Personal Independence PaymentLetter from the Minister for Disabled People to the Committee Chair following evidence session on 21 January 2013

Thank you for giving me the opportunity to answer queries at the Committee’s oral evidence session on 21 January 2013 concerning the introduction of Personal Independence Payment (PIP). As we now approach the final stage of implementation, Parliamentarians will continue to have an important role in scrutinising the detail, but also in helping to explain the changes and ensuring that they are well understood, and I am grateful for your support with this.

In your letter dated 28 January 2013 you have raised a number specific questions relating to PIP and the Government’s wider strategy on disability. I have responded to these questions in Annex A. I have also sought to clarify several topics which were discussed with the Committee during the evidence session. This is in Annex B.

Following the evidence session I can now confirm that guidance for the assessment providers is available on the DWP website.1 Although we are not running a formal consultation on this guidance, I would welcome any comments that the Select Committee may have. I have also enclosed a copy of relevant extracts from the working draft2 of the guidance for decision makers which we have made available ahead of the debates on the Regulations.

I look forward to continuing to work closely with the Committee as my Department works towards the implementation of Personal Independence Payment and thereafter on the Independent Review. I am copying this letter to all Members of the Work and Pensions Select Committee.

Annex A

1. How many and what proportion of working-age DLA claimants, projected to be in receipt of DLA in May 2018 without the introduction of PIP, do you expect to lose either some or all of their benefit by May 2018 as a result of the introduction of PIP?

This analysis is not currently available. The most recent information on caseload impacts and reassessment outcomes was published in a technical note on 13 December 2012, it is available at:

http://www.dwp.gov.uk/policy/disability/personal-independence-payment/briefing-notes/

2. What is the expected period of time between:
The claimant submitting a claim and a decision on whether a face-to-face assessment —  is required;
The claimant submitting a claim and a face to face assessment being carried out; — 
A face to face assessment taking place and the claimant being informed of the —  award decision; and
A PIP award decision being taken and the award being put into payment. — 

Once the claimant submits a claim, they will be issued a, How your disability affects you questionnaire. They will have one month to return the questionnaire, although we have the discretion to extend this time period where there is good reason, for example where the claimant needs the assistance of an adviser.

As soon as the, How your disability affects you questionnaire is returned, the case will be sent to the assessment provider to action. I can confirm that the service standard for Assessment Providers is 97% of cases to be cleared within 30 working days (six weeks), with an additional service standard that on average no cases take longer than 40 working days to clear. This is based on indicative timings for each of the processes that the assessment providers will need to carry out once a referral is received, including four weeks (20 working days) for requesting and awaiting the return of further evidence. The timings of individual steps within this process will vary on a case-by-case basis, for example where it is clear a face to face consultation will be required the claimant may be informed immediately, in other cases the provider may decide to await the return of evidence before scheduling a consultation. In all cases the claimant will be given notice of a face to face consultation at least seven calendar days in advance of the appointment, unless they agree to a shorter notice period. The seven calendar day notice period is specified in the Regulations.

We believe 30 working days allows sufficient time for assessment providers to gather the necessary evidence and return their advice to the Department. We will monitor the impact of this service standard once the benefit is operational.

Once the health professional’s report has been received, the time the Departmental Decision Maker takes to make a decision on the claim will depend on individual cases. Some cases may be straightforward and a decision can be made immediately, in other cases the Decision Maker may want to go back to the assessment provider for further information.

The time between a decision being made and the claimant receiving payment will depend on the claimant’s payday and payment cycle. But in all circumstances claimants will receive at least 28 days further payment of DLA, before the PIP award, where applicable, is put into payment.

3. In making a decision that a claimant does NOT have to undergo a face to face assessment, will DWP and/or the contracted assessor require corroborating medical evidence in addition to the claim form?
If so, who will be responsible for gathering such evidence? Who will meet the —  costs, including for financial costs where there is a fee, such as for a heath professional’s letter?

Where possible, assessment providers will be expected to carry out assessments on the basis of a review of documentary evidence only, without the need for the individuals to attend a face-to-face consultation. Decisions on whether this is possible will be taken on a case-by-case basis. Guidance for assessment providers on when to conduct a paper-based review is contained in the PIP Assessment Guide, which is available on the DWP website at: http://www.dwp.gov.uk/docs/pip-assessment-guide.pdf.

We expect that in most of the cases where a paper-based review is conducted there will be additional corroborating evidence, either submitted by the claimant with their, How your disability affects you questionnaire, or gathered by the assessment provider, as it is important that all assessments are fully evidence-based. However, there is no requirement for the assessment provider to gather corroborating evidence in all paper-based review cases. Where the information contained in the, How your disability affects you questionnaire is sufficient to provide accurate and robust advice, the Health Professional may advise on that basis.

Where additional evidence is needed, assessment providers will be responsible for gathering that evidence. The Department will meet the cost of GP Factual Reports and DS1500s (evidence of terminal illness). The fees for GP Factual Reports will be paid by the assessment providers but reimbursed by the Department.

While we encourage claimants to submit any evidence they have to hand, we are clear in the information booklet which accompanies the, How your disability affects you questionnaire that we do not expect them to request or pay for any supporting evidence.

4. For reassessed DLA claims, in what circumstances will claimants be allowed longer than four weeks to complete and return their PIP claim form?

The reassessment arrangements allow for a period of four weeks in which a claimant must make their PIP claim. Postal reminders will be sent midway through the claiming period and at the end. Attempts to telephone claimants will also be made where a claim has not been received within time. We will ask information on whether a claimant has a mental health or behavioural condition, learning disability, developmental disorder or memory problem and we will offer them the additional support that they need.

Where someone is unable to make their claim within the four week period, for example where the claimant has recently gone into hospital, the Secretary of State may extend the claiming period. If, after these reminders, PIP remains unclaimed within the claim period, the claimant’s DLA will be suspended for a period of up to four weeks during which a claim to PIP can still be made.

 — How many and what proportion of reassessed DLA claimants do you expect to require longer than four weeks to return their PIP claim?

In advance of live running we have no reliable estimates of the volume of claimants that will require longer than four weeks to return their claim form but we will be keeping this under review; and will be seeking regular feedback on this issue from disability representative organisations through the Independent Stakeholder Forum.

5. Is it the case that no claimant will lose benefit before they have a final decision on their eligibility for PIP and the award is in payment, including those who require extra time to compete and return their PIP application and those whose face to face assessment may be delayed because the claimant is ill or in hospital?

Provided claimants supply all the information within the required timescales, including where these have been extended, and comply with all requirements, such as attending a consultation when required, individuals will continue to receive their DLA until an initial decision on PIP entitlement has been made.

Following a decision on PIP entitlement, DLA will remain in payment for a further 28 days following the payday after the decision is made.

 — Are there any circumstances in which a claimant’s DLA will be stopped before their PIP award is in payment?

So long as a claimant complies with all the requirements of the claiming process there are no circumstances where there would be a break in payment between DLA and PIP.

6. Will all the DWP guidance on PIP be published before the relevant Statutory Instruments are considered by both Houses of Parliament?

Guidance for assessment providers is now available on the DWP website. This can be found at:

http://www.dwp.gov.uk/docs/pip-assessment-guide.pdf.

Although we are not running a formal consultation on this guidance, we will consider any comments that are submitted, this includes any comments that the Select Committee may have.

The guidance for Decision Makers is still being developed, however we have provided relevant extracts of the working draft to the members of the Delegated Legislation Committee who will consider the affirmative PIP regulations and are also making it available to Lord McKenzie and Lord German.

7. Will there be a limit on the time taken to carry out mandatory reconsideration of PIP award decisions?

The priority for the Department in undertaking mandatory reconsideration is to ensure that the decision being disputed has been fully reviewed in light of all the available evidence. This will include, where necessary, requesting further evidence from the claimant, or allowing a reasonable time for any additional evidence that the claimant wishes to provide, which they believe will help their case. The Department believes, therefore, that it would be wrong to put pressure on decision makers to complete mandatory reconsideration in an arbitrary time period by setting a time limit, and that it is more important to ensure that the decision is correct and then explained fully to the claimant.

That being said, the Department does not wish to unnecessarily delay issuing a mandatory reconsideration decision, or to cause unnecessary delays to claimants who may wish to make a subsequent appeal to HM Courts and Tribunals Service. The Department is considering how best the mandatory reconsideration process may be monitored and managed to achieve this

8. What target will DWP set for the time between an appeal being lodged and it being heard by the Tribunals Service?

The Department will have a target set in the Tribunal Procedure Rules to provide its response to appeals lodged with HM Courts and Tribunals Service (HMCTS). This target will be set at 28 calendar days from the date the Department receives the request for a response, but may be extended at the Tribunal’s discretion.

There are no proposals to set a target covering the period from an appeal being lodged to the Tribunal hearing, any such target would be a matter for HM Courts and Tribunals Service rather than the Department.

9. What is the anticipated rate of appeal as a percentage of PIP assessments carried out, for both new PIP claims and reassessed DLA claims?

Based on our experiences with DLA and ESA and following a PIP decision being made we are expecting an appeal rate of 12.5% for new claims and 40% for reassessed cases. The Department has been working closely with HMCTS sharing our forecasts of future workload to inform their resource requirements. We’ve been working with business analysts to develop current volumes and have factored in some worst-case assumptions to ensure we do not underestimate volumes—we’ll continue to refine the forecasts.

10. Were the contracts with Atos Healthcare and Capita Business Services for the delivery of the PIP assessment agreed on a fixed price over a fixed term basis? If so, what is the total value and time-period of each of the contracts?
Within the terms of the contracts are the suppliers required to complete a certain —  number of assessments within certain timescales? If so, how many are they required to complete and within what timescales?
Under what circumstances would you be able to terminate the contracts in the —  event of poor service delivery?

I would like to clarify the information given to the Committee on the value of assessment provider contracts. The figures provided were estimates as the contracts are not fixed price. The contract is for a demand-led service and the providers are paid for outputs, but we were able to generate estimate values of contracts based on the current pricing and volumes from the tender. This value is £571 million for the three lots in Great Britain over the five year term of the contracts.

No targets have been set in relation to the number of assessments completed within certain timescales. Bidders were invited to tender for the PIP assessment service based on projected volumes of claims to PIP, derived from historical DLA claims data. During the competition we asked bidders to describe how they plan to manage service capacity and potentially fluctuating claim volumes. However, as DWP has no control of the actual number of PIP claims received, provision was made within the contract in the eventuality that volumes are significantly greater or fewer than those outlined in the service specification.

If the provider fails to deliver against our quality service measures, agreed service credits will be applied. Ultimately the Department has the right to terminate the contract if there is sustained underperformance in a range of areas.

11. How will existing DLA claimants who reach the age of 65 in or after April 2013 be affected by the introduction of PIP? In particular, will all such claimants be reassessed for PIP rather than continue to receive DLA after the age of 65?

In developing our plans for PIP for older people our overriding principle has been to ensure that people of the same age who are in receipt of DLA are treated equally. So anyone aged 64 or under on 8 April this year who is in receipt of DLA, or has recently been in receipt and claims again within the linking period, will, at some point in the future be invited to claim PIP. This means that as the bulk of activity to invite claims to PIP will not begin until October 2015 there will be some people who will have reached age 65 or above by the time they are invited to make a claim. To ensure that these people are treated as fairly as possible the Transitional Regulations will enable anyone undergoing reassessment for PIP, after age 64, to access all components and all rates without the usual age restrictions applying.

12. Where a DLA claimant with a Motability car which they have adapted at their own expense has to return the car as a result of being found ineligible for PIP enhanced mobility rate, will they be reimbursed for the adaptations they have paid for?

Motability is consulting with their customers and disability organisations to develop a package of support to help those customers who lose their eligibility to use the Motability Scheme as a result of their PIP reassessments.

These measures will be in place by October 2013 and could include:

Allowing them to retain the Scheme car for a short period after their mobility allowance ends, giving them some time to make alternative arrangements. In exceptional cases—for example, where a customer is likely to have particular challenges due to adaptations or where there are immediate personal circumstances, Motability will consider whether they can accommodate a later return date for the car;

an opportunity to purchase their current Scheme car; and

A package of information and advice on motoring, insurance and associated services outside of the Scheme.

13. Will any mechanism be put in place to alert Motability that a DLA recipient is to undergo a PIP assessment in the next three months to avoid them being supplied with a car before their eligibility for PIP enhanced mobility rate has been established?

DWP is working closely with Motability to ensure the smooth introduction of PIP as it relates to users of the Motability Scheme. Under these plans, DWP will inform Motability of any decisions which affect a user’s eligibility to remain on the Motability Scheme. Motability are also taking a number of steps to ensure that users and potential users of the Scheme are aware of PIP and understand the potential implications for their eligibility to use the Scheme.

Annex B

Further clarification of topics that were discussed during the Committee Meeting on 21 January 2013

Younger Disabled People

Children under the age of 16 will continue to be able to claim DLA in the usual way. The arrangements are entirely consistent with the way DLA works currently: at age 16 a claimant is considered under the adult rules and is able to claim the benefit in their own right. What we have done, however, is to amend the arrangements for inviting the claim to PIP and exclude terminally ill claimants from the general provisions (meaning they only need to apply when their DLA award is due to expire). The claim process for young people approaching the age of 16 is included in more detail in the Government response to the Detailed Design consultation, available at: http://www.dwp.gov.uk/docs/pip-detailed-design-response.pdf

The process was amended to reflect the responses we received to the consultation.

In terms of the impact of reassessment I should make clear that children will not be disproportionately affected by the finalised reassessment timetable. Only one in every 14 reassessment claims from October 2013 onwards will be children reaching the age of 16 and being invited to claim PIP—around 2,500 per month. The numbers newly claiming PIP at age 16 are expected to be similarly low, for example between April and September this year we estimate that fewer than 2,000 claims will be made by 16 year-olds out of a total of around 160,000 claims.

We also discussed how we can ensure that assessment providers can work with young people’s schools and colleges to make the process as smooth as possible for them when they transition on to PIP at age 16. Although the assessment providers have already largely determined their strategies for the locations of consultations, we will pass them the Committee’s suggestion about carrying out consultations in schools or colleges. I can also confirm that we consider information from a young person’s school or college to be a potentially good source of evidence for PIP claims and this was included in the guidance for assessment providers.

Young people aged 16 and over who are disabled or have special educational needs and disability (SEND) may be eligible for PIP. We will explore how evidence gathered as part of a single assessment for the Education, Health and Care Plan might be used to support a PIP claim, where possible avoiding the need for the individual to provide the same evidence multiple times. We are working closely with officials in the Department for Education so that the design and evaluation of the SEND pathfinder programme—which will run through to September 2014—can inform future decisions on this.

Mobility Criteria

There was considerable discussion on the PIP mobility criteria at the evidence session and I thought it would be helpful to set out clearly the Government’s position. We have always intended that being unable to walk more than 50 metres should lead to entitlement to some rate of the Mobility component. Within this, we wanted those who face the greatest barriers to mobility to receive the enhanced rate and the remainder the standard rate. Effectively ensuring that the enhanced rate goes to those who are unable to walk or virtually unable to walk.

In the second draft of the assessment criteria we made this differentiation by looking at the types of aid individuals used. But we did not do it well. We used terms such as “up to” certain distances that meant it was not clear which descriptor applied to people. As such people received variable outcomes, as demonstrated by our own case studies. The strong response we got in our consultation and meetings with disability organisations was that the criteria were very unclear. And many organisations told us that it looked like only those people who need to use wheelchairs could receive the enhanced rate. We heard this from the Disability Benefits Consortium, MS Society, Parkinson’s UK and Leonard Cheshire among others.

As such we changed the criteria to make them clearer and easier to apply. We have now differentiated within the eligible group by looking at the distance individuals can walk, introducing a 20 metre measure linked to the enhanced rate. We feel that this is much clearer, whilst still reflecting the original policy intent. I do accept, however, that we may not have communicated this intent as clearly as possible.

Importantly, the criteria must be looked at in context of whether individuals can complete activities safely, repeatedly, to an acceptable standard and in a timely fashion. If individuals can walk more than 20 metres but can’t do so in this manner, they would receive 12 points and therefore the enhanced rate of the component. This is a significant protection for individuals.

The result of this is that our analysis on the impact of the second and final drafts of the assessment criteria shows that the numbers of people who score 12 points on the ‘moving around’ activity will be broadly the same under both sets of criteria, despite an overall component caseload reduction. This shows that the change to this activity does not create an overall tightening of entitlement.

Mobility Caseloads

It may also be helpful to clarify an issue in relation to the estimates of the overall Mobility component caseload. The Committee referred to the fact that figures published in January 2012 referred to an estimated 280,000 difference between the enhanced rate Mobility component caseload in PIP and the equivalent in DLA, while the estimates for May 2018 now show that there will be a difference of 428,000.

As the Department made clear in the response to the assessment consultation, while the 280,000 figure was our best estimate when we released it in January 2012, it is not possible to compare this with the latest figures published in December 2012. Firstly, the two figures refer to different time periods. Secondly, the latest figures reflect the significant changes to the reassessment timelines announced in December and are based on a new, OBR (Office of Budgetary Responsibility)-approved model, which also reflects updated policy assumptions. For this reason in the December document we also published new estimates on the impact of the second draft of the assessment criteria, in addition to those for the final draft. This showed that:

the estimated difference between the numbers of people receiving the highest rate of DLA or PIP in October 2015 under the second draft of the assessment would have been 192,000 (213,000 under the final version); and

the estimated difference between the numbers of people receiving the enhanced rate of PIP in May 2018 under the second draft of the assessment would have been 377,000 (428,000 under the final version).

The caseload figures are set out in the table below for ease. I would, however, reiterate what I said at the evidence session that the April 2018 figures do not take into account any potential changes to the design or delivery of PIP as a result of operational experience, including the findings of the first independent review of the PIP assessment which will report by the end of 2014.

Scenario

Highest rate Mobility component
caseload (PIP and/or DLA)

No reform October 2015

1,029,000

Second draft PIP Assessment October 2015

837,000

Final PIP Assessment October 2015

817,000

No reform May 2018

1,030,000

Second draft PIP Assessment May 2018

652,000

Final PIP Assessment May 2018

602,000

Question 41: Safely, Reliably, Repeatedly and in a Timely Manner

During the evidence session discussed the issue of whether the Regulations for the assessment could make clear that, when assessing individuals, consideration must be given to how well they are able to complete them and whether they can do so in a way that is safe, repeatable and timely.

This concept has always been integral to the Department’s proposals for the PIP assessment but as I said at the Committee, we have been looking urgently at this again, as I recognised the strength of feeling on the issue.

I can now confirm that the Government will be making changes to make this matter clear in the PIP Regulations. We will lay an amending Regulation once the main PIP entitlement Regulations are made by Parliament, ensuring that the change is included before the PIP Regulations come into force from 8 April.

Draft amending regulations were published online on 31 January and are available at:

http://www.dwp.gov.uk/policy/disability/personal-independence-payment/the-assessment-criteria/

Blue Badges

The UK Government is committed to ensuring that the Blue Badge scheme continues to be focused on those people who will benefit most from the parking concessions that it offers, and that it is sustainable in the future.

The Department for Transport (DfT) consulted between July and October 2012 on the options in England for dealing with the impact of the welfare changes on Blue Badge eligibility. Having carefully considered the responses to their consultation, they have concluded that when DLA is replaced by PIP, there should still be a legislative link to Blue Badge eligibility.

People who score 8 points or more in the ‘moving around’ activity of PIP will be automatically eligible for a Blue Badge. This activity assesses a person’s physical ability to get around and a score of 8 points or more will be awarded to people who cannot walk further than 50 metres. This means that future eligibility for a Blue Badge will be as similar to the current eligibility criteria for the scheme as possible.

The Welsh Government ran a three month consultation on the blue badge scheme which ended on 30 October 2012, in response to the introduction of Personal Independence Payment. They announced on the 14 December 2012 that automatic entitlement for a Blue Badge will be linked to Personal Independence Payment when it is introduced.

They have also announced that under PIP automatic eligibility for a Blue Badge is to be granted to individuals who:

Score 8 points or more in the ‘moving around’ activity of PIP will be automatically eligible for a Blue Badge.

Score 12 points in the ‘planning and following a journey’. This is awarded when the claimant cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid.

We are expecting an announcement shortly from the transport departments in Northern Ireland and Scotland on the approach they intend to take to eligibility for a Blue Badge following Disability Living Allowance reform.

Evaluation and Independent Review

The Committee asked about our proposals for an evaluation of PIP. I can confirm that we are developing detailed proposals for a programme of monitoring, evaluation and analysis that will help the Department to learn about and improve the delivery of Personal Independence Payment. The evaluation will aim to explore the extent to which Personal Independence Payment has met its policy objectives and is intended to be flexible, recognising that over time the importance of issues may change and new areas of investigation may be required.

On the 13 December 2012 we published our outline evaluation proposals:

http://www.dwp.gov.uk/docs/pip-evaluation-proposals.pdf.

The Department has also committed to commissioning and publishing two independent reviews of the operation of the assessment for Personal Independence Payment, the first of which we intend to complete by the end of 2014. We haven’t set the detailed parameters of the independent review yet but we will work together with interested parties to do so.

Carers

I would also like to respond to a point made by the Committee about allaying some of the fears which exist around these reforms.

On the 18 January my officials met with Carer’s UK as part of our on-going discussions with organisations representing disabled people and their carers. Officials outlined where we are with the legislation and impacts work, as well as our proposals for a programme of monitoring, evaluation and analysis to help the Department learn about and improve the delivery of PIP. I understand that this was a useful and informative meeting. Carers UK’s insight is immensely valuable, and I appreciate their important contribution—a further meeting is planned for early this month.

4 February 2013

1 www.dwp.gov.uk/docs/pip-assessment-guide.pdf

2 Information provided, not printed

Prepared 7th May 2013