The role of incapacity benefit reassessment in helping claimants into employment - Work and Pensions Committee Contents

Conclusions and recommendations

The Government's policy objectives for the IB reassessment

1.  We support the Government's objectives of helping people with disabilities and long-term health conditions to move back into work, whilst continuing to provide adequate support for people who have limited capability for work or are unable to work. However, the scale of the challenge should not be underestimated and nor should the level of anxiety which currently surrounds the process. A suspicion persists that the only objective of the Government is to save money. 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. It is vital that the Government's objectives are firmly supported by the reassessment process, and by the WCA in particular, but at the moment we are not completely convinced that it does this. Our report focuses on the changes we would like to see to help ensure that this happens in practice. (Paragraph 18)

Improving communication of the Government's objectives

2.  The Government needs to develop its communications strategy for the IB reassessment in a way which ensures clarity and minimises anxiety. Providing claimants with the right level of information at the time that is appropriate for each individual forms an important part of this, bearing in mind that the reassessment process as a whole will last three years. It also requires the Government to be clearer about what the word "support" means in the context of Employment and Support Allowance. Currently it is used to describe employment support on the one hand and financial support through benefits for those who cannot work on the other. These two different meanings in the context of one benefit can be very confusing. (Paragraph 31)

3.  The message which the Government sends to claimants involved in the reassessment process should be clear and simple: if the assessment process correctly finds someone fit for work, that is a successful and desirable outcome. However, we believe that the Government also needs to take greater steps to reassure claimants. It needs to explain that being found "fit for work" does not equate to denial or disbelief about the existence of an illness or health condition: rather the condition is acknowledged but its impact has been assessed as not being so serious as to prevent the person from returning to work at some point in the future. (Paragraph 34)

4.  We believe that the language currently used to describe the outcome of the WCA is a barrier to the Government's objectives for the reassessment being properly communicated. The idea that a claimant has "failed" the assessment if they are found fully capable of work risks negating the positive messages which the Government is trying to convey. It needs to be addressed across the board and to include all communications between claimants and DWP staff, especially Jobcentre Plus staff who tell claimants the outcome of the process, and Atos Healthcare employees who may explain the process to claimants. We also believe that the communications need to explain clearly and at every stage of the process that, where someone is found not fit for work, they will be eligible to receive ESA at the support rate. (Paragraph 35)

Media coverage

5.  Sections of the media routinely use pejorative language, such as "work-shy" or "scrounger", when referring to incapacity benefit claimants. We strongly deprecate this and believe that it is irresponsible and inaccurate. The duty on the state to provide adequate support through the benefits system for people who are unable to work because of a serious health condition or illness is a fundamental principle of British society. Portraying the reassessment of incapacity benefit claimants as some sort of scheme to "weed out benefit cheats" shows a fundamental misunderstanding of the Government's objectives. (Paragraph 40)

6.  Whilst fully accepting that the Government, and this Committee, have no role in determining the nature and content of media coverage, we believe that 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. In the end, the media will choose its own angle, but the Government should take great care with the language it itself uses and take all possible steps to ensure that context is provided when information about IB claimants found fit for work is released, so that unhelpful and inaccurate stories can be shown to have no basis. (Paragraph 41)

Role of representative organisations

7.  We agree with the Minister's view that organisations which represent benefit claimants may sometimes face a conflict in being both advocates for the people they represent and key players in helping to design and implement the reassessment process. We believe that these organisations could contribute enormously to allaying 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. We also consider that this would help reassure potential employers and thereby reduce the risk of stigma and discrimination. (Paragraph 45)

The Work Capability Assessment—claimants' experience and Atos Healthcare

8.  Atos acknowledged that its call-centres had experienced significant problems in the past. We welcome the assurance that this has been addressed to ensure that waiting times are significantly reduced and most calls are picked up first time. We expect call statistics to be maintained and published to demonstrate that progress is being made and sustained. However, claimants are still unable to contact the assessment centre they are due to attend directly, and we believe they should be able to do so, even if calls are routed through the call-centre. (Paragraph 55)

9.  Atos routinely overbooks WCA appointments by 20% on the basis of the non-attendance rate for new ESA claims, which was 30%. However, the non-attendance rate in the IB reassessment trials was much lower, at around 9%, although it is too soon to say whether this low rate seen in the trials will continue in the national roll-out. We recommend that Atos reviews its overbooking policy as a matter of urgency, to take account of this much higher attendance rate by IB claimants, to ensure that people are not turned away from assessment centres without being seen. Atos should also continue to monitor and adjust its overbooking policy as necessary. (Paragraph 58)

10.  Instances have occurred where vulnerable claimants have had their benefit stopped as a sanction for non-attendance at a WCA appointment when the non-attendance arose because of administrative errors on the part of Atos or JCP, or because the claimant was too ill to attend but was unable to get in touch with Atos to inform them of this. We agree with the Minister that this is unacceptable. We recommend that DWP and Atos Healthcare 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. (Paragraph 63)

11.  We believe that 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. (Paragraph 66)

12.  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. We note DWP's assurance that Atos Healthcare is "moving rapidly toward" a situation where this is no longer the case. We request that, in response to this Report, the Government sets out progress towards this aim. This should include 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. (Paragraph 71)

13.  Most of the submissions we received from individuals were from claimants who were dissatisfied with the WCA process and who did not believe that they had been accurately assessed. The Minister asked us to bear in mind that much of the evidence submitted to us related to assessments carried out prior to implementation of the two sets of review recommendations and experience from the Aberdeen and Burnley trials. We fully acknowledge this fact. However, we believe that there is no room for complacency and we have identified a number of areas where further improvement is required. (Paragraph 76)

DWP contract with Atos Healthcare

14.  We recognise that Atos Healthcare, as the sole provider of the Work Capability Assessment, takes the brunt of public criticism about the WCA. Some of this arises from the understandable anxiety which claimants feel about the process. We accept that considerable efforts have been made on the part of both Atos Healthcare and DWP to improve the quality of assessments. However, it is also clear that many claimants have not received the level of service from Atos which they can reasonably expect. (Paragraph 92)

15.  We remain concerned about whether there are sufficient levers within the DWP contract with Atos to ensure that Atos consistently gets the assessment right first time. We therefore recommend that, when the 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. (Paragraph 93)

16.  We agree with the Minister that it would not have been practical to introduce a second provider for the IB reassessment but we believe that 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. We recommend that the Government publishes proposals, before the end of 2012, for how such a system of competition could work in practice. (Paragraph 94)

The Work Capability Assessment—Reviews

17.  We congratulate Jobcentre Plus on the improvements made to the claimant journey during the reassessment trials in Aberdeen and Burnley. However, we are concerned 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. We welcome the Minister's commitment to ensuring that the improved system is implemented nationally and urge 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. (Paragraph 109)

Future of the WCA

18.  We welcome the improvements to the WCA which have resulted from the Harrington Review and the lessons learned from the reassessment trials. However, we believe that 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. (Paragraph 120)

19.  The Government decided to suspend the Work Focused Health-Related Assessment for two years without putting anything in its place. This separate component of the WCA focused on health-related or workplace interventions which might support claimants into work and would have been particularly useful for people moving off incapacity benefits. We welcome Professor Harrington's commitment to consider whether an additional assessment is needed to determine a claimant's suitability for work, and his engagement of employers in the process through the CBI. (Paragraph 121)

20.  Any new employability test must effectively link into the employment support available under the Work Programme. We recommend that Professor Harrington also includes 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. (Paragraph 122)


21.  We welcome Professor Harrington's central recommendation on the need to strengthen the role of Jobcentre Plus decision-makers in the reassessment process. There are signs that decision-making is already improving and this needs to be reinforced by ensuring that all the supporting information from the claimant is available to the decision-maker at the time the decision is made. To facilitate this, it is important to ensure that claimants are able to submit medical reports, but GP charges for this service put it beyond the reach of some claimants. We recommend that the Government considers how to address the problem of charges acting as a barrier to the full range of medical information being available to decision-makers. (Paragraph 129)

22.  We congratulate the Department for the marked improvements in the decision-making process achieved during the trials in Burnley and Aberdeen. However, DWP's own research suggests that this new approach is very resource-intensive and may not be sustainable in the national roll-out. Nevertheless, it should remain a priority for the Department to ensure that it gets the decision-making right first time. We agree with the Government's assessment that investing resources in the decision-making process will provide savings in the medium and long-term through reducing the costs in appeals. An improved decision-making process will also help to increase claimants' trust in the process and enhance their sense that "procedural justice" has been delivered by allowing their case to be properly presented. (Paragraph 130)

23.  We welcome Professor Harrington's recommendation on making more effective use of the reconsideration process. The trials in Burnley and Aberdeen have shown that claimants find the additional contact with the Department, and the opportunity to present further evidence in support of their claim, helpful. This should help to address the problem identified by Professor Harrington of new information appearing at the tribunal stage that was not available earlier in the process. However, we also request that the Government 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. (Paragraph 137)


24.  The high number of appeals for new ESA claims is a cause of concern. The estimated cost to the public purse is £50 million per annum. The pressure on the Tribunals Service has also resulted in a significant delay for claimants before appeals are heard, causing stress and anxiety for claimants and their families. (Paragraph 146)

25.  We welcome the Minister's commitment to improving decision-making to ensure that fewer cases are overturned at tribunal. However, as the Minister rightly acknowledged, the volume of reassessment cases means that it is unlikely that the number of cases going to appeal will decrease significantly in the next few years. We welcome the Government's acknowledgment of the importance of reducing the time taken to process appeals and we recommend that the available resources are kept under regular review. The tribunal system must be adequately equipped both to address the backlog and to provide an ongoing, efficient appeals service. (Paragraph 147)

26.   It is not acceptable that some claimants have to go through the entire assessment process again shortly after their appeal without any of the information from the appeal being passed on to JCP and Atos Healthcare. This is a waste of resources and causes unnecessary stress and anxiety for claimants and their families. (Paragraph 151)

27.  We agree with Professor Harrington that it is important for the outcome of appeals to be fed back into the WCA system effectively, to avoid unnecessary future appeals. We also believe that when cases do go to appeal, it is important that the DWP case is properly presented. We recommend that DWP review whether JCP presenting officers should attend more tribunal cases in order to ensure both that this happens, and that information is fed back from the appeals process, thus promoting more effective learning of lessons by JCP. (Paragraph 152)

Reassessment outcomes

28.  The Government's argument for time-limiting contribution-based ESA to 12 months is a result of tough decisions about the budget deficit and also to put it on an equal footing with Jobseeker's Allowance. It is true that the huge majority of JSA claimants move into employment within a year. However, we know that the JSA demographic of mainly young, male claimants with previous work experience is different to the ESA demographic, who may find it much harder to move into employment even though they may have done everything required of them to find work. (Paragraph 168)

29.  Nor does it appear that the Government has the data available to make an evidence-based decision on the appropriate length of time for which contributory ESA should be payable in order to support its objective of moving claimants into employment. We recommend that the Department conducts 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. The research should also include an assessment of the costs of such a change. The Government should adjust its policy accordingly if the need for change is borne out by the research. (Paragraph 169)

30.  We share the Minister's concern about the high rate of claimants who withdraw from the assessment process before completion. It is important that the Government understands the reasons for this and gains a greater understanding of the destination of these people, to ensure that no one is left without appropriate support. (Paragraph 172)

Tracking of claimants

31.  We strongly believe that the success of the IB reassessment is dependent on its effectiveness in helping people with disabilities and long-term health conditions into employment. In order to understand whether the assessment process is achieving this, the Government needs to track the destination of all claimants. We recommend that tracking includes categorising claimants on the basis of the health condition they presented with, to establish how different groups fare in terms of getting into sustained employment. It should also include recording the number of claimants who are initially allocated to the wrong group and have to be moved at a later date. (Paragraph 176)

32.  The trials in Aberdeen and Burnley would have provided an ideal opportunity to begin this form of tracking, from assessment to employment outcomes. We believe it is regrettable that steps were not taken to ensure tracking was in place for this first cohort. However, we believe that it is not too late to do this and recommend that the Government begins tracking outcomes for the reassessment trial cohort without further delay. (Paragraph 177)

Employment support for ESA claimants

33.  The measure of success of both the Work Programme and the IB reassessment will be the proportion of people helped to move from benefits into employment. Recent research suggests that a very large proportion of customers in the Work Programme by 2014 will have previously claimed ESA or IB. This highlights the challenge for the Work Programme and the need to ensure that the WCA is effective in allocating claimants to the differentiated groups within the Programme. Until the introduction of Universal Credit, claimants will be assigned to the groups within the Work Programme based on the benefit they are claiming. This reinforces the importance of ensuring that claimants are allocated to the correct benefit in the IB reassessment process. (Paragraph 184)

34.  It is too early to assess whether the current grouping and incentive structure under the Work Programme will be effective in leading to employment outcomes for former IB claimants. We reiterate the recommendation in our recent report on the Work Programme: that the Government keep the payment model under review and assess the outcome for participants within and between each client group. This review should be carried out by an independent panel and repeated on a regular basis. (Paragraph 185)

35.  We support the Government's view that claimants in the WRAG should undertake work-related activity to prepare for a return to employment. However, it is important that decision-makers have discretion to apply exceptions to this requirement, where appropriate. One group of claimants which needs to be treated with sensitivity is those with a limited life expectancy. We recommend that decision-makers should be able to exercise discretion, on the basis of the claimant's own medical questionnaire, to place these claimants in the Support Group, where appropriate. (Paragraph 189)

36.  Evidence shows that the accurate assessment of disabled people's employability and needs in the workplace is crucial in gaining their trust and engagement, and through this achieving employment outcomes. The Government should consider how information from the WCA can help Work Programme providers to identify the employability needs of customers. (Paragraph 195)

37.  In almost all of the discussion of the Government's plans, the emphasis is on getting the claimant ready to go back to work. However, the Government will only achieve this laudable aim if employers are willing to employ someone who might have been on incapacity benefit and out of work for some time and who might still have substantial health issues. This will require a great deal of co-operation and change of attitude from many 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". (Paragraph 201)

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Prepared 26 July 2011