative effects on a person’s health. This stands in contrast to the positive effects that good work (work that is well paid, secure, autonomous, with a good work life balance and opportunities to directly participate in organisational decisions) can have.

So, moving those with health conditions and disabilities into any job won’t guarantee individual and economic benefits – it may even exacerbate the problem. With this in mind we can reframe the challenge from: “How do we help those who are disabled or have long term health conditions stay in or find employment?” to “what can we do to make sure that the work that’s on offer is good quality?”.

When thought of in this way, we can see that both employers and employability services have a part to play in ensuring this challenge is met.

What can employers do?

The social model of disability states that people are disabled not by their impairments or health conditions, but by structural, environmental and attitudinal barriers in society. Adopting this perspective with regards to work and health puts more of an onus on employers to make workspaces more inclusive. Examples include making reasonable adjustments, job carving (tailoring jobs to make them suitable to specific workers), promoting flexible working practices and implementing accessible recruitment processes. However, employers – particularly smaller employers – often lack the knowledge or capacity to make these changes and need help to improve their ‘employerability’.

 A number of projects we work with are aiming to change this. We are currently working with the Department for Work and Pensions on their Challenge Fund– a multi-million pound fund that is looking at different approaches to keeping people in employment with MSK and mental health conditions through 19 test to learn initiatives. A number of these initiatives focus on the views, sense of responsibility, knowledge, skills and confidence of employers to increase their employerability. Traditionally, employers have been only passively involved in employability support programmes as the recipients of job seekers. These projects illustrate a welcome shift in the expectations placed on employers.

What can Employability Services do?

For employability services, adopting this perspective implies that it is crucial that services support jobseekers with a disability and/or health need to find a ‘good’ job that matches their skills and meets their health needs in a sustainable way. This requires flexible, personalised employability services and a shift away from what is referred to as a  “Work First” approach – ie aiming to place people into any employment as quickly as possible.

We have recently worked with a number of services who are doing just this – offering individualised support that is intended to move people with long-term health conditions into good work.  Through working with these services, we have been able to identify a number of key lessons that have contributed to their success. These include:

Service users’ needs and ambitions need to guide support. Good work will look different for everyone. In order to ensure that service users are moving towards what they feel is good work services need to align employment outcomes with their ambitions, skills, and health requirements. We have seen this be particularly effective when service staff work in collaboration with participants to identify and source a variety of different training and employment opportunities.

Health often intersects with other issues. We have found longstanding health problems can be both a cause and consequence of issues in other areas. Specifically, we have found that poor physical health and mental health can often intersect with issues such as insecure housing, poverty, and social isolation. Services can help respond to these intersecting issues by having well-trained specialist staff and strong referral links with relevant organisations.

Moving someone into employment is a first step. Often, moving someone into work is just the first step. When in work individuals may need to continually manage their health and, as discussed previously, workplaces made need to make active adjustments to accommodate individual need. Services need to provide users and employers with the skills and knowledge to manage their health conditions and adapt their work environment. In some instances, this will require that services provide ongoing support to help service users transition into work.

Managing expectations

While there are many steps that employers and employability services can take to ensure that good work is provided for those with disabilities and long-term conditions, it is also important to note that providing good work will not guarantee economic and individual benefits in all cases. There are, for instance, some health conditions and disabilities that will mean employment is not a feasible option for some people, a reality which employability services must navigate carefully.

Clara is a PhD student at the University of Edinburgh researching work-disability and social security in Germany and the UK, find out more about her work here: https://bit.ly/35qsj1z. Hamish is a consultant based in our Edinburgh office. For more information about anything discussed in this blog, please get in touch on 0131 226 4949.