Title
Contents
Acknowledgements 7
The Authors 8
Summary 9
1. Introduction 16
1.1 Policy background 17
1.2 The 'gateway' model of delivery 18
1.3 Aims and objectives of the study 19
1.4 Research design 20
1.4.1 Assessing the effectiveness of, and the difference made by, the Pathways Advisory Service 20
1.4.2 Original and final research designs 21
1.5 Research methods 21
1.5.1 Survey of people using the Pathways Advisory Service 21
1.5.2 Qualitative follow-up study of survey respondents 22
1.5.3 Qualitative interviews with key actors 23
1.6 Structure of the report 24
1.7 Using this report 24
2. Engaging potential Pathways Advisory Service users 25
2.1 How people learned about the Pathways Advisory Service 25
2.2 How GPs engaged their patients 27
2.3 Benefit and employment status of referred patients 30
2.4 Reasons for meeting a Pathways Support Adviser 31
2.5 Making the Pathways Support Adviser appointment 33
2.6 Conclusion 34
3. Content and outcomes of meetings with Pathways Support Advisers 35
3.1 The form and content of Pathways Support Adviser meetings 35
3.2 Outcomes of meetings with Pathways Support Advisers 38
3.3 Usefulness of meetings with Pathways Support Advisers 40
3.4 How people found Pathways Support Adviser meetings useful 41
3.4.1 Encouraging thinking about work 42
3.4.2 Clarifying employment options 43
3.4.3 Providing advice about benefits and permitted work 43
3.4.4 Providing information about help and support 43
3.5 Dissatisfaction with the Pathways Advisory Service 44
3.5.1 Perceived lack of support 44
3.5.2 Unhelpful suggestions 44
3.5.3 Information incomplete, inaccurate or confusing 45
3.6 Conclusion 46
4. Further activity after the Pathways Support Adviser meeting 47
4.1 Responses to suggestions from Pathways Support Advisers 47
4.2 Short-term experiences and outcomes - changes in status at time of survey interview 49
4.3 Longer-term experiences and outcomes 50
4.3.1 The appropriateness and value of referrals 50
4.3.2 Experiences of direct support from Jobcentre Plus 51
4.3.3 Experiences of the CMP 52
4.3.4 Experiences of Job Brokers 53
4.3.5 Experiences of other types of provision 53
4.4 Positive impacts of the journey back to work 54
4.4.1 Returning to work 54
4.4.2 Moving closer to work 54
4.5 Barriers to progress 55
4.5.1 Health and caring barriers 55
4.5.2 Job market constraints 56
4.6 Conclusion 57
5. Assessing the pilot 58
5.1 GPs' views 58
5.1.1 Evidence of positive impacts for some patients 58
5.1.2 A new option for GPs in managing patients' health 59
5.1.3 The value of benefits and other advice 60
5.1.4 The importance of locating PSAs in surgeries 60
5.2 Pathways Support Adviser views 61
5.2.1 Linking health and employment 61
5.2.2 The importance of locating PSAs in surgeries 61
5.2.3 Potential for helping patients not yet on IB 62
5.2.4 Characteristics required of a PSA 62
5.3 Pathways Support Adviser client views 62
5.3.1 How PSAs influence people's decisions 62
5.3.2 The importance of locating PSAs in surgeries 64
5.4 Delivering a 'gateway' service 64
5.5 Conclusion 66
6. Conclusions and policy implications 68
6.1 Conclusions - meeting policy aims 69
6.1.1 Provision of early help and support to SSP recipients 69
6.1.2 Encouraging new contact with Jobcentre Plus services 69
6.1.3 Deepening the relationship between health professionals and Jobcentre Plus 70
6.1.4 Helping GPs to help their patients move towards work 70
6.1.5 Additional conclusions 71
6.2 Policy implications 71
6.2.1 Pilot design 72
6.2.2 Staff recruitment and training 72
6.2.3 Take-up and delivery 73
6.3 Final comments - the wider policy context 74
References 75
Table 1.1 Main characteristics of the survey sample 22
Table 2.1 How people learned about the Pathways Advisory Service 26
Table 2.2 Benefit receipt at time of meeting with a Pathways Support Adviser 30
Table 2.3 Employment status at time of meeting with a Pathways Support Adviser 30
Table 2.4 Reasons for seeing a Pathways Support Adviser 31
Table 2.5 Relevance of work in reason for wanting to meet a Pathways Support Adviser 32
Table 2.6 Main reason for wanting to meet a Pathways Support Adviser by age band 32
Table 2.7 Who arranged appointment with the Pathways Support Adviser 33
Table 3.1 Topics discussed at first meeting, by main reason for seeing PSA 36
Table 3.2 Length of first meeting 37
Table 3.3 Suggestions from PSA, by main reason for seeing PSA 39
Table 3.4 Overall helpfulness of meeting 40
Table 3.5 Extent to which PSA was listening 41
Table 3.6 Helpfulness of suggestion to see Jobcentre Plus Pathways adviser 41
Table 3.7 How much meeting PSA helped thinking about work, by main reason for seeing PSA 42
Table 4.1 Suggestions carried out by time of research interview 48
Table 4.2 Changes to work or benefits 49
Table 4.3 Work situation at time of interview 50
Table 5.1 Influence of PSA on Jobcentre Plus adviser visit 63
Table 5.2 Number of meetings with PSA at GP surgery 64