Petition Full review of Personal Independence Payment (PIP) application process

Shaping Future Support, the health and disability green paper, explored better meeting the needs of disabled people and those with health conditions. We will publish a White Paper later this year.

We are committed to ensuring individuals applying for health and disability benefits receive high quality, robust and accurate assessments and decisions on their claim. We work continuously to improve the quality of service.

Last year we published Shaping Future Support: The Health and Disability Green Paper. This explored how the welfare system can better meet the needs of disabled people and those with health conditions to build a system that enables people to live independently and move into work where possible.

Personal Independence Payment (PIP) contracted providers

Both PIP assessment providers, Capita and Independent Assessment Services (IAS), strive to provide excellent service to claimants and are held to account for their performance. They have consistently exceeded their customer satisfaction targets of 90% for PIP, achieving collectively 96.6% until the end of February 2022. More information can be found here.

As part of the Functional Health Assessment process, the feasibility of a paper- based assessment will always be considered in the first instance for all cases. Health Professionals may contact GPs, any named specialist medical professionals or the claimant if they need more information to undertake a paper-based review. Health Professionals are expected to consider all available evidence when formulating their advice. All evidence must be interpreted and evaluated using medical reasoning, considering the circumstances of the case and the expected impact on the claimant’s daily living and/or mobility. Providers work continuously to drive improvements in assessment services. They have introduced new management processes to drive performance across their services, including enhanced assessment report quality checks to improve the quality of advice the DWP receives. In addition, PIP assessment reports have been redesigned to have clearer justifications which support improved benefit decision making.

The department maintains providers’ high standard through Independent Audit that continually monitors performance and provides feedback to providers. Quality performance is also regularly reviewed at DWP and provider governance meetings at a national level and in each of the provider areas.

Provider performance is measured across a range of service level agreements setting out the department's expectations for service delivery. These include quality, performance delivery targets and customer experience. Contractual remedies are in place if the provider fails to deliver against the agreed service standards and service credits are applied, where appropriate, in order to recover estimated financial loss to the department. Ultimately the department has the right to terminate the contract if there is sustained underperformance in a range of areas.

Correct decisions

It has always been our aim to make the right decision at the earliest opportunity so that claimants do not have to appeal. Consequently, and learning from tribunal decisions, we have introduced a new approach to decision making at both the initial decision and the Mandatory Reconsideration stage, giving Decision Makers additional time to proactively contact claimants where they think additional evidence may support a claim.

The new approach to decision making has resulted in a greater proportion of decisions being changed at Mandatory Reconsideration, which in turn has contributed to a reduction in the proportion of decisions resulting in an appeal lodgement. Only 7% of initial decisions made in 2020-21 have seen an appeal lodged against them, compared to 9% in 2019-20, and 10% in the three years previous. In addition, since PIP was introduced 4.5 million initial decisions following an assessment have been made up to March 2022; 9% have been appealed and 4% have been overturned at a tribunal hearing.

The latest statistics on PIP initial decisions for the period April 2013 to March 2022 and Mandatory Reconsiderations and appeals for the period April 2013 to June 2022 show that 66% of appeals cleared at a hearing, where the initial decision was disallowed, were overturned. Out of the 4.5 million PIP initial decisions made, 1.6 million (36%) were disallowed, 1.1 million (23%) registered for mandatory reconsideration, 390,000 (9%) lodged an appeal, and 200,000 (4%) were overturned.

PIP Case Managers receive extensive training and are supported and coached by an experienced mentor before passing rigorous Line Manager checks to ensure they have reached the high standard that DWP expects. The Department has a thorough ongoing checking regime to drive continuous improvement and consistency across all Case Manager Teams. As a learning organisation, the Department is continually supporting Case Managers to develop their understanding of the functional needs arising from complex health conditions and disabilities to ensure that robust decisions are reached weighting all of the claimant’s evidence, health professional advice and all supporting evidence.

Department for Work and Pensions

This response was given on 28 September 2022. The Petitions Committee then requested a revised response, that more directly addressed the request of the petition.