Employment and Support Allowance and Work Capability Assessments – Work and Pensions Committee Report

Guest blog piece from Carer Watch:

 

This is what multi party Select Committees were invented for. As a safety measure for situations exactly like this – when the main political parties cause a disaster and then gang up and turn their faces to the wall and refuse to see the enormous harm their misguided policies are causing.

 

This report has been written by MPs who actually understand what is happening to sick and disabled people on the ground.

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Work and Pensions Committee
Select Committee Press Notice
AN06 2014-15
22 July 2014
Under embargo until 00.01am on Wednesday 23 July 2014
Report: Employment and Support Allowance and Work Capability Assessments – read report here
List of conclusions and recommendations here  
Employment and Support Allowance is not achieving its aims and needs fundamental
redesign, say MPs

The flaws in the Employment and Support Allowance (ESA) system are so grave that simply “rebranding” the assessment used to determine eligibility for ESA (the Work Capability Assessment (WCA)) by appointing a new contractor will not solve the problems, says the Work and Pensions Committee in a report published today.

The Committee calls on the Government to undertake a fundamental redesign of the ESA end-to-end process to ensure that the main purpose of the benefit – helping claimants with health conditions and disabilities to move into employment where this is possible for them – is achieved. This will take some time, but the redesign should be completed before the new multi-provider contract is tendered, which is expected to be in 2018.

In the meantime, the Committee recommends a number of changes which should be made now, to help ensure that claimants receive an improved service, and that the outcomes for claimants are more appropriate.

Dame Anne Begg MP, Committee Chair, said:

“Many people going through the ESA claims process are unhappy with the way they are treated and the decisions which are made about their fitness for work. The current provider of the WCA, Atos, has become a lightning rod for all the negativity around the ESA process and DWP and Atos have recently agreed to terminate the contract early.
     “But it is DWP that makes the decision about a claimant’s eligibility for ESA – the face-to-face assessment is only one part of the process. Just putting a new private provider in place will not address the problems with ESA and the WCA on its own.”
     “We are therefore calling for a number of changes which can be made to improve ESA in the short-term, while also recommending a longer-term, fundamental redesign of the whole process.”
     “We hope that the new Minister for Disabled People, who was appointed last week, will respond positively to our constructive recommendations for improving the ESA process.”

One of the key issues which the Report identifies is that ESA is not achieving its purpose of helping people who could work in the short to medium term to move back into employment.
One of the reasons for this is that the outcomes of the ESA claims process are too simplistic. Claimants can be found “fit for work” and are then ineligible to claim ESA. Claimants found to have such limited functionality that that they cannot undertake any work-related activity are placed in the Support Group, where they are subject to no work-related conditionality. This leaves a large and disparate middle group of claimants who are not yet fit for work, and may even have a deteriorating condition, but who are required nonetheless to undertake activity which is meant to help them find work in the longer term. These claimants are placed in the Work-related Activity Group (WRAG). The WRAG covers too wide a spectrum of claimants with very different prognoses and employment support needs.

Redesigning the ESA process

The Committee recommends that the ESA redesign should aim to ensure that the process properly identifies claimants’ health barriers to employment and the particular support they need, so that the conditionality that they are subject to and the employment support they receive can be tailored more closely to their circumstances. For claimants in the WRAG, proper account needs to be taken of where they are on the spectrum of readiness for work, given the wide range of conditions and disabilities which the WRAG encompasses, and the different impacts these have on an individual claimant’s functional capacity.

The descriptors used in the WCA process should also be reviewed as part of the redesign, as concerns about their effectiveness, and the way they are applied, remain, despite the recent review commissioned by DWP.
Dame Anne Begg MP, Committee Chair, said:

“ESA is not properly joined up with employment support because an individual’s health-related barriers to working are not being properly assessed as part of the process. We recommend that the Government reintroduces a separate assessment of these barriers, along the lines of the Work-focused Health-related Assessment – the WFHRA – which it suspended in 2010.”

Shorter term measures to improve ESA

Dame Anne Begg MP, Committee Chair, said:
 
“We know that the redesign can’t happen overnight, but the current system needs to
be improved now, because it is clearly causing claimants considerable distress and
anxiety.
     “The re-letting of the contract provides an opportunity to address some of the
problems. The new contract needs to set out robust and clear service standards on
the quality and timeliness of assessments and the reports produced by the
contractor, and for the way claimants are dealt with.”
     “DWP has acknowledged that this will cost more money, but this is justified if the
service provided by the new contractor is better. To ensure this is the case, DWP
needs to rigorously monitor the service standards to ensure they are being met and
to take immediate action, including imposing penalties, if they are not. This has
not always happened with the Atos contract.”
     “The changes we recommend include ensuring that, where possible, paper-based
assessments are used to place people in the Support Group, rather than requiring
them to go through a WCA, where their health condition or disability clearly has a
severe impact on their capability to work. Unnecessary and too frequent
reassessments should also be avoided.”
     “DWP should also improve the way it communicates with claimants – at the moment, the
letters that are sent to claimants are too technical and complex. They need to be in
plain English and avoid using jargon. The terms “limited capability for work” and
“limited capability for work-related activity”, which are currently used to categorise claimants, are too confusing and DWP needs to find more meaningful alternatives.”

The Committee recommends that DWP implements a number of other changes in the shorter-term to ensure better outcomes and an improved service for claimants. These include:

• DWP taking overall responsibility for the end-to-end ESA claims process,
  including taking decisions on whether claimants need a face-to-face assessment,
  rather than this decision being made by the assessment provider.
• DWP proactively seeking “supporting evidence” on the impact of a
  claimant’s condition or disability on their functional capacity, rather than leaving
  this primarily to claimants, who often have to pay for it. DWP should seek this
  evidence from the most appropriate health and other professionals, including social
  workers and occupational therapists, rather than relying so heavily on GPs.
• The “descriptors” used to assess functional capability in the WCA being
  applied more sensitively.
• Placing claimants with a prognosis of being unlikely to experience a
  change in their functional abilities in the longer-term, particularly those with
  progressive conditions, in the Support Group and not the WRAG.

Mandatory reconsideration and appeals

The Report also considers the impact of the introduction of mandatory reconsideration (MR) of ESA decisions, and the appeals process. MR has the potential to be beneficial, if it leads to fewer decisions being taken to appeal, and therefore reduces both stress for claimants and the cost to public funds.

However, the Committee calls on the Government to set a reasonable timescale for completing reconsiderations, rather than leaving it open-ended, and to end the current illogical situation of claimants being unable to claim ESA during the reconsideration period.

It is also important that both DWP and the assessment provider learn lessons from the feedback which the Tribunals Service now gives in the summary reasons for its decisions, so that more initial decisions are “right first time”.

–ENDS-

Notes to Editors:
1.    Employment and Support Allowance (ESA) is the benefit paid to people who are unable to work because of ill health or disability. It was introduced by the previous Government for new claimants in 2008. Existing Incapacity Benefit claimants began to be migrated to ESA in 2011.
2.    Most claimants are required to undergo a face-to-face assessment of functional capability carried out by a private sector provider (currently Atos Healthcare) under a contract with DWP.
3.    DWP has agreed with Atos that it will exit the contract for delivering the WCA 6 months earlier than planned. A new provider is expected to take over sole delivery of the WCA in February 2015, with a new contract involving multiple providers expected to be tendered in 2018.
Committee membership:
Dame Anne Begg MP (Chair) (Lab, Aberdeen South),
Debbie Abrahams MP (Lab, OldhamEast and Saddleworth),
Graham Evans MP (Con, Weaver Vale),
Sheila Gilmore MP (Lab,Edinburgh East),
Glenda Jackson MP (Lab, Hampstead and Highgate),
Kwasi Kwarteng MP(Con, Spelthorne),
Nigel Mills MP (Con, Amber Valley),
Anne Marie Morris MP (Con,Newton Abbot),
Teresa Pearce MP (Lab, Erith and Thamesmead),
Mr Michael Thornton MP(Lib Dem, Eastleigh),
Dame Angela Watkinson (Con, Hornchurch and Upminster).