Monday 15 February 2016

For better or worse; changes in Employment & Support Allowance prognosis

I've had far too many Work Capability Assessments. I think I've had something like 8 since 2010, mostly done on paper. My condition has either not changed substantially, or gotten worse. It struck me that this has never been reflected in the results of my WCA.

Take my latest one. My original prognosis was 2 months, then went up to 2 years and finally "indefinite". My health got worse, and on the urging of Relevant People, I tried to get into the Support Group. I failed, and my prognosis was reduced to 18 months. The council's advisor said this was likely a punishment for daring to question them (no, really.)

I did what I always do when I'm annoyed - moan on Twitter. After that, I had a look for data on changes in ESA prognosis. There wasn't any, so I began an annoyingly drawn out Freedom of Information case against the DWP. It ended up with the Commissioner having to intervene to get them to give me the data after ignoring me for months on end.




Raw
WRAG
SG
FFW
Percentages
WRAG
SG
FFW
No change
56,500
12,100
91,700
17.91
3.84
29.07
Increase
78,200
37,300
24.79
11.83
Decrease
24,400
6100
7.74
1.93
Terminal
600
0.19
Unknown
6,200
2,300
1.97
0.73

Table 1. Prognosis and WCA outcomes for people originally assigned to the Work-Related Activity Group.


Raw
SG
WRAG
FFW
Percentages
SG
WRAG
FFW
No change
47,700
6,400
23,400
23.18
3.11
11.37
Increase
90,400
8,600
43.93
4.18
Decrease
13,900
4,800
6.75
2.33
Terminal
2,600
1.26
Remain
1,100
0.53
Unknown
5,900
1,000
2.87
0.49
Table 2. Prognosis and WCA outcome for people originally placed in the Support Group.

Prognosis Change
Total
Percentage
Fit for Work
115,100
22.49
No change
122,700
23.98
Increase
214,500
41.92
Decrease
49,200
9.62
Became terminal
3,200
0.63
Remain terminal
1,100
0.21
Unknown
5,900
1.15



Total
511,700
100.00

Table 3. Changes in prognosis across all groups.

You'll notice a few things that seem a little bit off. For example, 4.2% of people in the Support Group are reassessed and placed in the WRAG, but with an increased prognosis? 2% of people being placed in the Support Group after being in the WRAG have a decreased prognosis - their condition is worse, but more likely to improve?

20% of WRAG claimants and 25% of Support Group claimants are given the same prognosis in later assessments, despite the fact that the prognosis was evidently wrong the first time. 50,000 people (~10%) had their prognosis reduced - the HCP decided they were likely to improve in a shorter length of time, despite being unwell longer than the previous HCP had estimated.

The DWP says that the prognosis given is just how the schedule assessments, but if you've seen a WCA report, you will know that the prognosis is the the time at which the assessor thinks the claimant will be able to get a job.

The prognosis system is important for claimants. It determines the frequency of assessments (a massive strain in itself), but also the claimants' conditionality. Lower prognoses trigger the claimants' "eligibility" for the Work Programme. This data shows that there is little consistency or logic in how prognoses are determined. In 10% of cases, the HCP is predicting a faster return to work than previously, despite no improvement in health or, sometimes, even a significant worsening.


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