Benefits system 'exacerbating health conditions', DWP study finds

Claimants described benefits application process as “physically and mentally exhausting” and say health assessments can "set back their wellbeing for days"
PIP consultation centre. Photo: Penelope Barritt/Alamy

By Tevye Markson

14 Oct 2024

The processing for claiming benefits is exacerbating some claimants' health conditions, a study commissioned by the Department for Work and Pensions has found.

A newly published report carried out by research consultancy Basis Social on behalf of DWP, shines a light on the experiences of Personal Independence Payment, New Style Employment and Support Allowance and Universal Credit recipients with disabilities and health conditions.

The study looked into the barriers claimants face in accessing health support and aimed to address evidence gaps where DWP can “offer timely and targeted health related support” such as signposting.

While the study found that there was “a clear and genuine desire among claimants to receive health support signposting from DWP”, many of its participants were more concerned about improving the claims process and that "elements of the application process itself may be exacerbating some people’s health conditions".

“Participants who faced challenges with the benefits system often focused on discussing enhancements to the claims process when asked about potential health support and guidance within the benefits journey,” the report said.

“They felt that if DWP wanted to promote health improvement then this was not just about health signposting; it could also involve tweaks to the claims process itself, with the aim of making their lives simpler and less stressful.”

Participants in the study raised particular concern about the application and assessment aspects of the claims journey.

‘Exhausting’: The application process

The report said claimants found the application process to be “lengthy and complex” and warned that this “posed significant challenges, particularly for participants experiencing fatigue, poor mental health, memory difficulties, and learning disabilities”.

Participants in the study described completing the form as “physically and mentally exhausting”, and researchers said this led to heightened anxiety for some claimants and “had triggered periods of ill health” in some cases.

In a case study included in the report, a PIP recipient who suffers from severe arthritis and chronic fatigue – which significantly impacts her writing ability, energy levels, and ability to focus – spoke of how her first application for the benefit was rejected “due to insufficient evidence showing the impact of her condition on her daily life”.

The claimant, anonymised as Caroline in the report, attributed the initial rejection to the “overwhelming amount of information she felt she was expected to submit” and that she found the PIP form to be “excessively long, taking her days to complete”.

The “experience of being denied support despite the profound difficulties she faced had a severe impact on Caroline’s mental health at the time”, the report added.

“She felt disheartened and frustrated by the initial rejection, as it failed to acknowledge the extent of her struggles. She strongly feels the claimant process needs to be adjusted to better reflect the needs of people like her, that struggle with completing forms, especially if they do not have anyone in their life to help.”

‘Anxiety through the roof for days’: Health assessments

In regards to health assessments, participants with mobility challenges and anxiety told researchers that they found the requirement to attend face-to-face interviews distressing.

They reported how “the stress of attending in person could set back their wellbeing for days, leading to periods of depression and low mood”.

“My anxiety was through the roof days before,” said one PIP claimant who suffers from anxiety and depression. “I couldn’t sleep. That morning I was in so much pain I had to fork out for a taxi. I kept thinking ‘why do I need to do this?’. It’s all on the doctor’s note. Is it because they don’t believe me?”

And the researchers said they “encountered a handful of instances where participants explained that they had been denied the opportunity for a remote assessment despite their expressed need for it”.

The study warned that these negative experiences can “significantly influence claimants’ relationship with DWP and their trust in any health support signposting offered” and said efforts to enhance claimants’ health “should not solely concentrate on health support signposting”.

“This research has found that elements of the application process itself may be exacerbating some people’s health conditions,” the report said. “It also sets the tone for a claimant’s relationship with DWP, including their expectations around understanding, empathy, and trust. This is likely to impact how receptive or otherwise claimants might be to receiving health support and signposting in the future.”

‘Encouraging’ signs

The report said DWP could address some of the challenges and stress claimants reported by improving its communication and education about what they can expect from the process. The research found that claimants with a better grasp of the process tended to report a more positive experience.

It also suggested providing practical administrative assistance for navigating the claims journey for those who need it, either directly or by signposting to relevant organisations such as Citizens Advice.

The report said it is “encouraging” that several of the project findings reinforce proposals ithe Transforming Support: The Health and Disability white paper, which was published by Rishi Sunak's government in March 2023, such as the offer of “more personalised support to claimants”.

The white paper said the government would create “a better experience for disabled people, people with health conditions, and their carers, when applying for and receiving health and disability benefits”.

Proposed steps included abolishing the Work Capability Assessment for benefit claimants who say they have a health condition or disability that affects their ability to work. The assessment is carried out by a healthcare professional and determines if someone is “fit to work”.

The white paper also included plans for a “new user-centred service for PIP” to improve support for people making applications, and reduce the time it takes to make a claim. This will include providing targeted content to help people better understand if they are eligible and simplifying application questions.

The white paper also committed to “improve trust and transparency” in DWP's decisions and processes. It said this would include testing “sharing health assessment reports with people making the claim before a decision is made, offering them the opportunity to clarify evidence so that we can make the right decision as early as possible” and continued trials of the introduction of a Severe Disability Group for those with the most severe health conditions, so they do not need to complete a detailed application form or go through an assessment.

What is Labour's plan?

Labour has pledged to “get sick Brits back to health and back to work” and change DWP from a "Department of Welfare to a Department for Work" but has not yet unveiled any details about its policies on benefits for those with disabilities and health conditions.

Keir Starmer was asked last month if he believed that “those who are out of work, who may think that they can’t work, that the country has a right to expect that they look for work, they do everything they can to get work” and that this was “the sacrifice they need to make”.

He responded: “In relation to long-term sickness, which is at very high levels, then of course people need to look for work. But they also need support.”

Starmer added that “there will be hard cases” but that the “basic proposition, that you should look for work, is right”.

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