Written evidence from GIPSIL Community Support Centre (HAB0037)

GIPSIL is registered as a Cooperative & Community Benefit Society with Charitable Status No. 27762R. We are an organisation based in Gipton and Harehills, Leeds, providing a range of services including, accommodation based and floating support to young people; young parents; and care leavers aged 16 to 25 years across Leeds.

 

GIPSIL is also a partner in the Engage Leeds consortium providing citywide housing support and homelessness prevention, including through Advice provision, to vulnerable service users aged 18+ with a range of complex needs. GIPSIL undertakes and hosts other support services, including specialist engagement and wellbeing work. The Advice Service provides outreach support and consultancy to other services including Women’s Health Matters Domestic Violence Support Groups & through the ‘Open Doors’ Help Through Crisis Project. The Advice Service provides free & independent generalist advice, principally in relation to welfare benefits and housing to our target client groups.

4. Do the descriptors for ESA accurately assess claimants’ ability to work? If not, how should they be changed?

Work capability descriptors often bear little relation with work activities. Questions on whether someone can pick up a pound coin or place something in the pocket of their jacket, for instance, do little to examine how someone would behave whilst working, or the distress it could cause them.

Questions that are more focused on mental health are brief. In general, the threshold to qualify for the Limited Capability for Work and Work Related Activity groups is very high. For instance, if a claimant’s main issues are to do with socialising due to high anxiety, they would have to demonstrate they cannot socialise in any setting at all – even with people familiar to them – to score enough points to be placed in the support group.

A claimant can be treated as having limited capability for work through exceptional circumstances either because they have a life-threatening disease or there is a substantial risk to any person’s mental or physical health if the claimant was found fit for work. However, we would argue that the amount of people having to appeal WCA decisions proves the bar is still too high. Indeed, the Equality and Human Rights Commission has condemned Work Capability Assessments for the “harm and distress” caused to claimants and for the mortality rates of disabled claimants found fit for work.

6. How practical would it be for DWP’s decision makers to rely on clinician input, without a separate assessment, to make decisions on benefit entitlement? What are the benefits and the drawbacks of such an approach?

Many claimants who are assessed and declared fit for work, in the context of ESA, are given this verdict in contradiction with their doctor’s advice to avoid working. This can place claimants’ health at risk.

At the same time, health assessments can be carried by clinicians whose medical background have little in common with the claimant’s main health conditions. For example, someone who struggles mainly with their mental health will not be adequately assessed by a physiotherapist. However, their therapist or specialist doctor would be able to give a far better insight into this claimant’s mental health.

Doctors and practitioners who have regular contact with their patients, as opposed to a few hours or less during an assessment, are the best placed to provide information on a claimant’s health and the impact it has on their day to day. This needs to be considered when deciding whether separate assessments should bear the weight they do in decision making.

 

7. Appeals data shows that, for some health-related benefits, up to 76% of tribunals find in favour of the claimant. Why is that?

Most people who claim benefits on the grounds of their disability do so because they are entitled to them. Over the years, and especially since the Department for Work and Pensions replaced the Department for Social Security, benefits have been administered through the lens of placing claimants into work rather than alleviating their poverty. For disabled claimants this focus has been particularly detrimental as they can have their health overlooked so the DWP fulfils their goal of having more claimants look for work. We believe this urge to place more claimants in work may have contributed to DWP denying health-related benefits to claimants which would class them as unfit for work or prove they have a health condition which limits their ability to fulfil certain tasks.

  1. What could DWP change earlier in the process to ensure that fewer cases go to appeal?

The DWP needs to place more trust on claimants and their doctors, they are best placed to know how their health impacts them on a day to day. The DWP needs to ensure the right physicians are assessing claimants, so that their health condition is not judged by someone who lacks the background to assess it correctly.

Along these lines, many claimants state that when receiving their decision letters these fail to accurately represent what happened during the assessment. Indeed, many decision letters are poorly written, with paragraphs being copied and pasted within them and with little explanation of how a decision maker arrived at its decision. It’s only at the appeal stage that claimants are able to get a better insight into their assessment after being provided a written-up copy. More needs to be done to ensure decisions made by the DWP are adequately backed demonstrating that they have really listened to the claimant and considered the medical evidence available to them. The DWP could provide a copy of the medical report to claimants before a decision is made to allow the claimant the opportunity to comment on any inaccuracies or gaps in the report.

These changes would ensure a more accurate assessment process. However, in broader terms there needs to be a bigger structural fix to the institution of the DWP. We fear the hyper-focus of placing claimants into work is leading to these high appeal success rates as well as negatively affecting disabled claimants. The lengthy appeals’ process, can potentially worsen the health of disabled claimants who need to be focusing on getting better and living with their health condition. Ironically, it may have the adverse effect of delaying someone’s return to work.

The DWP needs to act as an effective safety net to guarantee a decent income so those out of work or unable to work can lead dignified lives. At the moment this is far from true with many disabled claimants living in poverty due to poorly administered benefits.

8. Is there a case for combining the assessment processes for different benefits? If not, how else could the Department streamline the application processes for people claiming more than one benefit (eg. PIP and ESA)?

Whilst many disabled people who claim PIP will be able to work, those who are not will have to be subjected to a further assessment to confirm this. We have already laid out above that assessments can often be very distressing for claimants and have an adverse impact on them. Therefore, multiple assessments undoubtedly increase unnecessary distress.

Many claimants would benefit from different benefit bodies, such as ESA and PIP, communicating with each other and sharing the outcome of previous assessments to inform their decisions. Indeed, we are often faced with service users having very different outcomes on their Work Capability Assessment and PIP assessment.

In one occasion, one of our service users had these assessments one day after the other. In the first assessment she qualified for the LCWRA group on Universal Credit, in the second assessment she was given 0 points for PIP. When we reached the tribunal stage the judge was baffled that these two very different decisions related to assessments occurring in the same week.

9. What are your views on the Department’s “Health Transformation Programme”? What changes would you like to see under the programme?

b. What would be the benefits and drawbacks of DWP bringing assessments “in house”, rather than contracting them to external organisations (Capita, Atos and Maximus)? In particular, would this help to increase trust in the process?

The involvement of external organisations into the health assessments has been criticised by many disabled claimants, namely by organisations like Disabled People Against Cuts. The involvement of private companies raises the question of the extent to which the need to make a profit is at the core of the assessment process, rather than the care of claimants.

In November 2021, DWP subcontractor Capita had to compensate the family of Philippa Day over their negligence when dealing with her which has been ruled a factor in her taking a deadly overdose. The family of Ms Day stated that Capita’s wall of bureaucracy meant they had no consideration over her mental health and her requests to have a home visit rather than a face-to-face assessment.

Rather than outsourcing health assessments, these should be run by public bodies such as the NHS. This would ensure the wellbeing of the claimant is the main priority in these assessments, rather than maximising revenue or force disabled people into the labour market.

10. What lessons should the Department learn from the way that it handled claims for health-related benefit claims during the pandemic: for example, relying to a greater extent on paper-based assessments, or using remote/telephone assessments?

Many claimants find face-to-face assessments very distressing and anxiety inducing. This is especially the case with claimants who struggle with leaving their homes due to mental or physical health issues.

When claimants are forced to attend face-to-face assessments, this may be used against them on the grounds that they were able to attend the assessment hence they can leave their homes. This ignores the fact that the fear of losing their benefit may propel claimants to undertake behaviours that they may not usually carry, such as leaving their home and going to an unfamiliar place. It can also mean that whilst the claimant was able to attend, they may have been distressed throughout the assessment due to having had to do this. This can impact on their performance when assessed with claimants often unable to express themselves due to a mixture of fear, anxiety and distress.

The provision of telephone assessments has helped many clients with circumventing this. We would welcome the option of telephone assessments becoming routine for those claimants who have difficulties with face-to-face assessments.

 

November 2021