Mind logoThe latest review of the work capability assessment (WCA) for employment and support allowance (ESA) does not go far enough in addressing the disadvantages faced by claimants with mental ill health, charities have claimed.

The review of the WCA, carried out by Dr Paul Litchfield, chief medical officer for BT Group, concluded that Department for Work and Pensions (DWP) is doing well in implementing the recommendations of Professor Harrington, who carried out the previous three reviews, and has made further recommendations for improvements.

Acknowledging that there is no ‘gold standard’ against which to judge fitness for work the recommendations, made by Dr Litchfield, include: 

Further simplifying the assessment process and enhancing the experience of the assessment itself, such as building rapport during interviews

Building on the knowledge of mental health among decision makers and healthcare professionals

Continuing to streamline the decision-making process.

Dr Litchfield said: “Much has changed since ESA was introduced. I have tried to assess whether recommendations have been fully or partially implemented and I hope that there is some useful learning that comes out of this exercise.

“Another area of focus for me in this review has been mental health. The impaired capability associated with mental health problems can be difficult to assess and I hope my review will help the government improve things even further.

“Good work is good for the health of most people and a benefits system that helps people back into employment when they have been incapacitated must be the aim of a compassionate society. An effective WCA which is fair – and perceived to be so – is important in achieving that.”

A formal government response will be published early next year. Ministers have already announced their intention to secure additional providers on a regional basis to conduct WCA from next summer.

Not far enough

However, mental health charities, while welcoming the acknowledgement of the problems of the WCA for people with mental ill health, believe that Dr Litchfield’s recommendations fall short of what is needed to address these issues.

Paul Jenkins, CEO of Rethink Mental Illness, said: “[Dr Litchfield’s] recommendations do not go far enough and do not tackle one of the biggest flaws in the assessment process for people with mental illness, which is the way medical evidence is collected. 

“Under the current system, claimants are expected to gather their own medical evidence from a professional such as a GP or social worker. Organising for written evidence to be submitted on their behalf can be very challenging for people with severe mental health problems. If you are too ill to do this and fail to produce your own evidence, you will simply be assessed without it being looked at. This penalises the most vulnerable. 

“We think the DWP should be responsible for gathering evidence on behalf of people with severe mental illnesses who are too ill to do it themselves. Unfortunately, Dr Litchfield has not recommended this. 

“However, we are pleased that Dr Litchfield has advised the Government that they need to redesign the paperwork, to make it clearer how important it is to submit medical evidence, but this won’t make a difference to those who are the most ill. 

“We also welcome the fact that he has recognised the problem of benefits assessors not having proper mental health expertise and has made recommendations around improved training. 

“While this review represents some positive moves in the right direction, the work capability assessment process remains deeply unfair for people with a mental illness. This means some of the most ill and vulnerable people in our society are having benefits they are entitled to, wrongly taken away.”

Paul Farmer, chief executive of Mind, added: “This report fails to tackle some of the fundamental problems with the assessment process. We continue to see people being incorrectly assessed as ‘fit for work’ and being placed under inappropriate pressure to push them into employment, rather than supporting them to overcome the barriers they face. This leads to anxiety and distress that often pushes people with mental health problems further from work.

“Mind, along with many other organisations who support people with disabilities, has been providing evidence on behalf of those we represent since these reviews began. Now after four years, we desperately need to see an overhaul of this broken system which continues to consistently let down thousands of the most vulnerable people in society. We want to see assessments carried out by healthcare professionals with expertise in mental health, a more nuanced and sensitive assessment, and the DWP proactively collecting additional evidence from relevant health professionals.”