Migration to ESA

ESA 47

Written evidence submitted by the Mindfulness Programme

1 SUMMARY

1.1 This document sets out evidence provided by participants on the Mindfulness Programme of their experience in the current benefits system, and how this relates to the migration from incapacity benefits (IB) to employment and support allowance (ESA).

1.2 The Mindfulness Programme is supported by the Department for Health and NHS North West, and delivered a programme of work to help individuals with mental health issues and in recovery from addiction to be more mindful. The programme was attended by several individuals recovering from addiction and with mental health issues, some of whom also had physical health issues. Many were either claiming incapacity benefits or had previously claimed some form of inactive benefit.

1.3 The evidence presented is a reflection of the experiences of participants on the programme, and a summary of the main barriers faced.

1.4 The document covers the main aspects of the call for evidence, in particular:

§ The Department’s communications to customers going through the assessment and whether the information, guidance and advice provided by the Department and Jobcentre Plus is effective in supporting customers through the process;

§ The Work Capability Assessment (WCA) including the assessment criteria; and

§ The appeals process, including the time taken for the appeals process to be completed; and whether customers who decide to appeal the outcome of their assessment have all the necessary guidance, information and advice to support them through the process.

1.5 None of those providing evidence have undergone a Work Capability Assessment yet. Whilst they are aware of the process, they are not aware of when their assessment will be. For confidentiality reasons, individual names have been left out of this submission.

1.6 The evidence gathered identified three main issues that individuals feel that they will face as part of the migration to ESA:

§ Communication

§ Support; and

§ Flexibility.

1.7 Communication is a key issue for those already on IB. Many feel that they have not formally received enough information about either the Work Capability Assessment (WCA), or the migration to ESA and JSA. This has resulted in some emotional distress for individuals who have been out of work for a long period of time, and who feel that they may be considered fit for work or pushed towards work at a pace that they are uncomfortable or unfamiliar with.

1.8 As a result, the continuation of support is essential to claimants. During the WCA process, individuals may find themselves on a lower rate of pay, which may be further extended beyond the initial 13 week period of assessment if they decide to appeal the decision. Again, this adds unnecessary stress and emotional discomfort to individuals who may be in a process of recovery.

1.9 Lastly, participants on the programme identified the need for flexibility in the approach. Having received no formal information about the assessment or how this would affect them, individuals were keen to stress that the WCA and ESA approaches need to be flexible to individuals’ circumstances, previous mental and physical health and expected future health.

2 COMMUNICATION

2.1 Individuals who are currently claiming incapacity benefits are aware that there will be changes to their benefits in the near future. However, this information has not been provided formally, and has often only been received from an informal source. Whilst the information is available online, individuals feel that they have not been formally provided with guidance or understanding about the process.

2.2 This has placed undue stress on individuals who may have mental health issues, or be in recovery from addiction. For many individuals, receiving information that they will be expected to attend a Work Capability Assessment will be the first formal communication that their benefits will change. The lack of communication in this respect can place unnecessary strain on individuals and does not help to support their mental or physical health. In particular, it was felt that this could lead to misconceptions about the changes, and lead to potential further emotional distress.

2.3 Many have been claiming an out-of-work benefit for a long period of time. This has meant that they are assured of continued support, and as a result have the ability to develop at an appropriate pace that does not rush them or place unnecessary expectations or strains on them. The lack of communication around the future of their benefits does not contribute to the mental wellbeing individuals, who may fall ill due to unnecessary pressure.

2.4 The communication issue is perhaps hindered by the fact that some individuals have only heard of the future changes to their benefits through informal sources – their friends, fellow claimants or through the media. A lack of official clarity and communication heightens the likelihood for potential misconceptions about the migration.

CASE STUDY: IMPORTANCE OF COMMUNICATION

2.5 The lack of communication has also added undue pressure in terms of expectation of income. One individual who is in recovery highlighted that their previous experience of a change in benefits coloured their perceptions about what may occur with the migration from IB to ESA. In particular, their previous experience has included several instances of lack of clarity and communication prior to changes to their benefits. As a result of this, they expect a significant change in benefits as part of the migration from IB to ESA. This has led to additional and unnecessary pressures on this person. This is particularly distressing, as the individual suffers from both a mental health condition and a life-threatening illness. Further to this, when the individual suffers mental ill health, her condition also manifests itself physically.

2.6 In one instance, the individual in question was claiming the high rate of Disability Living Allowance, alongside housing benefit, as well as working with a health professional on their care plan. In deciding to attend university to study towards a career in support work, the individual also moved into new accommodation with a friend. The expectation of responsibility fell to her new housemate, leading to an overall reduction in benefits. However, this was not fully explained or communicated beforehand – despite the individual’s obvious desire to move towards employment, they felt they were not supported in doing so.

2.7 As this person’s benefits changed, they did not feel they were given the same level of support towards employment as they would have received had they stayed in their original accommodation. Their belief is that when they are expected to move towards ESA the change will again alter the support they receive – to the detriment of this person’s physical and mental health, as well as this person’s road to recovery and their road to sustained employment.

2.8 Better communication in this respect could reduce the fears and negative expectations of individuals about the forthcoming change to their benefits. Some individuals felt that the expected change could benefit their road to recovery and employment. However, others felt that the lack of formal communication did not assure them of continued financial, and subsequently emotional, support towards employment and recovery.

3 SUPPORT

3.1 As identified above, support, especially the continuation of financial support, is an important issue for existing claimants. The latest DWP figures (January 2011) show that 33% of those who were found fit for work between October 2008 and November 2009 have had appeals heard by September 2010. Furthermore, two-fifths of these appeals had a decision in favour of the appellant. Whilst these figures are not final, it is estimated by DWP that the number of decisions in favour of the appellant will rise.

3.2 The appeals process resulted in a 9% reduction in the number of individuals in the ‘fit for work’ group – indicating that the process may be pushing individuals who are not yet ready for employment towards work. After the appeals process, the number of individuals experiencing enhanced support towards work (in the ‘work related activity (WRA) group’) increased by 21% - indicating that over one in six currently in the WRA group were assessed as being fit for work when they actually required more tailored support towards employment.

3.3 In addition, a further one in twenty claimants in the support group was initially assessed as either ‘fit for work’, or suitable for additional support to return to work in the longer term.

3.4 As a result, individuals expecting to be assessed want to ensure that the WCA process does not result in a reduced level of support – either financially, if individuals feel they should be in the higher level support group; or towards employment, training and education, if they feel they are in the WRA group.

3.5 Individuals have identified a variety of expectations: some indicated that the expectation of getting a full-time job at present would benefit them, but that they would need continued support towards employment; others felt that if they were assessed as ‘fit for work’, this could cause significant mental health issues and emotional distress. Being incorrectly categorised within the ‘fit for work’ group for those who feel they would need more enhanced support towards work could potentially have an adverse effect on individuals suffering from mental ill health, or in recovery, and therefore push them further from employment.

3.6 Many individuals have expressed a desire to move into employment, training or education. This corroborates findings from previous research, which has found that 90% of psychiatric service users wanted to go back to or into work [1] . Individuals have identified the desire to attend university; to start a new career in a variety of sectors; to learn basic literacy, numeracy and IT skills to support their personal growth and recovery; and generally to work towards a rewarding job.

3.7 However, for many, this also involves a period of recovery. Whilst many individuals are aware of the positive benefits of employment – especially in aiding recovery – the need for support throughout this is important. If individuals find themselves without a required level of support – either towards work, or generally if the individual is unable to work – it may take several months for individuals who feel they have been allocated to the wrong group to have their appeal heard. In the meantime, individuals are worried that the support received will not be suitable.

3.8 The limited weekly rate during the assessment phase can also promote mental discomfort and emotional distress. Individuals moving from the long-term basic rate of IB to the assessment phase of ESA see a drop of over two fifths (43%) in their income – up to £40.80 a week – if they are under 25; those aged over 25 see a smaller fall of £26.75 a week, but this still accounts for a fall of over one quarter (28%) in their weekly income.

3.9 Similarly, if individuals are found ‘fit for work’, they would continue to receive the same amount as in the ESA assessment phase – a significant reduction in the income of individuals who would have to adapt, for at least a short period of time, to a much lower level of financial support.

3.10 Seeing such a dramatic fall in financial support throughout the assessment phase is likely to impact on the emotional wellbeing of claimants. If individuals feel they want to appeal this decision, the level of financial support they receive could continue to be lower than expected until the appeal is heard – further prolonging difficulties for individuals who feel they have been assigned to the wrong group.

3.11 Further to this, and linked to the overall issue of communication, is that the effects on other associated benefits are not fully understood by many claimants. After a WCA, individuals are unsure as to how their assignment to each group would affect other benefits, such as housing benefit. Again, this provides a needless cause of worry for claimants who have not yet been assessed and may heighten misconceptions about the process.

4 FLEXIBILITY

4.1 One key factor reflected on by individuals was the need for flexibility in the Work Capability Assessment to take account of differences in mental and physical ill health. An internal report has already identified the need for widening the support relating to people’s mental functions [1] . A further review by Professor Malcolm Harrington noted the need to involve mental health charities and organisations to help refine mental, intellectual and cognitive descriptors for the WCA [2] .

4.2 Individuals feel that this is especially important, as different people suffer different mental health issues. Mental wellbeing is not consistent and, especially for those in recovery from addiction, the path to recovery and employment is not always a straightforward and easy one. Continued support throughout recovery and towards employment should be something an individual in recovery can rely on.

4.3 Individuals have noted a concern for the WCA to take account not only of current mental and physical health, but also of previous health and wellbeing. One individual noted that, with a life-threatening illness, the medications they take often vary. As a result, they would seem a confident and healthy individual one day, but may not feel consistently well throughout the week. As such, they may be fit for a part-time job, but not a full-time job. The differences and sensitivities within the WCA, without any formal communication on the issue, is a worry for some individuals.

4.4 Therefore, the WCA should take note of previous changes (especially regular changes) in medication as well as in physical and mental health.

April 2011


[1] Grove, B. (1999) ; Mental health and emplo yment: Shaping a new agenda ; Journal of Mental Health, Vol. 8, No. 2, p131—140

[1] DWP (October 2009); Work Capability Assessment Internal Review;

[2] Harrington, Prof. M. (2010); Harrington WCA Review: Year 2 Recommendations – Timeline