Revising health assessments for disability benefits

Public Accounts Committee Closed Inquiry
Opened: 24 May 2023 Closed: 8 Mar 2024 Parliament page
In 2021-22 the Department for Work & Pensions (DWP) spent £63.1 billion on a range of benefits to support people with a disability or health condition. This includes Personal Independence Payments, Employment and Support Allowance and certain Universal Credit payments. DWP undertakes a health assessment of the claimant to decide … Read more
11 Recommendations
20 Conclusions
1 Report
1 Oral session
1 Letter
1 Event
Activity timeline 5 events
8 Mar
2024
Report published
29 Nov
2023
Report published
19 Sep
2023
Correspondence
6 Jul
2023
Oral evidence
6 Jul
2023
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
Oral evidence sessions 1 session
6 Jul 2023
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Revising health assessments for disability benefits
James Bolton · Department for Work and Pensions Katie Farrington · Department for Work and Pensions Peter Schofield CB · Department for Work and Pensions
Title HC No. Published Items Response
Third Report - Revising health assessments for disability benefi… HC 79 29 Nov 2023 31 Responded
Recommendations & Conclusions
9 results
Clear
3 Recommendation Rejected
Third Report - Revising health ass…
Publish comprehensive outcome indicators for health assessment programme, measuring claimant benefits and experience.
The Department’s approach to monitoring the Programme’s progress and performance has so far focused on process and not on the transformation of the service for benefit claimants. The Department has not yet completed the work needed to define how it … Read more
Government Response
The government disagreed with the recommendation to publish outcome indicators in the new business case and annual reports, stating the program is too early-stage and they will refine their approach as it matures.
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6 Conclusion Rejected
Third Report - Revising health ass…
Monitor and publish data on health assessment services by area and provider to identify differences.
The Department has not worked out how it will manage the inevitable differences between claims made and processed in its new test areas and in areas using the current service. A key objective of the Programme is to help the … Read more
Government Response
The government disagreed with the recommendation to monitor and publish specific data points for transformation areas, stating they already publish HTP MI and PIP Official Statistics. They will consider including equivalent measures in future HTP publications once the service is mature.
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11 Recommendation Rejected
Third Report - Revising health ass…
Department plans wider testing of health transformation service to ensure representative claimant sample.
The Department has started to process applications from claimants living in specific postcodes in London and Birmingham through the health transformation. The Department acknowledged that the two health transformation areas alone will not provide it with a representative sample of … Read more
Government Response
The government explicitly disagrees with the committee's recommendation regarding the need for a wider range of claimants in testing. It notes it publishes HTP management information quarterly and will look to include overturn rates in future publications.
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13 Recommendation Rejected
Third Report - Revising health ass…
Include the updated business case in baseline assessments for all 47 key performance indicators.
In May 2023, the Department published the evaluation strategy for the Programme.24 The evaluation strategy includes nine key performance indicators, which focus more on the performance of the service the Department is building rather than the outcomes for claimants. The … Read more
Government Response
The government disagrees with the recommendation, stating the program is in early stages and they will refine their performance measurement approach as it matures, including defining outcome indicators. They are already publishing quarterly management information and will evolve it to report against KPIs, and are evaluating services.
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14 Recommendation Rejected
Third Report - Revising health ass…
Department acknowledges need to better link performance metrics with claimant outcomes.
We also asked the Department how it would ensure that the performance indicators and metrics it used encapsulated the outcomes intended from the Programme, and linked outputs to these outcomes. The Department acknowledged that there was more that it can … Read more
Government Response
The government explicitly disagrees with the recommendation. It acknowledges the need for transparency and states it will refine its performance measurement approach as the programme matures, including defining and tracking outcome indicators, and will continue to publish management information quarterly.
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16 Conclusion Rejected
Third Report - Revising health ass…
Significant disparity in staff satisfaction between Department and Social Security Scotland.
We asked the Department about how it measured the quality of benefit decisions, why it did not publish more information on the performance of contractors given the potential impact of their decisions on the lives of claimants, and about difference … Read more
Government Response
The government explicitly disagrees with the committee's implied recommendation regarding publication of information on contractor performance. It states it has published the first of a new series of HTP MI, which will continue quarterly, and will keep under review what data can be published on existing providers.
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24 Conclusion Rejected
Third Report - Revising health ass…
Fifteen percent of initial PIP benefit decisions are revised or overturned on appeal
As part of the Programme, the Department wants to ensure that the new service provides “getting the decision right the first time more of the time”. It recognised this may mean it needs to spend “more time up front to … Read more
Government Response
The government explicitly disagrees with the committee's implied recommendation regarding 'right first time' decisions and overturn rates. It states it has started publishing new HTP MI quarterly and already publishes overturn rates in PIP Official Statistics, and will look to include equivalent measures in future HTP publications.
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25 Conclusion Rejected
Third Report - Revising health ass…
Department attributes overturned decisions to assessment judgement and fluctuating medical conditions
We therefore asked the Department whether it was concerned that so many decisions were being overturned. The Department stressed that there was a degree of judgement involved in the health assessment process it used to determine eligibility for disability benefits, … Read more
Government Response
The government explicitly disagrees with the committee's implied recommendation regarding overturned decisions. It states it has started publishing new HTP MI quarterly and already publishes overturn rates in PIP Official Statistics, and will look to include equivalent measures in future HTP publications.
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27 Conclusion Rejected
Third Report - Revising health ass…
Department ensures consistency and fairness in pilot health assessment services through intense oversight
The Department is running two distinct health assessment services, one processing most claims using its current approach and one which is testing how it might change its approach in the future. We asked the Department how it was ensuring that … Read more
Government Response
The government explicitly disagrees with the committee's implied recommendation, stating it has started publishing new HTP MI quarterly and will keep under review what data can be published. It does not address how it ensures consistency between distinct health assessment services or safeguards claimants in trial areas.
HM Treasury
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Government Response AI assessment · 30 of 11 classified
Accepted 19
Acknowledged 2
Rejected 9
Total 11 recs + 20 conclusions
Correspondence 1 letter
19 Sep 2023 Correspondence from James Bolton, Senior Responsible Owner, Health Transformation Programme, Department for Work and Pensions, re DWP follow up to the Public Accounts Committee Hearing on Revising Health Assessments for Disability Benefits 6 July 2023, dated 20 July 2023
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