Working models

working models - ddn article on VIA drug service IPS employment schemeSince 2019, Via’s award-winning Individual Placement and Support (IPS) Into Work service has supported people with experience of drug or alcohol issues into sustainable employment across West London.

An external evaluation of the service was recently conducted by the University of Strathclyde covering the period January 2019 to March 2022. The study combined a quantitative analysis of data from 718 clients with 27 qualitative interviews, carried out primarily with Via team members, co-located drug and alcohol service staff, and IPS clients. 

We hear from three key stakeholders about the importance of (IPS) for people with substance issues, and why the evaluation has been so crucial in helping the service go from strength to strength.

Kim Archer, IPS lead at West London AllianceKim Archer, IPS lead at West London Alliance

Why did we apply for funding to deliver an IPS service for people with experience of drug and alcohol issues? I’ve worked with a range of people who’ve fallen out of mainstream society and found it hard to step back in. It was difficult for them to stabilise their lives and make their aspirations – such as a long-term home, stable relationships and improved wellbeing – a reality. That’s the heart of what I have to say.

 But my head said, we spend a significant amount of money on treatment and recovery and the consequences of addiction in A&E, prisons and with children in care. One of the key planks to achieving sustained recovery and reintegration is growing self-esteem, earning money and having wider sets of relationships through work and social interaction. 

Map showing what VIA's IPS service supported in London 2019 - 2022But any support to deliver health and work outcomes needed to be scaled and replicated. I also knew this would be better delivered by people familiar with the ups and downs of people in recovery. 

I’d previously commissioned an IPS service for people with mental health issues so when I read Professor Dame Carol Black’s Independent review of drugs recommend that IPS be trialled with people with experience of drug and alcohol issues, I was very keen to find ways of funding a service.  

We achieved this through intensive collaboration and compromise. Gaining additional funding for people with drug and alcohol issues is not easy, as other groups of people can be seen as more ‘deserving’. But we were successful in applying to the Life Chances Fund (LCF), which allowed us to create a social impact bond. This paid for the running of the service while different outcomes were funded by some eight London boroughs, seven NHS CCGs and Jobcentre Plus. 

If this sounds complicated, it was – especially as shortly after the service started COVID presented more challenges. Part of the agreement for LCF funding included undertaking an evaluation, and this is where it gets interesting. While we had fewer participants than expected initially, even during COVID 30 per cent of them found work. In some boroughs, 38 per cent of clients found work.  

We’ve learnt so much from this evaluation. But key, from a commissioner point of view, is that it’s not enough to leave it to well-trained frontline teams to set up and deliver the service. You need a systems approach. All the organisations involved at all relevant governance levels need to understand and support service delivery.

Professor Adam Whitworth, professor of employment policy at the University of StrathclydeProfessor Adam Whitworth, professor of employment policy at the University of Strathclyde

The quantitative evaluation found that the IPS Into Work service supported a wide variety of clients and achieved a 30 per cent job entry rate overall. Most jobs were 16+ hours per week and around half of them lasted for at least 13 weeks. This is a strong performance for a new IPS service operating through the COVID pandemic. 

When controlling for other factors, statistical modelling shows large, consistent and statistically significant positive impacts on clients’ employment outcomes. There is notable local variation in referral volumes and employment impacts across the eight local authorities, and this maps onto qualitative evidence of the strength of integration between the IPS service and host drug and alcohol teams. 

The service delivered impressively consistent positive wellbeing benefits to clients across a wide range of wellbeing measures relating to substance recovery, physical and mental health, resilience, relationships, and positive behaviours and attitudes.

The qualitative evaluation identifies four critical success factors for a high-quality IPS service – integration, fidelity, employer engagement, and the employment specialist’s personal qualities and interactions. 

Effective local integration between the IPS service and drug and alcohol teams was essential to referral volumes and job outcomes performance, and commissioners of drug and alcohol services can play an important role in facilitating effective integration where challenges exist. 

graph showing strength of IPS service integration in local drug and alcohol teamsVia staff showed a good understanding of IPS fidelity and were convinced that high fidelity aided service quality, client experiences and job outcomes. The quality and interactions of employment specialists were key to all aspects of service success. 

Clients were overwhelmingly positive about their experiences and the quality of the support received. They particularly valued the consistency, intensity, and flexibility of support, the continual encouragement and supportive challenge, being listened to and the positive and person-centred support in response – as well as the broader commitment to their wellbeing: 

‘This for me is a service that says we will help you get back into working and how does that work? I think it’s about confidence. I think it was the way he listened really… we will accept it and we will support. What you need is that feeling of being respected and believed.’ 

‘I lost my confidence completely. You know, I was at the very, very bottom. I was thinking that I was never going to be able to pass a job interview again. But I got a job in my career. I’ve got a plan. I’m studying this course… because they gave me the confidence.’

Rebecca Odedra, head of reintegration at ViaRebecca Odedra, head of reintegration at Via

When IPS for addiction services was to be trialled in West London in late 2018, alongside the PHE trials across the country, it was an exciting time. It presented an opportunity to make a real difference in sustainable recovery outcomes by focusing on getting people into paid employment. 

It differed from traditional education, training and employment models in the sector, using an evidenced-based model which shifted thinking to ‘work first’. It felt novel and innovative, and we could see the real benefits. 

We’ve been running this service since 2019 across several London areas and it’s evident that this approach works. This has been further cemented by the IPS model being endorsed by Dame Carol Black and the government’s drug strategy, as well as additional funding from OHID and the Department of Work and Pensions. IPS has grown substantially and is intended to be in every local authority by 2025. 

This study has really helped us identify areas of good practice and learning. It’s also demonstrated the real impact on individuals, services, and communities. The client perspective was one of the areas that really struck me the most. Ultimately, delivering a high-quality service requires multiple interdependencies to work well, and the strength of collaboration, joint working and relationships with clients, stakeholders, and partners are really key to this.

Evaluation of the IPS Into Work West London service by the University of Strathclyde:

About Via’s IPS Into Work West London service:

Via and West London Alliance would like to thank Professor Adam Whitworth and his team for carrying out the IPS Into Work service evaluation

Kim Archer is IPS lead at West London Alliance; Professor Adam Whitworth is professor of employment policy at the University of Strathclyde, and Rebecca Odedra is head of reintegration at Via


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