Third Report - Revising health assessments for disability benefits

Select Committee
Public Accounts Committee HC 79 29 November 2023
Report Status Government responded
Conclusions & Recommendations 31 items (11 recs)
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Government Response (AI assessment · 30 of 31 classified)
Accepted 19
Acknowledged 2
Rejected 9
Government response
Treasury minutes: Government response to the Committee of Public Accounts on the Third report from Session 2023-24 · published 8 Mar 2024
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Recommendations & Conclusions

19 results
2 Recommendation Accepted
Publish revised business case detailing health assessment transformation benefits and progress tracking for claimants.
Recommendation
There is a risk that the Department will deliver a new service without the important improvements to claimant’s experience. The Department intends to make a lot of changes to the process of making a claim before it launches the new … Read more
Government Response Summary
The government committed to publishing a summary of the Transformation Programme business case by Spring 2024, along with its Accounting Officer Assessment, after receiving necessary clearances.
HM Treasury
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4 Recommendation Accepted
Set out preparatory work to maintain a realistic in-house option for future health assessment services.
Recommendation
The Department’s approach to working with contractors as part of the Programme could leave the taxpayer vulnerable to contractual disputes, higher costs and delays. Integrating digital systems is a common source of contractual failure and dispute. Contractors can use difficulties … Read more
Government Response Summary
The government stated it has already implemented the recommendation by engaging with Scotland to share best practice and will continue exploring approaches taken by devolved administrations and international comparators, also considering in-house delivery for some elements.
HM Treasury
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5 Recommendation Accepted
Set out how to involve claimants and raise national awareness of disability benefits system changes.
Recommendation
We are concerned that the Department has not done enough to communicate and engage with the public and claimants about what they can expect from the revised service. The Department is more likely to achieve its ambition to improve the … Read more
Government Response Summary
The government stated it has implemented the recommendation by already involving claimants through user research and engaging with stakeholders, and has communicated program scope through official channels. It will continue to inform the public and Parliament, including publishing the business case summary in Spring 2024.
HM Treasury
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7 Conclusion Accepted
Write to committee listing unpublished GMPP Accounting Officer assessments with a publication timetable.
Conclusion
It is not acceptable that the Department has spent £168 million on the Programme, and is about to commit to a further £2 billion for the Functional Assessment Service, without being transparent to Parliament about whether it is meeting Accounting … Read more
Government Response Summary
The government agreed with the recommendation to write to the Committee within three months, listing GMPP programmes without published Accounting Officer assessments and providing a rapid timetable for their publication.
HM Treasury
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8 Recommendation Accepted
Department acknowledges limits to full transformation delivery before 2029 service contracts.
Recommendation
We asked the Department how it would manage the delivery of the Programme and about the testing it was undertaking of the new service. We also asked, if the testing was not sufficient to provide the data it needed, whether … Read more
Government Response Summary
The government agrees with the recommendation, committing to update and publish the HTP business case by Spring 2024, publish quarterly management information, evolve reporting against KPIs, evaluate services through claimant research, and explore publishing evaluation findings to ensure safe and successful progress.
HM Treasury
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9 Recommendation Accepted
Department confident in financial savings, but wider programme success hinges on changing lives.
Recommendation
We asked the Department whether it was confident that it could deliver the benefits and savings expected from the Programme. The Department told us that it was confident that it could deliver the financial savings, as “the system costs a … Read more
Government Response Summary
The government agrees and will update and publish the Health Transformation Programme business case by Spring 2024, committing to track programme benefits through data analysis and research, publish quarterly management information, and explore publication of evaluation findings.
HM Treasury
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12 Conclusion Accepted
Department reset programme, separating transformation from service; testing with contractors still required.
Conclusion
In order to deliver the new service from 2029, the Department told us it needs certainty over the design of the new health assessments service by 2027 to either procure the new 12 Qq 45–46 13 Q 47 14 Q … Read more
Government Response Summary
The government agrees with the Committee’s recommendation and states that the Functional Assessment Service (FAS) contracts contain specific contractual levers and mechanisms to enable the supplier involvement required to support transformation.
HM Treasury
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15 Recommendation Accepted
Department prioritises balancing outcomes and costs through testing service improvements for claimants.
Recommendation
We asked the Department whether it considered its existing performance indicators and metrics were adequate to ensure that it achieved the time and cost reductions, and increased satisfaction among claimants, intended for the Programme. The Department told us that it … Read more
Government Response Summary
The government agrees and commits to updating and publishing the Health Transformation Programme business case by Spring 2024, which will detail costs and benefits and outline how programme benefits will be tracked using administrative data analysis and research.
HM Treasury
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17 Conclusion Accepted
Interim assessment contracts shift healthcare professional recruitment responsibility to contractors.
Conclusion
The Functional Assessment Services contract will see a new set of contractors providing functional health assessments on behalf of the Department from 2024 to 2029 as an interim service until the Health Assessment Service is delivered in 2029. We asked … Read more
Government Response Summary
The government agrees with the Committee’s recommendation and states that the Functional Assessment Service (FAS) contracts contain specific contractual levers and mechanisms to enable the supplier involvement required to support transformation.
HM Treasury
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18 Conclusion Accepted
Department's reliance on separate negotiations for IT integration carries risks.
Conclusion
Integrating digital systems is a common source of contractual failure and dispute. Contractors can use difficulties in the roll-out of a new system as justification for not 27 Q 32 28 Q 42; Civil Service People Survey 2022: Benchmark Scores, … Read more
Government Response Summary
The government agrees, stating that current Functional Assessment Service (FAS) contracts include levers for supplier involvement and transformation. It commits to mitigating competitive advantage through market transparency and developing a future health commercial strategy from 2024 to explore new contracting mechanisms.
HM Treasury
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19 Conclusion Accepted
In-housing health assessments poses significant recruitment and retention challenges for DWP.
Conclusion
There is also a risk that the current contractors will gain an advantage for the new service that reduces competition. One way to maintain competitive pressure on the contractors to perform is to keep open the question of whether the … Read more
Government Response Summary
The government agrees and states it will mitigate competitive advantage through market transparency and robust procurement processes. Its future health commercial strategy, to be developed from 2024, will consider the department's role and delivery model for services post-2029.
HM Treasury
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20 Conclusion Accepted
Department deems national in-housing too risky, but will learn from Social Security Scotland.
Conclusion
The Department recognised that Social Security Scotland is changing how it operates compared to the Department. For example, Social Security Scotland has brought the functional health assessments process in-house, something the Department says would be challenging to successfully do nationally.38 … Read more
Government Response Summary
The government agrees, stating it has been engaging with Social Security Scotland to share best practice and will closely scrutinise outcomes. It confirms the programme will continue to explore approaches by devolved administrations, and future delivery model assessments will consider direct delivery of health assessment service elements.
HM Treasury
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21 Conclusion Accepted
Department engages stakeholders, but has not widely promoted the programme to the public.
Conclusion
The NAO found that the department had worked with stakeholders to design the Programme but had not promoted the programme widely to the public.40 The Department told us that engaging with disabled people and their representative bodies and the public, … Read more
Government Response Summary
The government agrees, stating that HTP's claimant-focused design continues to be informed by user research and stakeholder engagement. It will publish a summary of the business case in Spring 2024 and continue to inform Parliament and the public about programme changes.
HM Treasury
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22 Conclusion Accepted
Department delays publicising programme changes until scaling up health assessment service.
Conclusion
The Department has yet to widely publicise or raise awareness of the changes the Programme is likely to bring to functional health assessments. We therefore asked whether the Department planned to have national information programme or equivalent to inform people … Read more
Government Response Summary
The government agrees, stating that it has already communicated through written statements and a White Paper, and will publish a summary of the business case in Spring 2024. It also recognises the need to build public awareness as the programme develops and plans become clearer.
HM Treasury
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26 Conclusion Accepted
Department is piloting new health assessment services to improve disability benefit decision-making clarity
Conclusion
The Department is testing improvements to the how it decides disability benefits using functional health assessments by developing the new health assessment service and the PIP application service within health transformation areas located in London and Birmingham. It told us … Read more
Government Response Summary
The government agrees, confirming that HTP's claimant-focused design is informed by user research and will enable iterative development and tailored communication, aiming to increase trust and improve outcomes. It also highlights ongoing stakeholder engagement and public communication efforts.
HM Treasury
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28 Conclusion Accepted
Accounting Officer Assessments enhance government accountability, decision-making, and programme transparency
Conclusion
An accounting officer assessment (AO assessment) is an important mechanism to help hold government to account for how it spends public money, whilst also providing a framework for accounting officers to show how their decisions on major programmes align with … Read more
Government Response Summary
The government agrees with the committee's observation on the importance of accounting officer assessments and commits to writing to the committee by February 2024 with information on the status of assessments for Government Major Projects Portfolio programmes.
HM Treasury
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29 Conclusion Accepted
Departments inadequately utilise and publish Accounting Officer Assessments, hindering government transparency
Conclusion
When we examined the Accounting Officer Assessment process in November 2022, we were disappointed that Departments were not making as much of these assessments as they should. We found that accounting officer assessments were not being used widely enough across … Read more
Government Response Summary
The government agrees with the committee's findings regarding the underuse and inconsistent publication of accounting officer assessments. It commits to providing the committee with information on GMPP programmes and their AO assessment status by February 2024.
HM Treasury
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30 Conclusion Accepted
Department delays publishing programme Accounting Officer Assessment pending HM Treasury guidance update
Conclusion
HM Treasury policy is that all programmes within the Government Major Projects Portfolio (GMPP) should have an accounting officer assessment conducted initially in 53 Q 30 54 Q 49 55 Q 30 56 Committee of Public Accounts, Improving the Accounting … Read more
Government Response Summary
The government agrees with the committee's observation concerning the application of accounting officer assessment policy for GMPP programmes. It commits to providing the committee with information on GMPP programmes and their AO assessment status by February 2024.
HM Treasury
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31 Conclusion Accepted
Department's claimed transparency contradicted by lack of detailed programme information and risks
Conclusion
Despite the lack of an accounting officer assessment for the programme, the Department told us that it had “sought to be transparent throughout” and had published information on the Programme as part of the Department’s annual report. It noted that … Read more
Government Response Summary
The government agrees with the committee's observation regarding transparency of programme details despite the lack of an accounting officer assessment. It commits to providing information on GMPP programmes and their AO assessment status by February 2024.
HM Treasury
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