Nearly 3.7 million working-age people in the UK with health conditions are neither employed nor looking for work—up from 3 million in 2015—and this project will build a research partnership to evaluate how supported employment initiatives can help those facing the most complex barriers. The problem is that existing employment support often fails people with overlapping challenges, such as a physical condition combined with a mental health condition—59% of people with work-limiting physical conditions also have mental health needs. Current programmes are fragmented, and there is little rigorous evidence on which individualised approaches work for specific groups, including young people not in education or training, people with disabilities, and those recovering from drug misuse. If successful, this development project will produce case studies and a programme theory showing how different components of individualised support lead to better outcomes. It will also prepare a full research proposal for a larger NIHR grant. The immediate impact is building research capacity and a shared evidence base across four local health and care research centres, rather than delivering direct changes to employment services.
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Research question What is the impact of supported employment initiatives for people who experience complex barriers to employment? Background The UK has an economic inactivity rate of 21.6%. 3.7mn people aged 16–64 years, who have a work-limiting health condition are neither in work nor actively seeking work, up from 3mn in 2015. 59% of people with physical conditions that prevent them from working also have mental health conditions. This development project will build a research partnership of Plymouth, Cornwall, Lambeth and Medway HDRCs, who have innovative supported employment initiatives for people with complex needs, young people who are not in employment, education or training (NEET), young people with disabilities, and people in recovery from drug misuse, respectively. We will evaluate these initiatives aiming to improve outcomes for different cohorts, capture and share learning across contexts, and set up a multi-centre research evaluation of individualised supported employment programmes. Aim To develop collaborative research capacity for evaluating the impact of individualised support for people who experience complex health and disability-related barriers to employment Objectives 1. Establish a sustainable collaboration, with inclusive stakeholder groups and expert research teams 2. Conduct a scoping literature review to further understand the nature and impact of supported employment initiatives; collate and analyse relevant secondary data 3. Develop case studies of supported employment initiatives in different UK contexts 4. Develop and disseminate initial programme theory describing the people with complex needs likely to benefit from individualised support (population), the range of components and mechanisms required (intervention) and key outcomes 5. Prepare a research proposal for a full NIHR Work and Health research grant Methods WP2: Extend initial scoping review to include indicators of receptivity to employment support and impact of different individualised approaches. Examine secondary data on needs and outcomes trends, and approaches to measuring impact. WP3: Recruit and train peer researchers from supported employment initiatives. Collate quantitative data, and qualitative data through interviews and focus groups. Realist-informed thematic data analysis, creating case studies focused on mechanisms and components of different initiatives WP4: Cross-case content analysis of case studies to understand commonalities and differences of populations and intervention mechanisms. PPIE, inclusivity and equality considerations will be embedded throughout. Timelines for Delivery Pre-grant prep work. July-Aug25 WP1: Establish a Sustainable Collaboration. Sept25-May26 WP2: Scoping Review and Secondary Data. Oct-Dec25 WP3: Case Studies. Oct 2025-March26 WP4: Develop and Disseminate Programme Theory. March-May26 WP5: Prepare and Submit Research Proposal. March-June26. Anticipated Impacts Lived experience peer researchers with enhanced research capabilities Collation of data sets and measures with potential for measuring impact Enhanced understanding of tools/ approaches that successfully support individualised working with people who experience complex barriers to employment Development case studies and programme theory showing how the varied components of individualised support could lead to better outcomes for people who experience complex barriers to employment Proposal for full NIHR Work and Health research award Dissemination Project findings, reports and academic papers disseminated at local and national stakeholder events, local and national policy events, and academic conferences and events.
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