Employment and Support Allowance needs fundamental redesign, say MPs

The Committee calls on the Government to undertake a fundamental redesign of the ESA end-to-end process to ensure that the main purpose of the benefit – helping claimants with health conditions and disabilities to move into employment where this is possible for them – is achieved. This will take some time, but the redesign should be completed before the new multi-provider contract is tendered, which is expected to be in 2018.

In the meantime, the Committee recommends a number of changes which should be made now, to help ensure that claimants receive an improved service, and that the outcomes for claimants are more appropriate.

Dame Anne Begg MP, Committee Chair, said

"Many people going through the ESA claims process are unhappy with the way they are treated and the decisions which are made about their fitness for work. The current provider of the WCA, Atos, has become a lightning rod for all the negativity around the ESA process and DWP and Atos have recently agreed to terminate the contract early.

"But it is DWP that makes the decision about a claimant’s eligibility for ESA – the face-to-face assessment is only one part of the process. Just putting a new private provider in place will not address the problems with ESA and the WCA on its own.

"We are therefore calling for a number of changes which can be made to improve ESA in the short-term, while also recommending a longer-term, fundamental redesign of the whole process.

"We hope that the new Minister for Disabled People, who was appointed last week, will respond positively to our constructive recommendations for improving the ESA process."

One of the key issues which the Report identifies is that ESA is not achieving its purpose of helping people who could work in the short to medium term to move back into employment.

One of the reasons for this is that the outcomes of the ESA claims process are too simplistic. Claimants can be found "fit for work" and are then ineligible to claim ESA. Claimants found to have such limited functionality that that they cannot undertake any work-related activity are placed in the Support Group, where they are subject to no work-related conditionality. This leaves a large and disparate middle group of claimants who are not yet fit for work, and may even have a deteriorating condition, but who are required nonetheless to undertake activity which is meant to help them find work in the longer term. These claimants are placed in the Work-related Activity Group (WRAG). The WRAG covers too wide a spectrum of claimants with very different prognoses and employment support needs.

Redesigning the ESA process

The Committee recommends that the ESA redesign should aim to ensure that the process properly identifies claimants’ health barriers to employment and the particular support they need, so that the conditionality that they are subject to and the employment support they receive can be tailored more closely to their circumstances. For claimants in the WRAG, proper account needs to be taken of where they are on the spectrum of readiness for work, given the wide range of conditions and disabilities which the WRAG encompasses, and the different impacts these have on an individual claimant’s functional capacity.

The descriptors used in the WCA process should also be reviewed as part of the redesign, as concerns about their effectiveness, and the way they are applied, remain, despite the recent review commissioned by DWP.

Dame Anne Begg MP, Committee Chair, said

"ESA is not properly joined up with employment support because an individual’s health-related barriers to working are not being properly assessed as part of the process. We recommend that the Government reintroduces a separate assessment of these barriers, along the lines of the Work-focused Health-related Assessment – the WFHRA – which it suspended in 2010."

Shorter term measures to improve ESA

Dame Anne Begg MP, Committee Chair, said

"We know that the redesign can’t happen overnight, but the current system needs to be improved now, because it is clearly causing claimants considerable distress and anxiety.

"The re-letting of the contract provides an opportunity to address some of the problems. The new contract needs to set out robust and clear service standards on the quality and timeliness of assessments and the reports produced by the contractor, and for the way claimants are dealt with. 

"DWP has acknowledged that this will cost more money, but this is justified if the service provided by the new contractor is better. To ensure this is the case, DWP needs to rigorously monitor the service standards to ensure they are being met and to take immediate action, including imposing penalties, if they are not. This has not always happened with the Atos contract.

"The changes we recommend include ensuring that, where possible, paper-based assessments are used to place people in the Support Group, rather than requiring them to go through a WCA, where their health condition or disability clearly has a severe impact on their capability to work. Unnecessary and too frequent reassessments should also be avoided. 

"DWP should also improve the way it communicates with claimants – at the moment, the letters that are sent to claimants are too technical and complex. They need to be in plain English and avoid using jargon. The terms “limited capability for work” and “limited capability for work-related activity”, which are currently used to categorise claimants, are too confusing and DWP needs to find more meaningful alternatives."

The Committee recommends that DWP implements a number of other changes in the shorter-term to ensure better outcomes and an improved service for claimants. These include:

• DWP taking overall responsibility for the end-to-end ESA claims process, including taking decisions on whether claimants need a face-to-face assessment, rather than this decision being made by the assessment provider.
• DWP proactively seeking “supporting evidence” on the impact of a claimant’s condition or disability on their functional capacity, rather than leaving this primarily to claimants, who often have to pay for it. DWP should seek this evidence from the most appropriate health and other professionals, including social workers and occupational therapists, rather than relying so heavily on GPs. 
• The "descriptors" used to assess functional capability in the WCA being applied more sensitively.
• Placing claimants with a prognosis of being unlikely to experience a change in their functional abilities in the longer-term, particularly those with progressive conditions, in the Support Group and not the WRAG.

Mandatory reconsideration and appeals

The Report also considers the impact of the introduction of mandatory reconsideration (MR) of ESA decisions, and the appeals process. MR has the potential to be beneficial, if it leads to fewer decisions being taken to appeal, and therefore reduces both stress for claimants and the cost to public funds.

However, the Committee calls on the Government to set a reasonable timescale for completing reconsiderations, rather than leaving it open-ended, and to end the current illogical situation of claimants being unable to claim ESA during the reconsideration period.

It is also important that both DWP and the assessment provider learn lessons from the feedback which the Tribunals Service now gives in the summary reasons for its decisions, so that more initial decisions are "right first time".