The Department for Work and Pensions has today announced a number of changes to Employment and Support Allowance (ESA) and Work Capability Assessments (WCA).
Some of those changes are outlined below:
“Today we are announcing a package of ESA measures to improve further the support we offer disabled people and people with health conditions.
“In early 2015 we are introducing a number of pilots to help us better understand what support ESA claimants need to help them move back into work. The more intensive support pilot will increase the frequency and intensity of Work Coach support for the first six months following completion of the Work Programme.
“The more intensive support pilot will increase the frequency and intensity of Work Coach support for the first six months following completion of the Work Programme.
“In specific ESA ‘hotspots’ (areas that need the most help) we will be piloting a more active regime for ESA claimants. Those awaiting a WCA will be offered voluntary employment-related Work Coach interventions and we will also be testing occupational health advice for Work Coaches and back pain management support for claimants with this common musculoskeletal condition.
“From early 2015, we are implementing a trial of the Claimant Commitment for ESA claimants at various stages of the claimant journey. Universal Credit claimants are required to accept a Claimant Commitment as a condition of entitlement, so the trial will inform our preparation for the cultural transformation that the introduction of Universal Credit requires for claimants and staff.
“The trial will take place in a single Jobcentre Plus District, with the groups being ESA claimants:
- awaiting a WCA (participation will be voluntary for this group);
- following a WCA (when allocated to the Work Related Activity Group); or
- who have completed their participation on the Work Programme.
“The Claimant Commitment helps to focus claimants on their work related requirements including, where appropriate, proactive work search that treats looking for work as a full time activity. For the first time claimants’ obligations are recorded in one place, clarifying both what they are expected to do in return for benefits and support, and exactly what happens if they fail to comply.
“We intend to introduce a measure to allow for a new extended period of sickness on Jobseeker’s Allowance (JSA) in April 2015.
“This will mean that claimants who expect to be sick for less than 13 weeks can opt to remain on JSA rather than switch to ESA. This will allow them to continue to benefit from the support of the Jobcentre to help them return to work – as soon as they have recovered from their health condition.
“We intend to introduce a measure to prevent claimants being paid the ESA assessment rate where a claimant has been found fit for work, but makes a repeat claim for benefit and has not developed a new condition or had a significant worsening of their condition.
“We would still need to consider the repeat claim but while we are considering it, and pending any appeal against our refusal of that claim, no ESA would be paid although JSA could be claimed. This is due to be introduced next spring and should help ensure that claimants found fit for work claim JSA and remain closer to the labour market, rather than looping around the ESA system.
“We will evaluate the results of these pilots and consider any changes needed as part of the next spending review.”
Responding to the announcement, Chief Executive of Citizens Advice Gillian Guy said:
“Employment Support Allowance is not fit for work. The Government’s failure to get right support for sick and disabled people is unacceptable. We have long campaigned to make ESA fit for work, and the changes proposed by Government today do not appear to address the deep-seated problems with this system. More than 180,000 people have come to us for help with ESA in the past year.
“Urgent changes to fit for work tests must be made to reduce waiting times and improve the accuracy and consistency of the assessments. Many Citizens Advice clients have been left for up to six weeks whilst waiting for a second opinion on their claim, whilst other people have been charged more than £100 by GPs for medical evidence to support their appeal. Ministers must ensure no one claiming ESA is left without financial support whilst challenging an assessment decision. Anyone who is sick or disabled and in need of support has every right to expect a system which is fair, gets decisions right first time and where they do not have to pay for medical evidence to support their claim.”
Statistics released today by the DWP show that only 7% of incapacity benefit to employment and support allowance (ESA) claimants were found capable of work in 2013, with almost 60% being placed in the support group. The figures raise a huge question mark over what the transfer process has achieved, other than causing enormous hardship, distress and, in some cases, the death of claimants.
The figures also show that decision makers are now ten times more likely to disagree with Atos health professionals who find a claimant fit for work than they were in 2009. Decision makers overruled Atos one in every five times that a claimant was considered fit for work by Atos in 2013. When reconsideration decisions and appeal decisions are also taken into account, the level of error by Atos begins to look colossal.
The figures also show a big increase in the proportion of ESA claimants getting into the support group on mental health grounds. There has also been a major rise in the proportion of claimants who do not have to have a face to face assessment before being place in the support group.
The DWP released the statistics to coincide with the fifth independent review of the work capability assessment.
Apart from the first section on IB to ESA transfers, all the figures below relate to initial claims for ESA. They don’t include repeat assessments or incapacity benefit to ESA transfers.
Comparison of initial claims, IB to ESA claims and reassessments
When the effect of appeals is taken into account, there is a big difference between initial claims, incapacity benefit to ESA claims and ESA reassessments.
In 2013, for initial claims:
- 39% were placed in the support group
- 26% were placed in the work-related activity group (WRAG)
- 34% were found fit for work
For ESA reassessments, the percentages were:
- 53% were placed in the support group
- 35% were placed in the WRAG
- 12% were found fit for work
For IB to ESA transfers, the percentages were:
- 59% were placed in the support group
- 34% were placed in the WRAG
- 7% were found fit for work
The figures for IB to ESA reassessment raise a big question mark over whether the whole expensive and deeply distressing process has been worthwhile, when only 7% of transferred claimants in 2013 were found to be fit for work.
Atos versus decision makers
There has been a big increase in the percentage of occasions on which the ESA decision maker (DM) has overruled an Atos finding on initial claims, almost always to the advantage of the claimant.
In 2009, where Atos said the claimant was fit for work the DM agreed in 98% of cases and placed the other 2% in the WRAG.
By 2013 where Atos said the claimant was fit for work the DM agreed in only 80% of cases and placed 17% in the WRAG and 4% in the support group. (Percentages don’t agree due to rounding)
In 2009, where Atos said the claimant should be in the WRAG, the DM agreed in 98% of cases and placed the other 2% in the support group.
By 2013 where Atos said the claimant should be in the WRAG, the DM agreed in 96% of cases and placed 4% in the support group.
In 2009 where Atos said the claimant should be in the support group, the DM agreed in 99% of cases and put 1% in the support group.
By 2013 the decision maker agreed in 100% of cases.
Support group awards
The total number of claimants placed in the support group on initial claim has risen from 31,000 in 2009 to 141,000 in 2013
Mental health awards
There has been a big increase in the proportion of claimants assigned to the support group on initial claim because of mental health. The percentage is up from 25% of those in the support group to 48% of those in the support group.
The proportion of claimants with a mental health condition getting into either group on initial claim has risen from 37% in 2009 to 45% in 2013.
By far the most common reason for an award of ESA on mental health grounds is a depressive episode, accounting for 50% of all awards.
Other anxiety disorders accounts for 18% of the total.
Age can make a big difference to outcomes, with young people aged 16-24 being more likely to be placed in the support group.
In 2009 of claims by 16-24 year olds:
- 16% went into the support group
- 32% went into the WRAG and
- 52% were found fit for work.
There were a total of 39,000 claimants in this group.
- 49% went into the support group,
- 23% went into the WRAG and
- 27% were found fit for work.
There were a total of 45,000 claimants in this group, down from 58,000 in 2012.
For claimants aged 25 and over in 2009:
- 11% went into the support group,
- 35% went into the WRAG and
- 54% were found it for work.
There were a total of 260,000 claimants in this age group.
- 38% went into the support group,
- 27% went into the WRAG and
- 35% were found fit for work.
There were a total of 320,000 claimants in this age group, down from a high of 290,000 in 2012.
Paper based assessments
There has been a huge increase in reliance on paper-based assessments for initial claims. These are up from 6% in 2009 to 28% in 2013. These are claimants who are assigned to the support group based on a review of the documents, without needing to have a face to face assessment from Atos.
Regulation 35, physical or mental health risk
Those being placed in the support group because of the exceptional circumstances rules – that there would be a risk to their health or the health of someone else if they were not found to be incapable of work-related activities – has more than doubled from 17% to 38% between 2009 and 2013.
In 2009 47% of these regulation 35 decisions were because of a face to face assessment and 53% were paper based. By 2013 the face to face assessments had fallen to 34% and paper based increased to 66%. These figures have remained similar since 2010.
My son Stephen is 19 years old. I love him to bits but right now I am desperately worried for him.
He has autism and finds it hard to communicate. For over a year now he has been living in a unit at St Andrew’s Hospital, Northampton, which is 80 miles from our home in London.
He has learning difficulties but he is being kept under the mental health act at a psychiatric unit, with patients much older and with a range of different conditions.
He has the sweetest smile but since he has been there I haven’t seen it once. It’s not the right place for him – even his consultant agrees he should not be on the mental health register and should be moved somewhere more suitable.
We have to travel miles each weekend to see him and sometimes we only see him for a few minutes, sometimes we travel all the way to see him, only to be told that we are not allowed a visit. And other times he has been put on so many drugs he just falls asleep. It’s is heartbreaking to have to leave Stephen there. He is covered in bruises and has gashes all over his head from where he has hit himself from being anxious.
Right now the local authority is reviewing where to place Stephen. They want to move him to another hospital in Colchester but that won’t solve anything.
We want Stephen to have a better quality of life; to be able to spend time outdoors, to be around his family more often. Ideally we want Stephen to live with us as a family with the support of carers. He should also be taken off the the mental health register, so he has more freedom for how he lives his life.
Other families who have loved ones with autism have successfully fought to have them live in homes with specialist carers near loved ones. And the Government made promises that people with autism and other learning difficulties should be cared for in their communities with the help of their families but this promise is being broken for Stephen.
Stephen is being let down by the institutions that are meant to be caring for him – locked up in a hospital and lost to a system that wants to tick boxes instead of care for my son.
Stephen deserves to be allowed to live a life in safe place with carers who understand his needs and surrounded by people that love him.
Please sign my petition and help my family but most of all help my son.
My petition was set up and established by leading Autism campaigner & Ambassador Kevin Healey.
The family of a severely disabled teenager who has the mental age of a five-year-old have been left furious after benefits officers demanded the girl be put through a fitness-to-work assessment.
Ellie McDonald, 19, suffers from the extremely rare genetic disorder called Chromosome 7 Deletion, which means she is unable to eat, sleep or walk without the help of mother Louise.
In preparation for Ellie leaving her special needs school, her mother and her full-time carer applied for employment support allowance (ESA) to replace their child benefit payments.
But the family were shocked to be told Ellie would need to be tested to rule out her being fit for work – a process Miss McDonald branded ‘bureaucracy gone mad’.
Louise McDonald is angry that her daughter Ellie - who has a mental age of five and cannot walk or eat without help – has been told she will have to undergo a fitness-to-work assessment.
The family, from Bradford, West Yorkshire, have hit out the government’s refusal to realise that Ellie, who cannot read or write and needs around the clock care, is entirely unfit to work.
They will now have to wait up to a year to receive medical tests, in which time they fear they’ll miss out on around £200 a month they are entitled to.
Miss McDonald, 42, said: ‘Ellie is completely reliant on us – she is unable to do anything for herself and has been in care from birth.
‘Two weeks before she left her special needs school we applied for employment support allowance as we would no longer be receiving child benefit.
‘They told us she would have to have another screening process to rule out she is unfit for work – even though the doctor has sent a note to show how disabled she is.
‘We filled this form out asking what Ellie could and couldn’t do. It was a joke – just crosses in every box. Ellie can’t read, write, talk or even sleep without help.’
The teenager, who turns 20 next month, was born with part of a chromosome missing and has to be sedated each night due to the part of her brain which induces sleep being disabled.
She also lives with one kidney – meaning she is prone to frequent infections – as well as bowel and bladder paralysis and 70 per cent curvature of her spine.
Miss McDonald, who lives with partner Ben, 38, and Ellie’s younger sister Megan, seven, and ten-year-old brother Joshua, added: ‘The system is too bureaucratic and it sees us as figures instead of people.
‘Surely anyone can see Ellie will never be able to be independent, let alone work. I know they only want to check to avoid fraud, but if you look fraud only accounts for one per cent of disability allowances.’
She added: ‘It’s a standard case of “computer says no” and it’s made things really difficult.
‘It’s a waste of public money and a drain on the NHS – they know of Ellie’s condition but will now have to conduct a series of degrading tests on her for the sake of proving what we all already know.’
The family receives £310 every four weeks for disability living allowance and £141 every fortnight for employment support allowance.
The family say she’ll continue to go to her day care centre after she finishes at her special school.
A DWP spokesman said: ‘No-one should doubt our commitment to ensuring that people who need an assessment get the best possible service and are seen in the quickest possible time.’
Performing poetry has its challenges, but more so if your breathing is controlled by a machine.
Owen Lowery is 46 and lives in Lancashire. He has a ventilator which helps him to breathe.
He began writing poems seven years ago on a university course and started to perform them for audiences in 2012 after an Arts Council grant made live shows possible. He brought in a musician, a producer and a film-maker to create a poetry performance which is accompanied by music and animation.
His ventilator is programmed to take breaths for him at set intervals which, he says, can make it tricky to read his work aloud. “I was a bit nervy at first,” Lowery says, “because I thought that the gaps between breaths would be too obvious and too long.”
He says that being on a ventilator is like breathing passively. “It’s done for you, without you having to think about it. You have to wait for it,” he says, “and that has a big impact on your reading and your performance of poems.
“When I perform, I try and be aware of it and almost use it as an advantage to make people think about what I am saying. But in general, when you’ve been on it quite a long time, you almost forget it’s there.”
Lowery spends time practising before a performance to work out where his breathing will kick in, so he doesn’t get caught out in the middle of a line. “You want the pauses to occur at fairly natural places,” he says. “It’s about pacing yourself out. Like doing a musical score and figuring out where to put the breaks.”
He hasn’t always been disabled, and writing wasn’t always his passion. At 18 years old he was holder of the British Judo men’s closed title when a promising sporting career ended abruptly for him. An accident in the ring during a charity tournament left him paralysed from the shoulders down. He’s now a tetraplegic and unable to breathe for long periods without help.
After two years Lowery left hospital with his new wheelchair and a portable ventilator. He describes the important device as: “a vanity case-sized thing with batteries, about the size of a Filofax”. A tube leads from the ventilator to a tracheostomy – an opening in the neck in front of the windpipe. “The tube goes under my jumper and I always wear a neck scarf, so you can’t even see the tracheostomy bit,” he says.
Following the accident, Lowery’s parents moved from Reading to Lancashire to help him. He went on to gain a first-class honours degree in humanities from the Open University followed by two master’s degrees, one in military studies and another in creative writing. He is currently working towards gaining a PhD on World War Two poet Keith Douglas.
He met his wife, Jayne, when she began working as his carer. They got married last year but Lowery is still living with his parents until Jayne’s house can be adapted.
Jayne reads some of the poems in the live shows, and often takes notes for Lowery if something inspires him when they are out together.
In his first book Otherwise Unchanged, nestled among works about historical events and his beloved Liverpool football club, there are many poems about his recovery.
One of them, Bruise from my Baclofen Pump Re-fill, deals with the complicated relationship between patient and doctor while having anti-spasmodic drugs administered to a pump underneath his skin. And another poem in the collection, New Admission, Southport ICU, recounts the arrival of a short-stay patient to the high dependency ward.
A new book, which doesn’t touch on disability, is based on the work of Portuguese visual artist Dame Paula Rego, and will be published early next year.
“Writing about disability in many ways is no different to writing about anything else,” says Lowery. “It is simply something that is there, in the way that an odd-shaped tree might be, or a football match, or a story from the war. The secret, if there is one, is to understate, rather than overstate, perhaps, allowing the reader to make their own mind up.”
Owen Lowery will perform poems from Otherwise Unchanged on 4 December at Liverpool’s The Bluecoat, as part of DaDaFest.
The Mirror has given very well deserved coverage to Operation Disabled Vote, a campaign which launches tomorrow.
People with learning disabilities in England are being kept in hospitals far from home for too long, a review says.
The report, written by Sir Stephen Bubb, recommends introducing a charter of rights and more community facilities for people with learning disabilities.
It also says some “inappropriate” in-patient facilities should be closed.
The report comes after abuse was exposed at Winterbourne View care home in Bristol in 2011.
Sir Stephen, chief executive of the Association of Chief Executives of Voluntary Organisations (ACEVO), was asked by NHS England how to address “serious shortcomings” in support for those with learning disabilities.
The report – “Winterbourne View – Time for Change” – offers 10 recommendations for the NHS, local government, regulators and the government.
They include a framework to support people with learning disabilities and autism move out of hospitals and into the community.
Its other recommendations include:
- the introduction of a charter of rights for people with learning disabilities and/or autism and their families
- giving people with learning disabilities and their families a “right to challenge” decisions and the right to request a personal budget
- a requirement for local decision-makers to follow a mandatory framework setting out who is responsible for which services and how they will be held to account
- a planned closure programme of “inappropriate” in-patient facilities
- improved training and education for NHS, local government and service provider staff
- the founding of a social investment fund to build community-based services
Sir Stephen said the Winterbourne View “scandal” had “shocked the nation” and that had led to pressure to prevent such a case from happening again.
Neglect and abuse of patients by staff at the Winterbourne View private hospital, near Bristol, was uncovered by BBC Panorama. Six people were jailed in 2012 and five given suspended sentences.
Sir Stephen said: “People are still angry and frustrated that more people with learning disabilities are being placed in institutional care than moved into the community.
“We urge immediate action, to close all Winterbourne-style institutions and ramp up community provision.
“We need a new charter of rights to empower people with learning disabilities and their families, and give them the right to challenge the system. We need that system to have the courage to act on these recommendations, and not to promise another false dawn.
“The time for talk is over. It’s time for people with learning disabilities or autism and their families to be put first.”
Leo Andrade, whose 19-year-old-son Steven has severe autism and lives in a hospital in Northampton, welcomed the report.
Mrs Andrade lives in London and spends up to four hours travelling to see her son. She said she has “no trust whatsoever in the system”.
“I do not want my son again in any other institution,” she said. “I also find the idea that having my son away from us is robbing us of having a family.”
Mrs Andrade also warned implementing the recommendations would not be easy, suggesting decision makers often shy away from risky decisions.
NHS England chief executive Simon Stevens has called for “radical changes” in care for those with learning disabilities, saying it would mean “challenging legacy models of institutional care”.
“NHS England’s recent work with people with learning disabilities, and this new report, all now prove that radical changes are needed in NHS and social care, so that people with learning disabilities and their families increasingly take control of how the services they want and need are provided,” he said.
Jane Cummings, chief nursing officer for England, said: “This report asks every part of the system to respond. We are committed to playing a full and active role in the implementation of the recommendations and call on others to do the same.”
NHS England said all local NHS leaders must now have a register of inpatients with learning disabilities and autism to create informed local care plans.
It is also carrying out care and treatment reviews, which looks at whether a patient is receiving the right care in the right place and takes into account the patient’s requests.
NHS England expect about 1,000 reviews, which are supported by clinicians as well as NHS and local authority commissioners, to have taken place by the end of the year.