The Government has promised to ensure its raft of welfare reforms do not increase demand for fit notes or pressure on GPs.
Today, work and pensions secretary Liz Kendall announced a series of changes to the welfare system which are expected to save over £5bn in the coming years.
This included scrapping the Work Capability Assessment (WCA) in favour of a single assessment, as well as narrowing eligibility for the Personal Independence Payment (PIP) so it is targeted at those with higher needs.
Alongside the intended savings, Ms Kendall also announced £1bn of new funding to improve the support offer for disabled people and people with health conditions to return to work.
This money will help to develop a ‘big, clear and simple’ offer – called ‘pathways to work’ – which builds on existing schemes such as fit note reform under WorkWell pilots and ‘trailblazer’ areas where GP practices will host job coaches to help reduce unemployment.
Summary of key changes
- Scrapping the WCA to end the labelling of people as either ‘can or can’t work’ and consulting on a new single assessment
- Under the new system, any extra financial support for health conditions (including PIP, ESA or UC health) will be assessed via a new single assessment which will be based on the PIP assessment – considering the impact of disability on daily living, not on capacity to work.
- Changing PIP Eligibility: PIP will be targeted more on those with higher needs by requiring a minimum of four points on one daily living activity, in addition to the existing eligibility criteria.
- The Government is currently consulting on how best to ensure those who fall out of eligibility can be supported by the health and care system.
- Ending reassessments for disabled people who will never be able to work and people with lifelong conditions.
- Legislating to protect those on health and disability benefits from reassessment or losing their payments if they take a chance on work – the ‘right to try’ guarantee.
- Reintroducing mandatory reassessments for people on incapacity benefits who have the capability to work to ensure they have the right support and aren’t indefinitely written off.
Source: DWP
The Government said that strengthening the NHS is the ‘foundation’ of delivering better employment outcomes for disabled people and people with health conditions, citing its efforts towards this with the recent £889m GP contract boost.
Its consultation on the changes asks how the health and care system could be improved for those who are currently claiming PIP but will lose entitlement.
The consultation also said: ‘The Department for Work and Pensions (DWP) will work with the Department for Health and Social Care (DHSC) to ensure the changes we are making do not increase demand for medical evidence and requests for fit notes or place additional pressure on any part of the health service including general practice (GP).
‘We are determined to reduce the pressure on primary care and ensure everyone can access GP services.’
Professor Azeem Majeed, a GP and head of primary care and public health at Imperial College London, said it is ‘too early to fully understand the detailed implications’ for GPs, but that any changes the Government makes to the welfare system will ‘inevitably’ impact general practice given their role in the welfare system.
He told Pulse: ‘The abolition of the Work Capability Assessment and the introduction of a new single assessment based around Personal Independence Payment (PIP) criteria could shift GPs’ responsibilities from certifying work capability to assessing how health conditions impact daily living.
‘Additionally, mandatory reassessments for incapacity benefits and stricter eligibility criteria for PIP may increase demands on GPs for medical evidence, despite the government’s aim to reduce administrative burdens.’
However, Professor Majeed said that the ‘right to try’ guarantee might ‘positively enable’ GPs to support patients ‘without immediate risk of losing benefits’.
‘It’s essential to closely monitor the outcomes of these reforms on benefit recipients and NHS workloads to ensure they are meeting their objectives for recipients and not leading to unnecessary work for primary care teams,’ he added.
At tomorrow’s special conference of England LMCs, local GP leaders will vote on issuing ‘indefinite’ fit notes on first presentation, as part of potential future collective action.
The proposal would see GPs passing all further fitness-for-work assessment to the Department for Work and Pensions (DWP).
