1PIP and ESA functional assessments
Our inquiry and this report
1.The public response to our inquiry on Personal Independent Payment (PIP) and Employment and Support Allowance (ESA) assessments has been unprecedented. Almost 3,500 individuals shared their experiences with us via written evidence and an online forum, an unprecedented public response to a departmental select committee inquiry.1 Many of their testimonies include very personal information that must have been difficult to share. We also do not doubt that corresponding with a select committee can be a daunting and time-consuming exercise. This report is a tribute to the efforts and bravery of those claimants who got in touch.2
2.Standard select committee reports set out some of the evidence they have received, analyse that evidence, and make policy recommendations to government. We will shortly produce a second report, which will further draw on evidence from claimants and organisations in setting out our policy proposals. This will include recommendations on:
- building trust in and improving transparency of assessments;
- improving the application process;
- the role of medical evidence and addressing concerns about lack of assessor expertise;
- improving assessment quality and feedback between the Department and contractors; and
- contracting arrangements, in advance of PIP and ESA contracts expiring in 2019/20.3
In this report we have sought to draw attention and give voice to some of the real life experiences reported to us, illustrating the human consequences of shortcomings in the benefit assessment system. Alongside a small number of representative organisations, most of the evidence in this report comes directly from the individuals affected.4 We have used a small fraction of our evidence to illustrate widely-expressed concerns. They are:
- errors in assessment reports, such as inclusion of incorrect information and omission of relevant information shared during the assessment;
- the difficulty and distress that claimants can experience filling in PIP and ESA application forms;
- inaccuracies in reports arising from lack of assessor knowledge about the functional implications of different conditions;
- problems with Mandatory Reconsideration (MR), and the stress associated with challenging a decision at MR or Appeal.
Box 1: PIP and ESA
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PIP and ESA support disabled people and those with long term health conditions. PIP provides help towards the extra costs of having a long-term health condition or disability. It is available both in and out of work. ESA is an out-of-work benefit for people whose capacity to work is limited by a health condition. Since 2013, 3.2 million people have applied for PIP, and 3.1 million have applied for ESA.5 Assessment processes for PIP and ESA are separate, but have similar structures. Assessments are carried out by contractors on behalf of the Department for Work and Pensions (DWP/the Department).6 In most cases, a contractor carries out a face to face assessment of the claimant and compiles a report for DWP. A member of DWP staff, known as a Decision Maker, then reviews the report and decides whether the claimant is entitled to benefits. If the claimant disagrees with the decision and wants to challenge it, they must first request a Mandatory Reconsideration (MR). This is an internal review carried out by a Decision Maker. If the claimant disagrees with the MR decision, they can appeal to a Tribunal. |
A process that works for many
3.People tend only to make representations about their experiences to MPs or select committees when they are in difficulty or have had a poor experience with a public service. It is therefore unsurprising that the vast majority of submissions we received were critical of the assessment process. We did, however, receive a few positive responses:
I was very pleased with the service I received. The process was a lot quicker than I thought it would be, which pleasantly surprised me. I was more than happy with the assessor, she was to the point but did what she needed to do. I don’t have any complaints. Beckey
I thought my PIP assessment was carried out sensitively, with proper appreciation of my circumstances. I was happy with the result. Everyone I dealt with, both by telephone and at the assessment centre, was aware of how frightening the process could be and did all they could to counter that. I was very happy with the way I was treated and thought the process was properly fair and objective. Nick
I was rather nervous when I had to apply for PIP. However, I was pleasantly surprised to find that the assessment would take place at my house. My assessor had worked in neurological healthcare and understood my condition. He was very easy to talk to and spent four hours interviewing me. When I received the result, I was very pleased to see that I would be able to retain my Motability car. Until I saw the letter I hadn’t realised how worried I’d been - I felt an enormous weight lift from my shoulders, and burst into tears of relief. Name withheld7
4.The Department told us that claimant satisfaction with PIP and ESA is high. In 2015/16, 76% of PIP claimants and 83% of ESA claimants surveyed were satisfied with the service they received from the DWP.8 All three contracted providers “consistently exceed” their customer satisfaction targets of 90% for PIP and 91% for ESA.9 Contractors and the Department both also reported low numbers of complaints about either benefit.10 The Secretary of State cited the relatively low proportion of all PIP and ESA claims that are appealed at Tribunal as further evidence of satisfaction.11 The claim that assessment processes work well for most claimants is generally supported by recent PIP claimant research.12
Failing a substantial minority
5.This evidence does not, however, tell the whole story. Since 2013 more than 1 in 20 PIP and ESA claimants only received what they were entitled to after challenging the DWP’s initial decision. This amounts to huge numbers of claimants: 290,000, comprising 227,000 for PIP and 63,000 for ESA. For both benefits, half of those claimants had to go through both challenge processes of MR and appeal.13 These figures will underestimate the scale of the problems as some claimants feel unable to face challenging their initial or MR decision.14 Though thousands of individuals responded to our inquiry, they amount to only a small proportion of people who have encountered difficulties with the process.
Conclusion and recommendation
6.The PIP and ESA assessment processes function satisfactorily for the majority of claimants, but they are failing a substantial minority. The response to our inquiry from claimants was striking and unprecedented. This report—featuring just a fraction of the evidence we received—is a tribute to their efforts and bravery in submitting evidence and a reflection of the importance of recognising the human consequences of policy shortcomings.
7.We recommend the Department set out in response to our report, for each category of concern we have identified:
a)whether it recognises this concern;
b)any assessment it has made of its prevalence;
d)what measures are in place to prevent it, and at what stage in the process;
e)any related performance measures; and
f)what further steps, if any, it intends to take.
1 We hosted an online forum on the parliament.uk website which received around 3,000 comments. We also received 550 written evidence submissions, the vast majority of which were from individual claimants.
2 We have lightly edited some of the submissions for readability or to put them into context.
4 Where the evidence is from individuals we have anonymised (if submitted as written evidence), or used first names only (if submitted via the forum).
5 Data correct to October 2017. See DWP, Personal Independence Payment: official statistics, December 2017; DWP, Employment and Support Allowance: Work Capability Assessments, Mandatory Reconsiderations and appeals, December 2017
6 Atos Independent Assessment Services provides PIP assessments in the North East and North West of England, London, the South East, East of England, South West England and Scotland. Capita provides assessments in Central England, Wales and Northern Ireland. ESA Work Capability Assessments are carried out nationally by Maximus Centre for Health and Disability Assessments.
8 DWP, Claimant service and experience survey 2015/16, January 2017, p.4
10 DWP (PEA0441), Maximus (PEA0532), Capita (PEA0547), Letter from Atos IAS to the Chair of the Committee, December 2017
11 The proportion of PIP/ESA claims that go Appeal is 8% for both benefits, when expressed as a proportion of all applicants. DWP (PEA0441)
12 DWP, Personal Independence Payment claimant research (wave 2): interim headline findings, December 2017. No comparable recent research is available for ESA.
13 DWP, Personal Independence Payment: official statistics and Employment and Support Allowance: Work Capability Assessments, Mandatory Reconsiderations and appeals; Ministry of Justice, Social security and child support tribunal data, table SSCS.3, December 2017. Appeal data correct to September 2017.
1 February 2018