The Collaborative Partnership to improve work participation
The Collaborative Partnership to Improve Work Participation (the Collaborative Partnership) is a unique public-private sector alliance to drive fresh approaches to improving work participation for Australians with a temporary or permanent health condition or disability that impacts their ability to work. The Collaborative Partnership is responding to stagnating work participation rates in Australia following a work-related injury or illness and employment rates among people with disabilities.
There is compelling international and Australasian evidence that work is generally good for health and wellbeing. While Australia has a record number of people in jobs, ill health and disability is preventing many Australians from reaping the benefits of work.
Australia currently ranks 21 out of 29 for employment rates among people with disabilities relative to the population amongst the OECD. Additionally, rates for return to work after work-related injury or illness have been static in this country for decades. Australia’s work disability systems are fragmented and operate in siloes – workers’ compensation, motor accident compensation, life insurance, veterans’ compensation, disability support and superannuation. Each of them separately and variously seeking to engage with common stakeholders: workers; families; employers; and healthcare providers.
The Federal Government recognised the need to drive improvement in – and minimise pressure on – the sectors that support people who have difficulty returning to or remaining at work. Gains in work participation are expected to lead to better health and wellbeing outcomes and productivity.
The Collaborative Partnership brings together public and private sectors to address this public health and social policy issue. The approach is underpinned by the Stanford Model of Collective Impact – a framework to tackle deeply entrenched and complex social problems. The innovative Partnership is focussed on breaking down the siloes the systems operate in and improving service delivery; helping employees understand the importance of work to their health and wellbeing; helping business to dismantle employment barriers; and giving General Practitioners (GPs) the tools they need to prescribe work as an integral part of recovery.
The Collaborative Partnership aims to achieve its objectives through a targeted program of work and key priorities which were identified through stakeholder consultations.
The major project streams include:
- Cross-Sector Systems: this project seeks to understand how the ten major income support systems in Australia operate, connect and interact with each other with an overall aim of driving system improvement and service alignment. This project has delivered new research that establishes an evidence base for the scale of the issue in Australia and the first conceptual map of Australia’s income support systems identifying the volume of people moving though the systems.
- Employer Mobilisation: aims to examine employer attitudes and barriers towards recruiting, supporting or maintaining individuals with a health condition in employment, with an overall aim of improving employers’ capacity to provide work opportunities. This project has delivered research revealing fresh insights into employer perspectives and drivers to providing or supporting employment of people with health conditions and disabilities.
- GP Support: aims to produce the first set of principles that provide clarity on the role of the GP in supporting work engagement, recovery at and return to work. This project recognises the critical role GPs play in promoting the health benefits of good work and acknowledges that there is no consistent understanding of the role of the GP. This project has sought to identify and incorporate the GP role relative to other stakeholders in the process.
- Employee Awareness: seeks to understand the perspectives of individuals with a health condition or disability that impacts their ability to work, towards navigating the various systems of income support and employment. The overall aim of the project is to empower individuals to use work as part of their recovery.
The major projects will use existing or establish new evidence to trial, test and learn from interventions in a real-world setting. The trials will be designed to be relevant across all systems of income support and scalable to multiple settings. The Collaborative Partnership will seek to use learnings from the trials to make recommendations and consider opportunities for their respective systems.
What Makes Your Project Innovative?
The Collaborative Partnership is the first real attempt in Australia to work across multiple benefit systems to deliver change in work participation rates for Australians with a temporary or permanent health condition or disability. This work builds on the Health Benefits of Work program aimed at promoting the evidence base that good work is positive for individuals health and wellbeing and will ultimately improve return to work and health outcomes for individuals. It became apparent that to achieve meaningful change, cross-sector collaboration was required. As the only safety, rehabilitation and compensation authority with a national presence in Australia, Comcare saw the potential to use its reach to extend the health benefits of good work message across the public, private and not-for-profit sectors to delivery positive, system wide changes. The result is the Collaborative Partnership which uses a structure based on the Stanford Model of Collective Impact to affect change.
What is the current status of your innovation?
The Collaborative Partnership’s 4 major projects are being implemented:Cross-sector systems has delivered on a research report for the first time maps 10 different systems of income support and quantifies the costs, a total of $37.2 billion was spent on income support, the report identified 6 opportunities to improve work and health. The project is currently scoping opportunities for cross-sector collaboration between systems. Employer mobilisation: delivered research on employer attitudes towards recruiting, supporting or accommodating people with health conditions. The research is being used to design and implement trials with employers to improve their capacity to employ people with health conditions. GP Support principles to clarify the role of the GP in supporting work participation have been developed following a review of literature and stakeholder consultations.Employee Awareness:commenced research to explore the views of individuals with health conditions on their experiences.
Collaborations & Partnerships
The Partnership founded by federal workers compensation insurer Comcare includes the Australian Departments of Jobs and Small Business and Social Services. The private sector is represented by insurer EML, Insurance Council of Australia and Australasian Faculty of Occupational and Environmental Medicine and the Australian Council of Trade Unions. Partners have seen the real opportunity to improve productivity nationally and recognise increasing work participation requires collaborative effort.
Users, Stakeholders & Beneficiaries
The long-term beneficiaries of the Collaborative Partnership are working age Australians with a health condition or disability that impacts their ability to fully enjoy the health benefits of good work. Working across both public and private systems through collaboration enables us to design and trial new service offerings that will increase opportunities to improve health and employment outcomes for many working age individuals and their families.
Results, Outcomes & Impacts
Collaborative Partnership has:raised almost $1.5m; developed positive relationships between disparate sectors:established a community of over 150 stakeholders;developed draft principles for treating practitioners;released two pieces of novel research under the Cross Sector System Project & Employer Mobilisation Project; and published one peer reviewed paper.This has enabled: improved understanding of scale and cost of health‐related work incapacity, greater clarity on the available data, existing gaps and opportunities for improved data capture and sharing, clearer understanding of how people transition between systems and opportunities for improved support,identification of opportunities to share knowledge, including best practices,between sectors for improved outcomes, increased clarity on the relative roles of treatment providers in supporting work participation;and improved insight into the attitudes, perceptions and intentions of employers.
Challenges and Failures
Key challenges in operating a partnership is in ensuring consistency of effort. A tension exists between having a facilitator and driver for the partnership in Comcare, while devolving and encouraging partners to lead their respective projects.Collective and shared decision-making and accountability can be a challenge at times when there is an engaged, active lead. Challenges for Federal Government as the lead is to ensure that the Partnership is not politicised or used for political gain and conflicts of interest are managed. Attracting & securing ongoing funding to sustain the partnership is an ongoing challenge, competing interests in the key sectors the partnership is working to engage with is an ongoing issue. Promoting through effective communications by mobilising the partners and their networks and more broadly the community of practice has proved to be difficult. The response to these challenges and risks has largely been through establishing strong governance.
Conditions for Success
These conditions of success also reference the Stanford Model of Collective Impact’s five conditions of success.
Leadership and guidance – strong leadership provided by the Chair (Comcare CEO) enabled attention and efforts to be focussed and created a sense of urgency. In addition, an Advisor with industry connections and a strong and credible academic background was engaged to guide the Collaborative Partnership.
Supporting infrastructure - Collective impact requires a backbone support organisation to provide dedicated staff to plan, manage and support the initiative. Comcare provides secretariat support and Chair to the Collaborative Partnership and offers a significant in-kind contribution, enabling Partners to direct their resources towards the projects.
Strong governance framework – the Collaborative Partnership required the Partners to establish on a common agenda with a consistent understanding of the issue and agreed activities to contribute to the solution.
Another Federal Government department has used a similar collaborative partnership approach to address the related issue of improving work participation in the ageing workforce. This approach was adopted following direct involvement with the Collaborative Partnership. The Stanford Model of Collective Impact is used more widely in the United States to address complex social problems. Challenges to adapting the model to the Australian context include the different role of public sector in the social policy context compared to the United States.
The Collaborative Partnership to Improve Work Participation has been a new and unique experience for the Partners. A number of lessons have been learned that may be of value to other government bodies looking to use a Collective Impact approach to tackle complex and entrenched social issue including:
- Collaborators need to be engaged at the senior level to ensure the initiative attracts attention, influence, and resources. The Collaborative Partnership used connections with senior bureaucrats and corporate leaders through strong leadership to establish funding and commitment of resources to progress and promote the objectives.
- A backbone support organisation skilled at encouraging and supporting partners to lead initiatives requires significant resourcing. Comcare has performed the Chair and Secretariat roles to support Partners to focus on the projects and when required, provided project management and procurement support to ensure progress of the projects.
- Ensure and guard against potential collaborators seeking an opportunity to politicise the initiative by developing a common agenda and consistent understanding and/or terms of reference. The Collaborative Partnership has developed a terms of reference, memorandum of understanding, risk management framework, and limited the positions available for founding Partners.
- Commit resources to evaluation and communication early to ensure the ongoing success and sustainability of the collaboration. Evaluation to demonstrate rigour and identify achievements and effective communication to build relationships with existing and emerging Partners has commenced for the Collaborative Partnership.
The Cross-sector systems project is new research that has never been undertaken before and has provided valuable insights into the scale and cost of work-incapacity in Australia and the transition of individuals through a complex system. Only through extensive engagement across multiple sectors and iterative implementation of initiatives can organisations and governments begin to collaborate more effectively to enable effective and sustainable systems change that ultimately improves health outcomes and work participation rates for affected individuals.