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US and UK Routes to Employment: Strategies to Improve Integrated Service Delivery to People with Disabilities


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Executive Summary

In both the United States (US) and the United Kingdom (UK), there are large numbers of people of working age with disabilities not working and claiming benefits —10.6 million in the US in December 2007, and 2.64 million in Great Britain in August 2007. In the US in October 2008, only 34.9 percent of men with a disability aged 16-64 were employed, compared to 79.4 percent of men without a disability. This difference was even more pronounced for women: 28.4 percent of those with a disability were employed, compared to 68.6 percent for those without a disability. In the UK in the three months prior to September 2008, the employment rate of people of working-age (ages 16-60 for women; ages 16-65 for men) with a long-term disability was 50.7 percent, compared with 80.2 percent for those without disabilities.

Governments in both the US and the UK have been taking policy measures over the last decade to improve Public Employment Services (PES) so that they are more effective in assisting people, including those with disabilities, to move off benefits and into work. Studies have shown that an important reason for the limited effectiveness of the PES was the system's fragmented nature, leading to uncoordinated and often duplicative service delivery. Governments in both countries have started to address these issues by employing a "One-Stop Shopping" approach to service delivery. This approach is about providing customers with a single access point (physically or virtually) to public services that may be delivered by multiple agencies. The goal is to provide more integrated service delivery while reducing costs and increasing efficiency.

In the US, the Workforce Investment Act (WIA) of 1998 brought together a number of different employment and training programs (but not Social Security) into a comprehensive system. Services are delivered through a national network of locally operated and monitored One-Stop Career Centers that provide universal services. WIA provisions require the promotion and development of employment opportunities, job counseling, and placement of people with disabilities. Other US initiatives to improve the employment situation of people with disabilities include the Ticket to Work and Work Incentives Improvement Act of 1999, and the New Freedom Initiative of 2001.

The UK merged its Benefits Agency and the Employment Agency in 2001 into one integrated service called Jobcentre Plus. Services are provided through a network of local offices, coordinated by a central government department, the Department for Work and Pensions. There are some differences in Northern Ireland, though services are generally similar.

In 2001, the New Deal for Disabled People, a voluntary program, was also established through a national network of contracted Job Brokers to provide assistance to people on various disability-related benefits who want to work. Limited utilization of this program led in 2003 to the start of the Pathways to Work program, which requires people newly claiming or re-applying for incapacity benefits to have a series of Work-focused Interviews with a personal adviser, and very recently (October 27, 2008) to changes in the benefits system, designed to further encourage people with disabilities and health problems to work.

Implementing a One-Stop shopping approach into PES delivery is a challenging endeavor evidenced by both the US and UK experiences. The aim of this report has been to identify strategies that PES activities in both countries have used in the delivery of services to meet the more complex employment support needs of people with disabilities within systems designed for the "universal" job seeker. The second aim of the report was to investigate the extent to which these strategies are effective in reaching their goal—achieving sustained and appropriate employment.

Challenges to effective service delivery for people with disabilities are:

This report presents 12 strategies, including evidence of their effectiveness, that have been grouped into three themes. These strategies are a potential response to the challenges listed above. The strategies described are the result of a scoping review that the authors conducted of existing empirical research on PES delivery for people with disabilities in the US and the UK. Empirical research included both published and unpublished materials that were produced between January 2000 and June 2008.

Strategies to deliver existing services more effectively to people with disabilities:

  • Proactively reach out and market to people with disabilities to increase access to employment programs and services.
  • Create universally accessible and customer-friendly environments for direct employment service delivery.
  • Provide specialist support to people with disabilities as needed.
  • Train staff on disability and related issues to build organizational capacity to more effectively serve people with disabilities.
  • Calculate whether people with disabilities would be better off working and give advice on work incentives to help them overcome financial worries about returning to work.
  • Provide supports to help people with disabilities do their jobs and stay in work.
  • Measure the effectiveness of job finding for people with disabilities to continuously improve employment service delivery.
  • Strategies to create partnerships to better serve people with disabilities:

    1. Engage disability organizations in direct employment service delivery.
    2. Partner with other service providers and share resources to provide more comprehensive employment service delivery but also prevent duplication.
    3. Understand employers' needs as an essential part of the process of finding jobs for people with disabilities.

    Strategies to provide new services to people with disabilities:

    1. Intervene early to help prevent people going from sickness absence onto long-term disability benefits from becoming disconnected from the labor market.
    2. Help people to understand and manage their disability or health condition so that they are in a better position to obtain and keep employment.