Employment and Support Allowance and Work Capability Assessments - Work and Pensions Committee Contents


2  ESA claims process and outcomes

10. To claim ESA, an individual must first contact Jobcentre Plus (JCP), either by telephone or by submitting a form (ESA1), and provide some basic information. Once the claimant has provided a medical certificate or Fit Note (issued by a GP), then ESA is paid to them at an initial assessment rate, which is equivalent to the amount paid to people claiming Jobseekers Allowance (JSA). At this stage, all cases are referred to Atos Healthcare, which then sends claimants a Limited Capability for Work Questionnaire (ESA50). In completing this form, claimants are asked to provide information about their health conditions or their disability, and their physical and mental, cognitive and intellectual functions. Claimants can also submit additional information that they wish to be taken into account in their claim. Once this form has been submitted, Atos makes a decision on whether, on the basis of the information provided, the claimant can be placed in the Support Group, or whether a WCA is necessary.[10]

11. Those invited to undergo a WCA are required to attend an Atos assessment centre. A Health Care Professional (HCP) employed by Atos will assess the person making a claim. The assessment is based on points being awarded against a number of measures of functionality, based on a set of "descriptors". The assessor will then pass on a report, along with an overall recommended "score", to a DWP decision-maker (DM).[11]

12. The DM decides whether the claimant is fit for work, or is to be placed in the WRAG or the Support Group. They make this decision by taking account of the Atos report and the recommended score, alongside the ESA50 and any other supporting evidence provided. If the claimant has reached the 15-point threshold required to be placed in the WRAG, the DM will also consider whether the claimant meets one of the 16 further criteria to be placed in the Support Group. Claimants not assigned to either the WRAG or Support Group are considered to be fit for work and are not awarded ESA.[12]

Trends in ESA outcomes

13. DWP's commentary on the latest ESA outcome statistics refers to "the bedding down of the benefit, with distinct growth in the Support Group and decline in the WRAG from April 2011".[13] Statistics for each of the outcome groups are shown below.

FIT FOR WORK CLAIMANTS

27% of new claimants were found fit for work in the period July to September 2013. This compares with 64% when ESA was introduced in 2008.[14] For migrated IB claimants, the figure was 11%, down from 27% in the second quarter of 2012.[15]

WORK-RELATED ACTIVITY GROUP (WRAG)

The proportion of new ESA claimants placed in the WRAG rose from 24% when the benefit was introduced in 2008 to a high point of 30% at the end of 2010, but has fallen steadily since to 16% in the third quarter of 2013. This is in the context of an overall increase in the numbers eligible for ESA, from 36% in 2008 to 73% in 2013. For reassessed IB claimants, the latest figures show that the percentage of claimants placed in the WRAG fell from 22% to 17% compared to the previous quarter.[16] In the second quarter of 2012, the comparable figure was 38%.[17]

SUPPORT GROUP

The latest ESA statistics covering the period July to September 2013 show that the proportion of new claimants assigned to the Support Group increased from 49% to 57% compared to the previous quarter. In the same period 72% of IB claimants being migrated to ESA were placed in the Support Group, an increase of 6 percentage points. [18] In the first 18 months of ESA, only 6% of new claimants were assigned to the Support Group.[19] At the start of the IB reassessment process the Government estimated that 20% of claimants would be assigned to the Support Group.[20]

14. The Secretary of State has referred to claimants "languishing" on IB.[21] Figures for the latest quarter show that, rather than "languishing" inappropriately on IB, 89% of IB claimants who were reassessed were entitled to ESA, with the vast majority being placed in the Support Group.[22]

The claimant experience

15. Throughout this inquiry, we have heard from a large number of claimants, and their relatives and support workers, who shared with us their experiences of claiming ESA, and particularly in going through the WCA. Some of these people wrote to us; others came along and described their experiences at the public meeting we held in Newcastle. Many reported feeling dehumanised, ignored or questioned inappropriately. Some felt that the progress they were making towards recovery, and then moving back into work, was hampered rather than aided by the anxiety caused in facing the WCA. While it might be expected that those who believed that they were placed in the wrong group felt aggrieved, we also heard from those who felt that they were placed in the most appropriate group in the end, but who also felt that the process had still been a harrowing and stressful ordeal for them.

16. It is too early to predict whether the current trends in ESA outcomes will stabilise. However, we note the recognition within the ESA system that a higher proportion of claimants than initially expected are not fit for work and are therefore eligible for ESA, and that, of these, many need the higher level of benefit and absence of work-related conditionality which the Support Group provides. Nevertheless, it is clear that many claimants still find the process very stressful. Many find themselves in an outcome group which does not reflect their health barriers to employment, because the current system is not sufficiently sophisticated to cope with the wide variety in prognosis and impact which arises from the huge range of conditions which claimants present with.

17. In the next chapters, we raise concerns about the current system and set out a number of shorter-term changes which we believe will help ameliorate some of its most egregious flaws. However, our overall conclusion is that the design of the ESA benefit and assessment process is so problematic, particularly in relation to the confusion and limitations of the outcome groups, that its inefficiencies and the detriment inappropriate decisions cause to claimants can only be resolved in a fundamental redesign of the ESA claims process over the next few years. Our views on what this redesign process should consider are set out in Chapter 8.


10   Dr Litchfield, An Independent Review of the Work Capability Assessment - year four, December 2013, Chapter 1, paras 8-16; Gov.uk webpage, accessed 7 July 2014  Back

11   DWP, A guide to Employment and Support Allowance - the Work Capability Assessment, January 2013, pp 8-16; Dr Litchfield, An Independent Review of the Work Capability Assessment - year four, December 2013, Chapter 1, para 11 Back

12   Dr Litchfield, An Independent Review of the Work Capability Assessment - year four, December 2013, Chapter 1, paras 12-16 Back

13   DWP, ESA: outcomes of WCAs, Great Britain, Quarterly official statistics bulletin, 12 June 2014, Results, p 6. The outcome of appeals is likely to increase percentages in both the WRAG and the Support Group. Back

14   DWP, ESA: outcomes of WCAs, Great Britain, Quarterly official statistics bulletin, 12 June 2014, Results, p 2  Back

15   DWP, ESA: outcomes of WCAs, Great Britain, Quarterly official statistics bulletin, 12 June 2014, Results, p 12; DWP, ESA: outcomes of WCAs, Great Britain, Quarterly officials statistics bulletin, April 2013, p 4 Back

16   DWP, ESA: outcomes of WCAs, Great Britain, Quarterly officials statistics bulletin, 12 June 2014, Results, pp 2 and 12 Back

17   DWP, ESA: outcomes of WCAs, Great Britain, Quarterly officials statistics bulletin, April 2013, p 4 Back

18   DWP, ESA: outcomes of WCAs, Great Britain, Quarterly officials statistics bulletin, 12 June 2014, Results, pp 2 and 12 Back

19   DWP, Employment and Support Allowance: Work Capability Assessment by health condition and functional impairment: Official Statistics, October 2010, Executive Summary Back

20   See Work and Pensions Committee, The role of incapacity benefit reassessment in helping claimants into employment, para 154 Back

21   Speech of the Secretary of State for Work and Pensions to the Ways and Means Committee, House of Congress, 27 June 2012, accessed 09 July 2014 Back

22   DWP. ESA: outcomes of WCAs, Great Britain - tables, 12 June 2014, table 10 Back


 
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Prepared 23 July 2014