22nd November 2013). The average monthly cost to the NHS of buying generic SSRI in England and Wales is £14/patient (Nice, 2004). Allowing for the growing costs of SSRIs this can parsimoniously be estimated to be £16/month; we can estimate savings for 6 beneficiaries over nine months of the WP following their experience of being on BO to be £844. Improved Well-being It is very hard to valorise well-being. Let alone improved well-being. Our impact data reported above suggest that beneficiaries have statistically significant improvements on all ONS wellbeing indicators. Our 1 to 1 in-depth semi-structured interviews with 40 beneficiaries also delivered strong testament to how far beneficiaries had come in terms of their improved sense of well-being: It’s (the WP) absolutely brilliant. I have never felt better. It’s really sorted out my mind. I have got a totally different outlook. Positive thinking. I have real consistent outlook on life…..It feels like a miracle. (Beneficiary N15) ******(The Worker) there and I can see the light at the end of the tunnel. I feel so much better in myself (Beneficiary N33) I found it (The WP) really useful…and I was quite surprised because I am 58 years old so I have tried everything and I have got the T-shirt. (Beneficiary N32) There is also additional evidence of improved financial well-being for beneficiaries. The WWQ included an item on perceived economic well-being. Table 17 Perceived economic well-being Living comfortably Doing alright Just about getting by Finding it quite difficult Finding it very difficult Mean scores Baseline (N=86) 2% (n=2) 17% (n=15) 36% (n=31) 20% (n=17) 24% (n=21) 3.41 3 month follow-up (N=46) 14% (n=7) 19% (n=9) 40% (n=19) 21% (n=10) 6% (n=3) 2.78
Displacement Displacement is another component of impact and is an assessment of how much of the outcome displaced other outcomes. Our interviews and focus groups with stakeholders and new beneficiaries revealed very limited evidence of displacement. Their loneliness, absence from or lack of work and the lack of suitable mental health services to suit their needs suggest very little displacement. NEF and others are currently working on specific guidance on displacement in relation to employment support and recommended displacement rates for state outcomes of similar projects in a range from 20 – 60%. We will opt for a median estimate of 40% (Bates, 2013:26). Table 21 Deadweight, attribution and displacement values applied to scaled up values in Adjustment Calculation Adjusted Value Deadweight £288,656 - 10% £259,791 Attribution £259,791 – (30% of 10,927 + 10,800) £253,138 Displacement £253,138 - (40% of 10,927 + 10,800) £244,448 SROI £244,448 Having established the impact of the WP we calculate a Social Return on Investment ratio of £2.90: £1 This means that for every pound of investment in the WP, £2.90 of social value is created. We feel this is a very parsimonious reflection of the value created. Health economists like Knapp et al (2011) suggest quantifying these impacts across all beneficiary life years, whereas we are just commenting on one year. Drop off Discounting is usually applied to those values that could be projected for longer than one year. The interest rate to be used to discount the value of future benefits should be 3.5% as recommended in the Treasury’s Green Book. For the wellbeing benefits identified in the analysis we could reduce the value by a still quite conservative 10% drop-off rate. Our thinking is that almost without exception the beneficiaries and particularly the GPs we spoke to felt the WP considerably improved the health and wellbeing of beneficiaries who were on the programme. Our data using validated items shows that over time the majority of beneficiaries make positive improvement to their lives having come from situations and