Fair Start Scotland - individual placement and support review: findings

Conclusion

The decision to include an IPS element within Scotland's mainstream disability employment programme, Fair Start Scotland, was a clear demonstration of the commitment by Scottish Ministers to evidence-based practice.

The IPS model is the best-evidenced approach to supporting people with severe mental illness into work. There is growing evidence that it works for people with other health conditions and disabilities and other complex barriers to employment.

However, while IPS has been proven to work, it is a different approach that requires new ways of working by both commissioners and providers of services. The challenges faced by Fair Start Scotland providers in delivering high-fidelity IPS are typical of those experienced in other countries when the model was first introduced.

We believe the recommendations we have made in this report can help to address those challenges and to improve the fidelity of IPS provision within the Fair Start Scotland programme. However, we believe there are opportunities for Scotland to go even further to develop evidence-based practice and help those who need it most to get a job.

• First, the health system in Scotland could embed IPS as part of core mental health provision in line with NICE guidance. This would help IPS services to better integrate with mental health teams and build employment support into the mental health treatment pathway;
• Second, IPS could become the default for everyone within Fair Start Scotland with complex health and disability related barriers to employment. The IPS approach could also be part of the new "blueprint" that the Scottish Government is developing for local authorities to use when commissioning employment support.

After an extensive evidence review, the What Works Centre for Wellbeing concluded that "people do not adapt to unemployment. Their wellbeing is permanently reduced". For people with a health condition or disability, a job means more than just financial independence, social contact, and a source of dignity. It can be a lifeline.

Scotland has started pioneering the use of IPS to help people in mainstream employment programmes to access the lifeline of a good quality job. Now is the time to take the next step.