The role of incapacity benefit reassessment in helping claimants into employment

Work and Pensions Committee - Sixth Report

11 November 2011

This report looks at the incapacity benefit reassessment process in two ways. The first looks at the Government's objectives for helping long-term disability benefit claimants back into work and how effectively they are being communicated to claimants and the wider public. In doing this the report considers the how effective the Work Capability Assessment is in assessing a claimant's capability to work in a way which is useful to employment providers.

Secondly the report looks at the process from the claimant's perspective, including the services provided by Atos and the quality of decision-making by Jobcentre Plus and the appeals process. It also examines the outcomes of the reassessment process for claimants in terms of the benefit group to which they are allocated and the subsequent support available to them.

DA welcomes the focus of the committee on the need for welfare reform to demonstrate that disabled people are moving into work.

The report states that the ultimate success of Government policy will be determined by whether it achieves its aim of helping people with disabilities and long-term health conditions into employment. It is therefore vital that the reassessment process assesses claimants' employability and needs in the workplace accurately and that information from the assessment is directly linked to the Work Programme to ensure that the level of support provided matches the needs of the claimant.

As the WCA is designed at the moment, there are concerns that this may not yet be the case. The Government needs to take steps to strengthen the link between the assessment process and employment support under the Work Programme.

DA is hugely disappointed that the committee appear to conclude that the WCA is now working well. This is not only disputed by the disabled people now routinely contacting us with concerns, but the rising number of appeals against WCA decisions which are expected to reach 436,000 in 2011/12 and could cost over £25 million. The WCA remains a barrier to an effective system geared towards ensuring disabled people can access appropriate support to get and keep work. 

Government response to the report

The government responded to the report on 11 November 2011. A summary of the response has been added to the relevant parts of the conclusions and recommendations below.

Conclusions and recommendations of the report

You can view the full report from the Parliament website link below. Conclusions and recommendations of the report include:

Government communication of aims

• The Government must be proactive in explaining its aims and spreading the positive messages about the benefits of work and the support which is available to find work, and in engaging employers.

DA believes work can be a route out of poverty for disabled people but the focus of assessments has not demonstrated if disabled people are moving into work which we understand is a focus of Professor Harrington’s next review of the WCA.

Government response: The Department for Work and Pensions is working on the design of the Employment and Support Allowance process and in partnership with employers to encourage them to rethink their attitudes towards disabled people.

The Department is supporting a Business to Business campaign, led by the Disability Employment Steering Group. Employers are being encouraged to sign up to Clearkit—an online resource, developed by employers, which helps identify and remove barriers in the recruitment of disabled people. To date 1,136 organisations have signed up to the resource, overtaking the 1,000 campaign target. This achievement was marked by a celebration event held on 2 November, hosted by BT.

• The Government needs to develop its communications strategy for the IB reassessment in a way which ensures clarity and minimises anxiety.

Government response: Significant improvements have already been incorporated into the reassessment process and are now being extended for new Employment and Support Allowance claims following implementation of the findings of the first Harrington Review. The context in which the term "support" is used is now clear in relevant communications. Products have been found to be clear and helpful in the independent research undertaken for the reassessment trial so far.

The Department will continue to seek and monitor feedback on communications and will keep the language used under review.

For the future, Atos Healthcare are looking at the possibility of deploying staff in Assessment Centres to provide more information for people attending the Work Capability Assessment to clarify its aims and purpose and to allay any concerns. The feasibility and benefits of this potential option are currently under consideration by the Department.

• More care is needed in the way the Government engages with the media and in particular the way in which it releases and provides its commentary on official statistics on the IB reassessment.

DA and the DBC have frequently raised concerns about inaccurate and misleading DWP releases and media coverage, including involving the Press Complaints Commission which upheld one issue.

Government response: The Committee and Government need to be mindful of the widespread public unease about the number of people claiming incapacity benefits and it is therefore unsurprising that this is reflected in the media. That said the Department takes great care when publishing statistics and works with the UK Statistics Authority to ensure that the published data are used in an appropriate manner. Since the Committee's Report the Secretary of State has decided to submit the publication of the Work Capability Assessment figures relating to Employment and Support Allowance claims for assessment as National Statistics.

This will take effect from spring 2011. As a result the Department is working with the UK Statistics Authority to consider any changes that may be needed to the presentation of the statistics. However, it is important to stress that it is not the Department's role to dictate what can appear in stories in the media. The Department's Press Office ensures that the language used in all press releases, publications and briefings is accurate and appropriate and endeavours to provide journalists with the context in which statistics are used and, where possible, attempt to correct errors in any copy.

As part of its ongoing dialogue with stakeholders through regular stakeholder forums, the Department will continue to listen to any concerns they may wish to raise around the use of statistics and language.

The role of representative organisations

• Representative organisations should allay the concerns about reassessment by giving equal weight to publicising the opportunities an effective assessment process could offer, and the back-to-work support available from Government, as they do to fulfilling their important role in raising legitimate concerns.

DA cannot offer support for an ineffective assessment process that routinely fails to identify disabled people’s needs. Sadly, we do not have an effective process currently and the WCA was toughened further in April 2011 which may see further disabled people inaccurately found fully fit for work.

Government response: While welcoming the Committee's comments, the Department recognises and respects the independence of external stakeholders and is ultimately unable to dictate the positions they chose to take. In trying to influence them, the Department has undertaken an extensive programme of engagement with claimant representative groups before finalising the detail and implementing the reassessment of incapacity benefits. This included the production of a comprehensive suite of products for external stakeholders to use with their clients, which include emphasis on the positive benefits of work and the back to work support available.

The Department is committed to working closely with external stakeholders on an ongoing basis and will look to engage them as much as possible in promoting the positive benefits of reassessment.

The role of Atos

• Atos should review its current overbooking policy as a matter of urgency, to take account of the high attendance rate by IB claimants, to ensure that people are not turned away from assessment centres without being seen. Currently Atos books appointments on the assumption the 80% when the actual figure is more like 91%.

Government response: Atos Healthcare's booking policy tries to balance the needs of the claimant and good customer service, with the Department's requirement to ensure that the use of the Healthcare Professional resource is optimised. The Department recognises that varying assessment times and claimants not attending their appointments add a level of complexity to the booking and scheduling process and it therefore also measures Atos Healthcare's performance against the number of claimants who arrive for their appointment, but are sent home without being seen by a Healthcare Professional.

• DWP and Atos Healthcare should jointly review the processes for recording non-attendance and change them where necessary to ensure that claimants are not sanctioned for "failure to attend" when the failure is on the part of Atos Healthcare and/or Jobcentre Plus.

Government response:..it is clearly desirable that claimants are made aware of their responsibilities and take them seriously. This will also help to improve the "Did Not Attend" rates highlighted above. There are large regional variations and it is clear that the Department needs to do more work at local level to improve this.

However, the Department is very clear that claimants should not be sanctioned in the circumstances outlined in this recommendation. Without evidence of the "instances" highlighted to the Committee, it is difficult to know what went wrong in the cases concerned. Significant safeguards have been built into the reassessment process to avoid inappropriate sanctions. Claimants who are unable to attend their Work Capability Assessment can reschedule before the appointment date, or on the day of the appointment itself. These claimants are not recorded as not attending.

Claimants who do not attend their appointment are sent a form by Atos Healthcare asking for the reasons and directing them to return the form to Jobcentre Plus. If the form is not received, Jobcentre Plus decision makers will contact the claimant by telephone to establish the reasons for non-attendance. If there is "good cause" for non-attendance the claimant will be offered a further appointment. In cases where the claimant is thought to have a mental health condition, additional safeguards apply and a visit may be made to the claimant's home.

Where it has not been possible to contact a reassessment claimant either by telephone or correspondence, benefit will not be terminated for 2-4 weeks after the decision is made, allowing a further period for the claimant to get in touch.

The Department will continue to keep this issue under review as part of an ongoing exercise by Jobcentre Plus and Atos Healthcare to improve the Work Capability Assessment process.

• Jobcentre Plus should be more proactive in establishing the reasons for non-attendance at WCAs, including by following up with a phone call as soon as is practical after an appointment has been missed.

Government response: The procedure the Committee recommends is already in place. Reasons for non-attendance are proactively sought, initially by correspondence, and supplemented by a telephone call as needed.

The Department will continue to keep this issue under review and further strengthen procedures if necessary.

• It is unacceptable that disabled people should be called to attend an assessment at a centre which is inappropriately located, inaccessible to them or where reasonable adjustments cannot be made to accommodate special requirements arising from their health condition. The report requests that the Government sets out progress towards the aim of accessible assessment centres, including options for the relocation of assessment centres where necessary, increasing disabled access, and improvements to the mechanisms for ensuring a claimant's needs are known to Atos Healthcare in advance of the WCA.

DA believes DWP and Atos need to be mindful of ensuring systems are as open and accessible to disabled people as possible.

Government response: Where sites are inappropriate the Department and Atos Healthcare are actively considering where relocation or adaptations of the existing sites are possible. Where a claimant's circumstances make attendance at the centre unreasonable, they will be offered a home visit.

• When the Atos contract is re-let in 2015 and in future contracts for other medical assessments, DWP reviews the performance indicators, with significant financial penalties built in if standards are not met.

Government response: The Department closely monitors Atos quality through a number of different channels, including audit, customer satisfaction surveys, complaints and reworks. This gives a picture of the overall quality and performance of Atos Healthcare. Following Professor Harrington's first review and the reassessment pilots, Atos have made several improvements

• The Government should consider contracting a second provider to deliver the ongoing Work Capability Assessments for new ESA claims when the reassessment of existing claimants has been completed, in order to drive up performance through competition. The report recommends that the Government publishes proposals, before the end of 2012, for how such a system of competition could work in practice.

Government response: All commercial options will be considered, whether that is for more than one supplier providing full end to end medical services, division by service lines, or other variants.

Claimant support

• The report has concerns that the resource-intensive nature of the additional claimant contact, which has been added to the process following the Harrington Review and the reassessment trials, may be difficult to scale up to a national level in the context of public sector spending cuts. It urges the Government to ensure that the necessary resources are made available to Jobcentre Plus, given that a more robust reassessment process is likely to save money in the long run.

Government response: Funding to support the reassessment exercise has been made available nationally to Jobcentre Plus and partner organisations to ensure the customer journey, including the improvements the Committee acknowledges, is delivered as designed. The Department will ensure that this funding is provided throughout the three year reassessment programme.

The role of the WCA

• The Government needs to do more to clarify whether the purpose of the WCA is to be an eligibility test for benefits or whether it is a diagnostic test to assess a person's ability to work. It is not yet clear whether it is quite achieving either of these effectively.

DA believes a ‘real world’ test is required to ensure support is adequately accessible for disabled people.

Government response: The Work Capability Assessment is an assessment of capability for work that is used to determine benefit entitlement and appropriate levels of conditionality. It provides an account of how a person's disability or health condition affects them. It looks at different areas related to physical and mental, cognitive and intellectual functions alongside additional criteria that do not directly measure function (such as terminal illness). The Assessment is not diagnostic in nature.

Following the first Independent Review of the Work Capability Assessment by Professor Harrington the Department has improved the way it communicates with claimants, with additional telephone calls to help claimants to understand the purpose of the assessment and to help them understand the result they receive.

The Department is committed to continuously improving the Work Capability Assessment to ensure that it is as fair and accurate as possible. Professor Harrington will shortly present his findings from his second review and the Government will respond in due course.

• Professor Harrington’s review should also include Work Programme providers and sub-contractors in the work he is undertaking to try to design an assessment that identifies a claimant's workplace capabilities and needs.

Government response: The Department look forward to receiving further advice and any recommendations from Professor Harrington in his forthcoming second report.

• The Government should consider how to address the problem of GP charges for medical reports acting as a barrier to the full range of medical information being available to decision-makers.

Government response: Professor Harrington was clear in his first independent review that it was the responsibility of the claimant to collect additional evidence that may support their claim.

• The Government should consider how information from the WCA can help Work Programme providers to identify the employability needs of customers.

Government response: The diagnostic assessment undertaken by Jobcentre Plus for a claimant and the action plan that is developed with the individual is shared with the Work Programme Provider at the time when a referral takes place. Greater local Jobcentre Plus flexibility means that when referring a claimant to the Work Programme the Jobcentre Plus adviser will follow the locally agreed process to ensure a smooth referral of the claimant to the Work Programme Provider.

• There should be discretion to place those with a limited life expectancy in the Support Group, where appropriate.

Government response: Individuals who are terminally ill, under the definition that they have less than six months to live, join the Support Group automatically without the need for a face-to-face assessment or the completion of a self assessment questionnaire (ESA50).

There is already provision within the Work Capability Assessment that allows decision makers the discretion to ensure that no one is found fit work where there is a substantial risk to them or others if they were not allowed into the Work Related Activity Group or even the Support Group. This recognises that in a small number of cases an individual may not meet the criteria for the Work Capability Assessment but it would be unsafe to expect them to work at that time.

There is also a key role for discretionary judgement in the range of work related activities to be agreed with the adviser for someone not given a prognosis of terminal illness, but who has limited or particular limitations to work related activity, because of his or her health condition or disability. It has always been the position that work related activity must be appropriate to the individual's capacity and kept under review.

Reviews and appeals

• The Government should put in place processes to track outcomes for cases which have been through the revision process in order to ascertain whether this is producing speedier and accurate final decisions, to avoid potential adverse consequences both for the claimant and for Work Programme providers.

Government response: The Department is committed to making quality decisions within acceptable and appropriate timescales and has instigated a number of measures to this end. National and local management information is available to track decisions through the revision process to determine the overall speed of the decision. The Quality Assessment Framework has also been introduced that allows quality issues to be identified and rectified. The Department will continually monitor its performance against these measures and will take appropriate improvement steps if performance falls below acceptable levels.

• The DWP should review whether JCP presenting officers should attend more tribunal cases in order to ensure that the DWP is properly represented and that information is fed back from the appeals process.

Government response: The Department accepts the Committee's recommendation to review whether Jobcentre Plus presenting officers should attend more appeal hearings and is actively looking at the use of Presenting Officers in providing feedback from Tribunals. When the work is complete the Department will inform the Committee of the outcome.

Contributory ESA time limits

• The DWP should conduct research on whether allowing former IB recipients to claim contributory ESA for more than 12 months would provide a more realistic timeframe for them to enter employment, taking account of the two years of employment support available through the Work Programme.

DA is very concerned that 400,000 disabled people will lose c-ESA from April 2012. Government plans ignore the evidence on the time many disabled people need to find appropriate work, including the 87% of disabled people previously using Pathways to Work who did not find employment in 12 months. Former incapacity benefits claimants are likely to have further barriers to work: 40% have no formal qualifications; 40% have one or more mental health problems and length of time out of work also generates further challenges in securing work.

Government response: The Department could commission research into the impact of time-limiting contributory Employment and Support Allowance, but this would take some time to complete and may not be particularly helpful in isolating the determining factor that either deterred people from, or assisted people with, moving into work.

The Department will continue to review policy as further evidence emerges and will work, in consultation with Work Programme providers and other stakeholders, to understand claimant behaviour.

Attitudes of employers

• Providers of employment support have a crucial role to play in building relationships with employers so that they can gain trust and an understanding of the challenges and benefits of employing former benefit claimants. However, it is also the Government's responsibility to engage in changing attitudes and spreading good practice amongst employers. The Government must pay as much attention to this side of the "back to work" equation as it does to getting the claimant "work ready".

Government response: The Department agrees with the Committee's assessment that Government has a role in helping employers recruit and retain people with health conditions and has an active programme of work.

The Department's Work Programme providers have a crucial role to play in working with employers and changing their attitudes to employing former benefit claimants. These providers are specialist organisations with an in-depth understanding of the jobs and opportunities in their locality. They are paid for getting people into work and helping them to stay there. The Department has not prescribed how providers must do this, but has given them the freedom to respond flexibly to meet local needs. It is in a provider's interest to build effective relationships with potential local partners, including employers, as a basis for helping more participants into sustained work.

Jobcentre Plus's National Employer Services team works with the largest employers across all sectors to influence recruitment practice, whilst advisers in Jobcentre Plus's small business helpline promote the benefits of making jobs more flexible. Local Partnership Managers and Disability Employment Advisers work with employers and other partners to help level the playing field for people furthest away from the labour market.

The Department is a founding partner of the cross-government Health, Work and Well-being initiative, which promotes evidence and good practice about the positive links between health and work to employers, healthcare professionals and individuals. Employers and employer organisations are represented on the Health, Work and Well-being National Stakeholder Council which advises Government and whose members champion positive health and work messages.

More information

• da press release
• parliament website

http://www.disabilityalliance.org/wpcib.htm

What to do when you receive notice that you have “Failed” your Atos “W.C.A.” Assessment

refer http://dwpexaminations.blacktrianglecampaign.org/phpBB3/

http://www.theoneclickgroup.co.uk/news.php?id=6713#newspost

Comment on this post.

Where you can, you should seek advice from a proper welfare support worker. This can be at your local HIV support service and/or Citizens Advice Bureau.  Some of these links talk about asking for a "reconsideration". However if you say you wish to appeal, then the first step of your appeal would include this "reconsideration".  You should also see the DWP form GL24 "Appealing a benefit decision".