MPs call for complete ESA redesign

Tue,22 July 2014
News

The flaws in the Employment and Support Allowance (ESA) system are so grave that simply "rebranding" the assessment used to determine eligibility for the ESA 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.

Philip Connolly, Disability Rights UK Policy and Communications Manager says:

“This report produced by a cross bench group of MPs on the Work and Pensions Select Committee has dug deeper in its analysis of the fault lines in the Work Capability Assessment (WCA) than four independent reviews. The Government should now seize on its recommendations, stop tinkering in dark corners and in the daylight of public scrutiny begin the redesign of the WCA that the report calls for.”

The Committee sees the purpose of ESA as helping claimants with health conditions and disabilities to move into employment where this is possible for them.

The report Employment and Support Allowance and Work Capability Assessments: First Report of Session 2014–15 demands a fundamental ‘end to end’ redesign of ESA to make it fit this purpose.

As part of this process, DWP should reintroduce an assessment of health-related employment barriers now, and then incorporate this type of assessment into the redesigned ESA process, something along the lines of the suspended work-focused health related assessment (WFHRA)

“130. In this context, it is worth reiterating that when the expert panels involved in the Evidence Based Review assessed WCA outcomes, they identified that 83% of claimants deemed fit for work would need “on average, two or three” adjustments; 50% would need flexible working hours; and 24% would need a support worker.195 If this is the case, a process needs to be in place to assess what these support needs are and how they can best be provided. When we put this point to DWP witnesses, they were not able to provide any clarity on what the implications of this finding were, in terms of assessment of a claimant’s employment support needs.

131. The support an individual needs to get back to work was previously considered as part of the Work-focused Health-related Assessment (WFHRA). This assessment was carried out by Atos, at the same time as the WCA. It focused on “what the individual was capable of doing and how to manage his/her condition at work” and its purpose was to “explore customers’ views about returning to work, what difficulties they faced in doing this, and what they thought they could do to move back into work.” Based on the WFHRA, the HCP would recommend steps to be taken to improve a person’s functional capacity and to help move them closer to entering employment. A report of the discussion in the WFHRA was sent to the claimant and their JCP adviser, for use in the Work-focused Interviews that claimants in the WRAG are required to attend.”

This 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. These are:

  • DWP should be responsible for the end-to-end ESA claims process, including sending out information-gathering forms to claimants, and deciding whether they need a face-to-face assessment, rather than this being the role of the contracted assessment provider.
  • DWP should decide whether “supporting evidence” from “appropriate health and other professionals “on the impact of a claimant’s condition or disability on their functional capability is needed and, crucially, it proactively seeking it, rather than leaving this to claimants, who often have to pay for GPs to provide it.
  • Greater use of paper-based assessments to place people in the Support Group.
  • Avoiding unnecessary reassessments. Decisions on reassessment intervals should be made in the best interests of claimants and be a good use of public funds.
  • An acknowledgement that the “descriptors” used to assess functional capability in the WCA are imperfect; accompanied by a more sensitive and common-sense application of them in the WCA and benefit decisions.

“58. We welcome the Evidence Based Review as a step towards evaluating the effectiveness of the WCA descriptors. However we do not believe that the Review was sufficient in itself to lay to rest concerns about the descriptors. There were factors both in the way the Alternative Assessment was piloted, and in how its outcomes were compared with those of the WCA, which limit its value as a comparative test. To help address the limitations of the descriptors in the short term, we recommend that DWP remind both Atos assessors and its decision-makers that they must take proper account, in coming to a decision, of the claimant’s ability to undertake an activity reliably, repeatedly and safely. Clear guidance should be issued to HCPs to avoid reporting inferences from a claimant’s responses as factual statements of capability (as recommended by Dr Litchfield), and instead to use follow-up questions to ensure that they fully understand the impact of a health condition or disability on a claimant’s functionality. In the longer-term, DWP should reconsider the effectiveness of the descriptors as part of the redesign of the system that we recommend in Chapter 8.”

  • Clearer communication with claimants throughout the process, including on what the decision on eligibility means for them in practice, in terms of the amount of money they will receive and for how long; the work-related conditionality associated with the level of benefit awarded; and their right to ask for reconsideration or to appeal the decision.
  • Mandatory reconsideration and appeals have the potential to be beneficial in reducing unnecessary appeals but there should be reasonable time limits for clearance. Claimants should also be able to continue to receive ESA instead of being required to claim Jobseeker’s Allowance (JSA) whilst undergoing the mandatory reconsideration process. The Committee were also concerned that mandatory reconsideration was acting as a deterrent to appealing.

“98. Mandatory reconsideration will be a success if it results in a reduction in unnecessary appeals to HMCTS. We are however concerned that its introduction may deter claimants who were likely to have been successful in their challenge from appealing, because the new dual process is more onerous. We recommend that the Department monitor claimant behaviour, to evaluate whether the policy is having this undesired effect, rather than fulfilling its intended purpose of ensuring a correct decision is reached more quickly and without needing to go to appeal.”

You can find out more at http://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/news/esa-wca-report-substantive/

You can download the report at http://www.publications.parliament.uk/pa/cm201415/cmselect/cmworpen/302/302.pdf