We have been calling for such end-to-end reform since 2015 and it has been the focus of our meetings with key MPs, the Department of Work and Pensions and other stakeholders.
The Claimant Experiences report emphasises problems with the assessment process, the stress and difficulty experienced by claimants in preparing their applications and undergoing face to face assessments, the inexperience and lack of awareness of mental health conditions of the health care professionals performing the assessments, and the resulting errors in the reports caused by the lack of assessor specialist knowledge.
We have consistently recommended that specialist assessors be appropriately trained to assess complex, progressive or fluctuating conditions that relate to mental and cognitive health, as well as physical conditions. We have also called for such training to ensure that assessors are sensitive to the specific needs of those presenting with complex conditions and understand that additional support may be need to be provided to those individuals to ensure sufficient comprehension and understanding of the assessment and what is being assessed. We welcome the Select Committee’s recommendation that the development of appropriate support materials be co-produced with service users and professionals. It is important that the materials include a range of literacy-ability and are available to those without easy access to the internet or perhaps even to a fixed address.
The report also sets out concerns that the focus of the assessment on providing details of the things that claimants struggle with or feel unable to do can be highly distressing and damaging to self-esteem. Our concerns regarding the nature of the process and its focus on capacity rather than individual needs have also been part of our campaign on the need to reform ESA process and are further highlighted in our report Psychology at Work.
The PIP and ESA Assessments report further emphasises that the process can be stressful and challenging. A lack of claimants’ confidence in the process adds considerably to this distress. In the evidence provided to the Committee, witnesses highlighted the need to review and reformulate the descriptors for both PIP and ESA so that they accurately assess the functional impact of all conditions. The lack of the validity and reliability of Work Capability Assessment and the inadequacy of its descriptors and scoring system have been hugely criticised in the 2013 Litchfield Review and in our own submissions to the Select Committee.
Of particular significance, our concerns regarding the impact of the assessments on the psychological wellbeing are quoted in the report; “any process designed to support those in need must uphold or improve the psychological wellbeing of those individuals” (p.16). Importantly, the Select Committee recommends that the DWP commission and publish independent research on the impact of application and assessment for PIP and ESA on claimant health. Moreover, the DWP should openly state that it is alert to the risk to mental health posed by parts of the application process and that it will seek to offset this. We fully endorse these recommendations and would be keen to input into any such reviews to ensure that psychological theory and practice informs future reform within the benefits system.
Finally, the issue of “trust” or the lack of trust that claimants have in the assessments is repeated in both reports. Any attempts to reform or improve the assessment system, must begin with a clear commitment to re-building public trust in the benefits system and in ensuring improvements in the accuracy of the assessments of individual’s needs and the level of support that is needed.
We continue to press forward with our calls for reform and our significant concerns regarding the impact of the current system through the APPG Psychology and in advising individual parliamentarians, in meetings with the Department of Work and Pensions and in collaboration with other key stakeholders. For the Select Committee, “The question of whether a more fundamental overhaul of welfare support… is necessary remains open”. For the BPS, this remains absolutely essential.
BPS Acting Director of Policy Dr Lisa Morrison Coulthard