Our recommendations

Determining eligibility for sickness and invalids' benefits

We recommend that the Ministry of Social Development:

1. find out why there are variations in the amount and quality of information provided by health practitioners in the medical certificate, and help health practitioners provide – without undue burden on their time – the information that Work and Income needs;
2. in cases of long-term and complex medical conditions, actively use information about treatment to inform decisions about the permanence and severity of a person's condition(s) and how they affect a person's ability to work;
3. improve its monitoring of patterns in how health practitioners issue medical certificates to help ensure that certificates are completed and issued appropriately;
4. when deciding on eligibility for long-term sickness beneficiaries, provide further guidance to case managers on when to refer cases to a regional health advisor or regional disability advisor for a detailed review of the beneficiary's file;
5. consider using vocational assessments more often for beneficiaries with complex and long-term medical conditions and multiple barriers to work;
6. provide Work and Income case managers with more guidance about using the Medical Disability Advisor, clarifying when they ought to use that database to check the expected effect of a person's medical condition on their ability to work and likely return to work;
7. broaden the criteria used to refer benefit applications to regional health advisors and regional disability advisors so that, as resources allow, more cases can be reviewed for ongoing entitlement to the sickness benefit or invalid's benefit; and
8. better promote best practice for Work and Income regional health advisors and regional disability advisors and make best use of these advisors.

Comprehensive case management

We recommend that the Ministry of Social Development:

9. review the circumstances of longer-term sickness and invalids' beneficiaries to better identify those for whom work is an option, and provide them with appropriate case management and employment-focused services;
10. as resources allow, use the available information to determine whether invalids' beneficiaries classified as "never to be reassessed" should be more actively case managed;
11. investigate why contact with beneficiaries is intermittent and reactive, and introduce improvements to ensure that case managers engage systematically and actively with beneficiaries, in keeping with the Ministry's expectations for periodic contact;
12. ensure that Work and Income case managers contact sickness and invalids' beneficiaries about work planning if information indicates that they may be ready to prepare for or return to work;
13. investigate ways of working more actively with general practitioners and responding to their comments in medical certificates;
14. where fair and appropriate, explore the full range of options for engaging with those sickness and invalids' beneficiaries who do not express an interest in preparing for or moving towards work;
15. reinforce the need for Work and Income case managers to consistently follow the recommendations made by regional health advisors and regional disability advisors; and
16. expand the scope of regular monitoring to help ensure that case managers maintain periodic contact with beneficiaries in keeping with Work and Income's guidance.

Monitoring and evaluating the effectiveness of the Programme

We recommend that the Ministry of Social Development:

17. extend the monitoring framework beyond beneficiary numbers, and prepare measures that will assist the ongoing development of the Working New Zealand: Work-Focused Support Programme; and
18. modify its evaluation strategy to better measure the extent to which the Working New Zealand: Work-Focused Support Programme is achieving the intended outcomes, including increased numbers of beneficiaries case-managed into work (where appropriate) and expected savings in benefit expenditure.