Conclusions and recommendations
The Government's policy objectives for the IB
reassessment
1. We support the Government's objectives of
helping people with disabilities and long-term health conditions
to move back into work, whilst continuing to provide adequate
support for people who have limited capability for work or are
unable to work. However, the scale of the challenge should not
be underestimated and nor should the level of anxiety which currently
surrounds the process. A suspicion persists that the only objective
of the Government is to save money. The Government must be proactive
in explaining its aims and spreading the positive messages about
the benefits of work and the support which is available to find
work, and in engaging employers. It is vital that the Government's
objectives are firmly supported by the reassessment process, and
by the WCA in particular, but at the moment we are not completely
convinced that it does this. Our report focuses on the changes
we would like to see to help ensure that this happens in practice.
(Paragraph 18)
Improving communication of the Government's objectives
2. The Government needs to develop its communications
strategy for the IB reassessment in a way which ensures clarity
and minimises anxiety. Providing claimants with the right level
of information at the time that is appropriate for each individual
forms an important part of this, bearing in mind that the reassessment
process as a whole will last three years. It also requires the
Government to be clearer about what the word "support"
means in the context of Employment and Support Allowance. Currently
it is used to describe employment support on the one hand and
financial support through benefits for those who cannot work on
the other. These two different meanings in the context of one
benefit can be very confusing. (Paragraph 31)
3. The message which the Government sends to
claimants involved in the reassessment process should be clear
and simple: if the assessment process correctly finds someone
fit for work, that is a successful and desirable outcome. However,
we believe that the Government also needs to take greater steps
to reassure claimants. It needs to explain that being found "fit
for work" does not equate to denial or disbelief about the
existence of an illness or health condition: rather the condition
is acknowledged but its impact has been assessed as not being
so serious as to prevent the person from returning to work at
some point in the future. (Paragraph 34)
4. We believe that the language currently used
to describe the outcome of the WCA is a barrier to the Government's
objectives for the reassessment being properly communicated. The
idea that a claimant has "failed" the assessment if
they are found fully capable of work risks negating the positive
messages which the Government is trying to convey. It needs to
be addressed across the board and to include all communications
between claimants and DWP staff, especially Jobcentre Plus staff
who tell claimants the outcome of the process, and Atos Healthcare
employees who may explain the process to claimants. We also believe
that the communications need to explain clearly and at every stage
of the process that, where someone is found not fit for work,
they will be eligible to receive ESA at the support rate. (Paragraph
35)
Media coverage
5. Sections of the media routinely use pejorative
language, such as "work-shy" or "scrounger",
when referring to incapacity benefit claimants. We strongly deprecate
this and believe that it is irresponsible and inaccurate. The
duty on the state to provide adequate support through the benefits
system for people who are unable to work because of a serious
health condition or illness is a fundamental principle of British
society. Portraying the reassessment of incapacity benefit claimants
as some sort of scheme to "weed out benefit cheats"
shows a fundamental misunderstanding of the Government's objectives.
(Paragraph 40)
6. Whilst fully accepting that the Government,
and this Committee, have no role in determining the nature and
content of media coverage, we believe that more care is needed
in the way the Government engages with the media and in particular
the way in which it releases and provides its commentary on official
statistics on the IB reassessment. In the end, the media will
choose its own angle, but the Government should take great care
with the language it itself uses and take all possible steps to
ensure that context is provided when information about IB claimants
found fit for work is released, so that unhelpful and inaccurate
stories can be shown to have no basis. (Paragraph 41)
Role of representative organisations
7. We agree with the Minister's view that organisations
which represent benefit claimants may sometimes face a conflict
in being both advocates for the people they represent and key
players in helping to design and implement the reassessment process.
We believe that these organisations could contribute enormously
to allaying the concerns about reassessment by giving equal weight
to publicising the opportunities an effective assessment process
could offer, and the back-to-work support available from Government,
as they do to fulfilling their important role in raising legitimate
concerns. We also consider that this would help reassure potential
employers and thereby reduce the risk of stigma and discrimination.
(Paragraph 45)
The Work Capability Assessment—claimants'
experience and Atos Healthcare
8. Atos acknowledged that its call-centres had
experienced significant problems in the past. We welcome the assurance
that this has been addressed to ensure that waiting times are
significantly reduced and most calls are picked up first time.
We expect call statistics to be maintained and published to demonstrate
that progress is being made and sustained. However, claimants
are still unable to contact the assessment centre they are due
to attend directly, and we believe they should be able to do so,
even if calls are routed through the call-centre. (Paragraph 55)
9. Atos routinely overbooks WCA appointments
by 20% on the basis of the non-attendance rate for new ESA claims,
which was 30%. However, the non-attendance rate in the IB reassessment
trials was much lower, at around 9%, although it is too soon to
say whether this low rate seen in the trials will continue in
the national roll-out. We recommend that Atos reviews its overbooking
policy as a matter of urgency, to take account of this much higher
attendance rate by IB claimants, to ensure that people are not
turned away from assessment centres without being seen. Atos should
also continue to monitor and adjust its overbooking policy as
necessary. (Paragraph 58)
10. Instances have occurred where vulnerable
claimants have had their benefit stopped as a sanction for non-attendance
at a WCA appointment when the non-attendance arose because of
administrative errors on the part of Atos or JCP, or because the
claimant was too ill to attend but was unable to get in touch
with Atos to inform them of this. We agree with the Minister that
this is unacceptable. We recommend that DWP and Atos Healthcare
jointly review the processes for recording non-attendance and
change them where necessary to ensure that claimants are not sanctioned
for "failure to attend" when the failure is on the part
of Atos Healthcare and/or Jobcentre Plus. (Paragraph 63)
11. We believe that Jobcentre Plus should be
more proactive in establishing the reasons for non-attendance
at WCAs, including by following up with a phone call as soon as
is practical after an appointment has been missed. (Paragraph
66)
12. It is unacceptable that disabled people should
be called to attend an assessment at a centre which is inappropriately
located, inaccessible to them or where reasonable adjustments
cannot be made to accommodate special requirements arising from
their health condition. We note DWP's assurance that Atos Healthcare
is "moving rapidly toward" a situation where this is
no longer the case. We request that, in response to this Report,
the Government sets out progress towards this aim. This should
include options for the relocation of assessment centres where
necessary, increasing disabled access, and improvements to the
mechanisms for ensuring a claimant's needs are known to Atos Healthcare
in advance of the WCA. (Paragraph 71)
13. Most of the submissions we received from
individuals were from claimants who were dissatisfied with the
WCA process and who did not believe that they had been accurately
assessed. The Minister asked us to bear in mind that much of the
evidence submitted to us related to assessments carried out prior
to implementation of the two sets of review recommendations and
experience from the Aberdeen and Burnley trials. We fully acknowledge
this fact. However, we believe that there is no room for complacency
and we have identified a number of areas where further improvement
is required. (Paragraph 76)
DWP contract with Atos Healthcare
14. We recognise that Atos Healthcare, as the
sole provider of the Work Capability Assessment, takes the brunt
of public criticism about the WCA. Some of this arises from the
understandable anxiety which claimants feel about the process.
We accept that considerable efforts have been made on the part
of both Atos Healthcare and DWP to improve the quality of assessments.
However, it is also clear that many claimants have not received
the level of service from Atos which they can reasonably expect.
(Paragraph 92)
15. We remain concerned about whether there are
sufficient levers within the DWP contract with Atos to ensure
that Atos consistently gets the assessment right first time. We
therefore recommend that, when the contract is re-let in 2015
and in future contracts for other medical assessments, DWP reviews
the performance indicators, with significant financial penalties
built in if standards are not met. (Paragraph 93)
16. We agree with the Minister that it would
not have been practical to introduce a second provider for the
IB reassessment but we believe that the Government should consider
contracting a second provider to deliver the ongoing Work Capability
Assessments for new ESA claims when the reassessment of existing
claimants has been completed, in order to drive up performance
through competition. We recommend that the Government publishes
proposals, before the end of 2012, for how such a system of competition
could work in practice. (Paragraph 94)
The Work Capability Assessment—Reviews
17. We congratulate Jobcentre Plus on the improvements
made to the claimant journey during the reassessment trials in
Aberdeen and Burnley. However, we are concerned that the resource-intensive
nature of the additional claimant contact, which has been added
to the process following the Harrington Review and the reassessment
trials, may be difficult to scale up to a national level in the
context of public sector spending cuts. We welcome the Minister's
commitment to ensuring that the improved system is implemented
nationally and urge the Government to ensure that the necessary
resources are made available to Jobcentre Plus, given that a more
robust reassessment process is likely to save money in the long
run. (Paragraph 109)
Future of the WCA
18. We welcome the improvements to the WCA which
have resulted from the Harrington Review and the lessons learned
from the reassessment trials. However, we believe that the Government
needs to do more to clarify whether the purpose of the WCA is
to be an eligibility test for benefits or whether it is a diagnostic
test to assess a person's ability to work. It is not yet clear
whether it is quite achieving either of these effectively. (Paragraph
120)
19. The Government decided to suspend the Work
Focused Health-Related Assessment for two years without putting
anything in its place. This separate component of the WCA focused
on health-related or workplace interventions which might support
claimants into work and would have been particularly useful for
people moving off incapacity benefits. We welcome Professor Harrington's
commitment to consider whether an additional assessment is needed
to determine a claimant's suitability for work, and his engagement
of employers in the process through the CBI. (Paragraph 121)
20. Any new employability test must effectively
link into the employment support available under the Work Programme.
We recommend that Professor Harrington also includes Work Programme
providers and sub-contractors in the work he is undertaking to
try to design an assessment that identifies a claimant's workplace
capabilities and needs. (Paragraph 122)
Decision-Making
21. We welcome Professor Harrington's central
recommendation on the need to strengthen the role of Jobcentre
Plus decision-makers in the reassessment process. There are signs
that decision-making is already improving and this needs to be
reinforced by ensuring that all the supporting information from
the claimant is available to the decision-maker at the time the
decision is made. To facilitate this, it is important to ensure
that claimants are able to submit medical reports, but GP charges
for this service put it beyond the reach of some claimants. We
recommend that the Government considers how to address the problem
of charges acting as a barrier to the full range of medical information
being available to decision-makers. (Paragraph 129)
22. We congratulate the Department for the marked
improvements in the decision-making process achieved during the
trials in Burnley and Aberdeen. However, DWP's own research suggests
that this new approach is very resource-intensive and may not
be sustainable in the national roll-out. Nevertheless, it should
remain a priority for the Department to ensure that it gets the
decision-making right first time. We agree with the Government's
assessment that investing resources in the decision-making process
will provide savings in the medium and long-term through reducing
the costs in appeals. An improved decision-making process will
also help to increase claimants' trust in the process and enhance
their sense that "procedural justice" has been delivered
by allowing their case to be properly presented. (Paragraph 130)
23. We welcome Professor Harrington's recommendation
on making more effective use of the reconsideration process.
The trials in Burnley and Aberdeen have shown that claimants find
the additional contact with the Department, and the opportunity
to present further evidence in support of their claim, helpful.
This should help to address the problem identified by Professor
Harrington of new information appearing at the tribunal stage
that was not available earlier in the process. However, we also
request that the Government put in place processes to track outcomes
for cases which have been through the revision process in order
to ascertain whether this is producing speedier and accurate final
decisions, to avoid potential adverse consequences both for the
claimant and for Work Programme providers. (Paragraph 137)
Appeals
24. The high number of appeals for new ESA claims
is a cause of concern. The estimated cost to the public purse
is £50 million per annum. The pressure on the Tribunals Service
has also resulted in a significant delay for claimants before
appeals are heard, causing stress and anxiety for claimants
and their families. (Paragraph 146)
25. We welcome the Minister's commitment to improving
decision-making to ensure that fewer cases are overturned at tribunal.
However, as the Minister rightly acknowledged, the volume of reassessment
cases means that it is unlikely that the number of cases going
to appeal will decrease significantly in the next few years. We
welcome the Government's acknowledgment of the importance of reducing
the time taken to process appeals and we recommend that the available
resources are kept under regular review. The tribunal system must
be adequately equipped both to address the backlog and to provide
an ongoing, efficient appeals service. (Paragraph 147)
26. It is not acceptable that some claimants
have to go through the entire assessment process again shortly
after their appeal without any of the information from the appeal
being passed on to JCP and Atos Healthcare. This is a waste of
resources and causes unnecessary stress and anxiety for claimants
and their families. (Paragraph 151)
27. We agree with Professor Harrington that it
is important for the outcome of appeals to be fed back into the
WCA system effectively, to avoid unnecessary future appeals. We
also believe that when cases do go to appeal, it is important
that the DWP case is properly presented. We recommend that DWP
review whether JCP presenting officers should attend more tribunal
cases in order to ensure both that this happens, and that information
is fed back from the appeals process, thus promoting more effective
learning of lessons by JCP. (Paragraph 152)
Reassessment outcomes
28. The Government's argument for time-limiting
contribution-based ESA to 12 months is a result of tough decisions
about the budget deficit and also to put it on an equal footing
with Jobseeker's Allowance. It is true that the huge majority
of JSA claimants move into employment within a year. However,
we know that the JSA demographic of mainly young, male claimants
with previous work experience is different to the ESA demographic,
who may find it much harder to move into employment even though
they may have done everything required of them to find work.
(Paragraph 168)
29. Nor does it appear that the Government has
the data available to make an evidence-based decision on the appropriate
length of time for which contributory ESA should be payable in
order to support its objective of moving claimants into employment.
We recommend that the Department conducts research on whether
allowing former IB recipients to claim contributory ESA for more
than 12 months would provide a more realistic timeframe for them
to enter employment, taking account of the two years of employment
support available through the Work Programme. The research should
also include an assessment of the costs of such a change. The
Government should adjust its policy accordingly if the need for
change is borne out by the research. (Paragraph 169)
30. We share the Minister's concern about the
high rate of claimants who withdraw from the assessment process
before completion. It is important that the Government understands
the reasons for this and gains a greater understanding of the
destination of these people, to ensure that no one is left without
appropriate support. (Paragraph 172)
Tracking of claimants
31. We strongly believe that the success of the
IB reassessment is dependent on its effectiveness in helping people
with disabilities and long-term health conditions into employment.
In order to understand whether the assessment process is achieving
this, the Government needs to track the destination of all claimants.
We recommend that tracking includes categorising claimants on
the basis of the health condition they presented with, to establish
how different groups fare in terms of getting into sustained employment.
It should also include recording the number of claimants who are
initially allocated to the wrong group and have to be moved at
a later date. (Paragraph 176)
32. The trials in Aberdeen and Burnley would
have provided an ideal opportunity to begin this form of tracking,
from assessment to employment outcomes. We believe it is regrettable
that steps were not taken to ensure tracking was in place for
this first cohort. However, we believe that it is not too late
to do this and recommend that the Government begins tracking outcomes
for the reassessment trial cohort without further delay. (Paragraph
177)
Employment support for ESA claimants
33. The measure of success of both
the Work Programme and the IB reassessment will be the proportion
of people helped to move from benefits into employment. Recent
research suggests that a very large proportion of customers in
the Work Programme by 2014 will have previously claimed ESA or
IB. This highlights the challenge for the Work Programme and the
need to ensure that the WCA is effective in allocating claimants
to the differentiated groups within the Programme. Until the introduction
of Universal Credit, claimants will be assigned to the groups
within the Work Programme based on the benefit they are claiming.
This reinforces the importance of ensuring that claimants are
allocated to the correct benefit in the IB reassessment process.
(Paragraph 184)
34. It is too early to assess whether
the current grouping and incentive structure under the Work Programme
will be effective in leading to employment outcomes for former
IB claimants. We reiterate the recommendation in our recent report
on the Work Programme: that the Government keep the payment model
under review and assess the outcome for participants within and
between each client group. This review should be carried out by
an independent panel and repeated on a regular basis. (Paragraph
185)
35. We support the Government's
view that claimants in the WRAG should undertake work-related
activity to prepare for a return to employment. However, it is
important that decision-makers have discretion to apply exceptions
to this requirement, where appropriate. One group of claimants
which needs to be treated with sensitivity is those with a limited
life expectancy. We recommend that decision-makers should be
able to exercise discretion, on the basis of the claimant's own
medical questionnaire, to place these claimants in the Support
Group, where appropriate. (Paragraph 189)
36. Evidence shows that the accurate
assessment of disabled people's employability and needs in the
workplace is crucial in gaining their trust and engagement, and
through this achieving employment outcomes. The Government should
consider how information from the WCA can help Work Programme
providers to identify the employability needs of customers. (Paragraph
195)
37. In almost all of the discussion
of the Government's plans, the emphasis is on getting the claimant
ready to go back to work. However, the Government will only achieve
this laudable aim if employers are willing to employ someone who
might have been on incapacity benefit and out of work for some
time and who might still have substantial health issues. This
will require a great deal of co-operation and change of attitude
from many employers. Providers of employment support have a crucial
role to play in building relationships with employers so that
they can gain trust and an understanding of the challenges and
benefits of employing former benefit claimants. However, it is
also the Government's responsibility to engage in changing attitudes
and spreading good practice amongst employers. The Government
must pay as much attention to this side of the "back to work"
equation as it does to getting the claimant "work ready".
(Paragraph 201)
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