Andrea Clement introduced the report by stating the Worklessness and Health Joint Strategic Needs Assessment (JSNA) had been developed to gain an understanding of the relationship between worklessness and health and the scale of this issue in Thurrock with the focus of the JSNA was Employment Support Allowance (ESA) claimants with mental health and/or musculoskeletal (MSK) conditions. The JSNA aimed to understand the barriers to employment in this group and to identify support to overcome these. The importance of assisting people who were able to, to return to work had benefits from both a wellbeing and economic perspective. The JSNA identified several key gaps; notably that there appeared to be no overall strategic approach to worklessness and health. Additionally, whilst there were a variety of local services for worklessness in general, access to support could be unclear and disjointed and services were not always identified to be person centred or flexible in their approach. The JSNA report made recommendations for addressing the gaps identified in the JSNA which could be broadly categorised into three overarching high level recommendations. These were:
- Development of a worklessness and health strategy with a framework of actions which encompassed both prevention and assisting timely return to work.
- The development of a clear pathway that joined up all services and allowed claimants to be signposted to the most relevant services in a timely and appropriate process.
- Development of a healthy workplace accreditation scheme for Thurrock that ensured good practice in relation to health at work and promotion of good health.
The next steps would be to refresh the data in the JSNA document as this had been prepared pre-COVID which would have had some impact, look at the impact of universal credit and work with the Economic Development Strategic Partnership to develop a strategic approach as this was a live document, the JSNA would continue to be reviewed.
Councillor Ralph thanked Andrea Clement for the in depth report and questioned whether community liaison officers would be more involved on what happened with job recruitment as they would become a major part of the strategy. Andrea Clement stated there would be a whole system approach to the strategy to involve all partners in driving the strategy forward with the engagement and involvement of all different partners.
Councillor Holloway thanked Andrea Clement for the report and had enormous amount of respect for public health colleagues in the amount of work undertaken in putting reports together but had been a little disappointed with this report. Her concern was that the report had focused on money as a key driver rather than the focus of health. Councillor Holloway questioned why the report had been undertaken at this point and questioned whether this had been a massive problem in Thurrock. Andrea Clement stated that work had started in 2019 and agreed that some of the data was now out of date and the JSNA had focused on the subset of people who could potentially be supported back to work. Councillor Holloway also raised an issue with the term “worklessness” and stated that it was horrid and should not be used and an alternative title should be considered. Councillor Holloway summed up by stating the report had focused on finances, there was not enough emphasis on the analysis of what kind of jobs there were in Thurrock, with retail, warehouses and logistics, what were the likelihood of matching jobs with people with those conditions, questioned whether we should be pushing people back into work when they should be left alone to heal, why investments into health services were not being considered, need to invest in mental health services and people might get better to then find work, the report did not work it seemed to be upside down.
Councillor Ralph had some sympathies to what Councillor Holloway had said as there was a fear of getting back into the work place and understood the positive drive, pride and self-esteem that people found when back into the work environment. Councillor Ralph did raise his concerns on the finances and stated that the worklessness statement was for people who could not work.
Councillor Redsell agreed that she did not like the word “worklessness” and although the report had been complex it had focused on finances rather than how it would happen and how we were going to get people back into work. Councillor Redsell stated that people had to be integrated properly into doing something from the beginning and questioned whether the involvement of the voluntary sector or having the opportunity to speak with people had been considered and offered.
Councillor Ralph stated this was only part of the offerings in Thurrock with a lot of other projects on-going such as development programs which were looking at getting people back into some sort of voluntary sector work.
Ian Wake provided members with some history as to the production of the report and how this was so important. That work was the most health protective factor in anybody’s life and there had been evidence that the more people that could be in work and those that want to work, the better it would be for the population in terms of population health. That there was a massive disparity between different wards which had been linked to deprivation, about the number of people with musculoskeletal problems or mental health problems who were unable or who were not in work. That there were two driving factors around the report, one around health inequalities and secondly being in work was the most health protective thing that could be done for the population. In regards to finances, the focus had been on making the decision makers in the system to demonstrate that this was one of the most cost effective thing that could be done. This was not forcing those people back to work who were too ill it was around facilitating and working with employers.
Councillor Redsell questioned with COVID would there be any anticipation of producing more health problems with people going back to work because of how this may have affected many more people. Ian Wake stated that self-isolation may deteriorate or may cause people’s mental health to deteriorate and evidence had started to be seen that was the case. That COVID lockdowns had damaged the economy and risked unemployment and we had to find a way to try and bring those two things together. With a more holistic approach and integrating employment support and mental health was one of those solutions.
Councillor Holloway stated there were also a vast amount of people in that RAG group that do not want to work or unable to work who should be in support groups. Councillor Holloway agreed to send Ian Wake a copy of a report that she worked on in 2016 which contained the recommendations they had given to Government. She welcomed the recommendation to have a standard for employers and wanted to push this forward. It was about national Government saying to big businesses and to employees to treat staff better, treat staff well but this needed to come from a national level. Councillor Holloway hoped that this could be done locally.
Councillor Ralph also hoped this could be done locally by working together and for Government to see how Thurrock were undertaking the work and be used as an example for this to be used nationally.
Councillor Muldowney thanked Officers and questioned where was the comprehensive evidence and data analysis of the health and wellbeing needs of those with musculoskeletal and mental health conditions. Requested some clarification on how 950 people had cost £47 million to Thurrock and stated that the figures around COVID in the report were very out of date. Andrea Clement stated that this was going to be a live document and agreed that the data was quite out of date, with some of the data going back to 2017. The process of developing the strategy could include going back and checking those changes in data. This had been the first part of the process and when developing the strategy further health would at the centre of the strategy with the review being constantly reviewed and refreshed. Andrea Clement confirmed that the musculoskeletal condition program had been launched and was available in health hubs and referrals would be made through general practitioners.
Councillor Ralph stated Members had to accept this was a live document and would be updated as it progressed forward.
Councillor Holloway appreciated that this was a working document and thanked Officers for the report but stated that the Thurrock element of the report should be brought to the front and with finances to the back of the report as this would help with the presentation of the report going forward.
Councillor Rigby stated that some of the wording had come across as unpalatable but the basis of what was required had been achieved. This was not all just about the money, there had been a plan and how to help people with musculoskeletal issues, such as physiotherapy, but maybe the report could be worded better.
Mark Tebbs stated his concerns that the report had referenced views that some of the services were kind of siloed, not person-centred and no flexibility. The pathway had tried to have mental health specialists as part of the clinical services so they would be embedded in, embedded in secondary care and in early intervention so that they formed part of the treatment program and be wrapped around the individual and to do this in a kind of holistic and co-ordinated way. Mark Tebbs continued to state that some of the descriptions for the mental health aspects of the report had been quite broad statements and needed to be more targeted. He also stated that he did not agree with some of the conclusions that had been reached particularly on the mental health side.
Ian Wake reconfirmed to Members that this report had been written in 2019 and there had been plans to refresh the entire document to include more data but the timing of that had been unfortunate due to COVID. The report had been presented this evening so that work could continue with the process rather than to start again.
Councillor Holloway stated that conversations had to take place with employers, speak with employers who employ someone with a disability, speak to people with disabilities and use this as an opportunity to delve in and speak with people about the support that they need.
Members discussed whether the report should be presented again once the data had been updated and consultations with groups had taken place and agreed this report should be returned to committee when Officers felt this was appropriate.
1. That the Health and Wellbeing Overview and Scrutiny Committee noted and commented on the content and recommendations contained within the report.
2. An update report will be added to the work programme for 2021/22.