The ‘Intensive Personalised Employment Support’ programme & the problematic political application of Lewin’s theory of change

An ‘Intensive Personalised Employment Support’ programme is to be introduced which will “provide personalised employment support for long-term unemployed disabled people,” the new Work and Pensions Secretary Amber Rudd has announced.

“Disabled people will be able to work with a dedicated key worker to get and stay in employment,” she says.

The support comes from a new £40 million fund and is expected to benefit around 10,000 people.

The Intensive Personalised Employment Support programme will provide “highly personalised packages of employment support for people who are at least a year away from moving into work.”

People will be provided with coaching to help build their independence, confidence and motivation, as well as work experience to help boost their career prospects.

Rudd added: “Everyone, no matter what their background is, should have the opportunity to thrive in the workplace, and having the right support in place for disabled people is one of my greatest priorities.

“To truly help people transform their lives, there can be no one-size-fits-all approach.

“That’s why this new programme is designed to offer people, who may think they will never move into work, tailored support to help them overcome any personal barriers they may have in the first instance, and then to focus on boosting their skills.

“There are also huge economic benefits to improving disability employment rates. More than half of disabled people are in work, but in order to realise the full potential of disabled people in Britain we want to go further and see one million more disabled people in work by 2027.”

People on the scheme will be offered a dedicated key worker who will work with them to overcome complex barriers which may be preventing them from entering work, ensuring they have a personal support network in place.

The voluntary scheme will be rolled out across England and Wales in 2019, and applicants will receive support for up to 21 months, including 6 months of in-work support for those who get a job.

Neil Heslop, Chief Executive of Leonard Cheshire, said: “Many disabled people with complex needs face significant barriers in accessing the workplace. It’s crucial that specialised employment support is available and the government responds to the challenges people often encounter.

“A more tailored approach can help reach those who are not currently receiving any employment support or skills development. The experiences of disabled people must be central for this support to meaningfully build confidence in an ongoing way, reflecting their individual circumstances and aspirations.”

The Intensive Personalised Employment Support programme will support people living with a disability who are unlikely to move into work within the next year or longer and may need additional support. Other existing government support to help disabled people get into and stay in work includes the Disability Confident scheme, the Work and Health programme, the Access to Work grant and Jobcentre Plus services.

The pathfinder report that informed the Intensive Personalised Employment Support programme

The government has established a managerial type of policy context in which it is aiming to “provide support which could enable disabled people to undertake employment in the open market rather than in protected or segregated employment.” 

The government have in particular targeted those disabled people who have just started claiming Employment and Support Allowance, before they undergo a work capability assessement for ‘interventions’. This approach is founded on an entrenched belief that “the longer a disabled person or an individual with a health condition is unemployed, the harder it is for them to return to work.”  

However, an alternative explanation is that those who are not employed because of a health condition for longer periods are simply too ill to work. Nonetheless, the government has focused on notions of “work-readiness” as a means to “help” disabled people into work, which tends to sidestep the barriers that people face because they are unwell. 

Research was carried out by IFF Research Ltd on behalf of the Department for Work and Pensions, to evaluate the Personalisation Pathfnder trial, which was  introduced in April 2015 in three Districts: South West Wales, Surrey and Sussex and Greater Wessex. The report can be found here.  

In part, the research aimed to “establish whether the Pathfinder worked in moving out-of-work individuals with a disability and/or health condition closer to employment and, if so, how and why it achieved this. Specifcally, the objectives of the research were to understand:   

  • Take-up of the Pathfinder programme – detailing the profile of individuals who joined the scheme in terms of employment history, claimant group, nature of health condition etc., as well as exploring the reasons and motivations for taking part  
  • The impact on outcomes for claimants. This includes both ‘hard’ impacts such as claim status and employment outcomes as well as ‘soft’ impacts such as attitudes towards work, levels of job-seeking activities, and perceptions of ability to manage health conditions 
  • Value for money 
  • Any impacts on the reputation of DWP and/or Jobcentre Plus among claimants.

The chief purpose of the Personalisation Pathfinder was to help claimants to become “work ready” through offered tailored support to those with a disability or health condition who are unemployed and aimed to investigate the impacts of an approach focused on personalisation, flexibility, peer support, and integration with local support.  

The report discusses findings from two waves of a quantitative survey with claimants on the Personalisation Pathfnder as well as from qualitative interviews with claimants and Pathfnder stakeholders.  

Job seeker’s Allowance (JSA) claimants with a health condition or disability accounted for the greatest proportion of participants on the Pathfnder (50 per cent), followed by Employment and Support Allowance (ESA) pre-Work Capability Assessment (WCA) claimants (38 per cent). 

Only around one in eight (12 per cent) of the participants were ESA Work Programme completers (WP). The majority of participants had been in employment at some point before joining the Pathfnder (76 per cent). Six in ten had left their previous employment due to health related reasons and more than seven in ten regarded their health as a key barrier to returning to work. 

Perhaps unsurprisingly, participants claiming JSA were generally less likely to perceive their disability as impacting on their employment before joining the Pathfnder. They were also less likely to believe their health condition or disability limited their ability to return to work. They tended to report fewer barriers to returning to work and were therefore generally more positive about this prospect. Three in ten claimants were in work twelve months after joining the Personalisation Pathfinder. 

ESA pre-WCA claimants were most likely to have found work while on the trial. Nearly a third of this group had, however, returned to a previous employer or job.

ESA WP Completers were the least likely to have found work, but the ones who did were more likely than the other claimant groups to credit the support they received from the Pathfinder in moving them into work. ESA WP Completers were also more likely to feel they needed health related support that the Pathfinder could not offer and that this prevented them from moving closer to employment.

The authors clearly stated that it is not possible to assess from the research what proportion of claimants would have achieved these outcomes without the assistance of the Pathfinder. Although there are indications of “work-readiness” improving among those who did not find work – and I am not sure how one measures that – improvements in wellbeing and social isolation, it was concluded,  were “more modest”. 

Methodology: some first glance criticism

The research was framed by the political application of the theory of change – this is essentially a description of how and why a desired change is expected to happen in a particular context. It is focused in particular on mapping out or “filling in” what has been described as the “missing middle” between what a programme or change initiative does (its activities or interventions) and how these lead to desired goals being achieved.

It does this by first identifying the desired long-term goals and then works backwards from these to identify all the conditions (outcomes) that must be in place (and how these related to one another ‘causally’) for the goals to occur. Government sectors use the theory of change to promote various managed social and political changes, to define their long-term goals. 

So it is a model based on backcasting, which is a planning method that starts with defining a desirable future and then works backwards to identify policies and programmes that will connect that specified future to the present.

The outcomes in a theory of change must be coupled with indicators that guide and facilitate measurement. The measurement is often of changes in behaviours and perceptions.

However, any serious explanation of anything in the social world should be suspect if it only uses one theory – e.g. a theory of financial incentives, or peer influences. All successful models are assemblies of multiple elements and theories – and they are open to exploration. Anyone familiar with systems thinking will be dubious of linear explanations, especially where complex  phenomena like disability, emloyment, homelessness, poverty or social isolation are concerned.

On key problem with the theory of change is that it does not model how events happen; rather, it models how strategists believe things will happen. Theory of change is a forecast that shows what conditions they believe must exist for other conditions to come into being. It’s easy to see how the model may very easily accommodate assumptions, prejudices and channel bias. The model may confuse accountability with ambitions and hopes.

Often, theory of change is insular and parochial, too. It can fail to take the external context into account. This is an important criticism in the context of current government behaviour change programes, as the emphasis is entirely on individuals, who are somehow viewed as detached from their social, cultural, economic and policy contexts. 

Participation in the programme was voluntary. However, people decided not to engage with the programme, so the invitation letters were reworded, making the statement about the programme’s voluntary basis of participation less prominent, to nudge people into engaging. That is unethical, because it bypasses the important condition of fully informed consent. Yet later in discussion between job coaches and claimants, the voluntary aspect became important in retaining some participants:

The voluntary issue is quite interesting actually, because I have had people who have come back from the Work Programme, have sat down in front of me and you can tell have arrived expecting me to say, ‘Right, you’re going to do this/you’re going to do that/you’re going to do this’, and they’ve been quite defensive, and they’ve said, ‘You know I can’t work.

“So when I’ve said, you know, ‘That’s fne, you don’t have to. This is a voluntary programme’, they’ve almost said, ‘Oh don’t walk away. I’m interested’, you know. The voluntary thing has defnitely produced a different reaction from people.”

Nonetheless, some 11% of the participants still said they were unaware they had a choice in whether they participated. Nearly one-ffth (19 per cent) of claimants thought that the Personalisation Pathfnder was mandatory; this proportion rose to 36 per cent for ‘ESA WP Completers.’  And even those who understood that participation was voluntary nonetheless expressed fears that they may be sanctioned if they refused to engage (page 59):

“I did not feel I could say no to the Pathfnder, because if we don’t do what they say, they’ll stop our money.” (JSA Caseload claimant, Surrey and Sussex).

Another criticism of the pathfinder is that it does not seem to differentiate between perceived health-related barriers to work and actual health-related barriers to work. Part of the aim of the programme was to influence people’s perceptions of barriers, a strategy which had little impact overall.

Another problem with the theory of change approach is that it doesn’t confirm the plausibility of the theory. Also, to be able to test, refine, and improve a theory of change over time, you need to be able to accurately measure its key elements. Not differentiating between perceived and actual health-related barriers leads to measurement problems.

Another major criticism of applied behavioural scientist Kurt Lewins theory of change model is that it ignores the influence of organisational power, conflict and politics; it is “top-down” and management-driven. As such, it is rather an authoritarian approach to policy making.

This is down to a misuse of the original theory and its underpinning intents. This presents an irony given that Lewin’s original wish was to extend democratic values and resolve social conflicts. Even critics of Lewin’s work have drawn on his Field Theory to develop their own models of change. Including the government.

Any change that the Conservatives initiate is generally imposed on others and micromanaged. If prescribed, theory of change quickly becomes a compliance exercise and loses much of its original  value. Theory of change frameworks requires a commitment to anopen,  reflective and realistic approach. 

Assumptions reflect deeply held beliefs, norms and ideological perspectives. These inform the design and implementation of programmes. The quality of a theory of change process rests on ‘making assumptions explicit’ and making strategic thinking realistic and transparent. Power relations, both in the programme’s context and within organisations, limit the ability to challenge established ways of thinking and working. So a theory of change process often brings to the surface conflicts and tensions which require negotiation. 

It’s certainly true to say that some “politicians, like any other social group that is in a rarefied or tightly knit, small community, will frequently suffer from psychological ‘groupthink’.” Dr Paul Taffinder, Chartered psychologist.

Common pitfalls of using theory of change, and rules of thumb for taking a systemic approach: pitfall 1) neglect context. rule of thumb 1) understand context. pitfall 2) change others only. rule of thumb 2) know yourself. pitfall 3) think in linear terms. rule of thumb 3) think systemically. pitfall 4) seek safety in certainty. rule of thumb 4) learn and adapt. pitfall 5) change is technical. rule of thumb 5) recognise change is personal.


 

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19 thoughts on “The ‘Intensive Personalised Employment Support’ programme & the problematic political application of Lewin’s theory of change

  1. They love their acronyms don’t they? like the classic “WRAG” designed to sound so appealing. So… “IPES”. I think they left the “CR” out at the beginning though.

    Liked by 1 person

  2. This is a long read so only had the chance to glance through it so far. What immediately strikes me though is how can they determine who is least likely to have found work within a year (if they don’t take up the intervention)? And if it is for those deemed the more “entrenched” disabled (as it states) then how can it be intended that most of the participants will be on JSA (as oppose to ESA)? Also the word “voluntary” is rather worrying. For how long one might wonder….

    Liked by 3 people

  3. Hopefully this (scheme) will fizzle out before it becomes Mandatory!
    It does’t say which groups or I have missed that part.

    Work experience=free labour for the Tories!!!

    Also it is not like work is an insentive, low pay and more bills to pay!!!

    Liked by 1 person

  4. The best way to help anyone into work is to offer them a job with a reasonable return which is within their skill set . The best placed employer to create jobs which are flexible enough to allow those groups of disabled who can work sometimes, being relatively well in fits and starts, unpredictably, is HMG. This initiative on the face of it seems to be providing jobs or probably profit for individuals or a company directing their focus on the unemployed person, not on the availability of suitable work. It assumes, rather arrogantly I think, that someone disabled can’t figure out some basic issues for himself or herself and needs hand holding to reckon what their availability is, what their skills are and if there is any one out there who might offer a job.

    Liked by 2 people

  5. I am just wondering how, if at all, this initiative could help someone I know.
    She is Aspergers, OCD and has a congenital heart condition. She is intelligent and has a Master’s degree, but is in the ESA support group, and has never worked.
    The thing that she cannot cope with in normal jobs is not the actual work – given interesting work she is a high acheiver. It is the social relationships and “normal” behaviour expected in ordinary workplaces.
    She is not incapable of forming and maintaing friendships, but she is so odd that trying to make friends is an ordeal for both her and for other people trying to be friendly towards her.
    In the right environment she could probably hold down a part time job, which would make her capable of supporting herself, and even, in a group of understanding colleagues, of having satisfying relationships. This scheme aims to get people into mainstream employment, a situation in which she is always likely to struggle.
    I find it difficult to see what even the most dedicated coach could do – because short of changing her, they would need to create an understanding work environment in which bitchy, hostile colleagues inclined to mock were eradicated. And should such a lovely workplace exist, why would it have any vacancies?

    Liked by 1 person

    1. One of the assumptions made in the research was that people on ESA long term tend to be unqualified. What was odd about that comment in the report was that there were professionally qualified people in the cohort they worked with. Stereotyping people to fit a preconceived framework. That way, it justifies the inane programes entailing demeaning “confidence and skills sets building”. Because at the end of the day, apart from a coach to chat to, that is all that is being offered, along with CV writing excerises. There is absolutely nothing to address the real barriers presented by people’s conditions. The report did take account of that, in fairness. Some people said that their health condition remained a barrier because the job coaches could not provide access to the level of health support needed to overcome that barrier.

      Like

      1. Argh. Yes. When I was on JSA for a (very) short period about 8 years ago (there was no way I could work for health reasons) the JC+ sent me to the Papworth Trust. I brought my CV:
        Worked since I was 14 in a variety of jobs, even when at uni
        B.Sc. in Earth Sciences
        M.Sc. (from the US) in Geosystems
        6.5 years as a researcher in Geophysics with 13 published journal articles
        2 years of a Ph.D in Seismology

        After about 30 minutes of discussing my health problems, she told me that they wouldn’t be able to help me. She said she’d just sign me on every week, and I didn’t need to come back. Dispiriting, but given today’s conditionality, I was lucky…

        Liked by 1 person

    2. My specialist has told me to avoid any infection at all, including people with colds and viruses. My immunity is rubbish because I have lupus. In 2017, I caught flu and ended up with advanced pneumonia and sepsis within a couple of days of being symptomatic. I almost died. Previously I caught a cold from a colleague which had also become pneumonia very quickly. I’m just wondering how it could possibly benefit someone like me returning to work… where people are encouraged to turn up coughing, sneezing, no matter how many germs they are harbouring. The whole mindset – work is a health outcome – is itself is a potentially life threatening issue for people like me, and those on chemotherapies, for example. No joined up thinking at all.

      Like

      1. Indeed! I did work for a couple of years at a job I found myself (2013-2015, I think?). I was constantly sick. I caught everything, it was worse for me than it was for others, and it took me longer to recover. I also came down with glandular fever for the *2nd* time (slightly different strain, as I’d moved continents), and hepatitis (inflamed liver, not actually one of the viruses). I had to leave work after I ended up in the hospital. Sigh.

        Like

  6. It is a sad reflection of the callousness of this government when the first reactions that the sick and vulnerable have when they are informed that the DWP has a yet another new initiative to ‘help’ them is fear and a deep forboding that they are going to be persecuted yet again..

    Liked by 1 person

  7. Not sure I can respond to your email but here goes. I note your article refers to England and Wales and I live in Scotland. Hope by the time they get to Scotland we will be independent. I was a civil servant for over 30 years and am now 61 yrs old. I was diagnosed with a malignant brain tumour. In 2010 and was medically retired from the civil service – not easily achieved since you really need to be regarded as unfit for all work at your grade. Since one of the main side effects of a brain tumour is short term memory loss – being required to retrain in a new job really is not an option. I do receive ESA but only about 50% of the going rate due to my civil service pension but this still leaves me well short on my salary prior to diagnosis of my brain tumour.
    Is it the case they are only looking at those who have just started claiming ESA or am I not reading this correctly? I sit here in dread of being subjected to further probing by the department I used to work for who already decided I was not fit to be redeployed it any other post and agreed medical retirement was the best option for me.
    Sorry for the rant and not sure you will know any more than I do but just felt I wanted to put this down in writing
    Regards

    Mary Spowart (Mrs)

    Sent from my iPad

    Liked by 1 person

    1. Hi Mary, firstly I am very sorry to hear about your illness and diagnosis. And it’s not a rant at all. It’s a very useful question.

      I don’t know for sure, but I can guess that those most likely to re-engage in work – the pre-assessed ESA claimants – are going to be the likeliest targets for this ‘intervention’. I don’t think it is likely that you will be targeted, or others with long term, chronic or degenerative conditions.

      The study also indicated that those on ESA for longer, who had already been assessed, were rather less likely to be ‘work ready’. The study did acknowledge that poor health was a key barrier for this group, in a roundabout way. It’s almost as if the starting point for the study was one of disbelief that some conditions exclude the possibility of any work…

      But I think you won’t be bothered. At this stage, any engagement on your part if you are approached would be entirely voluntary, anyway. So you can simply say “No”.

      Regards,

      Sue Jones.

      Liked by 1 person

      1. This comment: “The study did acknowledge that poor health was a key barrier for this group, in a roundabout way. It’s almost as if the starting point for the study was one of disbelief that some conditions exclude the possibility of any work…” seems to be the big elephant assumption in the room underlying their whole approach.
        I find that quite terrifying.

        Liked by 1 person

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