A healthy workforce

Occupational health is essential to supporting disabled people in work. This means providing integrated health and employer support. Disabled people are ten times more likely than non-disabled people to leave work following long-term sickness absence. Adequate health support is therefore a key lever in retaining disabled employees, preventing them from falling ill in the first instance, but also supporting them back into work after periods of poor health.

This was previously provided by Fit for Work, which offered free health assessments for employees during long-term sickness absences. However, this was withdrawn in 2018 due to poor referral rates. Although there were fundamental weaknesses, including poor collaboration between employers and healthcare professionals, its closure leaves a significant gap in the support disabled people can access when in work.

The Government has committed to alternative models of support, many of which will require long-term research and trials. In doing so, the failures of Fit for Work must be reflected upon and avoided. This requires a dialogue between relevant partners, including healthcare professionals and employers, and raising awareness of support. Digital tools should facilitate this, encouraging take-up and offering guidance on how to access support.

However, this development process cannot take place in isolation. Disabled employees urgently need occupational health support in the short-term. The Government must therefore explain how employers can access this in the meantime. This was a theme of Reform’s roundtable with Action on Disability, where it was highlighted that small and medium sized enterprises struggle to understand how to best support disabled employees. Guidance should be provided immediately, including examples of best practice and practical recommendations.

An able workforce

Occupational health support alone will not improve retention of disabled employees. A more efficient system of practical support is crucial. This is currently provided by Access to Work (ATW), which offers financial and practical assistance, including specialist equipment and support workers. ATW is a vital resource, with a record number of people receiving support in 2018-19. However, the system is inefficient and poorly designed, meaning that disabled employees aren’t receiving assistance when they need it.

Applying for ATW, which includes an assessment and evaluation, is lengthy and has been criticised for its delays and administrative errors. It can take between six to eight weeks from the point of application for support to be put in place, and even longer if there are delays or errors. An Inclusion London survey found that this poor service was affecting the ability of disabled people to remain in work, due to a lack of communication support and appropriate equipment.

The application process is also a “major barrier”. There was consensus among roundtable attendees that the system is “not fit for purpose”, with poor communication between employers, disabled people and advisors often resulting in a “last minute scramble” to receive support on time. Attendees described incidences where applications were closed due to 48-hour response time limits, even though advisors could delay applications for weeks while on holiday. These double standards, and a lack of support when it is most needed, create more barriers for disabled people in work and impact on retention.

Problems with ATW have not gone unnoticed. In 2018, then Secretary of State for Work and Pensions, Esther McVey MP announced that disabled people could apply for ATW twelve weeks before starting their job. Although this allows for pre-emptive applications, it overlooks the issue of the application process taking too long. In situations where assistance is urgently needed, this change is ineffective. To improve this, the application process should also be made more efficient, taking advantage of digital systems to prevent administrative errors and using the fast track mechanism for applicants who urgently need support to remain in work. An effective ATW scheme should be at the centre of the Government’s future efforts to address the disability employment gap.

Increasing amounts of money and attention can be invested in recruiting disabled people, but this will hold less value until retention levels are improved. This must involve an efficient ATW service and collaborative occupational health support. The Government’s aim must be sustainable employment for disabled people – and that means preventing them from exiting, not just supporting them in entering, work.