Ed Pybus considers a review of assessments and decision making in personal independence payment (PIP).
The 2012 Welfare Reform Act includes legislation1 that requires the Secretary of State to lay before parliament two ‘independent reports on the operation of [PIP] assessments’. The first independent review of the PIP assessment was published in 2014. In March 2017, the government published the second.2
This review was undertaken by Paul Gray, chair of the Social Security Advisory Committee. It produced 14 recommendations for the DWP to follow in relation to PIP, noting that they are ‘inter-dependent and mutually reinforcing’. Many, if not all, of them would be welcomed by those working in the advice sector. The recommendations are not binding on the DWP and, at the time of writing, the DWP has not issued a response. The review also looks at how the recommendations of the first review, published in 2014, have been implemented.
Gray focuses on the further evidence that is needed to determine whether or not the claimant meets the disability conditions for PIP, as well as trust and consistency of decision making.
Functional rather than medical
The PIP assessment is a functional, rather than a medical, assessment. The review notes that this is not clearly communicated to claimants, leading to confusion about entitlement. This confusion is institutional within the DWP and providers, with frequent references to ‘medical’ evidence and assessment ‘clinics’. The recommendation that, for example, the face-to-face assessment begins with a functional, rather than medical, assessment could provide claimants with more opportunity to explain how their condition affects their functionality rather than dwelling solely on their diagnosis. Advisers may soon be able to assess the impact of such a change in policy – ATOS has trialled this approach in a number of assessment centres and is now rolling it out across its regions. Medical evidence, though often important, is not the only relevant evidence. Despite the lack of clarity from the DWP, bearing in mind that PIP is a functional rather than medical assessment may influence advisers’ tactics at both claim and appeal stage.
This lack of clarity often leads to confusion as to what further evidence is relevant, with claimants sometimes supplying largely irrelevant medical evidence. The review makes it clear that carers and family members are often in a better position to explain the functional impact of the claimant’s condition than the claimant's medical history. The review recommends that the DWP amend its guidance to reflect this – the current assessment guide is largely silent on how evidence from carers and family members should be viewed. Advisers should note that, at present, despite an internal culture of viewing evidence as a hierarchy, the DWP should give equal weight to all evidence and provide reasons for preferring one piece of evidence over another.
At present, DWP policy is that it is the claimant's responsibility to supply further evidence to support the claim. The review makes no comment on the appropriateness of this policy but does recommend that, in light of this policy, the DWP should make it clear that the responsibility lies primarily with the claimant. This seems at odds from the way the section is worded on the PIP2 form and it may be necessary for advisers to make claimants aware of this.
Consistency and trust
Further recommendations look at the consistency and accuracy of decision making. It notes a wide variation in new claim and re-assessment award rates across local authorities and, although lacking the full data to do comparisons, suggests that there is concern about consistency of decision making. Differing processes by the two assessment providers mean, for example, that some assessors only review the PIP2 form and further evidence at the time of the assessment, or that some assessors undertake several assessments before writing up their reports. These, and other processes, have an impact on the accuracy of the assessors’ reports. The lack of consistency is exacerbated by an audit process that takes a piecemeal approach to monitoring. For example, the audit of the assessment providers is focused on the assessment report, but not on its accuracy or the final outcome of the claim.
This lack of consistency is one of the reasons for the lack of public trust in the PIP decision making process. The review suggests, perhaps with understatement, that ‘increasing claimant trust will be a challenging task’. One recommendation that it hopes would increase trust in the process is allowing all claimants to routinely access their assessment report by including a copy of the report with the decision notice. If implemented, this would be of great benefit to advisers, particularly in cases where they are considering a mandatory reconsideration but did not assist the claimant with the PIP2 form. It would provide claimants with some clarity as to how a decision has been made regarding their entitlement.
A longer term recommendation is that all assessments be recorded, to both improve accuracy and improve trust in the assessment system. Assessments can be recorded at present, but the task of arranging such a record is onerous, as any adviser who has attempted to do this will be aware.
The influence these recommendations have will depend on their implementation. Gray notes that there has been ‘some progress’ in implementing the recommendations of the first review – but there is still some way to go before they have been implemented in full. With no further independent review planned, it is unclear how the DWP’s progress in implementing these further recommendations will be measured.
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- 1. s89 Welfare Reform Act 2012
- 2. https://www.gov.uk/government/publications/personal-independence-payment...