Investigating experiences and perceptions of well-being during the work-capability re-assessment process

Fassioms, David and Holland, Paula and Ahmed, Faraz (2024) Investigating experiences and perceptions of well-being during the work-capability re-assessment process. PhD thesis, Lancaster University.

Text (2024fassiomsphd)
2024fassiomsphd.pdf - Published Version
Download (2MB)

Abstract

Previous research on the experiences of adults in receipt of welfare benefits has focussed on benefit recipients contending with health, social and economic difficulties, stigma while receiving benefits and experiences of conditionality measures. Those with ill-health or disability who have limited ability to work, or are unable to work and applying for benefits in relation to this need to go through a work-capability assessment process. Most claimants will then be subject to re-assessment of their capability to work periodically. There is existing research related to the work-capability assessment but a lack of research related to the re-assessment process specifically. In November 2020, approximately two million people in the UK were in receipt of work-related benefits and deemed to have severe functional disability as a result of their health conditions. Since the start of the COVID-19 pandemic in March 2020, there are 363,000 more people out of work due to long-term health conditions, with a 22% increase of people with long-term sickness as a result of mental illness specifically. Therefore, further understanding of individuals’ experiences and perceptions of their well-being during the benefit re-assessment process is vital, allowing potential issues to be identified and recommendations made which could improve the benefit system for those navigating it. Previous research has shown that long-term benefit recipients fear for their financial security due to anxiety around financial support being reduced or withdrawn, which impacted on their mental health and well-being. However, this research focussed predominantly on recipients of a legacy benefit that was phased out from 2008. Additionally, the work-capability assessment has been found to be detrimental to mental health and re-traumatising to military veterans. Prior to the research study, a literature review was conducted that scrutinised how individuals experience the benefit system and their health and well-being while claiming welfare benefits. The themes derived from the literature review were: 1) Benefit recipients have to contend with health, social and economic difficulties; 2) Benefit recipients struggle with identity and stigma; 3) Benefit recipients feel negativity, mistrust and are distressed by the benefits system; 4) Benefit recipients feel the work capability assessment (WCA) is not suitable in assessing some health conditions; 5) Benefit recipients do not see work related activity (WRA) as credible; 6) Benefit recipients can benefit from volunteering or permitted work. This thesis attempts to address the need for further research exploring experiences and perceptions of well-being during the work-capability re-assessment process. Specifically, for people who were deemed to have severe functional disability at a previous work-capability assessment (WCA) and are in the Employment Support Allowance (ESA) support group or the equivalent Universal Credit limited capability for work and work-related activity group (UC LCWRA group). The study employed qualitative methodology and 18 ESA support group or UC LCWRA group recipients participated in in-depth interviews. The narratives presented from this study portray how the re-assessment process is fraught with difficulties that can lead to stress, anxiety and depression amongst other symptoms and feelings. Moreover, it can exacerbate existing physical and/or mental health symptoms. The cycle of re-assessments for those in the ESA support group or UC LCWRA group were perceived as never-ending, harmful to health and led to social struggles including financial difficulties, food poverty and energy poverty. Despite already being found to have severe functional problems due to sickness or disability at a previous assessment, the process of being re-assessed represents conditionality, as non-compliance with the process will lead to the benefit being withdrawn despite individuals’ difficulties already being known to the Department for Work and Pensions (DWP). Furthermore, participants experienced stigma during the process due to feeling judged for being in receipt of benefits, which adds to the already arduous process of navigating the re-assessment process. The policy implications from the findings point to the need for major improvements to the re-assessment process, including: - Ensuring there is a longer period of time between re-assessments for people who have experienced numerous re-assessments and been consistently found to have limited capability for work and work-related activity. - The assessment provider should deliver further training for staff regarding claimants’ perceptions of the re-assessment process to provide a more sensitive approach and positive experience for claimants navigating the re-assessment process - The government and media should change how they communicate about people in receipt of benefits. This includes avoiding language that is discriminatory towards benefit claimants or will incite stigma.