Work and Pensions Select Comittee (UK) findings re: failures of PIP and ESA assessments

Skycloud · Feb 11, 2018

Article in the Guardian Friday Feb 9th 2018

'Substantial minority' of disability claimants failed by system – MPs

A “substantial minority” of long-term disability benefit claimants are being failed by an assessment system that is too often undermined by basic errors, insensitivity and ignorance about people’s conditions, MPs have said.

A report by the work and pensions select committee highlighted people with Down’s syndrome asked when they “caught” it, a woman reporting frequent suicidal thoughts asked why she had not yet killed herself, and someone whose assessment said she walked a dog daily, when she can barely walk and does not own a dog.

The MPs will next week publish the full findings of their investigation into the personal independence payment (Pip) and employment support allowance (ESA) systems. The two benefits support disabled people and those with long-term health conditions.
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https://www.theguardian.com/politic...ity-failed-by-assessment-system-mps-committee

Skycloud · Feb 14, 2018

PIP and ESA assessments: Claimant Experiences

https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/355/35502.htm

pdf version:
https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/355/355.pdf

PIP and ESA assessments: Full Report

https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/829/82902.htm

pdf version:
https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/829/829.pdf

edit - formatting also eta Full Work and Pensions Select Committee Report and pdf links

Esther12 · Feb 10, 2018

Also this is the assessment from the government:

Personal Independence Payment Claimant Research
– interim headline findings

December 2017

https://www.gov.uk/government/uploa...claimant-research-wave-2-interim-findings.pdf

They seem to have avoided asking claimants whether they think that the criteria used are an appropriate way of assessing eligibility for PIP.

Luther Blissett · Feb 10, 2018

Esther12 said: ↑

Also this is the assessment from the government:

Personal Independence Payment Claimant Research
– interim headline findings

December 2017

https://www.gov.uk/government/uploa...claimant-research-wave-2-interim-findings.pdf

They seem to have avoided asking claimants whether they think that the criteria used are an appropriate way of assessing eligibility for PIP.
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I've scanned it and it isn't clear to me who is involved in the sample.

Were people who were denied a claim involved?

What were the response rates for different claim outcomes? (awarded, awarded after appeals, not awarded, etc)

Without this information, how is the sample representative of people who have contact with the DWP in regard the survey?

I also cannot see willingness to respond being equal across all groups. If a claimant was traumatised, had difficulties, or was denied a claim, why would they want to open a letter or respond to a telephone call from the DWP (or proxy)?

The statistical part is included in the appedix to the report for those looking.

Skycloud · Feb 11, 2018

Luther Blissett said: ↑

I've scanned it and it isn't clear to me who is involved in the sample.

Were people who were denied a claim involved?

What were the response rates for different claim outcomes? (awarded, awarded after appeals, not awarded, etc)

Without this information, how is the sample representative of people who have contact with the DWP in regard the survey?
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Maybe the full report will have more information as to how the DWP collated the initial sample group candidates; but it seems that all of the sample were starting a new claim :

Footnote 2 of the Interim Headline Findings gives a link to this

Ipsos MORI/DWP (2017). Personal Independence Payment Evaluation: Wave one Claimant Survey Findings.

https://www.gov.uk/government/uploa...211/pip-evaluation-wave-1-claimant-survey.pdf

The research comprises three waves, each investigating a key stage of the PIP application process.
Wave 1 looks at the initial claims process, including motivations for claiming, the initial call to the claim line, completing the form, and expectations of next steps.
Wave 2 will cover the face-to-face assessment stage and decisions. This includes preparing for the assessment, experiences of the assessment itself, and the decision stage.
Wave 3 will examine mandatory reconsiderations and appeals.
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In wave one, Ipsos MORI sought to interview claimants who had called the PIP claim line to request a form, had received the form, and had not yet attended an assessment interview or received a final decision. The participant could be the claimant or someone claiming on another’s behalf (for example, a family member or a carer).

DWP provided Ipsos MORI with a sample of 8,000 people who had requested a PIP application form in early August 2016.

Each sample member was sent a letter which informed them of the study and gave instructions about how to opt-out of any further contact regarding this research.

Opt outs were received from 905 people before fieldwork began and a further 90 contacted Ipsos MORI during fieldwork to opt out. Fieldwork took place between 19th September and 17th October 2016, and 1,106 interviews were achieved. A further 1,869 people agreed to take part but were ineligible because they had advanced too far in the PIP claim process.

The survey included a recontact question asking participants if Ipsos MORI could contact them for future waves. Agreement to recontact was given by 999 of the 1,106 participants completing the survey, and they will be contacted in the second wave of the quantitative research in early 2017.
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Key characteristics of the sample include a reasonably equal split between genders and age groups.

Half of the sample is made up of new claimants (those who have started an entirely new claim and have never claimed DLA or claimed in the distant past), with a further quarter made up of natural reassessment claimants (those who have been asked to apply for PIP because their circumstances have changed) and those part of the full PIP roll-out (where those who previously claimed DLA were invited to apply for PIP as part of the process for replacing DLA) respectively.
Over half of the sample stated that they are ‘long term sick or disabled’ when presented with a list of ways in which they might describe their current work status, while six per cent reported being in full-time employment and six per cent in part-time employment.

Some reported being unemployed, whether looking for a job (five per cent) or not (13
per cent).

The differences highlighted and described in the text of this report are statistically significant unless otherwise stated.

Further information on sampling and statistical
reliability can be found in the Appendix
at the end of this report.
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my bold and formatting

edit: several for clarity and content and general fog battling

Luther Blissett · Feb 10, 2018

Thanks Skycloud!

I was curious as I was asked to take part in an ESA survey. I was asked after the claim was awarded.

Another thing that struck me was the usage of percentages instead of numbers in the written summary. 70 odd percent saying something was ok sounds reasonable (if uninspiring) if you don't think too much. When you convert the percentage into numbers, then extrapolate the numbers into total claimants, then not so much.

The latest numbers I can find for PIP are

At the end of July 2017 (the latest PIP data available), there were 1.5 million Personal Independence Payment claims in payment. Up until this point there had been 3.0 million registrations and 2.8 million clearances
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https://www.gov.uk/government/statistics/dwp-statistical-summaries-2017

So, if you read the next quote with that context, it becomes a disgrace.

Claimants were generally positive about the logistics of their face-to-face assessment. Most claimants agreed that the time was convenient (81 per cent), that they were given sufficient warning of the assessment (88 per cent) and that once they had arrived the assessment venue was accessible (83 per cent). Fewer agreed that the venue was easy to get to (65 per cent). Most claimants (73 per cent) attended the assessment appointment they were originally offered; 26 per cent did not. Of those who did not, one-quarter (26 per cent) said this was because they could not get to the location offered
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(emphasis added)

In any other type of job involving 'customers' (as they like to call us) how would those numbers be acceptable?

Stopping there as it's making me angry.

ArtStu · Feb 10, 2018

I waited over two hours to be seen at my last ESA assessment because they book in more people than they can see, using that 25% not turning up rate, it nearly killed me. I was one of the last to go in, so all those waiting with me could have been there for an hour and a half and then got sent home.

Esther12 · Feb 10, 2018

Luther Blissett said: ↑

Were people who were denied a claim involved?

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There was a figures for that in there. I think it was appx 70% were awarded something. Sorry - didn't make notes.

Arnie Pye · Feb 11, 2018

@Skycloud

Your link in post #1 doesn't work for me.

The first few characters of the link are : "http:// https://www."

ladycatlover · Feb 11, 2018

Skycloud said: ↑

PIP and ESA assessments: Claimant Experiences

https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/355/35502.htm
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Very chuffed to find that part of my evidence was quoted! On the second page, Patient Experiences.

18.Several claimants told us that that their assessors had made ill-informed assumptions about how far they could walk, providing an inaccurate basis for decisions about mobility-related awards:

The assessor ticked the box “can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres”. I [told] the assessor that I could just about walk the 5 metres to the end of my front garden and back (so 10 metres in all). Maggie
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Skycloud · Feb 11, 2018

Arnie Pye said: ↑

@Skycloud

Your link in post #1 doesn't work for me.

The first few characters of the link are : "http:// https://www."
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Thanks for letting me know Arnie Pye - I've reposted and it's working for me now

Arnie Pye · Feb 11, 2018

Skycloud said: ↑

Thanks for letting me know Arnie Pye - I've reposted and it's working for me now
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It's working for me too.

Esther12 · Feb 11, 2018

"A critique of the government’s claimant satisfaction survey"

https://kittysjones.wordpress.com/2...the-governments-claimant-satisfaction-survey/

I haven't read this yet, but saw others commenting on it, and it seemed relevant to this thread.

Sly Saint · Feb 11, 2018

Esther12 said: ↑

"A critique of the government’s claimant satisfaction survey"

https://kittysjones.wordpress.com/2...the-governments-claimant-satisfaction-survey/

I haven't read this yet, but saw others commenting on it, and it seemed relevant to this thread.
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"It seems that no-one has examined the validity and reliability of the survey cited, it has simply been taken at face value. It’s assumed that the methodology, intepretation and underlying motives are neutral, value-free. Objective. In fact the survey has been described as “scientific” by at least one Conservative MP."

ha, welcome to the world of BPS research

eta:
"In other words, those people with reason to be very dissatisfied with the Department for Work and Pensions and PIP process – those who haven’t been awarded PIP, for example – are not included in the survey.....
Given that people who are not awarded PIP make up a significant proportion of the PIP customer population who have registered for a claim, this will skew the survey result, slanting it towards positive responses."

"If the purpose of a survey like this is to produce a valid account of levels of ‘customer satisfaction’ with the Department, then it must include a representative sample of all of those ‘customers’, and include those whose experiences have been negative. "

"“Please also note that there was a methodological change to the way that Attendance Allowance, Disability Living Allowance and Personal Independence Payment customers were sampled in 2015/16 which means that for these benefits results for 2015/16 are not directly comparable with previous years.”

Skycloud · Feb 14, 2018

The full report is now available. I've also added these links to the post at the start of the thread.

PIP and ESA assessments: Full Report

https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/829/82902.htm

pdf version:
https://publications.parliament.uk/pa/cm201719/cmselect/cmworpen/829/829.pdf

Summary
Employment and Support Allowance (ESA, introduced in 2008) and the Personal Independence Payment (PIP, introduced in 2013) provide vital financial support to disabled people. Claimants of PIP and ESA should be able to rely on assessments for those benefits being efficient, fair and consistent. Failings in the processes—from application, to assessment, to decision-making and to challenge mechanisms—have contributed to a lack of trust in both benefits. This risks undermining their entire operation.

Most claimants proceed through their PIP and ESA assessments without significant problems, but a sizable minority do not. Since 2013, 290,000 claimants of PIP and ESA—6% of all those assessed—only received the correct award after challenging DWP’s initial decision. Those cases, set alongside other recurring problems with applications and assessments, have ramifications far beyond the minority of claimants directly affected. Applying for PIP or ESA—and in doing so, facing up to the full limitations imposed by a health condition—can be stressful and challenging. A deficit of confidence in the assessment processes adds considerably to claimants’ distress.

Central to the lack of trust are concerns about the ability of the Department’s contractors to conduct accurate assessments. We heard many reports of errors appearing in assessment reports (which may or may not effect eligibility). Such experiences serve to undermine confidence amongst claimants. So does the proportion of DWP decisions overturned at appeal. At worst, there is an unsubstantiated belief among some claimants and their advisers that assessors are encouraged to misrepresent assessments deliberately in a way that leads to claimants being denied benefits. This reflects poorly on contractor assessors and on the Department. The Department must urgently address these concerns. Offering audio recording of assessments by default would reassure claimants that an objective record of their appointment exists, to call on in the event of a dispute. Providing a copy of the assessors’ report by default with claimants’ decision letters would also introduce essential transparency into decision-making.

All three contractors carry out assessments using non-specialist assessors. Without good use of expert evidence to supplement their analysis, the Department will struggle to convince sceptical claimants that the decision on their entitlement is an informed one. The Department should introduce new requirements on contractors explicitly to indicate how they have used all additional evidence supplied. The resulting checklist should be supplied to DWP’s Decision Makers, and to claimants alongside a copy of their report.

It is extraordinary that basic deficiencies in the accessibility of PIP and ESA assessments remain, five and ten years respectively after their introduction. The Department must ensure it and its contractors communicate with claimants in ways that meet their needs, providing Easy Read and non-telephone options where necessary. It should give clear, consistent guidance on home assessments, ensuring all claimants who need a home visit receive one in a timely fashion, and that the process for obtaining it does not place burdens on claimants or the NHS. It should also issue refreshed, clearer guidance on the role of claimants’ companions during assessments, ensuring their contributions are appropriately reflected in assessment reports. These are small, but valuable steps.

The Department maintains that high overturn rates of its decisions at appeal reflect the presence of new evidence that was not available to its decision makers. It has displayed a lack of determination in exploring why it takes until that stage for new evidence to come to light. This is all the more striking because by far the most common form of “new evidence” is oral evidence obtained from the claimant. It is difficult to understand why this evidence was not, or could not have been elicited and recorded by the assessor. The Department and contractors should use audio recordings to quality assure the whole assessment, rather than just the resulting report. Given what we know about reasons for overturn, this should focus on questioning techniques and ensuring claimants’ statements during the assessment are given appropriate weight. It should also ensure that, when claimants bring a companion to assessment, their input is sought and recorded appropriately. All of this will improve the quality of decision making and cut down on Mandatory Reconsideration requests, allowing for a more thorough investigation of decisions that are disputed. It will also save public money, reducing the cost of poor decision-making to the Department and the Courts.

Ultimately, while the Department sets quality standards, it is up to contractors to meet them. The Department’s existing standards set a low bar for what is considered acceptable. Despite this, all three contractors have failed to meet key targets on levels of unacceptable reports in any single period. In Capita’s case, as many as 56% of reports were found to be unacceptable in recent months. The Department’s use of financial penalties to bring reports up to standard has not had a consistent effect. Both Capita and Atos have seen increases in the proportion of reports graded “unacceptable” in recent months. Large sums of money have been paid to contractors despite quality targets having been universally missed. The Government has also spent hundreds of millions of pounds more checking and defending the Department’s decisions.

The PIP and ESA contracts are drawing to a close. In both cases, the decision to contract out assessments in the first instance was driven by a perceived need to introduce efficient, consistent and objective tests for benefit eligibility. It is hard to see how these objectives have been met. None of the providers has ever hit the quality performance targets required of them, and many claimants experience a great deal of anxiety over assessments. The Department will need to consider whether the market is capable of delivering assessments at the required level and of rebuilding claimant trust. If it cannot—as already floundering market interest may suggest—the Department may well conclude assessments are better delivered in house.
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Sly Saint · Feb 15, 2018

"The Department will need to consider whether the market is capable of delivering assessments at the required level and of rebuilding claimant trust. If it cannot—as already floundering market interest may suggest—the Department may well conclude assessments are better delivered in house."

ie like they used to be!

It is ridiculous that they contract it out to companies who then have to hire people (potentially taking them away from the NHS) and re-train them to do the assessments
in addition to
sending a form to the GP to fill out to ask mostly the same questions (esa113 https://www.gov.uk/government/uploa...hment_data/file/251339/esa113-interactive.pdf for ESA and https://www.whatdotheyknow.com/requ.../3/1949 Attachment 1.pdf?cookie_passthrough=1 for PIP note from what I can gather on the net the GPs are paid to fill out these reports)

not to mention the assessment centres, the hoo-haa involved to try and get a home visit when the AC is too far to get to.

whereas they used to be carried out at your GP's practice (I think the last one of those I did was with one of the nurses). So less stress, and less problems getting there for the patient, more likely to feel a genuine assessment is made, the member of staff can still do their normal NHS work in between.

By all means pay the GP practices more for the service instead of paying the likes of ATOS...........it's still going to work out cheaper. I would have thought it was a no brainer, but what do I know.....

Skycloud · Feb 15, 2018

On the whole I like the report, though I do wonder what I'm missing..

Considering half the committee were Conservatives (party of government, therefore might be expected to be less critical) it was better than I expected.

Sly Saint said: ↑

ie like they used to be!
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I know!! So ridiculous and stupid.

Invisible Woman · Feb 15, 2018

Sly Saint said: ↑

not to mention the assessment centres, the hoo-haa involved to try and get a home visit when the AC is too far to get to.

whereas they used to be carried out at your GP's practice (I think the last one of those I did was with one of the nurses). So less stress, and less problems getting there for the patient, more likely to feel a genuine assessment is made, the member of staff can still do their normal NHS work in between.
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That wasn't my experience while assessments were done in-house. They wanted me to go to an assessment centre that was a total nightmare to get to. There was a closer centre, but I wasnt allowed go there because it wasn't my area. I spoke to the doc and the feeling was I should ask for a home assessment.

The GPs surgery was not an option.

MEMarge · Feb 20, 2018

You and Yours tomorrow 12.15 radio 4 are following this issue re PIP etc

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Work and Pensions Select Comittee (UK) findings re: failures of PIP and ESA assessments

Skycloud Senior Member (Voting Rights)

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Esther12 Senior Member (Voting Rights)

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Work and Pensions Select Comittee (UK) findings re: failures of PIP and ESA assessments

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