Department For Work And Pensions Research Articles

Cohort profile: working age adults accessing secondary mental health services in South London (UK) and benefits – a data linkage of electronic mental health records and benefits data.

IntroductionIn the UK, mental disorders are one of the most common reasons for claiming a benefit relating to unemployment, income, sickness and disability. Limited information exists regarding the demographic characteristics and psychiatric profiles of working age individuals claiming benefits in London. Until recently, detailed data on both mental disorders and benefit receipt were unavailable. ObjectivesTo establish and describe a cohort of working age adults accessing secondary mental health services and benefits related to unemployment, income, sickness, and disability. MethodsUsing a novel data linkage containing electronic secondary mental health records from the South London and Maudsley (SLaM) NHS Foundation Trust and benefits data from the Department for Work and Pensions (DWP), we present descriptive statistics on sociodemographics, psychiatric diagnoses, and benefits received among a cohort of working age adults. The DWP benefits data window covers the period January 2007-June 2020, the SLaM data window covers the period January 2007-June 2019. ResultsWe identified n = 150,348 patients (18-65 years), who had attended SLaM secondary mental health services, 78.3% of which had received a benefit relating to unemployment, income, sickness and disability. Of this group, 68% had a recorded primary psychiatric diagnosis. We found that a much higher percentage of those with a primary psychiatric diagnosis received more than one benefit (69.4%) compared to those who had not received a primary psychiatric diagnosis (30.6%). Almost 70% of claimants who obtained more than one benefit were identified as living within the two quintiles representing the highest levels of deprivation in the South-east London boroughs served by SLaM. ConclusionsWe showed types of benefits received among working age adults accessing secondary mental health services. This cohort will be further examined to explore trajectories of mental health care and benefit receipt and provide evidence that will help to inform both DWP policies and mental health care delivery.

Cohort profile: Working age adults accessing secondary mental healthcare services in South London (UK) and benefits – A data linkage of electronic mental healthcare records and benefits data

ObjectivesTo present an overview of a cohort of working age adults accessing secondary mental healthcare services and benefits related to unemployment, sickness, disability, or income support and describe the different benefit types received across diagnostic and sociodemographic groups.
 MethodsUsing a novel data linkage containing electronic secondary mental health care records from the South London and Maudsley (SLaM) NHS Foundation Trust and benefits data from the Department for Work and Pensions (DWP), we present descriptive statistics on a cohort of working age adults. The data window covers the period January 2007-June 2020.
 ResultsWe identified n=150,348 patients of working age (18-65 years), who had attended SLaM secondary mental health care services, 78.3% of which had received a benefit relating to unemployment, sickness, disability, or income support. Of this group, 68% had a recorded primary psychiatric diagnosis. We found that a much higher percentage of those with a primary psychiatric diagnosis received more than one benefit (69.4%) compared to those who had not received a primary psychiatric diagnosis (30.6%).
 ConclusionsWe showed types of benefits received among working age adults accessing secondary mental health care services. This cohort will be further examined to explore trajectories of mental health care and benefit receipt and provide evidence that will help to inform both DWP policies and mental health care delivery.

Weaponising time in the war on welfare: Slow violence and deaths of disabled people within the UK's social security system

In 2014, a long continuing battle began to find out more about Government record-keeping on the deaths of disabled people claiming benefits. Drawing on a timeline of evidence co-produced with disabled people, we analyse how deaths related to the benefits system are an outcome of slow violence, where both the delay between policies and their harmful effects, as well as the more active use of delay tactics, are central to how the Department for Work and Pensions (DWP) weaponise time as a strategy to avoid accountability and deny justice. DWP reviews into deaths are an under-researched yet significant focus because they are (supposedly) tools through which the DWP investigates the harms of its own policies, and yet, they are designed and carried out in a way that systemically invisibilise state accountability.

Exploring the health and sociodemographic characteristics of people seeking advice with claiming universal credit: a cross-sectional analysis of UK citizens advice data, 2017–2021

BackgroundThe UK Department for Work and Pensions (DWP) administers Universal Credit (UC) – the main UK benefit for people in- and out-of-work. UC is being rolled out nationally from 2013 to 2024. Citizens Advice (CA) is an independent charity that provides advice and support to people making a claim for UC. The aim of this study is to understand who is seeking advice from CA when making a UC claim and how the types of people seeking advice are changing as the rollout of UC continues.MethodsCo-developed with Citizens Advice Newcastle and Citizens Advice Northumberland we performed longitudinal analysis of national data from Citizens Advice for England and Wales on the health (mental health and limiting long term conditions) and socio-demographic of 1,003,411 observations for people seeking advice with claiming UC over four financial years (2017/18 to 2020/21). We summarised population characteristics and estimated the differences between the four financial years using population-weighted t-tests. Findings were discussed with three people with lived experience of seeking advice to claim UC to help frame our interpretation and policy recommendations.ResultsWhen comparing 2017/18 to 2018/19, there was a significantly higher proportion of people with limiting long term conditions seeking advice with claiming UC than those without (+ 2.40%, 95%CI: 1.31-3.50%). However, as the rollout continued between 2018/29 and 2019/20 (-6.75%, 95%CI: -9.62%--3.88%) and between 2019/20 and 2020/21 (-2.09%, 95%CI: -2.54%--1.64%), there were significantly higher proportions of those without a limiting long term condition seeking advice than with. When comparing 2018/19 to 2019/20 and 2019/20 to 2020/21, there was a significant increase in the proportion of self-employed compared to unemployed people seeking advice with claiming UC (5.64%, 95%CI: 3.79-7.49%) and (2.26%, 95%CI: 1.29-3.23%) respectively.ConclusionAs the rollout for UC continues, it is important to understand how changes in eligibility for UC may impact on those who need help with applying for UC. Ensuring that the advice process and application process is responsive to a range of people with different needs can help to reduce the likelihood that the process of claiming UC will exacerbate health inequalities.

Linking electronic mental healthcare and benefits records in South London: design, procedure and descriptive outcomes

ObjectivesTo describe the process and outcomes of a data linkage between electronic secondary mental healthcare records from the South London and Maudsley (SLaM) NHS Foundation Trust with benefits records from...

Benefit complaints: a critical analysis

ABSTRACT Benefit complaints are an important area of administrative justice. Drawing upon available data and information, this article critically analyses the benefit complaints system, which is administered by the Department for Work and Pensions (DWP). It finds a significant decline in the volume of benefit complaints, a lack trust in the complaints process, and deep concerns about the quality of complaint-handling. The article also examines how complaints can be escalated, the DWP’s reaction to complaints and its response to the deaths and suicides scandal, in particular the creation of the new Serious Case Panel. The decline in the number of complaints and poor-quality complaint-handling have coincided with austerity policies. Consideration is given to proposals to improve the handling of complaints. However, the core underlying issues concern institutional culture and the social and political demands for political change.

The State of the UK funeral industry

The UK funeral industry is a frequently overlooked sector within critical policy discussions of State practice and welfare provision. In this article, we propose three ‘ideal types’ for making sense of State-Industry interactions: Explicit State Provision; Public-Private Legislation; and Corporate Capital. Situating these ideal types against the backdrop of austerity, we highlight three respective examples from the industry to evidence different roles performed by Funeral Directors (FDs), including: negotiations with the Department for Work and Pensions (DWP); HM Coroner contract tendering; and larger scale processes of capital accumulation through the industry’s biggest provider, Dignity plc. Our analysis reveals that the funeral industry represents a nebulous political and moral economy whose local practices differ markedly, evidencing critical insights into the workings, both present and ‘absent’, of the neoliberal State.

Justice in the Digital State: Assessing the Next Revolution in Administrative Justice by JoeTomlinson (Bristol: Policy Press, 2019, 97 pp., £12.99 (pbk))

Justice in the Digital State: Assessing the Next Revolution in Administrative Justice by JoeTomlinson (Bristol: Policy Press, 2019, 97 pp., £12.99 (pbk))

Using Tax Data to Better Capture Top Incomes in Official UK Income Inequality Statistics

It is widely recognised that household surveys do not fully capture the incomes of the very richest individuals and households, particularly those among the so-called “top 1%”, for reasons including non-response and under-reporting. As a consequence, estimates based on survey data alone typically understate true levels of inequality. This paper presents new research and analysis to develop a methodology for improving the measurement of the upper tail of the distribution, which is suitable for use in ONS’s official statistics on household income, in terms of being methodologically sound and based on robust academic research; transparent and understandable by users; and an approach where adjustments are made to underlying microdata rather than aggregates. The methods presented in the paper build upon the work of both the UK Department for Work and Pensions (DWP) and Burkhauser et al. (2018a) in employing methods in which survey-based mean incomes for quantile groups at the top of the distribution are replaced by equivalent figures from tax data. The analysis examines two sets of methods developed from these approaches, with variants of each tested to determine the most appropriate methodology to apply in future official statistical releases by ONS. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

An evaluation of nurse-led mental health training for benefits staff

Background Meaningful employment can promote emotional and mental health, yet there are concerns around the support offered to those experiencing mental ill health in maintaining or returning to employment.Aim To evaluate the delivery of training by mental health nurses to staff in a benefits district in the west of Scotland.Method The Department for Work and Pensions (DWP) commissioned the delivery of a training programme for staff involved in job coaching. Six mental health staff from one university delivered training sessions to 61 DWP staff over a period of two months. Topics covered included first impressions, engagement, communication skills and problem-solving. Participants were given five statements about what they had learned during the sessions and were asked to indicate the extent of their agreement to them on a Likert-type scale.Findings Participant feedback was mainly positive. Mental health staff involvement was crucial to the success of the training programme.Conclusion Participant feedback supported the situated learning concept where learning takes place in the context of its professional application and through the involvement of experts and peer learners. Mental health nurses should be involved in the educational development of other staff groups and organisations involved in mental healthcare.

Psychological tyranny prescribed by the DWP: preventable harm is government policy.

Influenced by corporate America, the commonly labelled ‘welfare reforms’ began in July 2006 with the introduction of the Welfare Reform Bill by the New Labour government, and guaranteed that claimants of long-term out-of-work sickness and disability benefit were to be coerced and intimidated by the Department for Work and Pensions (DWP) simply for committing the ‘crime’ of being too ill to work. In October 2018 it will be 10 years since the DWP replaced Incapacity Benefit with the Employment and Support Allowance (ESA), adopted the Work Capability Assessment (WCA) to be conducted by an unaccountable private contractor to resist funding the ESA, and guaranteed that GP opinion would be rendered meaningless for chronically ill patients in need of …

Policy Practitioners’ Accounts of Evidence-Based Policy Making: The Case of Universal Credit

AbstractThis paper draws on insider accounts from UK Department for Work and Pensions (DWP) officials to analyse the relationship between evidence and policy making at a time of rapid policy development relating to Universal Credit (UC). The paper argues, firstly, that evidence selection within the DWP was constrained by the overarching austerity paradigm, which constituted a Zeitgeist and had a significant bearing on the evidence selection and translation process, sharpening the focus of policy officials and analysts on the primacy of quantitative evidence when advising Ministers. Secondly, while methodological preferences (or an ‘evidence hierarchy’) impacted on evidence selection, this was not as significant as practitioners’ perceived capabilities to handle and develop evidence for policy. These capabilities were linked to departmental structures and constrained by political feasibility. Together, these dimensions constituted a significant filtration mechanism determining the kinds of evidence that were selected for policy development and those omitted, particularly in relation to UC. The paper contributes to debates about the contemporary role of evidence in policymaking and the potential of the relationship between future evidence production and use.

A Literature Review of Individual Placement and Support (IPS) for Forensic Patients and Implications for Future Research

The positive correlation between work and health is widely acknowledged and evidenced; and a strong predictor for successful community integration for forensic patients. Conversely, a lack of vocational opportunities progressively damages health, and potentially leads to disability, exasperation of mental illness and decreased life expectancy [1]. A review and literature search was undertaken to ascertain how vocational rehabilitation, specifically the individual placement and support model (IPS), within forensic settings can assist those transitioning from secure units to community living. Methods: A literature search carried out between January-March 2018 comprised of literature a) published post-2008, b) in English, c) focused on forensic settings and/or forensic patients, and d) peer-reviewed literature from academic journals. Excluded literature included: unpublished results, such as protocols, supplements, dissertations, and poster presentations; primary research was prioritised over opinion pieces or secondary reviews. Following the Department for Work and Pensions (DWP) recommendations for improved employment support for those with mental health illness, legislation concerning greater work opportunities was successively introduced. Therefore, literature published post-2008 allowed for Government whitepapers [2] based upon these recommendations to be incorporated. In addition, it also reflects pertinent developments in the field of occupational therapy, following [3] review, which criticised current forensic research as weak, lacking relevancy and methodological rigour. Conclusion: IPS research has primarily utilised quantitative data, measuring job tenure and risk-reduction, rather than depth of experience of patients, which could greatly improve occupational therapy practice and service delivery. IPS’ efficacy has been recommended within forensic institutions, yet little research exists for IPS’ impact within community settings.

Pre-school practitioners, child poverty and social justice

Purpose – Several ideas exist about social justice and how inequalities can be tackled to help families and children in poverty. The Coalition government released the UK’s first Child Poverty Strategy in 2011. Pervaded by neoliberal ideology, the strategy mentions “empowering” pre-school services and practitioners within the childcare market “to do more for the most disadvantaged” (Department for Work and Pensions (DWP) and Department for Education (DfE) 2011, p. 35). The purpose of this paper is to bring to light how Early Childhood Education and Care (ECEC) practitioners across England have engaged with policy discussions and adopted expectations concerning their place in addressing child poverty. Design/methodology/approach – Using a phenomenological qualitative research design the paper draws upon 30 interviews with pre-school practitioners in three geographic areas of England. All interviewees worked with families and children in poverty and were senior ECEC practitioners within their pre-school settings. Findings – Many interviewees shared the Coalition’s construction of child poverty as a problem of “troubled” parenting. These views pervaded their interaction with parents and intersected with the regulatory influence of “policy technologies” to influence their practice within a context of austerity cuts. This limited practitioners’ poverty sensitivity and their promotion of social justice. Therefore this paper concludes by critiquing the contribution which ECEC practitioners can make to addressing child poverty. Practical implications – The findings suggest there may be a need for poverty proofing toolkits in the pre-school sector. Originality/value – This paper provides a rare insight into how pre-school practitioners have engaged with, adopted and adapted assumptions about their role within policy discussion over child poverty and the promotion of social justice.

The Emerging Talent Scheme: Accelerated development for high potential leaders

This article presents an insight into the Emerging Talent (EmT) development process at the Department for Work and Pensions (DWP). It outlines the selection process, the perceptions of the process, and evidence from the most recent evaluations.

Using administrative data for constructing sampling frames and replacing data collected through surveys

The UK Government agencies have an interest in making greater use of administrative data. This paper discusses the methodological challenges of using administrative data held by the Department for Work and Pensions (DWP) for constructing an alternative sampling frame for the Family Resources Survey (FRS) and for replacing income data collected in the FRS. The analysis shows that administrative data would provide a good basis for sampling the FRS by linking to socio-demographic data held administratively, which would be advantageous for sampling specific sub-populations (e.g. types of benefit recipients or households with children). Sampling using administrative data also potentially offers more representative population sampling by including some addresses currently excluded from the small users Postcode Address File (PAF) but which are important to DWP, such as people living in care homes. However, comparing FRS questions and income data held administratively, suggests little overlap. Therefore, limited gains may be realised from shortening the length of the FRS by using income data from administrative sources.

Welfare reform and labour market activation

In 2010, the UK’s Coalition Government published its White Paper on welfare reform: Universal Credit: Welfare that Works (DWP, 2010). Although mostly a continuation of the reforms of the last Labour Government, the ideas contained in the Department for Work and Pensions (DWP) document were distilled in long gestation during the Conservatives’ period in opposition, led by the Centre for Social Justice (CSJ), a think-tank established by Ian Duncan Smith, the current Secretary of State for Work and Pensions. The CSJ’s views on benefit reform were set out in the doorstep-like publication Dynamic Benefits (CSJ, 2009) which formed the basis for the Conservative Party’s campaign on the issue in the 2010 election. Both the DWP and CSJ documents dwell on a number of shortcomings identified in the existing system of social security, including complexity, poor incentives to work, and unsustainable costs, although in the CSJ document there is also considerable emphasis on the encouragement of desirable behaviour. The proposals formed the basis for the introduction of the Welfare Reform Bill, which received Royal Assent in 2012. Central to the reform is the introduction of Universal Credit, which will begin taking claims in October 2013, with the aim of complete transition by October 2017. It will replace a range of existing means-tested benefits and tax credits for people of working age including Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance, Housing Benefit, Child Tax Credit, and Working Tax Credit. To serve as a reminder that welfare reform is a never completed task for governments, it can be noted that one of the benefits designed to be replaced by Universal Credit – Employment Support Allowance (ESA) – is barely four years old, itself replacing Incapacity Benefit. The grand design is in the merging of out-of-work and in-work benefits in order to enable the introduction of a single taper rate – the rate at which benefits are

The Welfare Reform Act: poverty and the impact on people

224 British Journal of Community Nursing Vol ?, No British Journal of Community Nursing Vol 17, No 5 The Welfare Reform Act received Royal Assent on 8 March 2012. The Act legislates for the biggest change to the welfare system for over 60 years, bringing with it a wide range of reforms that will deliver the commitment made in the Coalition Agreement to make the benefits and tax credits systems fairer and simpler. The intention is to create the right incentives to get more people into work by ensuring work always pays, protecting the most vulnerable in our society and delivering fairness to those claiming benefit and to the taxpayer. The Act has the potential to simplify the benefits system, and this should be welcomed – but only if this is done in a fair and consistent manner. The Government’s comprehensive spending review and their plans for welfare reform continue to gather speed. The impact of these reforms, and they are far and widereaching, will be felt by a number of people who have long-term health conditions and disability – the people that community nurses care for on daily basis. It is suggested that there are many people living with long-term conditions who report that the benefits assessments they receive are unfair, and do not recognise the impact that their condition has on their lives (National AIDS Trust and Terence Higgins Trust (AIDS Trust), 2010). In some cases benefits assessors have refused Employment and Support Allowance, and unfair assessments are carried out by people who do not understand the person’s condition, resulting in some grossly unfair refusals of benefit. Changes to the benefits system have to be done as fairly as possible for people living with a range of disabilities and medical conditions. It is essential that the Department for Work and Pensions (DWP) ensures that assessors are provided with appropriate training and guidance for the conditions they are assessing, and that would include adequate awareness of a range of long-term conditions and an understanding of the impact that living with these conditions has on a person’s health and wellbeing. One in six people, for example, living with HIV has suffered severe poverty in the past three years (AIDS Trust, 2010). Living in poverty can have a detrimental impact on the health and wellbeing of those people living with a disability; disability and poverty go hand in hand. People with a disability are already in a position of vulnerability as a result of the attitudes of society coupled with the nature of their long-term condition, causing, for example, isolation and loneliness. The Government has announced further cuts to the Work and Pensions budget that could potentially have a severe effect on the lives of many people living with long-term conditions and claiming benefit. Recently the Government was defeated in its plans for restricting Employment and Support Allowance (ESA). It was calling for ESA to be means-tested for some people claiming the benefit for more than one year, but in the House of Lords peers rejected that part of the then bill, instead voting through an amendment to permit at least two years of ESA without means-testing it. The detail within the Act should be of interest and concern to all nurses and health professionals, as this would mean, for example, that someone living with a long-term health condition, who is unable to work, might not be entitled to ESA if they have savings or a partner who is employed. Nurses should be bothered about this. They offer care for the disenfranchised, and they see how people live: they experience the realities of people’s lives. Some of the people that nurses care for who need health and social support may be denied this as the ESA assessments may be carried out unfairly. Much of this is against a backdrop of the Government’s intention to reduce the DLA bill by 20%. The Chancellor of the Exchequer in the latest budget has warned that spending on state benefits is to be curbed in order to protect other departments from deeper cuts. He stated that welfare costs, if not reformed, would consume a third of all public spending. The impact of the Government’s plans will mean that the poverty crisis experienced by people living with long-term conditions will only get worse, exacerbating the vicious circle that is associated with poverty and poor health, clearly outlined in the Marmot Review (2010). The cycle of poverty is more than a socioeconomic issue; it has the ability to impact on health, wellbeing and quality of life for generations that knows no boundaries. If you are concerned with health then you also have to be concerned with fiscal policy such as that being considered and implemented by the present Government. BJCN

An examination, through roles of accounting, of the commissioning of public services from the third sector: the case of a DWP funded initiative

The commissioning of public services from the third sector is explored. The article is based on a qualitative review of pilots for a Department for Work and Pensions (DWP) project— ‘LinkAge Plus’—for people aged over 50. The article offers organizations and policy-makers new insights into the issues faced by the third sector and commissioners of services. The main issue identified is the fragility of the accounting information used to make decisions and monitor progress.

Proposals to change UK benefit system worry cancer charity

Macmillan Cancer Support has criticised UK Government proposals to reform the benefi ts system. The plans would lead to “seriously ill cancer patients in the middle of gruelling chemotherapy [being] forced to prove they are too sick to work” said the charity. The Department for Work and Pensions (DWP) said that it was disappointed with Macmillan’s stance and maintained that its proposals would help cancer patients. The row centres on the Employment Support Allowance (ESA), a benefi t paid to individuals whose ability to work is impaired by illness or disability. Claimants fi rst undergo a Work Capability Assessment (WCA). Eligible individuals are then grouped by their ability to work. Those judged to be unable to work, and eligible for unconditional fi nancial support, are placed in the support group. Patients undergoing intravenous chemotherapy are automatically entitled to enter the support group. Macmillan contends that patients undergoing oral chemotherapy for less than 6 months and certain site-specifi c radiotherapy should be similarly entitled. The government accepts that these treatments can be equally debilitating but suggests a wholesale reworking of the system for assessing cancer patients. Automatic exemption from the WCA would disappear, but the government reckons the new system would result in increased numbers joining the support group. “Our proposals would ensure a person would only be asked to attend a face-to-face interview when absolutely necessary” emphasised a DWP spokesperson, adding that the plans were within the spirit of Macmillan’s previous recommendations to the department. Cases would be decided on an individual basis with written evidence from health-care professionals. The DWP notes that Malcolm Harrington, who leads the independent review of the WCA, does not believe the proposals will lead to unnecessary and stressful assessments. Macmillan’s Thomas Cottam cites problems with the WCA (40% of appeals against decisions not to award the ESA have been upheld). “We don’t feel it delivers the right results for cancer patients at that crucial time during treatment” he said, adding that the uncertainty would cause additional worry to patients. “The principle of automatic entitlement is very important” he said. “It provides peace of mind for patients”. Plans to introduce the changes in April, 2012, will now be postponed while the government undertakes an informal consultation.