Question to the Department for Work and Pensions:

To ask His Majesty's Government how many assessors trained and qualified in autism will work in each of the five regions under the Department for Work and Pension's Health Assessment Advisory Service.

Answered by Baroness Sherlock - Parliamentary Under-Secretary (Department for Work and Pensions)

The department and the Health Assessment Advisory Service (HAAS) are fully committed to supporting those with mental health conditions.

All health professionals (HPs) within the five regions of HAAS are fully qualified in their health discipline and have passed strict recruitment and experience criteria. They must also be registered with a relevant regulatory body such as the General Medical Council, the Nursing and Midwifery Council, Health and Care Professions Council or European Economic Area equivalent. The department has not specified that HAAS employ HPs who are specialists in specific conditions or impairments. Instead, the focus is on ensuring they are experts in disability analysis, focusing on the effects of health conditions and impairments on the claimant’s daily life.

All HPs receive comprehensive training in the functional assessment of mental health conditions and disabilities, including Autism. From 09 September 2024 the educational material for all HAAS HPs was provided by DWP. As part of our review, we identified best practice in the NHS and have implemented the Oliver McGowan training as part of the mandatory training requirements for every HP. This training is recognised to be of significant value to HPs in ensuring they have the skills and knowledge to provide safe, informed, and compassionate assessments to claimants with autism and learning disabilities. This is in addition to our comprehensive education programme for HPs.

Following the completion of core training to undertake the role, HPs will engage in an annual training programme, and HAAS has been provided with materials (such as Continual Professional Development modules) to support the development of their HPs where learning needs are identified. This approach ensures that both service wide and individual training needs are met and will be of benefit to those with neurodiversity where applicable.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what qualifications are stipulated for assessors of people on the autism spectrum by the Health Assessment Advisory Service.

Answered by Baroness Sherlock - Parliamentary Under-Secretary (Department for Work and Pensions)

The department and the Health Assessment Advisory Service (HAAS) are fully committed to supporting those with mental health conditions.

All health professionals (HPs) within the five regions of HAAS are fully qualified in their health discipline and have passed strict recruitment and experience criteria. They must also be registered with a relevant regulatory body such as the General Medical Council, the Nursing and Midwifery Council, Health and Care Professions Council or European Economic Area equivalent. The department has not specified that HAAS employ HPs who are specialists in specific conditions or impairments. Instead, the focus is on ensuring they are experts in disability analysis, focusing on the effects of health conditions and impairments on the claimant’s daily life.

All HPs receive comprehensive training in the functional assessment of mental health conditions and disabilities, including Autism. From 09 September 2024 the educational material for all HAAS HPs was provided by DWP. As part of our review, we identified best practice in the NHS and have implemented the Oliver McGowan training as part of the mandatory training requirements for every HP. This training is recognised to be of significant value to HPs in ensuring they have the skills and knowledge to provide safe, informed, and compassionate assessments to claimants with autism and learning disabilities. This is in addition to our comprehensive education programme for HPs.

Following the completion of core training to undertake the role, HPs will engage in an annual training programme, and HAAS has been provided with materials (such as Continual Professional Development modules) to support the development of their HPs where learning needs are identified. This approach ensures that both service wide and individual training needs are met and will be of benefit to those with neurodiversity where applicable.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, whether he has considered the potential merits of allowing claimants' limited capability for work status to be reinstated without further assessment when (a) they have had their Universal Credit claim closed through no fault of their own, (b) they are in receipt of Personal Independence Payment and (c) their condition has not changed.

Answered by Mims Davies - Shadow Minister for Women and Equalities

Depending on the circumstances, if the department accepts that a Universal Credit claim should not have been closed, the claim would be reopened. If there has been no change in the claimant’s circumstances, and no changes to any health conditions they have declared, the claim would be reinstated at the same rate of payment as before it was closed, including any additional allowances due to the claimants’ limited capability for work. There would be no need for a further Work Capability Assessment in this scenario. Being in receipt of Personal Independence Payment would have no bearing on this decision.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, what progress his Department has made on the Health Transformation Programme.

Answered by Mims Davies - Shadow Minister for Women and Equalities

The Government is committed to continuously improving support for disabled people and people with health conditions, including through the Health Transformation Programme which is modernising Health and Disability benefit services to create a more efficient service and a improved claimant experience, reducing the time it takes to process a claim and improving trust in our services and decisions.

The department has started to publish HTP management information (MI). On 19 December 2023, the department published the first in a new series; publication of this MI will continue quarterly in line with the PIP Official Statistics release schedule. This can be found here.

The Programme published its Evaluation Strategy on 25^th May 2023 here.

The National Audit Office and the Public Accounts Committee published reports in 2023 on the Health Transformation Programme.

Transforming health assessments for disability benefits (nao.org.uk)

Revising health assessments for disability benefits (parliament.uk)

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, whether he has made an assessment of the potential mental health impact of (a) disability tests and (b) sanctions.

Answered by Mims Davies - Shadow Minister for Women and Equalities

No assessment has been made of the potential mental health impact of PIP or WCA, assessments or social security sanctions.

a) Evaluations of Personal Independence Payments (PIP) and Work Capability Assessments (WCA) policy are routinely carried out, and often include engagement with external researchers. The methods used are designed to be appropriate to the specific type of intervention being evaluated. Customer experience of assessments is also continually monitored. However, it would be extremely difficult to objectively separate the specific impact of disability tests on mental health from other contributory factors.

b) Under Universal Credit and Employment and Support Allowance, sanctions do not apply to all customers. Those with a health condition, illness or disability who are found to have ‘limited capability for work and work-related requirements’, are not subject to work-related conditions and will therefore not be sanctioned. Those found to have limited capability for work and claimants on work-related benefits are expected to take responsibility for meeting the conditionality requirements they have agreed with their work coach. Where a customer has a health condition, illness or disability, work coaches have the discretion to tailor these requirements to what is reasonable and achievable, taking into account the individual's condition. Additionally, in some circumstances a customer’s work-related requirements may be lifted for a period if their ability to carry them out is disrupted due to their personal circumstances.

A sanction is only applied where an individual has failed to meet their agreed conditionality requirements without demonstrating good reason for doing so. In cases where vulnerabilities are known or suspected, a pre-referral quality check is undertaken prior to any sanction referral to ensure that it is appropriate in the circumstances.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what progress they have made on their plans to audio-record all assessments for disability benefit by default.

Answered by Viscount Younger of Leckie - Shadow Minister (Work and Pensions)

Audio recording is now available for face-to-face and telephone assessments with all the department’s assessment providers. These arrangements are publicised on providers’ websites and in the assessment invitation letters to claimants. The department remains committed to offering audio recording on an opt-in basis, giving claimants the choice of having their assessment recorded.

Question to the Department for Work and Pensions:

To ask His Majesty's Government what training in customer mental health they give to contractors providing assessments of benefits claimants.

Answered by Viscount Younger of Leckie - Shadow Minister (Work and Pensions)

We are fully committed to supporting those with mental health conditions. The assessment of mental, cognitive, and intellectual function is an integral part of the assessment process.

All healthcare professionals (HPs) undertaking assessments on behalf of the department must be registered practitioners who have undergone comprehensive training in the functional assessment of disability, and mental health conditions. HPs continue to keep this knowledge up to date through continuous professional development.

In addition, mental health function champions support HPs by providing additional expertise about mental health, cognitive, developmental, and learning disabilities, and can be referred to at any time during the assessment process.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, what guidance is provided to health professionals who have been asked to provide medical evidence for (a) Personal Independence Payment assessments (b) Work Capability Assessments.

Answered by Tom Pursglove

The department publishes guidance for health professionals who have been asked to provide medical evidence for Personal Independence Payment assessments and Work Capability Assessments, on GOV.UK.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, with reference to his Department's prior information notice of 5 April on Additional Healthcare Capacity, reference 2023/S 000-009884, fow what reason additional capacity is required.

Answered by Tom Pursglove

This contract replaces an existing contract, which is coming to an end.

The Health Transformation Programme is developing a new Health Assessment Service through our Health Transformation Area. This is a controlled safe environment where we can develop the service at small scale, exploring ideas from claimants, stakeholders and DWP staff. The healthcare professionals who deliver WCA and PIP assessments within the Health Transformation Area, are directly employed by the DWP.

The new contract provides additional healthcare professionals, providing us with the flexibility to supplement the capacity as required to ensure we can continue to provide a stable service to meet the needs of claimants and to continue to test and build the new service.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, with reference to the policy paper entitled Transforming Support: The Health and Disability White Paper published on 15 March 2023, when his Department expects to complete its move to an IT system that will have the capability to record all assessments.

Answered by Tom Pursglove

During 2024, the department intends to move to a new telephony platform and make enhancements to the Video Assessment application, bringing the ability to record all assessments.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, what assessment she has made of the adequacy of training provided to assessors who consider Personal Independence Payments and the Work Capability Assessments for disabled claimants.

Answered by Tom Pursglove

All assessment providers are required to ensure that all health professionals (HP) carrying out assessments have sufficient training and knowledge of the clinical aspects and likely overall functional effects of a wide range of health conditions and impairments.

To ensure a high standard is maintained the department has an Independent Audit function that continually monitors performance and provides feedback to providers. Audit refers to a comprehensive check of the elements of the assessment, including the evidence collection, further evidence provided, and the assessment report completed by the HP. The check is completed against a set of guidelines to ensure a consistent approach is taken. This ensures that assessment reports are fit for purpose, clinically justified and sound, and provide sufficient information for the department to make an informed decision on entitlement to benefit.

Providers work with the department to continuously improve assessment quality through a range of measures including audit procedures. We also measure the adequacy of HP training through customer satisfaction surveys undertaken by independent third parties. All providers have consistently exceeded their customer satisfaction targets of 90% for Personal Independence Payment and 92% for the Work Capability Assessment.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, pursuant to his Answer of 7 November 2022 to Question 80819, how many times his Department visited assessment centres to help audit the performance of providers in each year from 2015 to 2022.

Answered by Tom Pursglove

The information requested is not available. We have a stringent performance management regime which includes Department for Work and Pensions (DWP) performance managers attending assessment centres; however, data for such visits is not retained.

Provider performance is measured across a range of service level agreements setting out the department's expectations for service delivery. These include quality, performance delivery targets and customer experience.

Independent Audit is one of the department’s tools to measure quality for performance management purposes. It is a self-contained team comprising of experienced health professional assessors who review a sample of assessment reports on a monthly basis to determine their quality. This helps ensure that assessment reports are fit for purpose, clinically justified, and provide sufficient information for the department to make a reasonable decision on entitlement to benefit. It is not an audit of the assessment provider as a whole.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, pursuant to his Answer of 7 November 2022 to Question 80819 on Social Security Benefits: Medical Examinations, if he will publish the results of the last audit of Health Assessors; Capita and Independent Assessment Services.

Answered by Tom Pursglove

We currently have no plans to publish the last audit results for Capita and Independent Assessment Services (IAS).

Referring to our previous answer to PQ80819, audit refers to a comprehensive check of the elements of the assessment, including the evidence collection, further evidence provided, and the assessment report completed by the health professional. It is not an audit of the assessment provider.

Provider performance is measured across a range of service level agreements (SLA) setting out the department's expectations for service delivery. These include quality, performance delivery targets and customer experience.

The monthly quality audit performance against the SLA target for Capita and IAS has already been published for January 2014 to April 2022 as part of the answer to PQ26035.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, how often her Department visits health assessment centres in person to audit the performance of assessment providers.

Answered by Tom Pursglove

The Department for Work and Pensions (DWP) does not have a contractual obligation to perform regular visits to assessment centres, but does retain the right to visit any assessment centre, at any time, subject to reasonable notice. The department exercises this right, with Personal Independence Payment (PIP) and Work Capability Assessment (WCA) performance managers visiting assessment centres on an informal basis.

The department has set standards for the quality of assessments for all its assessment providers and independent auditors. The department ensures a high standard is maintained by having an independent audit function that continually monitors performance and provides feedback to its providers. Audit refers to a comprehensive check of the elements of the assessment, including the evidence collection, further evidence provided, and the assessment report completed by the health professional.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, pursuant to his Answer of 1 November to Question 72384, if he will publish the training material which is shared between assessment providers.

Answered by Tom Pursglove

Although assessment providers share training material between themselves to encourage best practice, we have no plans to publish the training material.

The department introduced a Clinical Governance Quality Standards (CGQS) Framework to ensure that consistent quality standards are applied by all assessment providers. The CGQS Forum has the remit to facilitate embedding of the CGQS Framework across the department and its assessment providers. They share best practice including training and learning from leading national and international organisations, to continuously improve quality.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, pursuant to his Answer of 1 November to Question 72384, if she will publish her Department's audit procedures for assessment providers.

Answered by Tom Pursglove

Personal Independence Payment (PIP) assessment provider audit procedures can be found in sections 3.4 and 3.5 of the PIP assessment guide.

Details relating to the audit procedures for Centre for Health and Disability Assessments can be found in schedule 2.1 section 40 of the Health and Disability Assessment Services contract.

Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, how many health professionals employed by assessment providers have been dismissed as a result of poor performance in the last three years.

Answered by Tom Pursglove

Health Professionals (HPs) are subject to a rigorous recruitment process, followed by a comprehensive training programme. Given the high standards expected of HPs, it is anticipated that a number may not meet the required standard during the training and probation period.

All HPs are subject to on-going monitoring of the standard of their assessments. If any issues are identified there is a process in place to support the HPs to improve the quality of their assessments. Where they fall below the required standards and do not improve, processes are in place to revoke their approval to undertake assessments.

The number of HPs employed by assessment providers who have been dismissed as a result of poor performance in the last three years is shown in the table below:

Please note

• Capita 2022 figures are for the period between 1 January 2022 and 4 November 2022;
• IAS 2022 figures are for the period between 1 January 2022 and 4 November 2022;
• CHDA 2022 figures are for the period between 1 January 2022 and 1 November 2022;
• PIP figures include HPs that were dismissed during their training and probation period;
• PIP figures do not include employees who resigned during the training process;
• CHDA figures include HPs that were dismissed during their probation period;
• CHDA figures do not include HPs that failed to successfully complete their training period, nor those who resigned during the training process.