Quality standard

Quality statement 5: Supported employment programmes

Quality statement

Adults with psychosis or schizophrenia who wish to find or return to work are offered supported employment programmes.

Rationale

Supported employment programmes can increase employment rates in adults with psychosis or schizophrenia. It is estimated that just 5% to 15% of people with schizophrenia are in employment, and people with severe mental illness (including psychosis and schizophrenia) are 6 to 7 times more likely to be unemployed than the general population. Unemployment can have a negative effect on the mental and physical health of adults with psychosis or schizophrenia.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that adults with psychosis or schizophrenia who wish to find or return to work are offered supported employment programmes.

Data source: Local data collection.

Process

Proportion of adults with psychosis or schizophrenia who wish to find or return to work who receive supported employment programmes.

Numerator – the number in the denominator who receive supported employment programmes.

Denominator – the number of adults with psychosis or schizophrenia who wish to find or return to work.

Data source: Local data collection. Contained within the Royal College of Psychiatrists' National audit of schizophrenia.

Outcome

Employment rates for adults with psychosis or schizophrenia.

Data source: Local data collection. National data are collected in the NHS Digital Mental health and learning disabilities data set.

What the quality statement means for different audiences

Service providers (such as GP practices, community health services and mental health services) ensure that systems are in place for adults with psychosis or schizophrenia who wish to find or return to work to be offered supported employment programmes.

Health and social care practitioners ensure that they are aware of local referral pathways to supported employment programmes, and offer these to adults with psychosis or schizophrenia who wish to find or return to work.

Commissioners (such as NHS England area teams and clinical commissioning groups) ensure that they commission services that offer supported employment programmes and ensure that referral pathways are in place for adults with psychosis or schizophrenia who wish to find or return to work.

Adults with psychosis or schizophrenia who wish to find or return to work are offered a place on an employment scheme that supports them to find or return to work quickly.

Source guidance

Psychosis and schizophrenia in adults: prevention and management. NICE guideline CG178 (2014), recommendation 1.5.8.1 (key priority for implementation)

Definitions of terms used in this quality statement

Supported employment programmes

Supported employment programmes, sometimes referred to as individual placement and support, are any approach to vocational rehabilitation that attempts to place service users in competitive employment immediately. Supported employment can begin with a short period of preparation, but this has to last less than 1 month and not involve work placement in a sheltered setting, training or transitional employment. [NICE's full guideline on psychosis and schizophrenia in adults]

Equality and diversity considerations

Services should work in partnership with local stakeholders, including those representing black, Asian and minority ethnic groups, to enable adults with psychosis or schizophrenia to stay in work or education or access new employment, volunteering and educational opportunities.

Services should make reasonable adjustments to help adults with learning disabilities and psychosis or schizophrenia stay in work or education or find new employment, volunteering and educational opportunities.

Some adults may be unable to work or unsuccessful in finding employment. In these cases, other occupational or education activities should be considered, including pre‑vocational training.