Written evidence submitted by Maximus (ESD0104)

Introduction

1. Maximus has helped disabled people to find work for over 80 years, and has been a leading provider of health, work and support services for government and business for more than 45 years. Across the UK, more than 5000 Maximus colleagues deliver services to over 3 million people every year, on behalf of national, local, and devolved government. These include a wide range of employment support services, including the Restart Scheme, the Work and Health Programme (WHP), and Access to Work, on behalf of the DWP; and Fair Start on behalf of the Scottish Government. Through our delivery of these programmes, we have supported nearly 30,000 people into work in the last year alone. We have extensive experience of providing health and employment support at a local level, such as Individual Places and Support (IPS) provision on behalf of combined authorities and the NHS, and local authority programmes through European Social Fund funding. We are also proud to be a Disability Confident Leader. Having gained input from operational teams across the business, we welcome the opportunity to share our views on employment support for disabled people and people with long-term health conditions.

Why has progress with closing the disability employment gap slowed in recent years?

What barriers prevent disabled people who want to work, or to work more, from doing so? How do these vary across the country?

2. We believe that an holistic approach is required to address barriers to employment and reduce the disability employment gap, reflecting the broad range of support an individual may require to enter work.
3.  
4. We recently conducted an analysis of economic inactivity data, in partnership with the Learning and Work Institute, focused on local authority-level data, which found that disabled people and those with long-term health conditions face a multitude of potential barriers when looking for work beyond their condition. Despite long term health issues being listed as the main barrier to employment, other barriers faced by this group may include comorbidities, housing concerns, caring responsibilities, a lack of skills, among others. The figures vary greatly across the country, and within regions. For example, in Hackney 47% of people in this group have no qualifications, suggesting basic skills provision will be critical. In Barking and Dagenham, 31% of people in this group have dependent children, highlighting the requirement for childcare support. Elsewhere, in parts of Lincolnshire, more than 15% state they are an unpaid carer, a majority of which for more than 20 hours a week.
5. The existence of such barriers supports the findings of the IFS[1], which suggested that healthcare waiting times alone do not account for increases in health-related benefit claims. Compounding these various challenges, many people who want to work, or work more, are unable to access the specialist employment support they need.

6. According to the Learning and Work Institute, only one in ten out-of-work disabled people receive help to find work each year.[2] This will be fewer still when considering those who are not claiming out of work benefits or whose entitlement does not require them to look for employment.

7. With the closure of the Work and Health Programme, and with Connect to Work remaining a locally-targeted scheme focused on a range of groups to tackle economic inactivity, there is currently no consistent national specialist employment support programme available for disabled people. Ensuring that there is consistent and dedicated support available to help people - regardless of where they live - is thus crucial but difficult. We welcome the government’s recognition of this challenge, and the announcement in the Chancellor’s Spring Statement of an additional £1.9 billion investment in employment support over the next five years .

8. We believe that employment support should be quick and simple to access and engage with, which is unfortunately not the case at present. Further consideration should be given to removing the barriers for access to this provision. . 

9. Additionally, to create a more seamless process, better case management is needed to support people through the benefit and employment support system, signposting them to available provision in their local area from day one. For many individuals, as well as employers and other services, the landscape remains too confusing and fragmented.[3] To remedy this, a more effective model is required, guiding people from the point of referral from a Support Conversation or other community or statutory services, through to the benefit process.

10. We welcome the proposed ‘Chance to Work Guarantee’ and wider recognition – including a recent report by IPPR – that more should be done to remove the fear of exploring and moving into work, based on the impact on benefit eligibility.[4] This risk of financial hardship from entering work remains a key barrier for many disabled people. Enabling disabled people to trial moving into work, without facing financial penalties, is welcome. We would encourage the wider application of this principle, to young disabled people on an Education, Health and Care Plan for example, to ensure the first steps into work are made on a firm foundation.

11. Awareness raising and myth-busting around the benefits of work should also be explored, ideally utilising trusted providers and organisations.

12. Ultimately, quicker access to employment support, delivered at a satisfactory scale, would be an important and significant change to removing barriers, recognising that it can take years from the point of claiming benefit to accessing tailored employment support from an employability specialist or local authority service. The lack of data sharing in the current system means that important information about support requirements shared when applying for benefit or with a Work Coach are not passed on to employability or other specialist support providers.

13. There has been too little focus on employer ‘demand’, building employer capability and capacity. In a challenging labour market, support needs to be available to build capacity and capability and offer in-work support to reduce flows back on to benefit. This could include:
• an employer ‘offer’, linked to Disability Confident and Access to Work, including potential tax breaks for workplace health and wellbeing support. 
• Developing Disability Confident into a fuller support offer for employers, linked to local JCP and contracted employability provision, including specialist provision with employer support elements like WorkWell. Sharing best practice, for example the Tesco Launch approach that offers working interviews with a guaranteed role for those who successfully complete their placement. 

14. We advocate for proactive engagement and support with businesses on topics around disability and employment, and the avoidance of focusing communications and government messaging on legal obligations and legislative requirements, which could have unintended consequences of reducing opportunities for disabled people. While it is important employment and anti-discrimination laws are enforced, our experience working with thousands of employers is that a vast majority are keen to do the right thing, but some lack the awareness and understanding to do so. Our experience aligns with the findings of the Keep Britain Working Review: Discovery report, which described employers lacking confidence in managing sickness absences, understanding responsibilities, and holding a fear of doing the wrong thing and thereby inadvertently pressuring employees or triggering tribunals – often resulting in a lack of contact and ineffective support for a managed return to work.

15. As a local provider, we recognise the importance of geography in employment support. Barriers and needs vary across areas, and support is most effective when rooted in the local context. We continuously generate local labour market analysis to align with employer needs, adjust delivery to drive employment outcomes, and support local authority employment aims. As mentioned above, we have recently complemented this with analysis of local levels of economic inactivity due to ill-health and disability, including specific characteristics and support needs, which we have shared with local and combined authorities. 

What kinds of support are most effective at supporting people with different disabilities (such as physical, mental or fluctuating conditions) to enter and stay in work?

16. Early intervention is crucial for disabled people and those with health conditions, which means providing support before they feel unable to remain in work. Retention remains a major challenge and, where possible, the focus should be improving support (and awareness of support) for disabled people prior to them falling out of work. Previous programmes, such as Work Choice, offered a valuable retention service. We would encourage the Government to raise awareness of effective provision, notably Access to Work, and seek out best practice and examples of innovation from across the sector. We would further strongly recommend that the DWP consider the re-introduction of retention-based employment support services, which could be delivered online using an Access to Work model.

17. For those who have fallen out of work, we believe that the focus should be placed on:

• raising awareness of the specialist support available for individuals if they have fallen out of work at an early stage, including at their initial point of claiming benefit;
• offering the earliest possible specialist support to those who are keen to work or engage with provision to learn more about the opportunities available. Day-one access wherever possible for individuals with the highest support needs should be the goal, as access to effective support can often be delayed, only taking place after many months of mainstream JCP support which is unsuitable. The removal of day-one specialist provision with the loss of IPES and WHP represents an unfortunate backward step.

18. We strongly believe in the principle that disabled people should be able to access employment support on a voluntary basis. In our experience if disabled people feel compelled or forced into finding work this can break down trust and result in poorer outcomes. A supportive, facilitative model, tailored to individual need and based on individual choice and consent, can be an incredibly positive way of transforming disabled people’s life chances.

19. We also know from user feedback and performance data that contracted employment support which is distinct and separate from JCP is valued by disabled people, with a tailored approach to reflect their particular needs. Our sector has the expertise to develop trusting relationships with participants, to engage them with the support that those furthest from the job-market need to move forward - something recent research by the Institute for Social Innovation and Impact highlighted as critical in securing successful outcomes.[5]

20. Our experience tells us that support for disabled people that demonstrates integration and coordination with other support provision locally is vital. The Maximus Community Partnership Network (CPN) holistic model of employability is particularly relevant as each CPN contains within it a range of organisations (public, private and charity sector) broad enough to meet the needs of disabled people looking for work. This includes, for example, provision covering housing, mental health support, addiction services, debt advice and training opportunities. Employment advisers are able to direct disabled people to the CPN partners meeting their support needs and ensure a co-operative and personalised journey into work. The CPN has long been at the heart of our approach to employment support, and has been fundamental in enabling Maximus to achieve the highest performance on the WHP in Wales, where the CPN was first established.

How effective is the support provided by Disability Employment Advisers? Are they able to support across all disabilities?

21. We believe that DEAs are an important asset and see the many benefits of having this dedicated role within JCPs. We also welcome the recent announcement on Pathways to Work Advisers. However, it is vitally important to recognise that DEAs, and JCP more generally, should work in collaboration with wider employment support. There is a rich ecosystem of this provision in local communities, delivered by a variety of organisations, commissioned at the local and national level, with a proven track record of delivering strong outcomes for individuals. Programmes such as the WHP and the Restart Scheme, for example, have proven effective at delivering more personalised support for those who need it. Providing specialist employment support for disabled people which is recognised as independent and distinct is critical. This is especially important for engaging those who are economically inactive.

What can the Government learn from the Work and Health Programme?

22. We have delivered WHP and Pioneer since their respective launch dates. The latest statistics highlight the positive impact of the WHP. These show that, from November 2017 to the closure of the WHP to new referrals in September 2024, 510,000 individuals were referred and 350,000 started the programme. Of those who started between November 2017 and November 2022 (the most recent point by which participants would have had the full term on the programme), 46% achieved first earnings from employment and 31% achieved a job outcome within 24 months.

23. We have been particularly successful in delivering the programme in Wales, becoming the highest performing provider in the region despite this being one of the most challenging labour markets. More than 26,000 people have joined the WHP with us in Wales, of whom more than 20,000 have entered employment. Some key lessons we would like to draw attention to are:

• There are real benefits to programmes which are voluntary. This helps participants develop a positive mindset about the support offered, alongside a feeling of control over their journey towards work. The evaluation of the WHP supports this, highlighting voluntary referrals to the programme as a factor in successful outcomes.

• In contrast to the previous Work Choice programme, the WHP has much more limited referral routes, relying on JCP. The evaluation of the WHP noted challenges with inappropriate referrals and lower volumes – though this improved over time. Incorrect referral routes cause waste and inefficiency, leading also to negative customer experience and poor outcomes. We believe that improvements could be achieved with simpler eligibility criteria, multiple referral routes, better use of technology, and effective triaging and streaming of customers to ensure swift access to the right support for each person.

• The benefits of providing flexibility in delivery were demonstrated clearly in the WHP, particularly through the Covid-19 pandemic, where providers were able to adapt and establish a swift transition to remote delivery which further served to expand access to support. We believe that programmes should allow as much flexibility as possible for providers to drive innovation and respond to labour market changes. We further believe that the option of remote delivery is an important element in extending the reach of support, and that an overall hybrid approach can be effective in combining this with participant preference.

• Services are effective when locally informed and aligned, and enhancing this is a core aim of increasing devolution. The success of the WHP (and its predecessor Work Choice), however, has illustrated the value of large-scale programmes delivered by a diverse network of providers. Too often the benefits of scale and of localism are presented as binary options, and we get caught in a cycle of re-introducing one approach as a solution to the other. A better approach is to move away from this false dichotomy and harness the strengths of both. If a national programme has flexibility and local partner integration, it can be locally targeted and responsive while also realising the cost and delivery benefits of operating at scale. We enhanced this approach in our delivery of the WHP with our Community Partnership Network (CPN), bringing together a wide range of organisations to collaborate and to provide holistic support to participants - using local specialist services to address barriers. Our own research and analysis of economic inactivity due to ill-health, and experience delivering Pioneer, highlights the importance of a holistic approach to support - addressing multiple barriers (e.g. ill-health, lack of qualifications, caring responsibilities). to help disabled people into work.

• Understanding participant needs and providing one-to-one tailored support to address these was highlighted within the WHP evaluation as key to the programme’s success. Our own research illustrated the important benefits of specialist support from dedicated providers, separate and distinct from JCP. To address the needs of the economically inactive cohort, our analysis of this group shows the importance of addressing multiple, interconnected barriers, and of employing a range of engagement approaches to reflect the different communities, characteristics and access points for this population. In all cases, we believe programmes are most effective when participants are placed at the heart of decisions relating to design and delivery, and that personalised support is necessary to help those with complex barriers move into sustained employment.

• Ensuring programmes such as the WHP are suitably long-term is vital in allowing us to enhance our service over time; invest in systems and welcoming, accessible premises; develop long-term relationships with employers and other services (building trust and collaboration); and to field expert key workers. The length of support provided was also highlighted as an important success factor for the WHP, helping to establish trusted relationships and allowing time to overcome complex barriers. That we have been providing support in communities across Wales continuously for more than 10 years has also contributed to us delivering the highest WHP performance here.

How successful has the Disability Confident scheme been at improving employer practices? How could it be improved?

24. We value the Disability Confident Scheme and believe it has helped engage employers on the broad business benefits of employing disabled people and supporting disabled employees. Maximus was an early adopter of the Disability Confident Scheme, and through Remploy was among the first organisations to reach ‘Leader’ status.

25. However, we believe that there is scope for improving and increasing the impact of the scheme to drive higher levels of recruitment and retention of disabled people in a measurable way. Currently, the scheme is predominantly focused on information sharing and communication. This has led to some criticism regarding its lack of provision of tangible or ongoing support, or capability building for Disability Confident organisations.  There has also been criticism regarding a lack of rigour on evidence of recruiting and retaining disabled people, especially at ‘Leader’ level. We believe greater demands should be made of ‘Leader’ organisations, and this should be reported in a transparent and consistent way.

26. We believe that a number of further practical steps could be taken. These could include better links between existing specialist disability employment support provision commissioned by DWP, and Disability Confident organisations, particularly as they progress through Level 2 and 3 and develop an action plan for change. Maximus and other providers have worked collaboratively to develop and deliver information sessions and webinars as part of the Disability Confident campaign to share expertise on topics and themes relevant to this agenda. This approach could be widened, offering both new signatories and those undergoing renewal the opportunity to discuss recruitment and retention support with either JCP or an employment support provider. This approach could further include the offer of free training for Level 2 and 3 Disability Confident organisations in exchange for sharing vacancies or developing partnership agreements, offering a tangible benefit for ongoing engagement and demonstrable outcomes.

What should the Government prioritise with its additional employment support for disabled people arising from the Pathways to Work Green Paper?

27. A key priority is to ensure that there is sustained, dedicated, and long-term employment support provision available nationally to disabled people. With the closure of the WHP, there is currently a real gap in available support for disabled people which needs to be filled as soon as possible as we are already seeing experienced employment advisors, with extensive knowledge of supporting disabled people into work, forced to leave the sector. The evaluations of Work Choice and the WHP have demonstrated the benefits of this provision. The recently published evaluation of Work Choice considered the impact and cost-effectiveness of the programme,  highlighting that it successfully helped participants enter and stay in employment: Those who joined the programme had more than a 10 percentage point higher employment rate, and were more than 7 percentage points less likely to be in receipt of benefits. The evaluation also illustrated the cost effectiveness of Work Choice, with each £1 spent delivering: £2.19 to the participant, £1.67 to the Exchequer, £2.98 to wider society. Ensuring that this support is available alongside more mainstream support provided by JCP and highly-specialised interventions such as IPS/SE, is crucial in helping disabled people and closing the disability employment gap.  We would encourage government to shape and steward an employment and skills market that includes both national and local provision, utilising expertise across the public, private and voluntary sectors.

28. Quicker access to employment support would be an important and significant change to removing barriers, recognising that it can take years from the point of someone claiming benefit to them accessing tailored employment support from an employability specialist or local authority service. The lack of data sharing in the current system means that important information about support requirements shared at a PIP assessment or with a Work Coach are not passed on to employability or other specialist support providers

Are there any international examples, or examples from the devolved nations, of effective disability employment support that the Government could learn from?

29. Launched in 2018, Fair Start Scotland (FSS) is Scotland’s first fully devolved employment support service. FSS is a voluntary programme providing 12-18 months of tailored, flexible, and person-centred pre-employment support to people who want help to find and stay in fair and sustainable work. The service then offers up to 12 months of in-work support. The programme involves an up-front triage to three stands (Core, Advanced, Intense), based upon complexity of needs to ensure the level of support received within the programme matches an individual’s requirements. This includes provision of Individual Placement and Support (IPS) within the Intense strand. FSS closed to new referrals in March 2024.

30.            There are some useful learnings from FSS. An initial triage ensures support is more personalised and relevant to individual needs. This also delivers better value for money with the highest levels of support quickly directed to those with the highest needs. The regional contract areas are large enough (c.400,000-700,000 people) for economies of scale, but also allow for delivery of a localised approach.

To what extent is the success of DWP’s plans to improve disability employment contingent on improvements made to other public services, in particular, health?

31.            Our experience shows us that there are often multiple barriers to work which can impact jobseekers, and these can often be associated with a range of public services (e.g. transport and housing).  The intersection with the health system is clearly of real importance. We welcome and support efforts to facilitate closer collaboration and integration with the health system, and actively contribute to this as a provider of employment, functional assessment, and health services. We recognise also the scale of the challenge to achieve the kind of integration that will enable the health and employability systems to work seamlessly together. What is required is sustained efforts, learning from initiatives, pilots, international examples, that will foster this integration. The measures outlined in the Pathways to Work Green Paper, particular the Support Conversation, could help facilitate this, and the development of pilots such as the WorkWell programme are a promising start.

32.            We have seen that mental health has become an increasingly prevalent barrier to securing and maintaining employment. Here it is particularly important that people have access not just to work but good work which provides support and benefits wellbeing. Here, early support is crucial in helping people stay in, or quickly return to, work. Improving employer capability and capacity to offer workplace mental health support would undoubtedly help people remain in work. Improvements would include offering support earlier, continuing this support throughout the employability system, and utilising technology.

October 2025