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Executive summary

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Research Questions

  1. How did IPS maturity change during the initial two years of receiving support?
  2. How were the IPS services organised within the local healthcare system?
  3. What were the activities and outputs of the IPS services that received support?
  4. What support did each service receive from IPS Grow?
  5. How was IPS Grow perceived by its key audiences?
  6. Do organisational factors or levels of support account for variation in IPS maturity?
  7. What key elements of IPS Grow allowed new services to achieve good fidelity to the IPS model?

Individual Placement and Support (IPS) is an evidence-based model which supports people with serious mental illness into employment. In order to increase access to IPS services nationally, NHSE and Improvement has allocated funds to specific sustainability and transformation partnership (STP) areas. A proportion of funding was dedicated to IPS Grow: a national implementation support initiative that aims to speed up the time that services take to deliver high quality IPS and to ensure their sustainability. IPS Grow provides technical implementation support, workforce development support and data tools and performance standards support, through an online platform, networking and events, and support from a dedicated team.

Our evaluation used a theory-based approach and a logic model to examine IPS Grow's impact on funded IPS services. We aimed to answer seven evaluation questions through a combination of methods, including telephone interviews, focus groups, case studies, online surveys and a targeted documentation review (including of reports and plans from services' IPS fidelity reviews).

The study aimed to examine the uptake of support from IPS Grow by IPS services, explore the perceptions of IPS Grow by key audiences, and examine the impact that different elements of support from IPS Grow had on services, depending on their organisational features.

Key Findings

  • We found that high fidelity IPS practices were associated with better outcomes for clients. By 2020, all examined services delivered IPS to at least fair (or good) fidelity and had improved over time. Some aspects of good fidelity were in place from the beginning, such as tailored employment support, whereas other aspects of fidelity improved over time, such as integration with clinical teams.
  • We identified four potential profiles of likely IPS services in terms of funding sought, prior IPS experience and provider type. Considering and developing this model may help predict and provide appropriate levels of support in the future.
  • In IPS, clients are supported through six phases of an employment journey. Our data shows that, throughout the time of support, IPS services were growing and operating this support as intended the time of support, IPS services were growing and operating this support as intended.
  • IPS Grow offered wide-ranging support to services across three key workstreams: technical implementation support, workforce development, data tools and performance standards. Support in the form of workshops, informal advice, coaching and training, and use of online resources were frequently used.
  • Services were largely positive about the IPS Grow support they had received. The multifaceted support provided by the IPS Grow Regional Leads and attending Communities of Practices were widely considered key assets of this support. Along with IPS Grow online resources, these three types of support were identified as making the most difference to fidelity.
  • We found some evidence that previous experience with IPS affected some services' maturities — but little consensus about the influence of other organisational factors emerged.

Recommendations

Funders of IPS Grow should:

  • Ensure separate funding to maintain IPS Grow, as well as IPS fidelity reviews and action plans for supported services.
  • Evaluate IPS Grow over a longer period of time.

Implementers of IPS Grow should:

  • Continue to offer regular fidelity reviews and support for completion of action plans.
  • Consider different ways in which CoPs could operate, such as cross-regionally with a focus on specific challenges faced by types of services.
  • Improve services' awareness and accessibility of online resources.
  • Consider the role of the IPS Grow Regional Leads by reviewing how they are allocated between regions.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    The intervention (IPS Grow) and its evaluation (approach, questions and methods)

  • Chapter Three

    Findings

  • Chapter Four

    Conclusions and recommendations

Research conducted by

The research described in this report was prepared for NHS England and Improvement and the Department of Work and Pensions Joint Work and Health Unit and conducted by RAND Europe.

This report is part of the RAND Corporation Research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.