Abstract
OBJECTIVES: To investigate the role of individual factors (including age, health and personal circumstances) and external factors associated with clients having a job start while engaging with the Work Programme and variations by benefit type. SETTING: The UK Government's main return to work initiative (The Work Programme) in Scotland. DESIGN: Piecewise Poisson regression to calculate incident rate ratios using administrative data from 2013 to 2016 to identify factors associated with job start. PARTICIPANTS: 4322 Employment and Support Allowance (ESA) clients not in work due to poor health and 8996 Jobseeker's Allowance (JSA) clients, aged 18-64 years, referred to the Work Programme between April 2013 and July 2014. MAIN OUTCOME MEASURES: Starting a job and the time to first job start after entering the Work Programme. RESULTS: JSA clients (62%) were more likely to return to work (RTW) than ESA clients (20%). There is a strong negative relationship between age and the predicted probability of having a job start during the 2-year engagement with the programme for both JSA and ESA clients. JSA clients were most likely to RTW in the first 3 months, while for ESA clients the predicted probability of having a first job start was fairly constant over the 2 years. Health, including the number of health conditions, length of unemployment, client perception of job start and other individual factors were associated with job starts for both groups. CONCLUSIONS: Age plays an important role in influencing RTW; however, important potentially modifiable factors include the length of unemployment, the management of multimorbidity and the individual's perception of the likelihood of job start. Future welfare-to-work programmes may be improved by providing age-specific interventions which focus on health and biopsychosocial factors to enable more people to realise the potential health benefits of RTW.