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Yesterday's Welfare Reform, Work and Health conference at City Hall was one of the more impressive engagements between the worlds of health and employment that I have witnessed.  I made the sarcastic remark here that if the NHS and Job Centreplus were on a date, they  would turn up at different places and at the wrong time.  Yesterday's  event showed that at least the two worlds could start to talk, if not yet ready to settle down together.

Where differences showed was over the approach to welfare reform.  Healthcare Professionals (HCPs) do not trust the Work Capacity Assessment for health related claimants because of what they are hearing from their patients over perceived unfairness.  They are also not impressed with the high rate of successful appeals against WCA decisions.  The JCP take on this is that the decisions would be more accurate if  HCPs, especially GPs, fed in information earlier.  There is probably some truth in both points of view, and one suggestion from the conference would be worth exploring further. Sharing assessments over capability may help build a consensus prior to the formal assessment and may avoid HCPs having to attend assessments in person, which is costly and time consuming.  Overall there needs to be more development of trust between the occupational health professionals conducting the assessment and the patient's regular health support workers.  It is worth going back to basics a bit here.  Assessing a person's capacity for work is a highly contentious issue.  There are many examples of people who would undoubtedly fall into the support group of ESA clients and therefore not liable to have to look for work, who nonetheless are able to hold down regular work.  Indeed one contributor from the conference who has a child with severe learning disabilities was very concerned that he would not be written off if he ended up in the support group.  (The reassuring answer, incidentally, is that anyone in this group can volunteer for the Work Programme without fear of sanctions). 

The reality of the WCA is that medical assessment if only one factor, with other key factors being level of educaiton, previous work experience and levels of motivation. People's attitude to going back to work depends on their perception of the labour market, which as we know, is not looking good.  Where there was a clear consensus was over putting work on the agenda as part of good health.   In this context it was good to hear from the Work Programme Prime contractors that they were giving thought to co-commissioning services with the Health Service in relation to condition management, and were starting to think in partnership terms.  At a local level there are discussions taking place over focussed work on areas of social housing with high rates of worklessness.  

I am still of the belief that given that there is money to train up job candidates who are closer to the labour market, e.g. through apprenticeships, employers will need a lot of persuasion to take those further off without additional incentives.  There is also more to be done at a pan London agenda to get us working more closely. I will return to this conference next week.  in the meantime, well done to JCP and to the Health, Work and Wellbeing team in Regional Public Health for putting this together.