PIP Assessment reform
This form is a good example of a complex and difficult to complete ‘consulation’. There is a simpler version. But the questions are leading to get the response they want.
It reminded me of Humphrey explaining to Bernard how to manipulate responses to a government opinion poll on national service. Instructive and Entertaining.
First, you are sent to this long and complicated page. Then you click this link to go through to a 4 page, 39 question survey. I barely managed it and I’m a good detail person. The gist is, we need a case by case assessment of people’s needs. It has to be done by a social worker from the local authority because they can look at their overall situation, their families needs and any other needs like mental health, risk, education etc. Only refer to a doctor if necessary to get a medical assessment. The quality of a person’s life and what they need can’t be captured in a form.
Here is what I put as answers to the questions.
Chapter 1
PIP Overview and assessment reform
- What are your views on an assessment that places more emphasis on condition rather than the functional impact of a condition on the person?
Prefer an assessment on the full impact of a condition on an individual and their family. a full, direct and non-inferential description of all relevant dimensions of the person’s life and disability, for example, work capacity, including health condition, impairments, functional limitations, necessary accommodations and personal and environmental factors. This is based on the principle that all citizens in need are entitled to receive social security benefits and social services – regardless of their participation in the labour market.
- What are your views on people receiving PIP without an assessment if they have specific health conditions or a disability as evidenced by a healthcare professional?
That would be an ideal scenario. It is best if each person is assessed as an individual by professionals in their own community. Where a disability is for life and is not going to change, it makes sense not to put someone into the PIP assessment process. The assessment process should be decided and arranged at the discretion of a case-specific social worker working for the local authority (LA), according to the circumstances and needs of the claimant. The social worker takes into account the report from the doctor etc, and is the final decision maker. That person’s social worker generates the report. The claimant does not have to fill out a long form.
- What are your views on PIP claimants not being subject to an award review if they have a specific health condition or disability as evidenced by a healthcare professional?
The social worker has the power to order a medical examination of the claimant by a healthcare professional. This approach is faster and better.
- Do you agree or disagree on making provision of evidence or a formal diagnosis by a medical expert a mandatory requirement for eligibility for PIP?
(agree/disagree/don’t know)
The social worker should have the final decision even in the case where medical evidence has been sought from healthcare professionals. The decision to get a medical assessment is up to the social worker. So not mandatory.
- In relation to Question 4, please explain your answer and provide evidence or your opinion to support further development of our approach.
The process should be that the claimant makes a basic paper application, whereupon claimants are assigned to a social worker employed by the LA. Social workers are responsible for case management, and for working with claimants to assess their needs.
The nature of the assessment is decided on a case-by-case basis at the discretion of the social worker. Depending on the nature of the claimants condition(s), the social worker decides what evidence is necessary – and makes arrangements for this to be produced and collected. This may involve, for example, requesting notes from the claimant’s GP, or setting up face-to-face meetings with the claimant and appropriate healthcare professionals.
A functional assessment tool can be used in order to assess the claimant’s functional abilities. In cases where need is obvious (for example if a claimant doesn’t have legs), assessment may be made by the social worker, on the basis of a meeting with the client, and with little or no outside evidence required. Even in the case where medical evidence has been sought from healthcare professionals, social workers are responsible for the final decision on an award. This is similar to how Section 7 reports are prepared by CAFCASS or LA social workers for Family Court care arrangement recommendations/orders.
6.How could we prevent the provision of evidence or a formal diagnosis by a medical expert from impacting the NHS?
Please explain your answer and provide evidence or your opinion to support further development of our approach.
Medical assessment should only be required if Social Worker deems it necessary, thus reducing burden on the NHS.
- Do you agree or disagree that eligibility for PIP should be based more on condition?
(agree/disagree/don’t know)
How could we determine eligibility for the following conditions?
- Conditions that fluctuate
- Conditions that vary in severity
- Conditions that might be cured or have access to better/new/novel treatments over time
Please explain your answer and provide evidence or your opinion to support further development in our approach.
In Denmark, the approach is condition based. Benefits are awarded on a fixed-term rolling basis. The Municipality (AKA Local Authority) has a responsibility to ‘follow-up’ on whether the benefit addresses claimants’ needs. This usually involves an annual meeting with the Municipality, where claimants’ situation and needs are reviewed. Claimants are encouraged to provide evidence of larger costs alongside 2-3 months’ worth of relevant receipts – though, there is no obligation to do so. We could follow this approach.
Chapter 2
PIP – Eligibility Reform
- Do you think the need for an aid or appliance is a good/bad indicator of extra ongoing costs and why?
The need for an aid or appliance is generally a good indicator of extra ongoing costs associated with disability. These costs are not limited to the initial purchase but also include maintenance, consumables, and related supports necessary for the individual’s daily life and independence. Recognising this need helps ensure that financial assistance is appropriately targeted, supporting both the immediate and long-term needs of individuals with disabilities.
- Do you think the need for prompting is a good/bad indicator of extra ongoing costs and why?
The need for prompting is generally a good indicator of extra ongoing costs related to disability. This need highlights the requirement for continuous support, supervision, and specialised care, all of which contribute to increased financial burdens. Recognising the necessity for prompting helps ensure that disability benefits are appropriately allocated, addressing both immediate and long-term support needs to enhance the quality of life for individuals with disabilities.
- Do you think people who accumulate low points across activities have the same level of extra costs as those who score highly in one or more activities?
The answer here can be nuanced. Ultimately, both scenarios can lead to significant extra costs, but the nature and distribution of these costs differ. An effective disability benefits system should consider both cumulative low-level impairments and concentrated high-level impairments to ensure fair support for all individuals.
- Do you think any of the PIP activities measure similar functions and could be merged?
Not merged, changed to the conditions/disability approach, away from the functional limitation approach.
- Do you think any of the PIP activities should be removed or re-written and why?
They should be replaced with a one-to-one assessment by a qualified social worker. This is to reflect a full, direct and non-inferential description of all relevant dimensions of the person’s life and disability, for example, work capacity, including health condition, impairments, functional environmental factors, limitations and personal and environmental factors. - Should we consider adding any new activities? If so, which activities should be added and why?
No, do not agree with the functional limitation approach. We should also not use private contracted assessors for this.
- Do you think the current entitlement thresholds levels are set at the right levels to define the need for Government financial support and why?
Whether the current entitlement thresholds are set at the right levels depends on balancing the need to provide adequate support to all individuals with disabilities against the practical limitations of budget and administrative feasibility. There are valid arguments on both sides, suggesting the need for ongoing evaluation and adjustment.
To improve the system, the government could:
- Regularly update assessment criteria and thresholds to reflect current understanding and costs of disabilities.
- Provide clearer guidance and assistance during the application process.
- Adopt a holistic approach that considers the diverse impacts of disabilities rather than relying on rigid point-based systems.
An effective disability benefits system should be dynamic, responsive to changing needs, and rooted in understanding the lived experiences of people with disabilities.
16 .What are your views on changing the length of the current three-month qualifying period for PIP which is used to establish that the functional effects of a health condition or impairment have been present for a certain time period before entitlement can start?
It has to be done on a case-by-case approach to address individual circumstances more effectively. Shortening the period might allow people to receive support sooner who have suddenly become disabled, which can be crucial for those whose conditions cause immediate and severe impacts on their daily lives. For people born with or having enduring conditions, being assessed as such could prevent constant red tape for them and administrative cost for the local authority.
- What are your views on retaining, removing, or changing the length of the current nine-month prospective test which is used to determine if the functional effects of a health condition or impairment are likely to continue long-term?
Remove it. Assessment has to be done on a case-by-case approach to address individual circumstances more effectively.
Chapter 3
PIP – What do we provide support for?
- PIP provides a contribution towards extra costs. Which extra costs incurred by disabled people are the most important for a new scheme to address? Please rank the following options in your order of importance (with 1 being the most important and 10 being the least important).
Please drag and drop the answers to rank them. A list of health care issues
Description automatically generated
19.In relation to Question 18, please explain your answer and tell us about any other important kinds of cost not listed above.
It has to be done on a case-by-case approach to address individual circumstances more effectively.
20. What are the benefits and disadvantages of moving to a new system for PIP claimants?
- A catalogue/ shop scheme
- Benefits
- Disadvantages
- Other
Please explain your answer and provide evidence or your opinion to support further development of our approach.
It has to be done on a case-by-case approach to address individual circumstances more effectively.
21. What are the benefits and disadvantages of moving to a new system for PIP claimants?
- A voucher scheme
- Benefits
- Disadvantages
- Other
Please explain your answer and provide evidence or your opinion to support further development of our approach.
A terrible idea. It has to be done on a case-by-case approach to address individual circumstances more effectively.
22. What are the benefits and disadvantages of moving to a new system for PIP claimants?
- A receipt-based system
- Benefits
- Disadvantages
- Other
Please explain your answer and provide evidence or your opinion to support further development of our approach.
A terrible idea. It has to be done on a case-by-case approach to address individual circumstances more effectively.
23. What are the benefits and disadvantages of moving to a new system for PIP claimants?
- One-off grants
- Benefits
- Disadvantages
- Other
Please explain your answer and provide evidence or your opinion to support further development of our approach.
A terrible idea. It has to be done on a case-by-case approach to address individual circumstances more effectively.
- If PIP could no longer be used to determine eligibility to passport to other benefits and services, what alternative ways could service providers use to determine disability status?
It has to be done on a case-by-case approach to address individual circumstances more effectively.
- If PIP could no longer be used as the eligibility criteria to additional financial support in Universal Credit, what alternative ways of determining eligibility should we use?
It has to be done on a case-by-case approach to address individual circumstances more effectively.
- Are there specific groups of people whose needs are not being met by the current PIP provision and have a need for a greater level of support? What form should this support take (e.g., help with specific extra costs, access to improved healthcare such as mental health provision or enhanced local authority support such as care packages and respite)?
Parents who are carers for children with life-long disabilities. They should be assessed as a family as their needs will be complex. It has to be done on a case-by-case approach to address individual circumstances more effectively.
- Instead of cash payment, are there some people who would benefit more from improved access to support or treatment (for example, respite care, mental health provision or physiotherapy)?
It has to be done on a case-by-case approach to address individual circumstances more effectively.
Chapter 4
PIP – Aligning Support
- Do people already receive support from local authorities or the NHS with the need/costs that come with having a disability or health condition?
Not enough due to underfunding by central government. Centrally provided funding and legislation but delegation of authority to Local Authorities.
29. In relation to Question 28, please explain your answer and provide evidence or your opinion to support further development of our approach.
This approach works well in other countries such as Denmark. The functional approach and using private companies for assessment like Capita is expensive, dehumanising and ultimately ineffective. It would be best if each person were assessed as an individual: the assessment process should be decided and arranged at the discretion of a case-specific social worker working for the local authority (LA), according to the circumstances and needs of the claimant. The social worker is the final decision maker.
That person’s social worker generates the report. The claimant does not have to fill out a long form.
30.Which of the following do local authorities or the NHS help with?
Equipment and aids
Medical products
Personal assistance (e.g., help with household tasks)
Health services
Social care
Respite
Transport
Utility Costs
All of these except Utility costs.
31. In relation to Question 30, please explain your answer and provide evidence or your opinion to support further development of our approach.
Local authorities or the NHS help with the following:
- Equipment and aids: Yes, local authorities and the NHS provide equipment and aids to help individuals with disabilities or long-term health conditions manage daily activities.
- Medical products: Yes, the NHS supplies medical products such as medications, bandages, and other healthcare items.
- Personal assistance (e.g., help with household tasks): Yes, local authorities provide personal assistance for tasks like cleaning, cooking, and personal care through social care services.
- Health services: Yes, the NHS provides a wide range of health services, including medical treatments, consultations, and therapies.
- Social care: Yes, local authorities provide social care services, which include support for daily living activities, personal care, and assistance for those with disabilities or long-term conditions.
- Respite: Yes, local authorities offer respite care services to provide temporary relief for caregivers of individuals with disabilities or long-term health conditions.
- Transport: Yes, local authorities sometimes provide transport services for individuals who have difficulty accessing public transportation due to their health conditions or disabilities.
- Utility Costs: No, local authorities and the NHS typically do not assist with utility costs. This is usually managed through separate welfare benefits or specific grants and schemes.
In summary, local authorities and the NHS help with equipment and aids, medical products, personal assistance, health services, social care, respite, and transport, but generally do not assist with utility costs.
32.Which needs/costs that come with having a disability or health condition could local areas help with further?
Equipment and aids
Medical products
Personal assistance (e.g., help with household tasks)
Health services
Social care
Respite
Transport
Utility Costs
Local authorities or the NHS should help with the following. What does ‘local areas’ refer to?
- In relation to Question 32, please explain your answer and provide evidence or your opinion to support further development of our approach.
- Equipment and aids: Yes, local authorities and the NHS provide equipment and aids to help individuals with disabilities or long-term health conditions manage daily activities.
- Medical products: Yes, the NHS supplies medical products such as medications, bandages, and other healthcare items.
- Personal assistance (e.g., help with household tasks): Yes, local authorities provide personal assistance for tasks like cleaning, cooking, and personal care through social care services.
- Health services: Yes, the NHS provides a wide range of health services, including medical treatments, consultations, and therapies.
- Social care: Yes, local authorities provide social care services, which include support for daily living activities, personal care, and assistance for those with disabilities or long-term conditions.
- Respite: Yes, local authorities offer respite care services to provide temporary relief for caregivers of individuals with disabilities or long-term health conditions.
- Transport: Yes, local authorities sometimes provide transport services for individuals who have difficulty accessing public transportation due to their health conditions or disabilities.
- Utility Costs: No, local authorities and the NHS typically do not assist with utility costs. This is usually managed through separate welfare benefits or specific grants and schemes.
In summary, local authorities and the NHS help with equipment and aids, medical products, personal assistance, health services, social care, respite, and transport, but generally do not assist with utility costs.
- If we align the support offered by PIP into existing local authority and NHS services, how could this improve things for disabled people and people with health conditions?
The LA could provide PIP payments based on a one-to-one assessment by a qualified social worker. This is to reflect a full, direct and non-inferential description of all relevant dimensions of the person’s life and disability, for example, work capacity, including health condition, impairments, functional environmental factors, limitations and personal and environmental factors.
- Do you think aligning PIP with local authority and NHS services could reduce the number of assessments a person with a disability or health condition would have to undergo? Would this help to reduce duplication?
Only if the LA could provide PIP payments based on a one-to-one assessment by a qualified social worker. This is to reflect a full, direct and non-inferential description of all relevant dimensions of the person’s life and disability, for example, work capacity, including health condition, impairments, functional limitations and personal and environmental factors.
- What disability support services in your community are the most important services or support to deliver?
There is no one support service that is more important than another.
- Equipment and aids: Yes, local authorities and the NHS provide equipment and aids to help individuals with disabilities or long-term health conditions manage daily activities.
- Medical products: Yes, the NHS supplies medical products such as medications, bandages, and other healthcare items.
- Personal assistance (e.g., help with household tasks): Yes, local authorities provide personal assistance for tasks like cleaning, cooking, and personal care through social care services.
- Health services: Yes, the NHS provides a wide range of health services, including medical treatments, consultations, and therapies.
- Social care: Yes, local authorities provide social care services, which include support for daily living activities, personal care, and assistance for those with disabilities or long-term conditions.
- Respite: Yes, local authorities offer respite care services to provide temporary relief for caregivers of individuals with disabilities or long-term health conditions.
- Transport: Yes, local authorities sometimes provide transport services for individuals who have difficulty accessing public transportation due to their health conditions or disabilities.
- Utility Costs: No, local authorities and the NHS typically do not assist with utility costs. This is usually managed through separate welfare benefits or specific grants and schemes.
In summary, local authorities and the NHS help with equipment and aids, medical products, personal assistance, health services, social care, respite, and transport, but generally do not assist with utility costs. - How much flexibility should local areas have to decide their priorities in supporting people with disabilities and health conditions?
The LA could provide PIP payments based on a one-to-one assessment by a qualified social worker. This is to reflect a full, direct and non-inferential (a statement of fact) description of all relevant dimensions of the person’s life and disability, for example, work capacity, including health condition, impairments, functional environmental factors, limitations and personal and environmental factors.
- What capacity and capability would be required to better align PIP with local authority and NHS services?
The LA could provide PIP payments based on a one-to-one assessment by a qualified social worker. This is to reflect a full, direct and non-inferential description of all relevant dimensions of the person’s life and disability, for example, work capacity, including health condition, impairments, functional environmental factors. limitations and personal and environmental factors.
Compulsory Question
For analytical purposes, please answer this question before submitting your response.
39. Are you an individual or an organisation supporting claimants applying for PIP?
Individual *
Organisation
