Employment and Support Allowance

Employment and Support Allowance (ESA) is the UK welfare benefit designed to give financial support to people having difficulty finding employment because of a long-term illness or disability. ESA was also designed to shift recipients off the benefit and back into work once they had recovered from their illness or had retrained.

ESA was introduced in 2008 for fresh claims to replace three older benefits: Incapacity Benefit; Income Support paid because of an illness or disability; and Severe Disablement Allowance. From October 2008, these three older benefits were no longer available to new claimants, although people already on them were unaffected at first.

Between 2011 and 2014, most of the people who had been on Incapacity Benefit or Income Support since before October 2008 lost their entitlement to their "legacy" benefit: established recipients were assessed for a second time using a new test with more stringent criteria - the Work Capability Assessment - to see whether they qualified for ESA instead. The belief in Whitehall was that a million of these people - 40% of the entire caseload - were not disabled enough to qualify for ESA or otherwise could return to work within two years after receiving back-to-work training.

New Labour designed ESA and the Conservative-Liberal Democrat coalition expanded its scope. All three parties expected ESA to save billions of pounds each year from the social security budget. However, despite the attempts at major welfare reform that have taken place since 2008, the total number of people on out-of-work sickness benefits has remained much the same: about 2.5 million, and not one penny has been saved from the out-of-work sickness and disability benefit budget.

The scale of the allowance

The basic weekly allowance plus additional components from April 2016 is given below (the basic amount is lower for claimants under 25):

	paid in weeks 2*-13	paid from week 14
Basic allowance	£73.10	£73.10
Work-related activity component **	———	£29.05
Support component **	———	£36.20

* No money is paid for the first week ** only one component is payable

In addition, an enhanced disability premium of £15.75 a week may be paid to people receiving the support component of income-related ESA. In some circumstances, an additional severe disability premium of £61.85 a week may be paid.

From April 2017, the work-related activity component will no longer be available for new claims (or for reclaims, if more than 12 weeks has elapsed since the last period of receipt of ESA).

Who can claim?

An individual can put in a claim for ESA if they satisfy all of these conditions:

• They have a fit-note (previously known as a 'sick-note')
• They are over the age of sixteen
• They have not reached State Pension age
• They live in the United Kingdom

They will not be paid ESA if they are entitled to Statutory Sick Pay (this usually means 'if they have a job', but there are exceptions) and it is not possible to receive ESA at the same time as the other main out-of-work benefits i.e. Jobseekers Allowance - received by 635,000 people - or Income Support, given nowadays mainly to 437,000 lone parents. Universal Credit, which is received by more than 200,000 people nationally, can contain a component analogous to ESA.

ESA can be either contributory or income-related. If claimants have paid enough National Insurance they can claim contributory ESA for up to one year if they get the work-related activity component, or indefinitely if they get the support component. Income-related ESA is for people who have not paid enough National Insurance and is subject to a means test and certain other conditions (although the amount paid as contributions-based ESA can also be affected by financial circumstances). Income-related ESA is not time-limited.

Income-related ESA is not usually subject to Income Tax, but contribution-based ESA is. If a spouse or partner is also receiving out-of-work benefits, this might affect entitlement.

The claims process

Someone wanting to claim ESA will need a medical certificate, i.e. a sick-note, signed by their GP to say that they are not fully fit for work. The new claimant must then contact the Department for Work and Pensions (DWP), usually by phone, who will log their claim and usually post them a questionnaire to complete (except in rare circumstances where a full assessment isn't required, such as when a doctor has officially certified the claimant as being likely to die within six months). The completed form must then be sent in the envelope provided to the Health Assessment Advisory Service - the trading name of the assessment provider, Maximus.

Once a person has submitted a claim for ESA, they will normally be paid 'assessment rate' ESA at the same rate they would be paid if they were on Jobseekers Allowance - except for the first week, in which nothing is paid as the DWP considers it "self covered". At some point in this 'assessment phase' - in theory, after thirteen weeks, but, since 2013, very much longer - a Work Capability Assessment will normally be carried out to determine whether the claimant: a) is disabled enough to qualify for a higher rate of ESA or b) does not, in fact, qualify for ESA at all. Each assessment usually takes about an hour and a half and costs the DWP around £190.

The ESA50 claim form, together with any other information sent with it by the claimant, will first be read by a qualified healthcare professional employed by the outsourcing firm, who will then decide on whether a face-to-face medical assessment is necessary: some people with severe disabilities can be granted ESA based solely on the documents supplied, if that is clear from the paperwork. For this reason, Maximus encourages new claimants to send as much relevant information as possible and give a detailed description of their disability when filling in the claim form.

Assessing capability for work

Main article: Work Capability Assessment

The Department for Work and Pensions (DWP) contracted Atos to perform the core medical assessment - the Work Capability Assessment (WCA) - when it introduced the new benefit. Maximus took over the contract - worth £170million a year to the US firm - from Atos in March 2015. The WCA's performance in 2010, 2011 and 2012 was reviewed by Professor Malcolm Harrington and in 2013 and 2014 by Dr Paul Litchfield.

The assessment is often described as consisting of two separate assessments. In practice, if they have a face-to-face assessment, an individual claimant will experience only one assessment on the day (the decision-making is done afterwards). The two stages are:

• The 'limited capability for work' assessment, which determines whether the claimant is entitled to ESA at all.
• The 'limited capability for work-related activity' assessment, which tells the DWP whether somebody who has passed the first stage of the test is able to take part in 'work-related activity'. It also influences the rate of ESA paid to the claimant.

There are two groups of successful ESA claimants: the Work-Related Activity Group and the Support Group.

ESA terminology

ESA is often loosely described as being for people who are 'unfit for work', while the official term 'limited capability for work' is not clear in its meaning. In fact, people on ESA can and do take suitable jobs when the opportunity arises, without their impairment necessarily having improved - on paper, relatively few people receiving ESA are incapable of any work whatsoever.

People in the Support Group tend to have the more severe impairments, they are classed as having 'limited capability for work' and they are not required to prepare for work. The Work-Related Activity Group contains people who also have 'limited capability for work' because of their poor health, but they are required to participate in pre-employment coaching because they are deemed likely to work in the future - specifically, within two years.

Fundamentally, ESA is for people facing significant extra barriers to work. All jobseekers face some barriers to work, such as a lack of experience or childcare commitments. The extra barriers, as far as ESA is concerned, are those imposed by a disability or a long-term health condition. In this context, 'significant' refers to the threshold for eligibility, which was determined when ESA was designed (although it has been modified subsequently in legal rulings). For example, an inability to grasp a small object between finger and thumb is deemed to be significant.

Limited capability for work

At their WCA, an ESA claimant must be found to have 'limited capability for work' in order to qualify. The testing process gauges the claimant’s ability to perform up to 17 activities; these activities are set out on the ESA claim form. For each activity, a claimant can score 15, 9, 6 or 0 points: the more severe their disability, the more points they will score. Points are scored by having physical impairments, mental ones or a mixture of the two (if they are likely to significantly affect the claimant's ability to work). In order to be entitled to ESA, a person will need to score at least 15 points in total.

Other factors, such as some aspects of pregnancy, are also considered by the assessor, who will be a nurse, doctor, physiotherapist or occupational therapist; these factors do not operate on a points system but might nevertheless qualify the claimant for ESA.

Limited capability for work-related activity

This is about trying to decide whether a successful claimant of ESA is fully capable of taking part in interviews and pre-employment training, or whether their ability to do so is limited to a significant degree.

If someone who is found to be entitled to ESA is found not to have 'limited capability for work-related activity', they will have to take part in pre-employment training and will receive the work-related activity component of ESA.

If the claimant is found to have 'limited capability for work-related activity', they will be entitled to the support component of ESA after 13 weeks and will not have to undertake work-related activity or have work-focused interviews. Someone will go into this category - the Support Group - because they have one or more severe functional disabilities (such as being unable to move 50 metres by themselves) or if certain other conditions apply, such as where the 'risk' criteria apply.

A DWP official makes the final decision on entitlement, based on all the available evidence.

Success rates of claims

Recent data on the success rates of new ESA claims show that after their assessment, 62% of people are now declared 'unfit for work' and go into the Support Group; another 13% are also found to be 'unfit for work' but are deemed able to take part in work-related activity; 25% are found to be ineligible for ESA. Outcomes after reassessments are even better, from a claimant's point of view.

How ESA and its eligibility test developed

Conservatives 1992-1997

The first bespoke medical test for sickness benefit entitlement was brought in by John Major's government in 1995 when Incapacity Benefit was introduced to try and cap the rising number of people on these benefits. The All Work Test was carried out by doctors working for the government and, unlike before, set out to assess a claimant's ability to cope with a range of occupations, not just their old trade.

New Labour 1997-2001

Frank Field

In May 1997, Frank Field was made Minister for Welfare Reform. He approved of the principle of self-help through mutual organisations such as friendly societies, he thought the state should have only a small role to play in the provision of welfare, and he disliked means-testing and non-contributory entitlement. These ideas were out of step with those of the new Chancellor, Gordon Brown, in particular, and Field's ministerial tenure was short-lived.

A Green Paper published in 1998 foreshadowed New Labour's approach to out-of-work benefit reform from that point on: being in work was vital and the government would encourage people on benefits to find jobs, using the carrot and the stick; the claimant's contribution would be to try to find work; and Incapacity Benefit would be partially means-tested, with people receiving an occupational pension incurring a deduction in the amount of Incapacity Benefit they would receive.

Personal Capability Assessment

After 2000, some Incapacity Benefit recipients underwent the new eligibility test - the Personal Capability Assessment - to establish whether their condition had improved: if it had, benefit payments could be withdrawn; otherwise, a Capability Report was drawn up by the examining doctor and used by Job Centre staff to plan ways to boost recipients' employability, in the hope of returning them to work. Nevertheless, the Incapacity Benefit caseload continued to rise.

New Labour 2001-2005

In 2001, on the first full day of New Labour's second term in office, the Department of Social Security was amalgamated with the Department for Employment to form the Department for Work and Pensions (DWP). The new department set to work overhauling the test for Incapacity Benefit and vastly expanding its scope.

Replacing Incapacity Benefit

New Labour believed that work was the best route out of poverty, so it sought ways to move people on sickness benefits back into jobs. To that end, a new benefit was envisaged that would 'accentuate the positive' rather than lead recipients with moderate disabilities to feel that they were permanently incapacitated. However, policymakers acknowledged that some people really were incapable of all work so they needed a new medical test, one that would do more than just give a 'yes or no' answer to the question of sickness benefit entitlement. The new test would do three things:

1. Identify claimants who were already capable of work - they would get no sickness benefit at all
2. Identify claimants at the other end of the disability spectrum, who were very disabled and could not be expected to work
3. Identify claimants in the middle, who could be helped to find a job despite their disability

The belief in the DWP was that the new policy would not just cap the total number of people on sickness benefits, as Incapacity Benefit was supposed to have done, but actively reduce it to a small group of people with severe disabilities and another modestly-sized group who were undergoing fixed-term pre-employment training.

The new policy would achieve its objective in four ways:

1. The new benefit would be harder to get in the first place, because its eligibility test would be tougher
2. All new recipients would be reassessed at appropriate intervals in the expectation that the health of many would improve
3. Successful claimants with mid-range disabilities would be expected to prepare for a return to suitable work
4. Once the new testing process had bedded in, there would be a mammoth re-evaluation of the claims of more than two million long-term Incapacity Benefit recipients, in the belief that as many as 40% were able to work

The background trend

While the new sickness benefit was still at the planning stage, the total caseload peaked in 2004. Since then, the background trend has been gradually downwards.

The main reason for this change in trajectory was that World War Two 'baby boomers' on sickness benefits had begun to draw their State Pension instead. Other reasons were: men suffering from industrial diseases, such as asbestosis and silicosis, caused by working in mines, shipyards and other hazardous environments, were dying prematurely; eligibility criteria had become stricter since 1995; and the economy had improved and was creating more jobs.

"Thinking the unthinkable"

In February 2005, as another general election loomed, the BBC analysed New Labour's record on welfare reform:

Thinking the unthinkable on the welfare state has been one of the New Labour mantras since before the party was elected in 1997. So it has been a disappointment to many [...] on the Labour benches that, eight years later, the thinking has still to produce any concrete results.

On the same day, the Welfare Secretary Alan Johnson announced plans to replace Incapacity Benefit with two new benefits: "Disability and Sickness Allowance", for people deemed too ill to work; and "Rehabilitation Support Allowance", paid at the same rate as Jobseekers Allowance to less disabled people, who would be 'supported' by the DWP back into work. In reality, no benefits with these names ever materialised, and the policy behind "Rehabilitation Support Allowance" was still being debated more than a decade later.

Atos gets the contract

In March 2005, there was a sign of action on the ground: Atos was awarded the contract to work with the DWP to build the software programme that would be used in the assessment of claims for the allowance that would take the place of Incapacity Benefit. The firm, which was already carrying out the DWP's existing disability assessments, would employ hundreds more healthcare professionals to carry out the new test once it went live - in late 2008.

New Labour 2005-2010

This term of office was notable for the high turnover of Welfare Secretaries:

1. David Blunkett - 6 months in post
2. John Hutton - 20 months in post
3. Peter Hain - 7 months in post
4. James Purnell - 16 months in post
5. Yvette Cooper - 11 months in post

In January 2006, John Hutton published a White Paper outlining the government's latest plans for welfare reform: the benefit that would replace Incapacity Benefit would be called Employment and Support Allowance and its "gateway" assessment would be transformed. The resulting Welfare Reform Bill was introduced to Parliament for consideration in July 2006. Over the course of a decade, Hutton expected the number of people on Incapacity Benefit to fall by one million, thereby saving £7billion a year.

The Freud report

In December 2006, Tony Blair appointed David Freud, a former vice-chairman of investment banking at UBS, as an advisor on out-of-work benefit reform. Freud's 2007 report - dubbed 'the Freud report' but officially titled Reducing dependency, increasing opportunity: options for the future of welfare to work - called for the greater use of private sector companies who would be paid by results, for substantial resources to be made available to help people on Incapacity Benefit back into work, and for a single working-age benefit payment to replace Housing Benefit, Jobseekers Allowance, etc. His central thesis was that spending on 'delivery' - such as schemes to get people back to work - would save money in the long run because there would be fewer people being paid money in the form of benefits. The DWP coined the term 'Invest to Save' to describe this idea and referred to it in-house as "the AME-DEL switch".

On 3 May 2007, the Welfare Reform Bill received royal assent and a week later Blair announced his decision to leave Downing Street.

In July 2008 a Green Paper was published, which James Purnell said was "inspired by the reforms proposed by David Freud". It declared that "between 2009 and 2013, all Incapacity Benefit claimants will be reassessed using a medical assessment called the Work Capability Assessment" that would divide them into three groups: fit for work; unfit for work but fit for 'work-related activity'; or fit for neither. In the same month, Professor Paul Gregg was asked by the DWP to conduct a feasibility study of "conditionality" - a compulsory quid pro quo - as it might be applied to sickness benefit claimants. When responding to the Gregg Review, the DWP said that the study had recommended that conditionality be applied to "the vast majority of people in receipt of Employment and Support Allowance".

ESA introduced

In October 2008, ESA and its eligibility test, the Work Capability Assessment, were introduced for new claims. Reformers were disappointed to find that the total number of people on sickness and incapacity benefits went up, largely as a result of the financial crisis of 2008 and the consequent rise in background unemployment.

Plans were made to tighten up the eligibility criteria still further - something that would set the Incapacity Benefit reassessment programme back by two years. At the same time, James Purnell said that these and other changes would ensure that "only those who are genuinely incapable of work" would get full ESA, by which he meant people in the Support Group. Other sickness benefit recipients would have to comply with plans drawn up in conjunction with the DWP's private partners to get them back to work.

Independent review

Section 10 of the Welfare Reform Act 2007 said of the WCA:

The Secretary of State for Work and Pensions shall lay before Parliament an independent report on the operation of the assessments under sections eight and nine annually for the first five years after those sections come into force.

Under New Labour, the DWP commissioned no such report.

2010 manifesto

The Labour Party manifesto, drafted by Ed Miliband and published before the general election in 2010, declared that if Labour won:

More people with disabilities and health conditions will be helped to move into work from Incapacity Benefit and Employment and Support Allowance, as we extend the use of our tough-but-fair work capability test. This will help to reduce the benefit bill by £1.5 billion over the next four years. We will reassess the Incapacity Benefit claims of 1.5 million people by 2014, as we move those able to work into jobs.

Coalition 2010-2015

In early 2011, with a Conservative-led government, an even more stringent test and the Incapacity Benefit reassessment programme now underway, the caseload's falling trend resumed - until the middle of 2013, when the caseload began to grow again after fresh guidance had to be issued on how to judge fitness for work.

By 2015, the picture was clear: in the absence of the huge fall in recipients prophesied by the architects of ESA, and in spite of the broadly downward natural long-term trend, the total caseload was little different from when ESA was introduced.

As a reflection of this failure of ESA to achieve its goal of shifting large numbers of people off benefits and into work, the cost to the Exchequer of out-of-work sickness benefits did not fall at all after ESA was introduced: the annual cost is now predicted to rise to £14 billion or more in the course of 2016, largely because more people than anticipated have gone into the Support Group - particularly since the second half of 2013.

The future of ESA

In January 2016, the Conservative Welfare Secretary, Iain Duncan Smith, announced that ESA was "fundamentally flawed" and declared that a brand new policy, which would get nearly all ESA recipients back to work, would be unveiled within weeks. A hint of what that policy might be was given in a detailed report on ESA published the following month by Reform, the right-of-centre think-tank:

• Effectively, ESA would be abolished: the amount of money paid each week to the claimant would be reduced to the level of Jobseekers Allowance
• The resultant savings would be ploughed back into the Personal Independence Payment to balance the drop in ESA
• The WCA might be replaced by another assessment that set out to identify any barriers to work faced by the claimant, but which would play no role in determining eligibility to benefits
• As a way to 'nudge' claimants towards overcoming those barriers, extra money might be made available to fund a tailored programme of rehabilitation - although participation in this could be made a requirement of continued receipt of the benefit.

In March, Duncan Smith unexpectedly resigned after a clash with the Chancellor of the Exchequer, George Osborne. In his resignation letter, 'IDS' complained that there was "not enough awareness from the Treasury, in particular, that the Government's vision of a new welfare-to-work system could not be repeatedly salami-sliced". Duncan Smith's replacement quickly declared that there would be no new welfare policies, other than those set out in the Conservative Party manifesto of 2015, in the current parliamentary term.