Written evidence by Oasis Hub Waterloo (HAB0090)

Oasis background

Oasis is a movement of volunteers, activists and professionals that works in 36 communities across the UK. Oasis is a global family which collectively works around the world delivering a range of projects and services that help tackle social injustice in whatever form it manifests itself. We work to end disadvantage and create opportunity for all, providing education, housing, health, justice, youth and family support.

Oasis Hub Waterloo

Oasis Hub Waterloo offers a number of community services including welfare benefits advice, debt advice and also a food bank which is part of the Trussell Trust food bank network. Oasis Hub Waterloo offers its free, impartial, advice to anyone in the local community who needs support. We receive self-referrals and referrals through other services, including through our own food bank.

When providing welfare benefits advice we will support on all relevant welfare benefits (including Universal Credit, Personal Independence Payment and Employment and Support Allowance). If needed, we will support a client appealing a welfare benefits decision throughout the whole process of an appeal, including supporting them at tribunal stage.

At Oasis Hub Waterloo, we have taken 14 Personal Independence Payment (PIP) cases to tribunal over the last c.3 years and have 100% success rate at getting an increase in PIP allowance from these. We have taken on 1 Employment and Support Allowance (ESA) case to tribunal, also with the decision overturned and a positive outcome for the client. Primarily our evidence provided below relates to PIP.

Summary of overall issues with PIP assessments

The health assessments for benefits process is demonstrably failing clients, with the vast majority of decisions which are appealed overturned at an independent tribunal. For PIP appeals 76% are overturned in favour of the claimant. For the PIP appeals which we have supported clients with, we have seen 100% successful outcomes for clients.

In our experience those who are most in need of support of the system, are least able to navigate it. Trying to navigate the multiple stages of a PIP appeals process is exhausting and demeaning and would be difficult for anyone, let alone someone with ongoing severe health issues. Many of our clients who have poor mental health and physical health at the start of the process will find their health worsened as a result of the stress and strain of appealing the decision. They feel like they are not believed and find it demeaning feeling like they have to “prove” how unwell or disabled they are.

PIP is not a means tested benefit, and is available to anyone with an illness, disability or mental health condition to help them to manage the extra costs of living with a disability. However, it is probably less likely that those on medium/high income would put themselves through the process of applying for PIP. And certainly, for the clients which we support, they are not only struggling with significant health conditions, but they also tend to be struggling on low incomes and are the people who really need the financial support from PIP to help them to manage the extra costs of their disability or health conditions.

In our experience of supporting clients, the process of going through a PIP appeal (from sending a Mandatory Reconsideration to a tribunal hearing) can take between 4 months and 12 months. During this time, for many of our clients, their financial situation will worsen as they are not getting the financial support that they need and they may accrue debts.

We set out detail relating to the most problematic aspects of the PIP process throughout our submission below, including:

Do the descriptors for PIP accurately assess functional impairment? If not, how should they be changed?

PIP indicators

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?

Currently, conducting an outsourced health assessment is not working well, as many poor and incorrect decisions are made as a result. The initial decision seems to made almost entirely on the basis of what the assessor perceives to be the situation at the assessment, with little regard for other evidence submitted.

Given the high percentage of PIP decisions that are appealed which are then overturned it may be that a greater number of correct decisions would be made if decision makers relied on clinician’s input without a separate assessment. However, we also understand that there could be complications if decisions regarding benefit entitlement were made solely by GPs/ other healthcare professionals. This could lead to detrimental relationships between patients and GPs, with a lack of trust and GPs worried that their patients did not want to be open with them because they know that they could impact their benefit status.

There should at least be a more balanced approach, which gives greater weight to reviewing and considering all the medical evidence, and other statements submitted by the applicant and the people supporting the applicant, alongside any health assessment. In the longer term, a system which does not lead to so many poor and incorrect decisions is needed.

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

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

PIP appeals

In our experience as providers of welfare benefits advice, 100% of the PIP cases where we are supporting someone to challenge a decision are successful. In almost all cases we go through the full appeal process, it is rare that a Mandatory Reconsideration will lead to a change in a result, but very common for the tribunal stage to overturn a result. In our view, the assessment stage needs to be improved, as well as the Mandatory Reconsideration stage, to prevent so many people needing to go to tribunal stage to get support that they are eligible for.

Issues with application stage


Issues with assessment stage

Issues with Mandatory Reconsideration stage

Issues at tribunal stage /overall appeals process

Case study:

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?

There have been some changes made to PIP as a result of the pandemic including virtual health assessments and virtual tribunal hearings. These changes have had mixed impacts for our clients.

Some of our advisers have supported clients during virtual health assessments. In one case in which we were present, the session took 90 minutes when it was schedules to take 60 minutes, the questions weren’t asked in order, and the client was asked what felt like irrelevant questions such as about what the client fed her dog. All of this made the experience stressful for the client.

We have also had experience of supporting clients to attend tribunal hearings remotely (via video link or conference call). Most of our clients have come to our offices so that we can support them to take part. Some needed technical support to participate remotely; they would have been unable to use the online video links to access the hearing without our help, others came to our offices for the remote hearing for emotional support.

Even with some of the issues with clients accessing the remote assessments and tribunal hearings online, for some clients this change to remote participation is more accessible than the situation before the pandemic when clients had to attend assessments and tribunals in person. This is because for many of our clients having to navigate to a new place is often difficult and stressful and attending the tribunal centre in person can be intimidating. We have had clients who have said that they did not attend health assessments or tribunal hearings because they found the process of planning the journey and attending the centre too stressful or difficult because of their health conditions. We think that different options to participate should continue to be provided.

How effectively does the “assessment rate” for ESA cover disabled peoples’ living costs while they wait for an assessment? Is there a case for introducing an assessment rate for other health-related benefits?

ESA provides a basic assessment rate whilst someone is awaiting an assessment. Whilst the basic rate is not sufficient to cover living costs and should do so, it is still helpful that there is some provision during long waiting times.

There should be a similar basic rate which people receive whilst they are appealing a PIP decision. In our experience with PIP, the appeals process can often take 12 months or longer. We then know that the majority of people who appeal a PIP decision (76% of those who appeal, and 100% of our clients who appeal) will eventually have this decision overturned. Clients often come to us needing support because they are in financial crisis. During the appeals process clients will often build up debts. When the decision is finally overturned, the next stage for many of our clients is then to provide them with debt advice to help them manage the significant debt that has built up during this time. If people appealing a decision were paid a basic PIP rate during this process, that would be a significant improvement and a good short-term solution. For the minority that did not win their appeal, this money would need to be recovered gradually. In the long-term, improving the system so that it did not produce so many incorrect decisions would be the best for our clients.

What steps could the Department take to improve its engagement with stakeholders?

We would like to see the DWP engage better with people with disabilities and with experience of the system when designing their policies and systems. This would lead to better policy making and services which are more likely to work for the people who will be impacted by them.

We know that the DWP already regularly engage with different charities and groups of charities who represent people with a range of different disabilities, such as the Disability Benefits Consortium. We think that they should continue to do this regularly and take on board the input of these groups and outline the changes they have made as a result. The DWP should also consult advice organisations and organisations which represent the views of advice workers such as the National Association of Welfare Rights Advisers.


December 2021