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.