How can the clinical team support fidelity to IPS?

What is your role in IPS?

IPS creates a multi-disciplinary (MDT) approach to supporting people to return to paid employment. Health care professionals have an important role to play in both encouraging and empowering people to explore work opportunities and increase confidence and self-belief. In addition, providing clinical interventions to support the return-to-work process in partnership with the Employment Specialist, such as medication reviews and managing symptoms at work.

You don’t have to be an expert in having employment conversations about work, just remember the 5 Rs:

1. Raise work issues with people early in their treatment pathway.
2. Recognise the risk factors being out of work has on individuals and their family.
3. Respond effectively to the straightforward unemployment and work challenges that people identify.
4. Refer people who have more complex difficulties to the Employment Specialist in your team and ensure an MDT approach. If there is no capacity refer to an external employment agency and work jointly with that agency.
5. Revisit work issues to review progress and work jointly with the Employment Specialist in your team, or external agency.

Clients consistently tell us that they would like clinical staff to keep asking them about their interest in employment. In addition, many say they have gone on to access employment because the clinical team helped them believe they could work.

“It’s all about belief, someone believed in me when I didn’t believe in myself” – IPS Client

Here are some ideas that healthcare professionals have found helpful when starting to discuss with clients how they feel about work:

• Start with a simple open question – “have you thought about work?” and see where the conversation goes and to hear their feelings and thoughts about work, without leading one way or another.
• Sometimes a client may need time to process the question, but a seed has been sown, so it’s helpful to revisit the conversation again to see if their thoughts and feelings have changed, or if they have any questions.
• Talk about possible barriers to work, such as childcare, lack of interview or work clothes, or concerns over money for travel. There are often practical solutions available to deal with these challenges that an IPS Employment Specialist can help with.
• Listen out for change talk – where a client makes statements about their desire, ability, reasons and need for change. You could also use a change ruler or Likert scale question, such as “on a scale of 1 to 10, how important is it for you to get back to work?” It’s also worth exploring confidence to get into work as well, as this can often impact on the client’s motivation, and IPS being a strengths-based model is extremely helpful in building the confidence of the client.
• Now and then a client may have concerns about their benefits being affected by work, and it’s worth exploring where they heard about this and offering them the opportunity of getting a better off in work calculation via the IPS team. Often their benefits won’t be affected, and the calculation will show the different options available to the client based on hours worked and pay rates. This can give the client additional information to make an informed decision.
• Share success stories about clients who have been helped into work. You could even suggest setting up a meeting or phone call with them if that’s ok with the client. Your IPS colleague will also be able to help with this.
• Arrange for your client to have a conversation over the phone or face to face meeting with your IPS Employment Specialist to explore the options in more detail. You could even do a joint meeting or visit with the Employment Specialist.

In the next step we will discuss what happens after a referral is made and how you can work alongside the IPS employment specialist to support the client.