The fourth independent review of the Work Capability Assessment – what you need to know
An independent report on the Work Capability Assessment is being published later today. Here, we explain why it’s so important and what we’re hoping it will say…
What is it?
Every year, the Government must publish an independent review of the controversial Work Capability Assessment (WCA), which is the process used to decide whether hundreds of thousands of people are eligible for Employment and Support Allowance (ESA).This is the fourth of five planned independent reviews, and is the first to be carried out by Dr Paul Litchfield.
Have the last three reviews improved the system?
Professor Harrington, who carried out the previous three reviews, made some useful recommendations and some improvements have been made as a result. However, progress has been much too slow and the process is still failing people with mental health problems. We hear from people every day who tell us that the WCA is distressing and does not properly capture the impact of mental illness on their lives. This means vulnerable people are wrongly being found fit for work and having benefits they are entitled to taken away.
In addition to the problem of slow implementation, we also feel that Professor Harrington’s recommendations did not go far enough. His reports acknowledged many of the problems people with mental illness are having with the system, but this was not reflected in adequate recommendations for change.
The specific recommendations that were made for mental health, such as ‘Mental Function Champions’ and changes to the mental health descriptors in the assessment, have had little impact. We also disagree with Professor’s Harrington’s conclusion that the responsibility for collecting medical evidence should be on the claimant. We feel this disadvantages people who are most unwell and unable to collate this crucial supporting evidence.
We hope that Dr Paul Litchfield, who is taking over from Professor Harrington for the fourth review, will make recommendations to make the system fairer, specifically for people with mental health problems.
What are you hoping to see in this review?
We submitted evidence jointly with a number of other mental health organizations and we hope that our evidence will be reflected in Dr Litchfield’s report.
The key changes we want to see to are:
- Medical evidence to be collected on behalf of people who are too ill to do it themselves
Under the current system, claimants are expected to gather their own medical evidence from a professional such as a GP or social worker. The Department for Work and Pensions (DWP) only collects this evidence for someone if they explicitly report being acutely psychotic or having suicidal thoughts. This relies on people disclosing this information about themselves, which they may not be able to do at that point, and is a very high threshold on which to base the assumption that the claimant is able to gather this evidence.
Organising written evidence can be very challenging for people with severe mental health problems. Sometimes people become so ill that they struggle to navigate complex paperwork and to make arrangements for a professional to provide additional evidence on their behalf. People can also find it difficult to accurately communicate the impact of their mental illness when very unwell, as they may lack insight into their condition at this point. The system is essentially setting them up to fail.
If you don’t gather your own evidence, you will simply be assessed without it being looked at. So those who are the most ill, are the least likely to have medical evidence about their illness assessed as part of their claim.
- Less frequent reassessments
The system reassesses people on an ongoing basis, which is reasonable as conditions do change over time. However, the reassessments are not moved to take into account appeals. This means that in some cases, people who have been wrongly found fit for work and have eventually had that decision overturned through long and stressful appeals process, are immediately put through the whole process again from the beginning. For some this can feel like a never ending nightmare of assessment and appeal, which can make their mental health worse and means they are even less likely to become well enough to work.
WCA assessors, employed by Atos Healthcare, do not necessarily have any specialist experience or training in mental health. Face-to-face assessments provide only a ‘snapshot’ moment, and are unlikely to be representative of someone’s ability to work. Accurate scoring is therefore dependent on the assessor having specialist knowledge of the fluctuating nature of mental illness and being able to interpret the answers given. Without mental health training they are unlikely to have these skills. This can lead to assessors making ill-informed assumptions about a person’s mental health based on their appearance or ability to communicate. We would like this review to include a recommendation that research is done to find out whether assessors with specialist mental health knowledge make better quality decisions. We believe they will, and this evidence could be used to make the business case for having expert assessors.
We think that everyone going through the WCA should have a right to see what has been written about them and information about how decisions are made about their ability to work.