The Work Capability Assessment Keep this slide on at the end of your presentation while you answer questions Sue Royston Social Policy Officer Citizens Advice 12/4/2018

Outline A brief guide to Employment and Support Allowance (ESA) What is the WCA and what does it measure? The changes to the WCA in April 2011 How well does it measure barriers to work? What are the implications of this for the work programme Assessment processes in other countries A way forward?

A brief guide to Employment and Support Allowance (ESA) The structure of ESA The support group The Work Related Activity Group Where the WCA fits into the assessment process Exemptions ESA50 WCA

What is the WCA and what does it measure? Functional assessment A brief guide to the descriptors Exceptional circumstances

Changes ESA (CB) limit of 1 yr for those in WRAG (April 2012) Review by Professor Harrington Rollout to all on IB Spring 2011 to 2014 New people 13 weeks on basic rate then WCA Those on IB don’t need to apply – go straight to assessment process New descriptors

The new descriptors What is changing Assessment (WCA) – new regulations from March 2011 Support Gp (10% - predicted to become 11%) WRAG (24% - predicted to become 14%) Fit for work (66%% - predicted to become 75%)

Review by Professor Harrington Last year’s review Mental health descriptors Treatment of variable conditions Real world elements

How well does it measure barriers to work? Functional assessment Exemptions very limited Claimants with a life expectancy of less than 5 years Evidence of problems Citizens Advice statistics DWP survey

The evidence Evidence from Citizens Advice Many claimants who clearly cant work Many claimants who face substantial barriers to work Evidence from survey (DWP research report 745) - 1 yr after being found fit for work 29% in work 22% claiming JSA 43% neither working or claiming benefits

What are the implications for claimants WCA decides 4 things Level of benefit Level of support into work Conditionality Extra financial support in work Is work good for your health and wellbeing? “those who move off benefits but do not enter work are more likely to report a deterioration in health and well-being” Marmot report “good work is good for you”

What are the implications for the work programme? Often a very negative process Frequent appeals Worry about revolving door Claimants in WRAG who have a condition which is deteriorating and who have a limited life expectancy Funding is linked to level of benefit not barriers to work

Barriers to work Qualifications, age and work experience looking at effect of impairment on level of disadvantage Impact of underlying condition levels of fatigue deteriorating condition Barriers in the workplace

Assessment process in other countries Collection of medical evidence from claimants HCP Holistic decision looking at all barriers to work and deciding if job can do eg USA (underlying functional assessment )& invalidity benefit here. Netherlands also use this eg Australia uses more holistic assessment for deciding level of support Rule based system eg USA More diagnostic process eg Denmark

A way forward Automatic entry to support group for those with limited life expectancy and deteriorating condition Assessment more holistic Trial of more diagnostic assessment

Questions and comments 12/4/2018