That this House has considered Work Capability Assessment timescales.
It is a pleasure to serve under your chairship, Mr Western. I welcome the Minister to his place to discuss this important issue. I am grateful to him and his office for their recent engagement with my office on this issue. I am sure he has gathered from our recent correspondence that the focus of my remarks today will not be about the timescales for first-time applications for work capability assessments, but those for people who have requested a new assessment or a reassessment.
There are lots of reasons why someone might need a new assessment. No health condition follows a set path. Although we hope that someone’s health might stay stable or improve, often that is not the way it works out. I do not know how many applicants are waiting for brand-new work capability assessments, but I know that the Minister wrote to me last month to tell me there was a backlog of 35,000 reassessments waiting to be seen. That is a lot of people struggling or unable to work and arguably not getting the support that they need. In response to recent parliamentary questions, I was told that the Department has no breakdown on that backlog, which I find quite concerning. I hope the Minister will take that away. I hope he will tell me in his remarks all the ways they are trying to fix the backlog, but I put it to him that we cannot add capacity if we do not know where to target, so we need a breakdown of that backlog.
I commend the hon. Lady for securing this debate. To add my support from a personal point of view, in my office I have a lady who looks after nothing else but benefits. She has told me that there are major issues regarding reassessment waiting times for those who are up for review. The official internal figures for Northern Ireland show that the mean average wait was around 290 working days—58 weeks—and some people are waiting as long as seven to eight years. I have to say, in all honesty, those are extremes, but it does underline the very issue that the hon. Lady is talking about. Does she agree that the one way to solve this problem is more staff? They must be hired to deal with the backlog, as applicants are feeling stressed and anxious that their financial stability might change.
I am grateful to the hon. Member for his intervention. I will go on to talk about my own caseworkers’ experience. It is right that we recognise that they are the people dealing with the brunt of this. I am going to outline some of the challenges and what I hope the Minister might tell us he is doing to address those.
There are different assessment providers across the UK. Maximus serves my constituency of North East Fife, whereas other assessment contracts sit with Capita, Serco and Ingeus. I would be grateful for more staffing near North East Fife, but the Department for Work and Pensions seems to have no knowledge of whether the problems are greater in Scotland or Skegness. When I talk about delays, I am not talking about a service standard being missed by a few weeks or even a few months. Like the hon. Member for Strangford, I have cases where wait times are 18 months or more.
I want to talk about the impact of such delays on people on the waiting list. I hope the Minister and you, Mr Western, will understand that for the security and wellbeing of my constituents, I am not going to share individual details. There are common denominators across the cases that can paint a picture but, as most MPs know, the people we support are often vulnerable and have suffered considerably in their lifetimes, and it is important that we safeguard their welfare.
The common denominators are backgrounds of serious abuse, sometimes back to childhood—abuse that is hard to imagine and has a serious impact on adult mental health and wellbeing; severe anxiety, depression and post-traumatic stress disorder; physical symptoms and pain, sometimes linked to external factors like car accidents and other times linked to past and ongoing trauma. I also have at least one case waiting for a diagnosis of attention deficit hyperactivity disorder. In general, there is extreme vulnerability across the board.
As a former caseworker, I can reflect on how it can impact you as an individual. I used to play ABBA after hearing about particularly traumatic events on the phone with constituents of the MP I used to work for. We need culture change, and to make sure that those who undertake this service to the public, whether it is Capita or other providers, use a trauma-informed approach. Have you seen such a culture change within these organisations? I hope the Minister will reflect on that in his remarks later.
Culture does seem to be part of the problem in these circumstances. My view is that my caseworkers work incredibly hard, but if systems, processes and institutions worked the way they were supposed to, the casework often would not come to us in the first instance.
One of my caseworkers told me that, on the phone, someone can go from being completely fine and talking about their application and their health treatment to being in floods of tears and expressing suicidal thoughts with next to no warning. The DWP is not responsible for the underlying factors and histories of my constituents—let me make that clear—but it is here to provide a safety net. Leaving my constituents in limbo has made everything much worse. Mental and physical health are worse, and trauma responses are triggered. One of my constituents has been advised that there is no point pushing on with investigations and treatment for her pain while so many anxiety-inducing factors are ongoing, so recovery is being impacted too. Being unable to work without the additional health element of universal credit can make it incredibly difficult to make ends meet. As we all know, poverty and ill health is a terrible cycle.
The constituents I am working with are trying their best, and I am grateful to the local agencies that offer support. I would like to highlight the work of Fife Women’s Aid and Square Start. The former offers invaluable trauma support and counselling, and the latter can help with all sorts of essential life skills. Many of my constituents have particularly benefited from help with budgeting and managing their finances. However, the reality is that we are all stuck in a holding pattern until the assessments are carried out and decisions are made. My constituents are not alone; they are in a cohort of 35,000 others.
The Minister mentioned the steps the Government are taking to reduce the backlog in his letter to me last month. He will be unsurprised to know that I have some questions that I hope he will be able to address today. First, can he explain why his Department has prioritised new work capability assessments over applicants who have notified the DWP about a change in condition? I am not saying that existing claimants should be prioritised, but a “first come, first served” process, or some other type of prioritisation system, might be fairer. Can the Minister explain how the backlog has got so big? If it stems back from before the 2024 election, why is it taking so long to tackle it? What grounds does his Department use for considering expediting reassessment?
I am delighted to serve under your chairmanship this morning. I congratulate the hon. Member for North East Fife (Wendy Chamberlain) on securing this debate.
I welcome the opportunity to consider journey times in the work capability assessment, both for initial assessments and reassessments. I take the point that it is the latter group in which the hon. Lady is particularly interested. I echo her tribute to MPs’ caseworkers, which was very well made. I agree with the hon. Lady that it is important that people claiming health and disability-related benefits have their entitlement assessed as quickly as possible, so that they get the support they need.
Let me set out the Government’s policy on the work capability assessment. It was introduced in 2008 as the gateway to the employment and support allowance, which was the then new benefit to replace incapacity benefit. As it happens, I was the Minister responsible at the time. I remember being told that the WCA had been devised across Alan Johnson’s kitchen table in the period when he was Secretary of State. Since 2013, it has also been the gateway to the additional health-related sum in universal credit.
Two people with the same condition can be affected in different ways, so they can have different outcome decisions from their WCA. The three possible outcomes for a UC applicant are: fit for work, where the individual is not entitled to the additional health element of universal credit; limited capability for work, where the individual gains access to the work allowance in universal credit, but gets no increased rate of benefit; and limited capability for work and work-related activity, so-called LCWRA, which gives access to a higher rate of benefit with no requirement to take part in work-related activity.
The WCA links capacity to work to additional financial support. In our Pathways to Work Green Paper last year, we outlined our plan—and the hon. Lady touched on this matter—to abolish the WCA and end the binary categorisation of people as “can work” or “cannot work”. We do not think that black and white categorisation works. One of the problems with it has been that although people deemed not capable of work are still offered help to look for work, there is no requirement to take it up and, in practice, they rarely do. The system has given up on them, but we are now changing that. Work coaches with a new specific brief to support people classified as LCWRA say they are getting a positive response from the people they are contacting.
11:30 am
Sitting suspended.
Summer 2024 seems like a long time ago. There were 243 happy and optimistic newly elected Labour MPs filling the Palace, the Paris Olympics were just kicking off, London was full of Swifties for the Eras tour, and my constituents were taking the difficult decision that their health struggles were too much to manage to hold down a job and starting the process of requesting support from the DWP. That illustrates how long they have been waiting. These extended waits are absolutely debilitating. The not knowing is incredibly difficult. I think all MPs know from experience that these people worry to the point of obsessive hyper-fixation that their existing benefits will be taken away. That is added to by the stigma people feel for not being able to support themselves or their children, relying on the food bank and not being able to meet their basic needs for energy or clothes, and the anxiety of being judged by those around them.
The hon. Member for Strangford mentioned his caseworkers. I spoke with my caseworkers in the run-up to this debate. I want to take a moment to appreciate our caseworkers, because we need to remember that they are not trained as benefit advisers, counsellors or welfare specialists, but they are the ones picking up the phones day in, day out, trying to unpick what has gone wrong and providing back-up to constituents who find themselves in crisis with nowhere else to go. That is true of all MPs’ offices.
My caseworkers, coincidentally, went to an information session run by Maximus yesterday, and they, with the 50 or so other staffers on the call, were told that the DWP has the power to approve reassessments being processed if it thinks there are reasonable grounds for doing so. That was news to my team and me, because DWP case handlers have consistently said that Maximus is independent and that it has no influence over its operations.
However, we were told yesterday that Maximus is under instruction from DWP to prioritise all new applications, and to look at the backlog of reassessments only if it finds spare capacity. If we write to Maximus and make the case for a reassessment being prioritised, it can escalate it to DWP, and that is where the ultimate decision lies. I would be very keen to hear more about that and confirmation of what we were told yesterday from the Minister.
On making things faster, will the Minister please give more details of what is entailed in rapidly expanding reassessment capacity and accelerating the recruitment of health professionals? That goes to the point made by the hon. Member for Strangford. Given work capability assessments are outsourced to companies such as Maximus, what conversations is the Department having with providers about increasing that capacity? How will that be carried out and how will it be allocated geographically? The DWP already carries out some PIP assessments in-house. Has the Department considered adding capacity to work capability assessments with in-house resource?
The Minister said in his letter to me that health professionals are being encouraged to make recommendations based on the papers, rather than in person, where possible. What is he doing to make sure those decisions are being made correctly? I am aware, for example, that at least one of my constituents is stuck on a very long waiting list for PTSD and ADHD diagnoses. There are NHS backlogs everywhere, and Scotland, regrettably, is no exception.
That leads me on to my next question: how does the Minister intend to ensure, with this rapid expansion, that the right decisions are being made overall? Rushing at this stage and getting it wrong will just push the backlog into mandatory reconsideration, which helps nobody, and will lead to more delays for our constituents and more administration costs for his Department.
On a final note, although this is not why I secured this debate, I am aware that the Minister might be minded to mention the planned long-term reforms for work capability assessments. I make a plea for him to think very carefully about what assessments will be used for Scottish applicants, and how those systems will be linked with the DWP. As he knows, we have the adult disability payment under Social Security Scotland, and there are already so many problems that need fixing in how these two systems talk to each other—or do not, as the case may be. My caseworkers have to be experienced in both of these systems. At the moment, failing to fix those foundations and ensuring that the right conversations take place between the Scottish Government and the DWP would be unhelpful for everyone.
To conclude, 35,000 people waiting sounds like just another number, but it is the size of a medium town in the UK, or just a little bit smaller than the population of Lichtenstein. There is a significant cost for every person left in limbo, to us as a population and to our wider economy. I hope I have demonstrated that today.
In future, eligibility for additional health-related financial support in universal credit will be assessed in England and Wales via the personal independence payment assessment. It will be based on the impact of disability on daily living, rather than on capacity to work. The hon. Lady is right to make the point about how arrangements might work in Scotland and we are already discussing that with the Scottish Government.
Our ambition is a system that is simple to navigate, can be trusted by those who use it, provides a good experience and, generally, obtains the right decision the first time. Due to its link with the PIP assessment, the WCA abolition will not proceed until after the conclusion of the review into PIP that I am currently co-chairing. The co-chairs have recruited a steering group of a dozen people to oversee the co-produced review of PIP. Almost all of the steering group have lived experience of a disability or long-term health condition. We are going to have a full day together tomorrow, considering how to secure external input to our consideration of how the system should work in the future. The review’s recommendations will be submitted to the Secretary of State in the autumn.
In the meantime, the WCA process, as the hon. Lady rightly highlighted, needs to be as efficient and supportive as possible. WCA waiting times can vary depending on individual circumstance, including the complexity of the case, the need for further medical evidence, and customers’ availability and assessment capacity. The latest reported median end-to-end journey time for new employment and support allowance work capability assessments is 87 working days. That is broadly comparable with what it was before the pandemic. It includes the four weeks that people applying for the benefit have to complete and return their WCA50 questionnaire, as well as time for the providers to request and receive further medical evidence from a GP or another healthcare professional.
New benefit applications are primarily for universal credit rather than for ESA. Clearance times for WCAs in universal credit are not yet published, but they will be in phase 6 of the proposed development of universal credit statistics. There is a big plan for how those are going to be rolled out.
As the hon. Lady explained, she has a particular interest in claimant-led WCA reassessments—when somebody already in receipt of benefit reports that their condition has worsened. She has made representations to me on behalf of constituents about that. I think I have now replied to all the letters she has written to me about that, although one of them was just earlier this week, so we have only just managed that.
As the hon. Lady said, the Department prioritises initial assessments for new benefit customers. The reason for that is to make sure that people receive the correct entitlement and employment-related support as early as possible. It is right to prioritise for those assessments people who have not got any help at all yet, ahead of those wanting a fresh look at the amount they are receiving in benefit. Reassessments are carried out when there is capacity in the system to do them.
The background to the backlog that the hon. Lady referred to is that, in late 2024, after the general election, there was a surge of new benefit claims, so there was a need for a lot of new WCAs. Handling that surge led to a backlog of claimant-led reassessments, which built up from September 2024 until May 2025. When I was advised that we had a backlog of 35,000 claimant-led reassessments, I told officials to prioritise that group, and I am pleased that most of that backlog was cleared by the start of this calendar year. The vast majority of it will be cleared altogether by the end of this month. That should mean that the problems quite rightly highlighted by the hon. Lady will be behind us.
Alongside claimant-led reassessments, there are Department-led reassessments, where the Department decides that a reassessment is needed to check that the benefit being paid is correct. They are often carried out after a benefit award has been in payment for a specified period. Those Department-led reassessments stopped altogether for a period in the pandemic and for some time after, while the backlog of new claims left by the pandemic was processed.
In the Pathways to Work Green Paper last year, we said that we would turn on scheduled WCA reassessments as we build up capacity in our assessment providers. We are prioritising scheduled reassessments for people who are most likely to have had a change in their circumstances—for example, those with a short-term prognosis, for whom we can reasonably anticipate that a change in their health condition has occurred. That includes those with risks from pregnancy complications, or those who have recovered following cancer treatment.
We intend to do that while simultaneously reducing delays and improving timescales for those awaiting a reassessment—the group that the hon. Lady highlighted. That will mean that people who have asked for a review of their capability for work due to worsening health can be seen and receive an outcome as quickly as possible.
To do that, we will continue to increase assessment capacity significantly, through accelerated recruitment of healthcare professionals. Our providers have also expanded appointment availability, including some evening and weekend slots, and improved triage processes to identify cases that are suitable for paper-based or remote assessment, which can be dealt with particularly quickly. Those steps will continue to help improve the overall experience and ensure timely access to assessments for those who need them.
However, ensuring that people are assessed and get the support they are entitled to as quickly as possible is not everything. The hon. Lady rightly made the point, as she said in her most recent letter, that we need to “avoid cutting corners which could lead to wrong decisions being made”. She is absolutely right on that.
One important factor is whether assessments are carried out face to face. Before the pandemic, face-to-face assessments were the standard. Those stopped in lockdown and, for obvious reasons, assessments were carried out by telephone or by video call—mostly by telephone. Looking back, that worked rather better than people might have anticipated, but it meant that in 2021, only 5% of work capability assessments were carried out face to face. After the pandemic, there was a very slow return to face to face: in 2024, only 13% of work capability assessments were face to face.[Official Report, 11 March 2026; Vol. 782, c. 2WC.] (Correction) We think it is very important for accuracy and fairness that many more of them should be carried out face to face, so we have committed to increasing that proportion to 30%. We are making good progress in that direction; the statistics will be published in due course.
The hon. Member for Torbay (Steve Darling) rightly asked about a trauma-informed approach to assessment. Assessment providers adhere to a comprehensive quality and clinical governance assurance framework that aligns with the Department’s contractual and professional standards. All healthcare professionals conducting work capability assessments have to be fully qualified and appropriately registered, and have completed the necessary specialist training, before carrying out any assessments. Once they are in the role, they also have a full programme of continuing professional development to support them.
To maintain consistent standards of accuracy, justification and clarity, providers carry out regular audit sampling of their assessment reports, which helps them to identify areas for improvement. Alongside that, the Department conducts a programme of independent assessment quality audits. Where those identify problems, the Department makes sure that providers put things right through enhanced training, additional coaching or whatever is needed. Providers maintain a collaborative relationship with the Department, taking part in performance reviews to ensure that expectations are met and improvements are embedded.
Where performance falls below contractual quality thresholds, providers have to act promptly, perhaps with detailed improvement plans, strengthened audit processes, increased supervision or further training. The Department monitors progress closely and, if there is a significant or persistent problem of underperformance, is able to apply contractual remedies to address the problem.
Having said all of that, there are of course times when things go wrong. Earlier this week, I met with a Member who expressed concern about the outcome of a PIP assessment. I raised the case with officials in the Department who had a look at it. The assessment had been carried out by one of the assessment providers and, when the provider checked it, it agreed that the assessment was wrong; I think the individual who carried out the assessment was suspended. Things do sometimes go wrong, and it is absolutely right that Members raise these things with me so that we can address them.
One of the main reasons why maintaining quality is so important is that, as the hon. Member for North East Fife said, some of those going through the WCA are among the most vulnerable people due to the nature or severity of their disability or health condition, or for some other reason. We have in place a range of measures to identify, prioritise and safeguard vulnerable customers from the earliest stage, including helping them to complete the WCA50 questionnaire, encouraging people to have someone with them when attending an assessment and the provision of home visits, if that is needed.
We know that some people need more support than that. The hon. Lady raised that with me in a letter last October. We are not planning a triage system for prioritising such cases, because we are really focused on getting all the cases cleared as quickly as possible, but the Department has committed to a new safeguarding approach, as my right hon. Friend the Secretary of State outlined in a written ministerial statement in December, and a lot of work is going into that.
I am most grateful to the hon. Member for North East Fife for drawing this matter to the attention of the House, for her long-standing interest in this very important subject and for the contributions of others who have intervened in this debate.