…the evidence below appears to indicate that it will…

Working welfare: a radically new approach to sickness and disability benefits

(Charlotte Pickles, Ed Holmes, Hannah Titley, Ben Dobson, February 2016, Reform Research Trust)

In the UK many disabled people want to work but are trapped on what remains a broadly passive system – almost three quarters of claimants who have had their Work Capability Assessment (WCA) are in the support group with no requirement to engage with, and little access to, support services. As the Organisation for Economic Cooperation and Development has argued: “what is needed is to bring the disability benefit scheme closer in all its aspects to existing unemployment benefit schemes”.

(Charlotte Pickles: Senior Research Director at Reform spent two years as Expert Adviser to Iain Duncan Smith helping to design and deliver the Government’s welfare agenda. Before that she was Policy Director at the Centre for Social Justice.)

Chancellor George Osborne’s Spending Review and Autumn Statement 2015 speech

From: 25 November 2015

We confirm we’ll extend the same support and conditionality we currently expect of those on JSA to over 1 million more benefit claimants…we’ll increase in real terms the help we provide to people with disabilities to get into work.

Working welfare: a radically new approach to sickness and disability benefits

When ESA was introduced it was expected that “the vast majority” of claimants would be subject to “a clear framework of rights and…responsibilities” – a minority of claimants would be in the support group. Instead, almost three quarters of claimants who have had their assessment are in the support group and subject to no conditionality, with very little support to return to work. This will have to change if the Government is to achieve its ambitious pledge to halve the disability employment gap.


We will aim to halve the disability employment gap: we will transform policy, practice and public attitudes, so that hundreds of thousands more disabled people who can and want to be in work find employment. We will help you back into work if you have a long-term yet treatable condition. We will make sure the hardest to help receive the support they need for a fulfilling life.

Working welfare: a radically new approach to sickness and disability benefits

With limited access to employment support and no work-related conditionality, people in the support group are completely detached from the labour market…This is bad for the individuals, society and the wider economy.

Rt Hon Iain Duncan Smith MP: speech on work, health and disability: Reform event 24 August 2015

We need to be relentless in our efforts to get more people into work and off welfare…that means getting 1 million more disabled people into work. The poor quality of support they receive leads too many sick and disabled people languishing in a life without work, when work is actually possible for them. Under Universal Credit, people can expect early and continued support about what work they can do and what support they need to do it, until they leave the benefits system.

Working welfare: a radically new approach to sickness and disability benefits

The vision for a single allowance: In practical terms, a single out-of-work allowance would mean removing the support group component, or in UC, the LCWRA element. [LCWRA is Limited Capability for Work Related Activity].

The ‘Limited Capability for Work-Related Activity’ descriptors only require one to be satisfied for admission to the ESA support group… 60 per cent of those in the support group have been on ESA for more than two years.

The Welfare Reform and Work Bill

As stated in the Explanatory Notes published by the Department for Work and Pensions, the Bill seeks to introduce the following measures:

  • Removing the work‐related activity component in Employment and Support Allowance [ESA] and the limited capability for work element in Universal Credit.

The Bill’s third reading in the House of Commons took place on 27 October 2015. Speaking on behalf of the Government, the Minister for Employment, Priti Patel: “Our welfare reforms are focused on transforming lives by helping people to find and keep work. We are focused on boosting employment and ensuring fairness and affordability, while supporting the most vulnerable, and on making sure that people on benefits face the same choices as those not on benefits and in work”.

Rt Hon Iain Duncan Smith MP: speech on work, health and disability: Reform event 24 August 2015

Under Universal Credit, people can expect early and continued support about what work they can do and what support they need to do it, until they leave the benefits system…with ESA becoming part of Universal Credit it is that access and human interface which opens the way for us to re-think the relationship between sickness benefits and work. I want to look at changing the system so that it comes into line with the positive functioning of Universal Credit. A system that is better geared towards helping people prepare for work they may be capable of, rather than parking them forever beyond work. We need a system focussed on what a claimant can do and the support they’ll need – and not just on what they can’t do.

Working welfare: a radically new approach to sickness and disability benefits

The Occupational Health Plan and personal budget – The Proximity to the Labour Market Diagnostic will result in a score which will determine which of four broad employment support and conditionality regimes the claimant will be placed in. If the health questionnaire triggers an Occupational Health Assessment [this] will be used to develop an Occupational Health Plan, which would be accompanied by a personal budget to facilitate implementation. This rehabilitative programme will be co-created by the health professional and the claimant, and the personal budget will be unlocked via a ‘dual key’ – the claimant and their employment adviser – to increase choice and control. For example, a plan might include talking therapies and recreational activities for suffers of mental health conditions. Those with muscular skeletal conditions might receive a course of physiotherapy. Once the plan is agreed, it becomes subject to conditionality.

Adult Improving Access to Psychological Therapies (IAPT) programme

The programme has already helped over 100,000 people move off sick pay and benefits. In the coming year, the focus for the programme of work will be on the following areas:

  • working with services to address the wide variation in access and quality
  • increasing the integration of psychological services with persistent physical health conditions
  • strong focus on support for those in employment or seeking employment
  • exploring how other mental health services can adopt an IAPT-like approach to service delivery i.e. outcome-focused; with core standards and performance monitoring; and developing datasets to build the evidence-base.

Working welfare: a radically new approach to sickness and disability benefits

Occupational Health Plan conditionality: The Government is now considering whether claimants who are unable to participate in the labour market due to ill-health might also be subject to greater conditionality relating to that condition. In February 2015 the Prime Minister announced that he had asked Dame Carol Black to undertake a review to “consider how best to support those suffering from long-term yet treatable conditions back into work or to remain in work”, including “consider whether people should face the threat of a reduction in benefits if they refuse to engage with a recommended treatment plan.”

The requirement would simply be that individuals claiming out-of-work benefits due to a mild or moderate health condition which with support could be treated or managed should be expected to take reasonable rehabilitative steps. The Government should pilot this approach to ensure it is applied sensitively and

appropriately, before rolling it out as part of the UC model.

The new out-of-work benefit model laid out in the previous two chapters allows a more personalised approach to conditionality for benefit recipients with a health condition. Effective conditionality helps to ensure claimants are taking the necessary steps to move off benefits and into work, thereby improving their health and wellbeing.


People who might benefit from treatment should get the medical help they need so they can return to work. If they refuse a recommended treatment, we will review whether their benefits should be reduced. We will also provide significant new support for mental health, benefiting thousands of people claiming out-of-work benefits.

DWP Central Freedom of Information Team

Increasing disability employment is a key part of the Government’s aim to achieve full employment. That is why this Government is committed to halving the disability employment gap by creating the opportunity for a million more disabled people to work. The Spending Review announced a new ‘Work and Health Programme’ which is intended to provide the best possible support for claimants with disabilities or health conditions as well as those who are long term unemployed. The Department will work with stakeholders on the design, including the structure and how people will be referred to the programme. (DWP Strategy FoI Team)

Working welfare: a radically new approach to sickness and disability benefits

The more than 1.3 million people currently in the ESA support group have been completely written off.

Policy paper: Spending review and autumn statement 2015 (Updated 27 November 2015)

As the numbers claiming unemployment benefits come down, spending on employment programmes can also fall. But at the same time, there is more to do to ensure that as many people as possible can benefit from the growing economy and higher wages. The Spending Review and Autumn Statement announces further measures to support people into work:

  • doing more to get people into work and make the system fairer – Universal Credit will extend the same Jobcentre Plus support that people on Jobseeker’s Allowance (JSA) get to 1.3 million additional claimants who currently get little or no support, by 2020
  • introducing a new Work and Health Programme after current Work Programme and Work Choice contracts end, to provide specialist support for claimants with health conditions or disabilities and those unemployed for over 2 years

Increasing employment levels amongst people with disabilities and health conditions is a key part of the government’s aim to achieve full employment…the benefit system continues to deliver poor outcomes for people with disabilities and health conditions. Universal Credit will provide greater up-front support for claimants with disabilities and health conditions from the start of their claim and enable them to be referred to specialist support from day 1 where appropriate.

In addition to these measures the government wants to improve links between health services and employment support, recognising timely access to health treatments can help individuals return to work quicker. The government will publish a White Paper in the New Year that will set out reforms to improve support for people with health conditions and disabilities, including exploring the roles of employers, to further reduce the disability employment gap and promote integration across health and employment.

Lords Hansard text for 07/03/2016 Welfare Reform and Work Bill Commons Reasons Motion A Moved by Lord Freud

Lord Kirkwood of Kirkhope (LD): “we must now engage in careful and urgent monitoring across the piece of how the ESA support group is catered for in future.”

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  1. Simon says:

    The NHS is currently underfunded and at breaking point where are all these people with disabilities going to get this tailored support from specialists? The Tory’s are fantasists.

  2. Sarah Bradshaw says:

    So presumably workfare providers will be offered even more money to help their cherry picked customers find work? A better idea would be to apply the same discount given to those in the wrag at their local adult college better still arrange a voluntary appointment with them to discuss all the volunteer opportunities and gentle return to higher education courses in their local area. Most learning institutes can offer the support local mental health services won’t or can’t because of council cut’s. Asking someone what they would like to do and trying to help them achieve that goal is not only more humane it will produce better outcomes for everyone involved. Forcing someone to do something they don’t want to do will only set them back further.

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