In the fourth Review of the Work Capability Assessment (the 'fitness for work' test), Dr Paul Litchfield, who has taken over the role as independent reviewer, has highlighted specific areas for improvement:

The assessment should be carried out with dignity and respect for the claimant, with better communication, better rapport and listening skills to be employed by the Healthcare Professionals (HCPs).{jcomments on}

There should be a system of better decision making, with a recommendation that workloads are more effectively distributed: senior staff should be making decisions on borderline cases, with junior staff processing all other cases.

Further, with regard to decision makers (DMs), Dr Litchfield identified that there seems to be an “impaired relationship with HCPs, who should be regarded as trusted advisors”.

He advises that the process for gathering evidence should be simplified and recommends that the ESA113 (the medical report form sent to claimants' GPs for evidence gathering) is redesigned in conjunction with the British Medical Association.

He warns of the risk of condemning people with mental health (MH) problems to a life of worklessness if diagnostically labelled, due to the potential that they will become stigmatised.

The ESA50 (the claimant's health questionnaire) should be improved to make it clear to those with mental health problems that evidence from support worker is valuable in giving the DM guidance on a person’s functional ability.

Dr Litchfield further recommends that DMs and HCPs are given improved training in mental health issues and that HCPs should have suitable and sufficient previous experience.

Routine reassessments for those with severe or degenerative brain disorders, who are not likely to improve, should be extended to 5 years.

As 40% of claimants identify mental health as the primary illness and 60% have some data recorded about MH by the HCP during the assessment, it is imperative that this area of the assessment is improved overall.


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