Each year, the UK government provides around £12 billion of support to disabled people and people with health conditions through Personal Independence Payments (PIPs). After the Employment & Support Allowance, PIPs are the second biggest source of welfare benefit provided by the Department of Work and Pensions (DWP) to this group of individuals, distributing additional payments to 2.7 million people to help them with their higher costs of living.

Yet a wealth of evidence suggests the process of awarding PIPs is not currently fit for purpose. Despite surveys showing that PIP awards have a highly significant positive impact on the lives of recipients, multiple independent reviews have found that the vast majority of people who go through the PIP assessment process have a negative experience. More than a quarter of people who go through the process believe that the measurements and functional tests involved are not relevant or appropriate to them, and the same share believe that it doesn’t provide them with the opportunity to explain the impact of their disability on their daily lives.

The consensus from such high proportions of claimants that the process requires major improvements is borne out by the high rate of decisions which are not right first time. Of the 780,000 claims made in 2019/20, 92,200 had their award changed after they requested a Mandatory Reconsideration and a further 59,400 were successful at getting their decision overturned at the appeals stage. Taken together this means that that 1 in 5 of claimants had their original decision changed at either of the two stages.

Our analysis conservatively estimates that the administrative costs to DWP for processing the cases where initial PIP decisions were overturned at appeal in 2019/20 could have been £23-29 million. This excludes the costs of other Mandatory Reconsiderations that saw initial decisions overturned and there are also additional administrative costs for other agencies like the HM Courts and Tribunals Service. At a time of heavy pressure on departmental spending, the opportunity for savings that better decision making would provide should not be ignored.

Yet this administrative waste is just the tip of the iceberg of costs to the taxpayer which arise from poor decision making on PIPs, as the impact of stopped, reduced or delayed payments can have serious effects on individuals’ wellbeing. People applying for PIPs may have to wait over a year from their initial claim until completion of an appeal before they are able to receive money to pay for vital assistive equipment to help them with daily essential tasks such as bathing or reading.

Those individuals having to go through the reassessment  process to restore or increase a previous PIP award generally have their original payments stopped or reduced while they await a revised decision. This can mean that for long periods claimants have to live without vital financial support and other essentials such as adapted vehicles which are often a lifeline. This predicament can be exacerbated by knock-on effects to their personal incomes through simultaneous cuts in other benefits such as Universal Credit and housing benefits.

The effect that these consequences can have are numerous and serious. Claimants who are already in vulnerable positions as they await a revised decision are more likely to experience increased stress and uncertainty, financial hardship, increased risk of homelessness and reliance on food banks, and reduced mobility and ability to deal with their health conditions. An extended period without or with reduced PIP support has the potential to have negative impacts on an individual’s mental and physical health, and can lead to increased negative behavioural and psychological outcomes. Indeed, independent reviews of the appeals process found many people who go through the experience believe that it notably worsened their disability.

The costs of these indirect impacts – particularly on already stretched NHS services and local authorities – could potentially be substantial. For example:

  • If 1 in 10 claimants who successfully had their decision changed in 2019/20 have to pay one additional visit to the GP, then it would cost the NHS an additional 2,300 GP hours, at a cost of around £600,000 per annum.
  • If 1 in 20 of those who successfully had their decision changed in 2019/20 have to pay one more visit to A&E, for example, then it would cost around £1.1 million per annum.
  • If 1 in every 100 people who successfully had their decision changed in 2019/20 required statutory homelessness support whilst they await the outcome of their MR or appeal, it could cost an additional £4.4 million.
  • If 1 in 200 of those who successfully had their decision changed in 2019/20 require community social care in the interim, then it could cost an additional £9.9 million.

Yet different approaches are possible. The Scottish government has announced its plans to provide Short-Term Assistance to retain payments to claimants whilst they go through an appeal process. This could significantly reduce the harm that is likely to be resulting from the current system.

As the government looks to reform how it supports disabled people and people with health conditions through the Health and Disability Green Paper, and simultaneously seeks to manage its expenditure as the country emerges from the pandemic, making the PIP process fit for purpose would benefit taxpayers, departmental budgets, and individuals alike.

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