8 Redesigning the ESA and WCA process
The
case for a fundamental redesign of ESA
138. As we have stated, although we
hope that the shorter-term improvements we have recommended will
be adopted, we are convinced that a more fundamental approach
to improving ESA is necessary. ESA is trying to do two very different
things. Because the main purpose is to help claimants "achieve
their full potential through work", much of the design is
about identifying those who could work. As a result, not enough
thought has been put into helping those whose condition is worsening
but is not yet sufficiently advanced to warrant them being placed
in the Support Group. However, as our assessment of employment
outcomes in the previous chapter makes clear, ESA is not yet achieving
its work objectives either. Therefore there is a need for a redesign
of ESA.
WEAKNESSES IN THE ESA OUTCOME GROUPS
139. One of the key reasons for this
ineffectiveness in achieving ESA's employment objectives seems
to us to be that, although the ESA claims process is complex,
the outcomes it offers are too simplistic. As currently
designed, the three outcome groups fail to reflect the widely
varying needs of millions of people affected by the broadest spectrum
of health conditions and disabilities, for whom the functional
impacts on their capacity to work will depend on their individual
circumstances.
Support Group
140. The Support Group appears to be
the outcome group which is most closely meeting its objectives.
Claimants in this group are not required to undertake work-search
or work-related activity, reflecting the seriousness and longevity
of their condition or disability (although they are able to do
this voluntarily if they wish).
Fit for work claimants
141. The "fit for work" outcome
group includes people who have recovered from a temporary health
condition, or who have adapted to a disability, and who will move
easily into work with the right support. However, it also includes
people who face much greater barriers to finding work. As we have
noted above, the expert panel involved in the EBR found that a
high proportion of the sample group of claimants found "fit
for work" using the existing WCA were identified as needing
significant support to enable them to work. Although this support
may be available to some, the "fit for work" classification
needs to be regarded as conditional on this support being available
to claimants with this level of need.
Work-related Activity Group (WRAG)
142. The WRAG is by far the most problematic
of the three ESA outcome groups. As currently designed, the WRAG
is the default for any claimant who cannot be identified as fit
for work, but is not so ill or disabled that they cannot be subject
to any work-related conditionality. This means that the spectrum
of claimants in the WRAG is very broad—varying from those
who are expected to recover from a health condition in three months,
to those with progressive conditions which are expected only to
worsen.
ESA AND UNIVERSAL CREDIT
143. Even without the need to address
the employment outcome weaknesses in the ESA/WCA process, the
benefit would have required reassessment in the next few years
in any case, to take account of the introduction of Universal
Credit (UC), which will bring together tax credits and existing
working-age benefits, including ESA, into a single unified payment.
Contributory ESA will remain outside UC but income-related ESA
will be merged into it. The timetable for implementing UC has
slowed considerably but new claims to UC are expected to be being
made nationwide by 2016 and the bulk of existing claimants are
expected to be migrated to UC during 2016-17 (although DWP has
made clear that it expects about 700,000 ESA claimants in the
Support Group to remain outside UC beyond the 2017 date for its
full implementation, because of the sensitivities around migrating
this particularly vulnerable group).[206]
144. We
agree that an assessment of work capability of some sort is necessary
for an out-of-work benefit paid on the basis of ill health and
disability, and that eligibility should be based on functionality
and not diagnosis. We also agree that this assessment should seek
to distinguish between claimants who are unlikely to be able to
return to work in the long-term, and those who, with the right
support, could return to employment. Nor do we under-estimate
the scale of the task involved in determining eligibility for
an incapacity for work benefit, which is claimed by millions of
people, with a vast range of conditions and disabilities, which
may change over time and which affect individuals in different
ways.
145. However,
the current ESA system is not working as well as it should, particularly
in terms of achieving the intended employment objectives for claimants.
The ESA outcome groups are too simplistic: the WRAG has become
a "catch-all" group for those claimants who do not meet
the narrow criteria for being placed in the Support Group, but
who are not fit for work. The conditionality attached to the WRAG,
and the focus on moving into work in a relatively short period
of time, means that this group, as it currently operates, is not
appropriate for many of these claimants. Nor does the current
WCA provide an accurate assessment of a claimant's individual
health-related employment barriers, or their distance from the
labour market.
146. We recommend that the Government
undertakes a fundamental redesign of the structure of ESA outcomes.
This should focus on identifying changes to the assessment process,
to ensure that the health barriers to employment that an individual
faces are properly identified. For claimants in the WRAG, proper
account needs to be taken of where they are on the spectrum of
readiness for work. Work-related conditionality should be matched
to the identified employment barriers. The support made available
to help the individual move closer to work should be tailored
more closely to their individual circumstances. It may be possible
to use the different prognosis periods for when a claimant is
expected to be fit for work as the basis for varying the conditionality
and accompanying support. The redesign process will require a
considerable amount of research, and will take time, but sufficient
resources should be devoted to it to ensure that a new design
is in place before the new multi-provider contract is tendered
in 2018. The redesign will also need to take account of the implications
for ESA of the introduction of Universal Credit.
147. The descriptors used in the
WCA, and the way they are applied in the current points-based
assessment, are not producing accurate outcomes of functional
capacity in the workplace in many cases. The Evidence Based Review
was a useful process, but more needs to be done to evaluate the
effectiveness of the descriptors and to make them more responsive,
particularly for claimants with progressive and fluctuating conditions,
and those with mental, cognitive and behavioural difficulties.
We recommend that the redesign of the ESA process includes a fundamental
reassessment of the effectiveness of the design and application
of the descriptors used in the Work Capability Assessment.
206 See Work and Pensions Committee, Fifth Report of
Session 2013-14, Universal Credit implementation: monitoring DWP's performance in 2012-13,
HC 1209, paras 23 Back
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