Evidence shows that being in work improves people's quality of life and wellbeing, although this improvement is dependent on the quality of work. People with long-term conditions, disability or mental illness are employed at a much lower rate compared with the general population. Here we look at the employment rate of people with these conditions over time. With effective support, they can access the benefits of long-term quality work, but this requires cooperation between employment services, social workers, health professionals and others.
The rate of employment of adults (aged 16-64) with a disability in the UK has increased over time, from 44% in Q1 2013/14 to a high of 54% in Q3 2019/20. During the coronavirus (Covid-19) pandemic, the employment rate of people with disabilities decreased slightly, falling to 52% in Q1 2020/21 (April to June 2020), but has since increased again to 54% in Q2 2021/22. The gap in the employment rate between the general population and people with a disability has decreased slightly over time, from 33 percentage points in Q1 2013/14 to 28 percentage points in Q2 2021/22.
Enabling people with a learning disability to find employment when they want it can enhance their quality of life, maintain a family and social life, contribute to their community, and help them avoid loneliness or isolation. Here we look at the proportion of adults aged 18-64 with a learning disability receiving long-term support who are known to the council as being in paid employment.
The proportion of adults with a learning disability in paid employment has decreased over time, from 6.0% in 2014/15 to a low of 5.1% in 2020/21. A slightly higher proportion of men with a learning disability are employed than women; in 2020/21, 4.4% of women with a learning disability were in paid employment compared with 5.7% of men.
In 2014/15 there was a change to the definition of the eligible population so results prior to this are not directly comparable. For further details, please see ‘About this data’ below.
Around one quarter of adults in England are living with two or more long-term conditions, such as diabetes, asthma and coronary heart disease. The rate of employment among adults of working age (16-64) with a long-term condition increased from 58% in Q1 2007/08 to 66% in Q4 2019/20, before falling slightly to 65% in Q2 2020/21.
The overall employment rate in the general population has been increasing gradually since 2012, but also decreased during the Covid-19 pandemic. In Q4 2019/20, 77% of working age people in the general population were employed; this fell slightly to 76% in Q2 2020/21. The employment gap between the general population and people with a long-term condition has decreased over time, from 15 percentage points in Q1 2007/08 to 11 percentage points in Q2 2020/21.
Meaningful work is important in helping people recover from a mental illness, but there are many barriers to employment for people with mental health problems, including stigma and prejudice.
The rate of employment among adults of working age (16-64) with a self-reported mental illness increased markedly from 27% in Q1 2007/08 to 52% in Q4 2019/20. This may partly reflect a true improvement in the employment rate, but it could also be due to de-stigmatisation of mental illness in recent years, with people now more likely to self-report that they have a mental health disorder.
In Q1 2020/21 (April to June 2020), following the introduction of lockdown measures during the Covid-19 pandemic, the employment rate of adults with a mental illness decreased slightly, but has since risen again to 51% in Q4 2020/21 (January to March 2021).
The employment gap between people in the general population and people with a mental illness decreased from 46 percentage points in Q1 2007/08 to 24 percentage points in Q4 2020/21. This is a considerable improvement, however further progress is needed to reduce the gap.
People with severe or complex mental health needs tend to have their care coordinated under the Care Programme Approach (CPA). The term 'CPA' describes a framework introduced in 1991 to support and coordinate effective mental health care for people who are in contact with secondary mental health services. As part of the CPA, people should have regular care review meetings. Here we look at the proportion of adults (aged 18-69) in these meetings who are recorded as being employed.
Between 2010/11 and 2015/16, annual data shows that the proportion of adults receiving secondary mental health services who are recorded as being employed decreased from 9.5% to 6.7%. Due to a change to the methodology, data pre- and post- 2013/14 are not directly comparable, but the proportion decreased in both time periods. The measure was not published in 2016/17 due to the quality and completeness of the data. There was a further change to the data set in 2017/18, and since then the proportion has increased from 7% to 9% in 2019/20, remaining at 9% in 2020/21.
About this data
Labour Force Survey
Estimates of the labour market status of disabled people are sourced from the Labour Force Survey carried out by the Office for National Statistics (ONS). The Government Statistical Service’s (GSS) harmonised standard definition of disability is used, which defines people with a disability as those who report that they have:
- (current) physical or mental health condition(s) or illnesses lasting or expected to last 12 months or more; and
- the condition(s) or illness(es) reduce their ability to carry out day-to-day activities.
Respondents who did not answer questions about their health are excluded.
NHS Outcomes Framework
In the NHS Outcomes Framework, employment of people with a mental illness is indicator 2.5.i and employment of people with long-term conditions is indicator 2.2. The data for the two indicators is sourced from the Labour Force Survey and all values are calculated by the ONS. For more information, please see the NHS Outcomes Framework indicator specifications.
Adult Social Care Outcomes Framework (ASCOF)
The proportion of adults in contact with secondary mental health services in paid employment is measure 1F and the proportion of adults with a learning disability in paid employment is measure 1E in the ASCOF. Indicator 1E sources its data from the Short and Long Term Services (SALT) collection, and indicator 1F sources its data from the Mental Health Services Data Set (MHSDS).
For indicator 1E, prior to 2014/15, all adults with learning disabilities who were known to the council were included. In 2014/15, the eligible population was changed to include only those clients who have received a long-term support service in the previous year with a primary support reason of learning disability support.
For indicator 1F, prior to 2013/14 the measure was calculated annually from the Mental Health Minimum Data Set. From 2013/14 it was calculated each month from a snapshot and the ASCOF measure derived as an average of these monthly scores. Additionally, in January 2016, the mental health data set changed from the Mental Health and Learning Disabilities Dataset (MHLDDS) to the MHSDS. As a result of this change, the ASCOF measures for 2015/16 are calculated using the average of eight monthly scores from April to November from the MHLDDS, and data for 2016/17 was not published due to the quality and completeness of the data. In 2019/20, providers were able to resubmit missing or incorrect data before the final end of year data were produced, however this is not considered to be a break in the time series.
Data for indicators 1F and 1E is collected from each local authority. In 2020/21 Hackney Council did not submit their data because of a cyber-attack. To ensure 2020/21 data is comparable with previous years, NHS Digital calculated the aggregate totals using 2019/20 data from Hackney Council. Further details can be found in the Adult Social Care Activity and Finance data quality report.
For more information, please see the Adult Social Care Outcomes Framework Handbook of Definitions.