The government should commission an ‘end-to-end redesign’ of the Work Capability Assessment (WCA), according to the British Psychological Society (BPS).
In a new briefing paper, the BPS cites a growing body of evidence that seriously ill people are being inappropriately subjected to WCA, which determines eligibility for Employment and Support Allowance (ESA). It argues that the WCA does not effectively measure fitness for work and that its application is producing inappropriate outcomes for claimants.
It quotes the conclusion of the 2014 review by the House of Commons work and pensions select committee that: “Simply rebranding the WCA by taking on a new provider will not solve the problems… This will be time consuming and complex, but the re-designed ESA assessment processes needs to be in place by the time a completely new contract, involving multiple providers is tendered in 2018.”
The BPS strongly endorses this conclusion and calls for the government to undertake a full review of the assessment and its processes.
To redesign the WCA system the BPS advocates:
• A reliable, valid and fully researched method of assessment to replace the Limited Capacity for Work Questionnaire (ESA 50) and the face-to-face WCA
• Training in assessment, scoring and interpretation for the test administrators
• Specialist assessors to assess people with mental, cognitive and intellectual functioning difficulties
• Supervision of the assessors from qualified clinicians with expertise in rehabilitation, assessment and interpretation
• Referral routes to specialist assessment and support for those with psychological, cognitive and intellectual functioning difficulties
• Appropriate periods of reassessment for people with long-term conditions, based on specialist advice to accurately reflect the prognosis.
Professor Jamie Hacker Hughes, president of the BPS, said: “There is now a significant body of evidence that the WCA is failing to assess people’s fitness for work accurately and appropriately, with people who are seriously physically and mentally ill being found fit for work and those with acute, transient episodes being assessed as lacking capacity and treated in the same way as those with a longer-term prognosis.
“Appeals against the decisions are running at approximately 50% and around half of those appeals are upheld. The cost to the taxpayer from this alone is £50 million, with a similar amount being spent on reassessment. The DWP [Department for Work & Pensions] is now under significant pressure to publish data on the number of people who have died whilst claiming out-of-work disability benefits.”
“Deeply flawed system”
Mental health charity Rethink Mental Illness has welcomed the report. “This deeply flawed system is causing huge distress, and pushing many vulnerable people to the brink,” said Brian Dow, director of external affairs at the charity. “Indeed, in a court case earlier this year, judges said that it puts people with mental illness at a ‘substantial disadvantage’.
“We welcome this report’s call for major changes to the process, including using assessors who have specialist knowledge of mental health. But to really fix this test so that it no longer discriminates against people with mental illness, we need to see much more extensive reforms.
“Another huge problem is that people have to gather their medical evidence from their GP or psychiatrist, to prove that they are too unwell to work. That can be an almost impossible task if you’re experiencing serious mental health problems, and so people are often being assessed without this crucial evidence being considered.
“Until these major problems are addressed, the system will continue to disadvantage people when they’re at their most vulnerable. We’re calling on the Government to overhaul the system from top-to-bottom, otherwise it will continue to punish many of the people it’s meant to support.”