Does 'welfare-to-work' work? A systematic review of the effectiveness of the UK's welfare-to-work programmes for people with a disability or chronic illness

Soc Sci Med. 2005 May;60(9):1905-18. doi: 10.1016/j.socscimed.2004.09.002.


Welfare-to-work programmes promoting employment of people with a disability or chronic illness are an expanding aspect of welfare reform in the UK. What evidence is there of impact on employment outcomes? This paper presents a systematic review of the evidence on UK policy initiatives. Both quantitative and qualitative studies were identified: 5399 abstracts were located, from which 16 studies were critically appraised. Overall, each of the five main welfare-to-work strategies operating in the 1990s helped people with disabilities into work, who were previously on benefits. The proportion of participants gaining employment after involvement ranged from 11% to 50%, dependent on characteristics of participants, such as 'job-readiness', as well as wider labour market context. As most studies were uncontrolled, it was difficult to determine if the improved employment chances were due to the effectiveness of the welfare-to-work interventions themselves or to external factors. Wider impact, such as uptake of schemes as a proportion of the total target population, was weak. The qualitative components identified barriers and facilitators concerned with effective implementation, to aid design of future initiatives.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Chronic Disease* / economics
  • Disabled Persons* / legislation & jurisprudence
  • Employment / legislation & jurisprudence*
  • Employment / statistics & numerical data
  • Humans
  • Program Evaluation
  • Public Assistance / legislation & jurisprudence*
  • Public Policy*
  • Social Welfare / economics*
  • Social Welfare / legislation & jurisprudence
  • United Kingdom