Skip to main content

Health and Disability White Paper

Volume 741: debated on Monday 20 November 2023

I would like to update the House on the progress of a number of tests and trials set out in “Transforming Support: The Health and Disability White Paper”, which was published in March this year.

Our ambitious White Paper plans are part of our next generation of welfare reforms and will transform the health and disability benefits system. This includes supporting more disabled people and people with health conditions to start, stay and succeed in work, and making improvements to the benefits system so that people have a better overall experience when applying for, and receiving, health and disability benefits.

Among the White Paper initiatives under way, six test new and innovative ways to deliver our goals, responding to views we heard through the Green Paper consultation.

First, the employment and health discussion is a voluntary service available to claimants with a disability and/or long-term health condition, and is a discussion with a claimant about their health situation, any barriers it presents in moving towards work, and how to overcome them. The EHD is not part of the assessment process and takes place before the work capability assessment. It began as a small-scale test in Leeds health model office in 2022, with employment and health practitioners seconded to the Department for Work and Pensions from Maximus, which operates the Centre for Health and Disability Assessments.

I am pleased to update the House that from October this year, after a positive initial evaluation, we have expanded the test to 13 sites across England and Wales. With the support of Maximus, we have further grown our team of employment and health practitioners.

Secondly, the White Paper also set out our plans to test a severe disability group for claimants who have conditions that are severely disabling, lifelong, and with no realistic prospect of recovery. The SDG will provide these claimants with a simpler gateway to access benefits, identifying them at the start of the assessment process and removing the need to complete a detailed form or undertake a face-to-face, telephone or video assessment.

Our testing plans are progressing, following positive engagement with Blackpool Teaching Hospitals NHS Foundation Trust. We will test the SDG and its criteria in several specialist clinical areas in secondary care at Blackpool Teaching Hospitals. The British Society of Physical and Rehabilitation Medicine has also agreed to work in partnership to test the SDG. We expect to start generating referrals in the coming months.

Thirdly, we have started a small-scale test, matching personal independence payment, universal credit and employment and support allowance claimants’ primary health conditions to an existing assessor with professional experience of supporting people with that condition. This is taking place in health transformation area sites in London and Birmingham.

We want to understand whether claimants view this different approach positively and if it improves their trust in the assessment process. This test is scheduled to run until January 2024, at which point we will review our learning from the test and consider possible next steps.

Fourthly, the enhanced support service provides bespoke personalised support for people who find it hardest to use the benefits system. It provides practical support to these claimants—for example, by helping them to fill in forms, submit medical evidence and attend health assessments—as well as signposting to appropriate wider support. Testing is ongoing in East Anglia, Kent, Blackpool and Birmingham.

Through our fifth test, we are exploring options to introduce a new way of gathering evidence of fluctuation in a person’s condition before their assessment.

Some stakeholders have advised that current assessments do not always fully capture the impact of fluctuating conditions and that it can be difficult for some people with fluctuating conditions to answer questions about how their condition impacts them for the majority of the time.

We are in the early stages of testing a health impact record as a structured way to present evidence that demonstrates the changing impact of applicants’ health conditions.

Finally, the health assessment channels trial is nearing completion. Following the introduction of phone and video assessments, we have been analysing whether there is a difference in award outcomes for assessments completed remotely, compared to face to face. We have also been conducting research to gain an understanding of claimant experience by different channels.

Evaluation is taking place across all tests and trials to develop our evidence base, inform wider implementation, assess value for money and determine next steps.

We will continue to discuss progress with the devolved Administrations.

We are also committed to continue listening to and working with disabled people and people with health conditions, organisations, charities, business and other experts, as we develop our plans and continue the tests and trials I have set out today.

We have made good progress since the publication of the White Paper. These improvements will ensure that disabled people, and people with health conditions, can access the right support at the right time, and lead independent and fulfilling lives.