All the charities that were invited by Professor Malcolm Harrington to join in his review of the WCA descriptors as they affect people with both Fluctuating Conditions and Mental Health Conditions have signed off the attached statement. It contains the current version of our proposed descriptors – but not the current scoring.
Representation of people with ME/CFS on the fluctuating conditions group is through the Countess of Mar's Forward ME Group. MEA medical adviser Dr Charles Shepherd represents the Forward ME Group in this process.
To download the full, 7-page statement, please click HERE
BACKGROUND
The Department of Work and Pensions evidence-based review (EBR) of the Work Capability Assessment (WCA)
As part of the Independent Review of the WCA by Professor Harrington, Mencap, Mind and the National Autistic Society were asked to produce proposals for improving the ‘mental, intellectual and cognitive function’ descriptors used in the current WCA.
Another group of charities (MS Society, NAT (National AIDS Trust), Parkinson’s UK, Forward ME, Arthritis Care, and Crohn’s and Colitis UK) were asked by Professor Harrington to consider how the assessment might better take into account those with fluctuating conditions.
Both groups made proposals for reforms based on the problems with the current system experienced by the people we represent. We felt that these proposals were practical and achievable but we also flagged up that we felt a more fundamental review of the whole WCA system was needed and we, along with many others, continue to call for a more radical overhaul of the system.
What happened to those reports?
In response to the recommendations put forward by both groups, Professor Harrington called on the Department of Work and Pensions (DWP) to test the proposals in his second Independent Review (November 2011). The DWP agreed to this, as a way of gathering sufficient evidence on how the proposals put forward by the charities would work. This is what DWP are calling its evidence-based review (EBR).
How will the EBR work?
In June 2012 the charities were asked to regroup by the DWP, this time all together and combine our proposals into a single assessment that reflects the recommendations in the two reports. The regroup consists of : Crohn’s and Colitis UK, Forward ME, Mencap, Mind, MS Society, NAT (National AIDS Trust), National Autistic Society and Parkinson’s UK.
The aim of the EBR is to assess the fairness and accuracy of the existing WCA descriptors, as well as look at the alternative version put forward by the charities. The EBR is a DWP-led project, and the DWP is responsible for managing the design, testing and analysis of the review, with input from the charities.
Additional information will be collected during real assessments so that both sets of existing and the alternative descriptors can be completed. The outcomes of the assessments will then be compared to the views of a panel of experts, looking at all the available evidence about each applicant.
The proposals which have been put forward by the charities have not been endorsed by the DWP – they have simply agreed to look at how the outcomes of the WCA might be different with these descriptors compared to the current ones.
It will then be considered (in summer 2013) what changes might be made to the assessment on the back of this testing. The DWP has stated that: “Changes to the current WCA will be considered by the Department where there is good evidence that they would significantly improve the accuracy and fairness of identifying claimants as having Limited Capability for Work.”
Why are the charities involved?
Although we believe fundamental reform of the WCA is needed, we are hopeful that the EBR offers an opportunity to gain improvements to the current system. However there is a long way to go and it will depend on the evidence as to what of our suggestions will be adopted.
Our main hope is that the EBR will demonstrate where the current WCA descriptors aren’t working and whether our combined proposals would improve the system, looking at the principles behind our suggestions as much as the detailed drafting.
We aren’t claiming to be experts in assessment design and the proposals are not a perfect solution to the issues of the WCA.
Draft alternative
We haven’t yet finalised exactly how the scoring will work, but we hope the matrix style approach should allow for better recognition of the complexity and variability of people’s conditions.
Our focus has been on designing descriptors that better takes account of the fluctuation and variability of conditions. We have also tried to reduce the division between ‘mental’ and ‘physical’ impairments and recognise that, in many areas, people can experience a combination of the two, thus the reference to “global” descriptors where appropriate.
Timescales have been tight and there has been limited opportunity for wider consultation with disabled people and other representative groups, so we have been clear in our communications with DWP that we expect further stakeholder consultation will be undertaken before and if any changes are implemented as a result of this process.
Please read with interest and contact us with any questions you have. It may be helpful to have a copy of the current WCA to hand if you wish to compare which can be found here.
On behalf of: Crohn’s and Colitis UK, Forward ME, Mencap, Mind, MS Society, NAT (National AIDS Trust), National Autistic Society and Parkinson’s UK.
Is it just me, or are some of descriptors even more baffling and confusing than the current ones?
For example, there seems to be no option to tick if you can only stand for a couple of minutes.
It doesn’t take a genius to have come to these conclusions and this document should have been put together months ago.
The input from so many different organisations has clearly slowed the process down enormously.
The evident lack of urgency in sorting this out is both astonishing and infuriating.
Really don’t see these getting accepted, many of the descriptors are far too abstract for the DWP to accept.
For example; “some difficulty” vs “significant difficulty”, we’ve been trying to get a definition of what significant discomfort means for 20 years with no success, how is anybody supposed to interpret these.
And what are Occasionally, Frequently and Most supposed to mean, current case law accepts that someone suffering from a limitation for the majority of the time should be considered to be effected all of the time, the first two phrases are clearly less than this, so for these to be accepted there has to be a significant shift on current thinking.
I know this is a balancing act between using descriptors that are more friendly to fluctuating conditions and the current descriptors, but I really don’t see the DWP going for these, and worse still, I’m not sure they are actually practical.
A very difficult and time consuming task; we should be grateful to every one who gave so much time (unpaid) to make the best of a bad job – thank you.
Minor quibble – ‘Maintaining Focus’ appears to refer to ‘concentration’ instead of eyesight!
That’s because the task is about “poor memory or concentration, disorganised thoughts or anxiety”
Problems with sight are covered under (3)
Like Soloman, I would like to thank those who gave up so much time and effort for this.
With regard to occasionally, frequently and most: the ESA form does not really encourage you to provide the information needed for a fair decision as many descriptors are just of a can you or can’t you nature. The MEA document giving advice on filling in the form advises that you should provide additional information to give a picture of how you are for most of the time and also what happens when you attempt to carry out a task that is beyond your current limitations – especially if you do it repeatedly. I think the new descriptors go some way toward helping the claimant provide this information – especially those who are not aware of the advice provided by the MEA.
The new descriptors are not perfect but, depending on how they are scored, they are an improvement on the current form in my opinion.
I just wish there was a way we could get across to the powers that be just how damaging and disruptive the whole process is to someone with limited resources and very often limited support. Especially when you add in the fluctuations that can occur anyway. I understand the need for an assessment but is it fair that the assessment designed to check your current condition will almost certainly, for many, make that condition worse?