Petition End reviews of PIP and ESA awards for people with lifelong illnesses

Government responded

This response was given on 10 September 2021

We understand there are people with severe and lifelong health conditions which will not improve and want to test a simplified process which doesn’t require them to undertake a health assessment.

The Department for Work and Pensions uses functional assessments to help determine entitlement for a number of benefits, including Personal Independence Payments (PIP), Employment and Support Allowance (ESA) and, for those claiming because they have a disability or health condition that impacts on their capability for work, Universal Credit (UC).

There is strong evidence that work is good for physical and mental well-being and that being out of work can contribute to poorer health. We want to ensure people who can work are supported to do so. The Work Capability Assessment (WCA) was designed to ensure that people receive appropriate financial support and appropriate work-related support. Reassessments are important to take into account changes in how someone’s health condition or disability affects their capability for work over time.

We use a separate assessment to determine entitlement for PIP. Unlike in UC and ESA, PIP aims to help people with the extra costs of a disability or long-term health condition. PIP is paid regardless of income or savings. Once someone has been awarded PIP, which can be paid at one of eight rates, that award will be reviewed. Reviews of PIP are a key part of the benefit to ensure that awards remain correct where needs may change (including where needs increase and the award may need to increase) and that we maintain contact with the individual, both features that were missing from PIP’s predecessor Disability Living Allowance. The length of an award is based on an individual’s circumstances and can vary from nine months to an on-going award, with a light touch review after 10 years.

Over recent years, we introduced a range of improvements to avoid unnecessary reassessments. In WCA, for example, we have worked with healthcare professionals and other stakeholders to develop a set of criteria to waive the need to re-assess people with the most severe health conditions or disabilities (unless a change of circumstances is reported).

Those placed in the ESA Support Group or found to have Limited Capability for Work and Work-Related Activity (LCWRA) in UC, who have the most severe and lifelong health conditions or disabilities, whose level of function would always mean that they would have LCWRA, and be unlikely ever to be able to move into work, are not routinely reassessed.

Rather than being defined through a list of specific health conditions, the severe conditions criteria are considered as part of the WCA. This gives the individual the best opportunity to share with us the most up to date information about the functional impacts of their condition.

We have also made changes to help reduce the frequency of repeat assessments some people need to go through on PIP. We have ensured that people who receive the highest level of support whose needs will not improve and most people over State Pension Age, receive an ongoing award of PIP with a ‘light touch’ review at the 10-year point. Ongoing awards can be applied to any level or combination of award outcome so long as the person’s needs are unlikely to change. A review can take place sooner if a person’s needs change.

Furthermore, the Shaping future support: the health and disability green paper published on 20th July 2021 recognises that people who do not come within the special rules for terminal illness may still have severe and lifelong conditions that will not improve. These people are unlikely ever to work again and will always need extra financial support to live independently. We want to test a new Severe Disability Group (SDG) so that these people can benefit from a simplified process without ever needing to complete a detailed application form or go through an assessment. This will build on existing successful measures such as the Severe Conditions Criteria. The SDG could apply to people on PIP, ESA and UC.

We expect that the decision to place someone in the SDG will be based on information from medical professionals so we are working with a group of health and social care professionals to help us develop the criteria for the SDG and identify the evidence that would be required to meet them. We will also consult with charities and disabled people’s organisations on the criteria. Additionally, we will work directly with disabled people and people with health conditions to develop the service, and test the approach to make sure it delivers the improvements we are seeking. This test will look at whether the SDG achieves its goals while ensuring people receive the right level of benefit. We will consider the test results alongside the responses to the Green Paper when determining whether the policy should be rolled out further.

The consultation is an important step towards making changes that will improve our services, improve employment outcomes and enable people to live independent lives. Our approach must be informed by different views and opinions, particularly those of disabled people and people with health conditions.

Department for Work and Pensions