The Scottish Government

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Target C:

Public sector and large employers to tackle aspects of in-work poverty by providing employees with the opportunity to develop skills and progress in their career. NHS Scotland will set an example by providing 1000 job opportunities, with support for training and progression once in post, between 2004 and 2006 to people who are currently economically inactive or unemployed

SUMMARY EVALUATION

A4.87 Success for Target C has been defined in three parts: 1,000 places offered; a high (over 70%) translation to job entries; and evidence that other sectors are following suit by March 2006. Although the Target is defined within a timescale ending in March 2006, the training schemes have continued and new schemes have started in other Health Board areas.

A4.88 For the period up to March 2006, 1043 people were offered places on a training scheme, 585 (56% of the former) entered employment with NHS Scotland upon completing their training, and 455 sustained that employment beyond three months. This means that while the scheme met the first of its sub-targets (to offer 1000 places by March 2006), it did not meet the second (a translation rate from places offered to job entry of 70%).

A4.89 Different schemes experienced differing levels of success, due at least in part to the different training models employed. Lothian Healthcare Academy, the first scheme to be established, provided skills training with the specific intention of filling existing vacancies, experienced the highest rate of translation from places offered to sustained employment. The Greater Glasgow and Clyde Working for Health scheme took on the largest number of participants.

A4.90 Some employers in other sectors (within both the private and public sphere) are developing pre-employment initiatives similar to those run by the Health Boards, in order to help workless individuals into sustained employment. However, it is unclear that this is sufficient evidence that 'other sectors are following suit'.

WORK PROGRAMME AND POLICY CONTEXT

A4.91 Target C falls under CtOG's Objective 1, which aims "to increase the chances of sustained employment for vulnerable or disadvantaged groups". The NHS Scotland employment initiatives which are assessed under this Target are part of a much broader programme of work to improve employment prospects and progression opportunities for disadvantaged people and those currently receiving benefits. They come within the remit of 'Workforce Plus', a new employability framework developed by the Scottish Executive to achieve its goal of helping 66,000 individuals out of benefit receipt and into work. The driving force behind the framework is the belief that "for most people and their families, work is the surest way out of poverty" ⁹.

A4.92 To help deliver this target, six of the Scottish Health Boards have developed structured pre-employment schemes (Table A4.43) intended to 'provide participants with the confidence and skills to apply for permanent positions with health sector employers' ¹⁰.

Table A4.43: Pre-employment schemes and corresponding health boards

A4.93 The NHS pre-employment training schemes take a variety of models, but all intend to improve the employability of people who are currently without paid employment. The first scheme - the Lothian Health Care Academy - was developed to deal with the recruitment difficulties that arose when the New Edinburgh Royal Infirmary re-located. The model was developed to train people in the skills necessary for their hard-to-fill vacancies. The success of the scheme led to the establishment of a further five pre-employment training initiatives. Subsequent schemes had a wider remit, including training towards basic vocational qualifications rather than just for specific roles, although the aim of moving people into employment within NHS Scotland remains central, as recognised by the goal of a 70% translation rate from training to NHS job entries.

EVIDENCE

A4.94 As detailed in Table A4.44, a total of 1043 places were offered on NHS Scotland pre-employment training schemes to March 2006. Of these, 585 completed the training and entered employment, and 455 sustained that employment for 13 weeks or more.

Table A4.44: NHS pre-employment training: numbers of participants to March 2006

Note: Sustained employment is defined as employment sustained for 13 weeks or more.

Source: NHS Scotland.

A4.95 Figure A4.16 shows the number of training places offered by each of the six training schemes, up to March 2006, along with the number of individuals completing the training course, moving into employment after completing their training, and sustaining that employment. The Working for Health scheme has had considerably more participants than any other, 347 places being offered by March 2006 compared to 200 or less for the rest of the schemes. However, the number of people entering sustained employment from the Working for Health scheme was marginally lower than the number entering from the Lothian Healthcare Academy. The differences in participation numbers and employment entries between schemes will be partly due to the fact that different schemes followed different training models, as discussed above. For example, the Lothian Healthcare Academy scheme began as a six week skills training programme aimed at up-skilling individuals to move directly into existing vacancies, while the Working for Health scheme was originally a longer course which included work towards a vocational qualification. As such, the number of places offered by the Lothian Healthcare Academy was limited by vacancies, and could be expected to be lower, but participants were trained specifically to fill existing skills gaps, and so the proportion moving in to sustained employment could be expected to be higher.

Figure A4.16: NHS pre-employment training: numbers of participants to March 2006

Note: Activity began in January 2004 in Forth Valley, Greater Glasgow and Lanarkshire, in April 2004 in Fife and Lothian and in October 2005 in Grampian.

Source: NHS Scotland.

A4.96 'Progression rates' for the schemes reveal the percentage of participants at a given stage in the journey towards sustained employment that moved on to the next stage, and are shown in Figure A4.17. The graph shows that within some schemes, progression rates at some stages are 90% or more, and all rates for most schemes are 70% or higher. However, the compounded effect of people failing to progress at each individual stage results in an overall rate of translation from places offered to sustained employment of less than 60% for all but one of the participating schemes, as shown in Figure A4.18. The overall rate of translation from places offered to sustained employment was 44%. The overall rate of translation to employment (sustained or otherwise) was 56%, 14 percentage points lower than the 70% which was defined as success (see above).

A4.97 Lothian Healthcare Academy had the highest rate of translation from places offered to sustained employment. The Grampian Job Jump Start scheme had the highest progression rate from employment to sustained employment.

Figure A4.17: NHS pre-employment training: progression rates at March 2006

Source: NHS Scotland

Figure A4.18: NHS pre-employment training: translation rates at March 2006

Source: NHS Scotland

Impact on Equalities groups

A4.98 As well as monitoring participant numbers and rates of progression, some of the Health Boards recorded the er, age, disability status and benefit status of their clients, so that they could monitor the equalities impact of their work. The following figures reveal the breakdown of participants by these different factors, for individual schemes and overall. Note that the 'total' column in each Figure is the total for the schemes which provided data.

A4.99 It is important to note that while the figures above present outcomes up to March 2006, the end date for Target C, the gender, age, disability and benefits data were only available for all participants to date (Autumn 2006), and so do not sum to the same totals presented in Figure A4.19. Also, the charts include figures from NHS Tayside Healthcare Academy, which opened after March 2006.

By Gender

A4.100 It is noted in the Target C Equalities Impact Assessment that NHS positions, particularly support roles, are held predominantly by women. This is reflected in the overall gender breakdown, presented in Figure A4.19, which shows that 61% of training scheme participants were female. The Greater Glasgow and Clyde scheme, which had the highest overall number of participants, actually trained a slightly higher proportion of men than women, whereas 92% of the Lothian scheme intake was female.

Figure A4.19: Pre-employment training participants by gender

Notes: Figure shows percentages for those schemes which supplied data. 'Total' includes numbers for those schemes which provided data.

Source: NHS Scotland.

By Age

A4.101 The vast majority of training participants (59%) were aged between 25 and 49, although nearly one in five were aged 50 or over. Figure A4.20 shows that NHS Fife New Deal Activity took on a very high proportion of young workless people (aged 18-24), while nearly 30% of the Greater Glasgow and Clyde Working for Health scheme were aged 50 or more.

Figure A4.20: Pre-employment training participants by age group

Notes: This Figure shows percentages for those schemes which supplied data. 'Total' includes numbers for those schemes which provided data.

Source: NHS Scotland

Figure A4.21: Pre-employment training participants by benefit receipt

Notes: Thus Figure shows percentages for those schemes which supplied data. 'Total' includes numbers for those schemes which provided data. Not all participants were in receipt of either JSA or IB.

Source: NHS Scotland

By Welfare Recipient

A4.102 Figure A4.21 presents the proportion of training participants who were in receipt of Jobseeker's Allowance ( JSA) and Incapacity Benefit ( IB). 54% of all participants were receiving JSA, and 14% were receiving IB, meaning that more than two in every three participants were claiming one of these two workless benefits. Tayside Healthcare Academy, a new scheme which began after March 2006, has had the highest proportion of IB recipients, with one in three clients receiving IB.

By Disability

A4.103 Only two Health Boards provided information on the number of disabled clients participating in their training courses. This information is detailed in Table A4.45. Of the 440 Working for Health clients, 8% were disabled, while none of the Lanarkshire Employment Programme participants were recorded as having a disability.

Table A4.45: Pre-employment training participants by disability status

Source: NHS Scotland

A4.104 While data on the disability status of participants in the pre-employment schemes is limited, and data on faith, ethnicity, and sexuality not currently available, discussion with members on the Scottish Executive who are working on this Target, and examination of the Equalities Impact Assessment carried out at the beginning of the scheme, suggest that significant efforts have been made to ensure that the training schemes area accessible to all, although some barriers to training still exist for some groups.

A4.105 A number of issues were raised during the qualitative research:

A4.106 While schemes ensure childcare is available for participants during training, if subsequently employed by NHS Scotland, they are only eligible for the same childcare benefits as other employees and will incur some childcare costs. This can mean that some participants, having successfully completed their training, find themselves without the "sustainable support for childcare that would let them continue into work". It was felt that this was not something that Health Boards could do anything about, but the issue had been raised with local and national government.

A4.107 Particular difficulties, such as language barriers, exist for refugees who could otherwise benefit from the training schemes. A specialised refugee scheme was set up in Glasgow to provide refugees with the skills they needed in order to participate in the pre-employment training. For refugees, securing childcare - even during training - was particularly difficult. It is intended that lessons learned from this refugee pilot will inform future training.

A4.108 The Scottish Executive has emphasised to participating Health Boards the importance of assessing equalities impact, and particularly of ensuring that training is accessible to all economically inactive individuals, not only those who are in receipt of workless benefits. This is driven by an understanding that workless people of certain cultures, age groups or areas may not engage at all with the formal welfare system: "there are many people who would be economically inactive but wouldn't step through the door of Jobcentre Plus".

Additional outcomes

A4.109 Some of the participating Health Boards carried out research into the additional outcomes experienced by clients who participated in pre-employment training schemes. The findings presented and analysed here are taken from the latest Target C monitoring report and reports produced independently by individual Health Boards.

A4.110 Table A4.46 presents some headline findings of a survey of clients commissioned by Working for Health. Clients were surveyed at the beginning of their training course and again six months on, about their lifestyle and levels of confidence. The two sets of answers for each individual were compared; analysis shows how responses changed in the six month period. Figures are presented separately for those who were employed six months on, and those who were not.

A4.111 The figures suggest that entering employment can have a significant impact on the confidence of individuals who have been workless long-term ¹¹. However, of clients who undergone training but were not in paid employment when surveyed six months later, around half in each case felt less confident in general, and less confident about finding work. It appears that paid employment has had a less positive effect on lifestyle, with results for changes in smoking and drinking habits being generally more positive for those not in work at the time of the follow up survey.

Table A4.46: Additional outcomes for Working for Health clients

Notes: Confidence question: n=87, confidence looking for work question: n=87, smoking question: n=43, drinking question: n=55, exercise question: n=74.

Source: NHS Scotland.

A4.112 NHS Grampian Job Jump Start carried out some qualitative research into the opinions of scheme participants. The findings reveal how participation in the scheme has had an effect of the outlook and confidence of some participants, as well as their employability. The following quotes reveal some of the ways in which clients feel the training has impacted upon their lives:

• "The difference in my life is amazing. I am more confident, tolerant and keen to better myself"
• "I have managed to get back to normal life and now have a good reason to get up in the morning"
• "I now see life in colour instead of black and white"

Pre-employment and progression initiatives among other employers

A4.113 As discussed above, one of the requirements of success as defined for Target C was evidence that other sectors were following the example of NHS Scotland and making efforts to improve employment and progression opportunities for workless individuals.

A4.114 A range of employers in other sectors (within both the private and public sphere) are developing training and progression schemes in order to help workless individuals into sustained employment. However, even within the public sector, there is no single coordinated approach to achieving the second part of Target C. This means that data is only really available in the form of examples of current work.

DATA ISSUES

A4.115 The data provided here on the pre-employment training courses were provided to the Scottish Executive by the individual participating Health Boards. It was initially intended that the Health Boards would collect the following data:

• the number of people who had been offered places on pre-employment training
• the number who had completed the programme
• the number who had entered employment with NHS Scotland
• the number who were still in employment after 13 weeks
• the number who had achieved any additional outcomes ( e.g. further education or employment outside of the Health Sector)
• the number entering courses who were claiming incapacity benefit ( IB) and Jobseeker's Allowance ( JSA)
• The age, gender and disability status of all participants.

A4.116 However, information on age, gender, disability status and benefit status has not been provided by all Health Boards, and only two of the six original Health Boards have provided any information on additional outcomes.

A4.117 At the time of writing it is understood that no data on sexuality, faith and ethnicity are currently available for analysis. Some referring agencies, who refer individuals to the pre-employment training schemes (and NHS Scotland, in the case of those participants who secure employment with them subsequent to training) do ask participants for ethnicity information, but these data have not yet been passed on to the Scottish Executive, and there are difficulties in doing do because of their sensitive nature. No data on faith or sexuality are collected.

A4.118 The Scottish Executive is currently exploring possibilities for better data links between themselves, the Health Boards and the referring agency to ensure that all collated data is properly recorded and is available for research purposes where appropriate.

A4.119 Data evidencing whether other sectors are 'following suit' is currently only available in the form of examples. It would be difficult and time-consuming to collate an exhaustive record of initiatives that increase the chances of sustained employment for vulnerable or disadvantaged people, particularly if, as the Scottish Executive hopes, such practices become increasingly widespread over the coming years. A better approach might be a survey of large employers carried out at suitable intervals - widespread change among businesses can be expected to take time - allowing measurement of how employment and training practices change over time to improve opportunities for disadvantaged and workless people.

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