moneyThe Work Capability Assessment (WCA) for Employment and Support Allowance (ESA) should be allowed to continue because it has been modified as much as it can, and there is no replacement for it in the offing, an official review has concluded.

The fifth annual independent review of the WCA, conducted by Dr Paul Litchfield, also noted that while there have been some undoubted improvements, there remains an overwhelming negative perception of the WCA’s effectiveness among people undergoing an assessment and individuals or organisations providing support to them.

In terms of people with mental health conditions – who make up 40% of individuals going through a WCA and 41% of the Support Group – Litchfield noted that there were still concerns, such as a perception that some healthcare professionals (HCPs) did not listen properly to what was being said. In addition, there was still an undue focus on physical conditions when mental health was the prime cause of incapacity and lingering doubts about HCPs’ qualifications or experience of working with people that have mental health conditions.

The WCA has been controversial since it was introduced in 2008, and has been the subject of 5 annual reviews that have helped to reform the test. However, critics have consistently said that the changes do not go far enough to address the concerns with it, particularly around mental health, where conditions can fluctuate and it is said that the test does not take this into account.

Nevertheless, the WCA is here to stay. “It appears to me that we have taken the WCA about as far as it can sensibly go in terms of modification and adjustment,” Litchfield wrote in the foreword to the report. “Work and the workforce are going through a period of unprecedented change and it must be questionable whether an assessment designed in the early part of this century will best meet society’s needs in its third decade. If any new assessment is designed, the fundamental question of whether health related capability for work is the criterion that society wishes to use to determine benefit levels should first be considered. If that remains the remit then sufficient time must be allowed and suitable expertise must be deployed to create and test a tool which is both robust and meets the requirement for perceived fairness. 

“In the meantime, my counsel would be to let the current WCA have a period of stability – it is by no means perfect but there is no better replacement that can be pulled off the shelf.”

Tom Pollard, policy and campaigns manager at Mind, welcomed the on-going improvements to the WCA through the independent review process, and particularly the focus on the experience of people with mental health problems. “However, the narrow scope of these reviews means that wider problems with the system for people with mental health problems have still not been tackled,” he said.

“The Work and Pensions Committee report provided a comprehensive evaluation of ESA and the WCA and included strong recommendations. Unfortunately the Government’s response represents a missed opportunity, with little sign that they are willing to make reforms of the scale needed. 

“Very few people with mental health problems are being supported into work through ESA, and huge numbers of people are receiving benefit sanctions from a system that does not understand their needs and barriers. As a result, many people are finding that the stress and pressure they are put under is making their health worse, and making them feel less able to work. That’s why we’re calling for everyone with mental health problems claiming ESA to receive personalised, specialist support which acknowledges and addresses the barriers they may face in getting and staying in work.”