Findings from the qualitative study indicate that users’ views of Access to Work might be related to how they are treated as individuals with particular employment needs, who require advice, information and practical support,and have views of their
own about how those needs might best be met. DST staff might be expected,
therefore, to play a key role in shaping users’ perceptions of the quality of service. To investigate this further, we examined the association between users’ overall opinion of the acceptability of Access to Work and their opinion of how their application for support was dealt with by DST staff (see Section 5.1)
The findings shown in Table A.9.1 0 in the appendices indicate that the more positive ratings of DST staff are associated with affirmative views of AtW:
• almost four out of five respondents who rated DST staff as ‘very good/excellent’ described the overall acceptability of AtW as ‘very good/excellent’ compared with fewer than one in five of those rating DST staff as ‘poor/very poor’.
Overali Opinion of Access to Work 85
These findings indicate that users’ overall views about Access to Work are
influenced by the substance and quality of their relationships and discussions with those members of the DST who processed their applications for Access to Work. 9.3.5 Rating of acceptability by opinion on time taken
It was hypothesised that respondents’ views on the overall acceptability of Access to Work might be associated with the time taken to provide what had been applied for. Indeed, itis clear from the comments offered by users in the study that the time taken from application to support being in place can detract from their overall
evaluation of the service. Users who felt that Access to Work is 4a very good scheme’
and who were ‘positiveabout itoverall’ nevertheless felt let down by the time taken
to get their support.
As we have observed, respondents’ views about the time taken range widely over the six-point scale used (Table 8 1) whereas their views about acceptability cluster towards the positive end of the same scale (Figure 9.3). These contrasting
distnbutions influence the pattern of association between the two scales. In general, those whoratethe time taken as ‘good’ to ‘excellent’ also rate the overall
acceptability of Access to Work in a similar way, suggesting that time taken is an important ingredient shaping users’ views about quality of service. However, those who rate the time taken as ‘poor’ or ‘verypoor’ are as likely to place the overall acceptability of Access to Work anywhere from ‘poor’ to ‘good’ (see Table A.9.1 1 in the appendices). As a consequence, respondents’ views on the overall acceptability of Access to Work are not invariably related to their views about delivery times. In particular, those respondents who report negatively about thetimetaken for support to be provided are almost as likely as not to give a positive assessment of the overall acceptability of Access to Work.
This does not mean that delivery targets are not important; clearly most applicants would prefer support to be provided sooner rather than later. However, the findings indicate that there are other aspects of the service process which are as important as delivery deadlines, or more so, in shaping users’ views about the acceptability of Access to Work.
9.4
Appropriateness, usefulness and acceptability
So far we have examined users’ overall views of Access to Work according to three rating scales considered separately in turn. We recognise that each scale has not been properly validated for this respondent group and provides no more than a ‘rough and ready’ assessment of users’ views about their experiences of Access to Work and the extent to whichit enables them to remain in or take up paid
and raise the level of confidence that can be placed in such scales for monitoring and evaluating trends in users’ views.
In the meantime, one test of how well these scales perform in practice is to examine the levels of agreement between the different sets of scores. Such an approach
investigates how far users’ views of what we have called ‘appropriateness’ are
consistent with their views of ‘usefulness’ or ‘acceptability’. Cross-tabulations of each scale against the other two indicate that they are positively correlated. Vanations in
users’ views on the extent to which Access to Work enabled them to work are strongly associated with variations in their overall opinions of their experience of
using the scheme and how well it meets their employment needs. Statistically speaking the findings are very significant.9
Whatever the three scales are actually measuring, therefore, it is clear that each is tapping a single, common dimension with one end point representing more positive views of Access to Work and the other representing more negative views. It would
be idle to pretend that these scales provide a definitive assessment of how users evaluate Access to Work or the support they receive. At face value, however, these findings indicate that it is possible to represent, in a practical and consistent way, the views of users who have favourable or not so favourable experiences of Access to Work. As well as providing an overall summary of their views, such scales can be used to understand better the experiences of subgroups of users and draw
compansons. If repeated over time, they might also form part of a system for
monitoring the impact of changes in service inputs and processes and the extent to which users feel that Access to Work enables them to remain in or take up paid employment. In the next chapter, we consider users’ comments and suggestions on those aspects of Access to Work that might be routinely monitored.
9.5
Key points
To assess users overall views aboutAccess to Work survey respondents were asked to rate the support agreed or arranged for them on three scales.
~ T~statistical tests wsre used: the chi-square testand Kendall’s tau-c. in each case the observed significance levels werelessthan0001
Overall Opinion of Access to Work 87
How far Access to Work met users’ needs
• More than nine out of ten users said that Access to Work support met their requirements ‘completely’ or ‘mostly’
• TW users were most likely to report that their support ‘completely’ met their
needs, white SW, APE and SAE users were least likely to do so Onein five
users of CSI felt that Access to Work met their needs only ‘a little’ or ‘not at all’. Only one in three users of human support, compared with half of users of environmental adaptations, said that Access to Work met their needs ‘completely’.
• Employees in the private and independent sectors combined were more likely than those in the pubhc sector to say that Access to Work ‘completely’ met their
needs.
1~L
• Views vary according to disabling complaint reported. Half of theusers reporting
musculo-skeletal complaints said that their needs were met ‘completely’ while most users reporting visual impairments and mental health problems said that Access to Work met their needs ‘mostly’. Users with hearing impairments were
mostlikely to say that Access to Work met their needs ‘a little’ or ‘not at all’. How far Access to Work enabled users to work
• Asked how far support from Access to Work enabled them to work, almost half of users said they ‘could not work without it’ and a further one in three felt that the support they received helped ‘a great deal’.
• TW usersrated the usefulness of Access to Work in enabling them to work most
highly. One in four users of CSI felt the support they received helped ‘not much’ or ‘not at all’. ~
• Employees in the private and independent sectors combined were more likely than public sector employees to say that they could not work without Access to Work support.
• Users’ ratings of the usefulness of Access to Work in enabling them to work vary according to reported impairment.Users with mental health problems and visually impaired users were more likely to say that they ‘could not work without it’ while those with musculo-skeletal complaints were more likely to say that Access to
Workhelped ‘a great deal’. Users with a heanng complaint only were most likely to rate the usefulness of Access to Work less highly.
Users’ overall opinion of Access to Work
• Asked to rate their overall opinion of Access to Work on a six point scale,over
half of users said that in their experience it was‘very good’ or excellent’ and a further one in fourdescribed their experience as ‘good’.
• 1W users rated Access to Work most highly, rated ‘excellent’ or ‘very good’ by
over six in ten. A substantial minonty of SW and CSI users, one inthree or more,
rated it as no betterthan ‘fair’. Overall, users of human support rateAccess to
Work less highly than users of environmental adaptations.
• Employees in the private orindependent sectors were more likely than those in
the public sector to rate their experience of Access to Work as better than ‘fair’. • Opinions of AccesstoWorkvaryaccording to health conditionsor impairments
reported byusers. Survey respondents with niuscolo-skeletal complaints and mental health problems rate it most highly, whileone inthreeofthose with a
hearingimpairment and almost one in four visually impaired users rate it as no betterthan ‘fair.
• Opinions ofAccess toWork are associated with positive ratings of DST staff.
• Users’opinions onAccess to Work overall are not invariably related to their views about the time taken for their support to be provided. In general, those who rate
thetimetaken as ‘good’ or ‘excellent’ also rate Access to Work overall in similar
ways. However, those who rate the time taken as ‘poor’ or ‘verypoor’ are as
likely to place the overall acceptability of Access to Work anywhere from ‘poor to
‘good’.
• Vanations in users’ overall opinions of AccesstoWork arestrongly associated
withvariations in views on how well it meetstheir needs and the extent towhich it enables them to work.