Making benefits work: Improving support for disabled people

Orli Negri

Harriet Cavanagh

This report explores the experiences of disabled people using the benefits system. It highlights the challenges disabled people face. And sets out what disabled people told us needs to change.

We have known for a long time that the benefits system is complex. That accessing it can lead to stress and anxiety. And that the system is too-often based on catching people out.

This report makes it clear how common these experiences are today.

Disabled people we spoke to told us that they fear having to access support. That they worry about discrimination. And for those who can work, there is little support if a job does not work out.

Disabled people also told us that it is a fight to access financial support. Many said that the system is too complex.

It is clear from this research that major reform and change is needed.

Participants spoke often of ‘trust’ being the foundation for a better system, and of the need for empathy and kindness. Too often, people said they were not believed, have been made to feel second-class, and were left in impossible situations.

We hope that this research acts as a wake-up call to Government, to policy makers and to those involved in the benefits system. We know that tinkering at the edges will not change much. But we know what will. We must rebuild our welfare system so that everyone who needs to use it is treated with kindness and respect. And, crucially, that they are trusted as experts of their own lives.

We are grateful to the participants of this research who shared their experiences of work and navigating the benefits system with us.

Finally, we are grateful to the Joseph Rowntree Foundation for funding us to undertake this work.

What is in this report?

Scope and the Joseph Rowntree Foundation have partnered for this research. This report explores the experiences of disabled people using the benefits system. It highlights the challenges disabled people face. And sets out what disabled people told us needs to change.

Background

We know that life costs more if you’re disabled. Many disabled people who receive Universal Credit live in serious poverty. Most struggle to afford basic needs. And around half are experiencing food insecurity. This means their households had to reduce the amount, quality or variety of food.

In recent years, disability benefits in the United Kingdom (UK) have been a target for budget cuts across different governments. While the government and the media often talk about the low number of disabled people in work, the focus is mostly on cuts to benefits instead of fixing the barriers to employment.

Even though many disabled people want to work, there is still a gap of around 30% between disabled workers and non-disabled workers. And disabled workers are also more likely to have unstable jobs.

What did the report find?

We asked disabled people on our Lived Experience Research Panel about their experiences of using the UK benefits system. And what they thought could make the system better. This is what they told us:

The benefits system lacks understanding.

There is poor understanding of disability throughout the system. Disabled people feel that it is not there to support them.

The system is failing disabled people.

The system is not working for disabled people who cannot work. It also does not work for those who are already working or wanting to work.

The process is confusing and stressful.

People struggle to understand how the system works and what support they can access. Assessments cause a lot of anxiety and do not address the real barriers disabled people face. Often, disabled people feel they are not believed. They are treated as second class citizens and left in difficult situations.

Disabled people are harmed by pressure and shaming around benefits.

Government and media rhetoric impact negative public attitudes. People are made to feel unvalued by society and many feel forced to justify needing to claim.

Health and the job market are the real barriers.

The biggest barriers for disabled people entering the job market are not a lack of skills or motivation. The main challenges are not being well enough (93.8%), work making their condition worse (91.8%), barriers in the job market (86.3%), and fear of pressure from the benefits system (86.3%).

The benefits system creates its own barriers too.

Support is either not available for those who need it or is forced on those who do not. The system feels intimidating and impersonal, and sanctions create fear. This leads to distrust. Many people worry that getting support or trying out work could harm their benefits.

Support offered through Jobcentres does not meet disabled people’s needs.

People are not given information they need. And training or support is often not accessible or relevant.

Disabled people fall or are pushed out of work when employers do not support them.

This means that many people could still do their job with adjustments, after a period of sick leave or with a role change. But they are not allowed to do so.

What needs to change?

We asked disabled people what they would like to change about the benefits system. They told us:

• More information and support is needed. This includes:
  • finding suitable work opportunities and training courses
  • offering more personalised support
  • helping with adjustments
  • making changes to Access to Work
  • providing support while in work
• Staff should improve their knowledge of disability. This includes training and hiring more disabled employees.
• The process of trying out work must be risk free. This includes allowing a grace period and changing work restrictions.
• The Department for Work and Pensions (DWP) needs to collaborate with employers. This will help improve conditions and address the lack of opportunities.
• Employers need to stop people falling out of work. Employers must:
  • make adjustments
  • offer appropriate sick leave
  • improve flexible working options
  • support disabled people if their needs change
• An empathetic approach is essential for support. It should be based on listening and respecting lived experience.
• There needs to be a shift away from a punitive culture. This involves reducing pressure and accepting people’s needs, barriers, and goals. Without the risk of sanctions.
• Support should be accessible and optional. Support must be easy to access, optional, and provide practical help with clear advice. This includes information about their legal rights at work.
• Communication and information must be clearer and more effective. This will help ensure that everyone understands their options and rights.
• We must stop the stigma that harms disabled people. This includes addressing the shaming faced by those who need to claim benefits.
• Trust should be restored through collaboration. Designing services with disabled people will help to rebuild trust and address the power imbalance.

Policy report

JRF have published a joint policy report, built on findings from this research. It puts forward some broader findings and policy recommendations.

We hope this research highlights the urgent need for change to the Government, policymakers, and everyone involved in the benefits system. Rebuilding our welfare system is essential, so that everyone who needs it is treated with kindness, respect, and trust.

In recent decades, disability benefits have been a main target for UK government budget cuts. This focus appears to remain fairly stable across time and political parties. But we know that life costs significantly more if you’re disabled (Scope, 2023a; Scope, 2024a; WPI Economics, 2024). And that disability benefits often do not fully cover these costs (Scope, 2024a).

Another recent analysis has also revealed alarming levels of poverty among disabled claimants of Universal Credit. Most are in material deprivation. This means they do not have access to essential items and activities. And around half are experiencing food insecurity (JRF, 2024). This means their households had to reduce the amount, quality or variety of food. Such cuts can therefore be detrimental to many disabled people and their households.

Disabled people’s employment has been receiving much attention in political and public spheres. Many point to the lower rates of employment among disabled people as a major issue. This emphasis, however, tends to look for solutions within benefit budgets. It does not directly inspect employment barriers.

The repeated use of the concept of ‘economic inactivity’ in the context of disability benefits reflects a key issue. Supporting those in need is a moral obligation for every society. Social security or benefits are meant to serve this purpose. Yet instead of being a device to support those in need, this narrative positions disabled people in the context of a financial debt to national economy.   

Some claimants of health-related Universal Credit or Employment and Support Allowance are already working. However, not everyone can move into work or work more. Crucially, no one should be forced to. Evidence suggests that many disabled people are interested in working (DWP, 2020). But they are not able to try or move into work for different reasons.

Disabled people’s employment rate is lower than non-disabled people’s employment rate. This measure, called the 'disability employment gap', has remained around 30% over the last decade (Scope, 2023b). Disabled people are also twice as likely to leave their work (Scope, 2023b).

For work to be sustainable, it needs to be secure. Measures of work security include reasonable and stable pay and access to rights and protection. It also includes contract-based commitments around the amount and future of people’s work. A recent report has revealed disabled people are 1.5 times more likely to be in severely insecure work compared to non-disabled workers (The Work Foundation, 2023). Insecure work means work without guaranteed hours or future work, like temporary or zero hour contracts. With unpredictable pay or pay too low to live on. Or without access to employment rights and protections.

Disabled workers from Black and Asian backgrounds have a slightly higher likelihood to be in insecure work. And being a disabled woman increases this likelihood to 2.2 times. A total of 1.3 million disabled workers are currently in severely insecure work in the UK. Another 430,000 disabled workers are underemployed. This means they are working, but would like to work more hours. (The Work Foundation, 2023).

All these facts demonstrate the imperative need for profound changes in the benefit system and the culture around it. Benefits should be stable and reliable. And they should provide accessible support for disabled people who wish to work.

The current and previous governments have suggested several potential proposals for reform (DWP, 2023). Some of these have, however, raised serious concerns among disabled people.  Consultations with charities and disabled individuals took place before formal government policy proposals. But many feel the final proposals do not reflect people’s wishes or best interests.

Scope and the Joseph Rowntree Foundation (JRF) have partnered for this current project. We wanted to offer disabled people the opportunity to respond to the new proposed changes and consider how they might affect them. As part of this, we also wanted to allow people to share their experiences of the benefits system more broadly. With this aim, we conducted a mixed methods research study to examine possible barriers and solutions to people's move into work.

We will use some terms and abbreviations in this research to describe different parts of the benefit system.

The Department for Work and Pensions (DWP)

The Department for Work and Pensions (DWP) is a ministerial public service department. They are responsible for the benefits, pensions and child maintenance policy. They administer benefits and run Jobcentres. Benefit policy is decided by the government and enacted by the DWP.

Employment and Support Allowance (ESA)

If people cannot work because of disability, they might be able to claim New Style Employment and Support Allowance (ESA).

There are 2 types of ESA: New Style ESA, also called contributory ESA or contribution-based ESA, and income-based ESA. New claimants can only claim New Style ESA.

The 2 groups for ESA are the Work-Related Activity Group (WRAG) and the Support Group (SG).

People can be entitled to New Style ESA and Universal Credit at the same time.    Although the ESA would count as income for somebody’s Universal Credit calculation.

Work-Related Activity Group (WRAG)

ESA claimants might be assessed to have limited capability for work.

People can only be in this group for 12 months, and will receive the lower amount of ESA.

People do not have to work, but a work coach may ask them to do some regular tasks to get ready for work. These tasks are called work-related requirements. And would be recorded as part of someone’s claimant commitments .

Support Group (SG)

ESA claimants might be assessed to have limited capability for work and work-related activity.

There is no time limit for the support group, and they will receive the higher amount of ESA.

People do not have to work or prepare for work.

The Equality Act 2010

The Equality Act 2010 says that discrimination is illegal. The Equality Act 2010 replaced the Disability Discrimination Act. It says that disabled people have the right to ‘reasonable adjustments’ that make jobs and services accessible to them. Access for disabled people is a legal requirement.

This applies to employers, public and private services. Some things such as transport are covered by specific regulations.

Extra costs

Life costs more for disabled people and their families, spending more on essential goods and services like; heating, insurance, equipment and therapies. These extra costs mean disabled people have less money in their pocket than non-disabled people, or go without.

The result is that disabled people are more likely to have a lower standard of living, even when they earn the same.

Jobseeker’s Allowance (JSA)

If people are looking for work, they might be able to claim Jobseeker’s Allowance (JSA).

There are 2 types of JSA: New Style JSA, also called contributory JSA or contribution-based JSA, and income-based JSA. New claimants can only claim New Style JSA. Income-based Jobseeker’s Allowance has been replaced by Universal Credit. People can be entitled to New Style JSA and Universal Credit at the same time.

Income Support

Income Support was a benefit for people on a low income who were not in full-time employment. And had other factors like disability, being a lone parent, or a carer. People cannot make a new claim for Income Support and now would claim Universal Credit instead.

Personal Independence Payment (PIP)

Personal Independence Payment (PIP) is a benefit for disabled people. It is meant to be for people who struggle with everyday tasks or mobility. This is designed to address the extra costs that disabled people face.

It is made of 2 components: the daily living component and the mobility component. People are assessed for their eligibility.  It is not a means-tested benefit. People’s earnings, other income or savings do not affect this.

Reasonable adjustments

The Equality Act 2010 requires an employer to make reasonable adjustments to enable a disabled person to work.

People can get adjustments if they are or become disabled. Or if their condition or role at work changes.

People can ask for reasonable adjustments during recruitment or once they’ve started work. Many reasonable adjustments cost little or nothing. But they can make a big difference.

Universal Credit (UC)

is a means-tested benefit. This means it is for people on a low income and without significant savings.

Universal Credit has a standard allowance. People may be eligible for extra payments, known as elements. These are extra amounts for things like childcare or housing, or if people cannot work because of sickness or disability. The 2 health-related elements of UC are Limited Capability for Work (LCW) and Limited Capability for Work and Work-Related Activity (LCWRA).

Limited Capability for Work (LCW)

Universal Credit claimants might be assessed as having Limited Capability for Work. Someone with LCW does not have to work now, but needs to prepare to work in the future. You will not receive any more money if you’re in this group, if you claimed after 3 April 2017.

Limited Capability for Work and Work-Related Activity (LCWRA)

Universal Credit claimants might be assessed as having Limited Capability for Work and Work-Related Activity. People will not have to work or prepare for work. They receive extra money as well as the standard allowance.

Work Capability Assessment (WCA)

Work Capability Assessment (WCA) is the process where the Department for Work and Pensions (DWP) decides if someone has limited capability for work or work-related activity. This is part of the claim process for a health-element of Universal Credit, or for Employment and Support Allowance.

This happens after someone’s doctor has provided a fit note. There is usually paperwork then an assessment appointment.

Work-related disability benefits

We will use work-related disability benefits to mean benefits disabled people of working age can claim from the Department for Work and Pensions (DWP). If their disability or health condition means they can’t work or it is harder for them to work.

When we refer to work-related disability benefits in this report, we mean Employment and Support Allowance (ESA) or the health-related elements of Universal Credit: Limited Capability for Work (LCW) and Limited Capability for Work and Work-Related Activity (LCWRA).

People are awarded work-related disability benefits after a Work Capability Assessment (WCA).

We use HemingwayApp to make sure our content has: 

• a reading grade between 6 and 8 maximum 
• no “very hard to read” sentences 

Because of the topic of this report, there are some complex words that we cannot remove. This means the Hemingway algorithm shows a higher readability grade than what we would usually aim for. There are also some places where we’ve not been able to reduce very hard to read sentences. 

We have still worked to make our content as accessible as possible. We focused on having: 

• shorter paragraphs 
• shorter sentences 
• bullet points 
• additional headings to help you navigate the content  
• plain language where possible

Research objectives

We focused on the following questions:

What is disabled people’s current experience of claiming work-related disability benefits? To be able to understand the types of change most needed, and to adequately evaluate existing proposals, we first sought to explore people’s experiences of the current system.

We then moved on to focus on needed changes:

• How effective are current white paper (‘Transforming support: the health and disability white paper’. [2023]) and other related reform proposals at supporting people into work? What are potential issues with these proposals?
• What other changes would make the biggest difference to remove barriers and help disabled people into sustainable work?
• What changes would help remove the risk for disabled people who are interested in trying work or engaging with employment support?
• What changes to the work-related disability benefit system would improve people’s experience of the system and make it fairer?

What we did

To answer these questions, we used a mixed method approach across 5 stages:

1. A survey about disabled people’s general experiences of claiming work-related disability benefits
2. Discussion groups and interviews with people currently receiving health-related Universal Credit about their experiences and responses to main policy proposals
3. A survey about assessments, disabled people’s engagement with employment support and barriers to work
4. Deliberative workshop discussion groups with people currently receiving health-related Universal Credit about what they think would help and responses to developed policy proposals
5. A survey to disabled people about policy proposals

We used data from each stage to inform the next one.

Fieldwork took place between February and July 2024.

Qualitative data from our groups and interviews was recorded and transcribed verbatim. We then analysed the data thematically. Thematic analysis is a method for identifying different patterns in the data. As part of this process, we used a deductive and an inductive approach to coding. Codes are patterns of meaning that we found in the data. This means that when looking at the data, we were guided both by some of the things we wanted to find out, and by things that participants raised.

All of the findings presented in this report have been made strictly anonymous.

Participants

A total of 921 participants from Scope’s Lived Experience Panel have taken part in the project (please see full details in the appendix). Each stage had a different number of participants, with some taking part in more than one stage.

Throughout this report, we use the term ‘disabled people’ to describe participants in this research. We used this term to mean people with an impairment, health condition, or access need. Participants in this research all identified as disabled using this definition or received a disability-related benefit.

Scope is a pan-disability charity that promotes the social model of disability. This means we believe people are disabled by barriers in society, not by their impairments or conditions. As part of this, we try to avoid using diagnostic labels when unnecessary.

Instead, we used broad impairment categories from Scope’s unified diversity monitoring questions. These were developed through a content design process which involved gathering best practice research. Then feedback from a diverse group of colleagues, volunteers, customers, and panellists.

Out of the total number of participants in the project, 382 were disabled people who currently receive Universal Credit (UC) with Limited Capability for Work (LCW) or Limited Capability for Work and Work-Related Activity (LCWRA) or Employment and Support Allowance (ESA). Participants’ age in this group ranged from 18 to over 65, and most were women (74.4%). The majority were White British (87.2%). 11.5% were employed (full-time, part-time, or self-employed) and another 10.5% were actively seeking employment.

Participants who currently receive UC, with LCW or LCWRA, or ESA had a broad range of impairment or condition categories (many identified as having more than one category):

A further 66 survey respondents over the whole project had gone through or said they were currently going through the Work Capability Assessment process. Some of these respondents said that they hadn’t had (61) or started (5) the WCA process when they first took part in the project, but had by the time the fieldwork ended. This means we spoke to 443 people who had interacted with the work-related disability benefits claim process.

Our first survey included a sample of 425 disabled people. 35.3% (n=150) of them currently receive Universal Credit with LCW or LCWRA or Employment and Support Allowance (ESA). And another 15.1% (n=64) have had a Work Capability Assessment (WCA) but are not currently claiming these benefits.

Our second survey included a sample of 527 disabled people. 46.9% (n=247) currently receive Universal Credit with LCW or LCWRA or Employment and Support Allowance (ESA). Another 15.7% (n=83) have had a Work Capability Assessment (WCA) but are not currently claiming these benefits.

Our third survey which focused on policy proposals, included a sample of 559  disabled people. 39.5% (n=221) currently receive Universal Credit with LCW or LCWRA or Employment and Support Allowance. Another 11.6% (n=48) had had or are going through a WCA. 78.7% (n=440) of respondents currently receive PIP.

In the first qualitative stage, we spoke with 16 participants who all receive Universal Credit with LCW or LCWRA (4 have  LCW and 12 have LCWRA). They also received a number of other benefits and support, such as Personal Independence Payment (9 participants) and Council Tax Reduction (5 participants) and Employment and Support Allowance (1 participant).

Participants spread across impairment categories (many identified as having more than one category):

• 10 had a chronic or long term condition
• 9 had a mental health condition
• 9 had chronic or long-term pain
• 9 had a mobility impairment
• 7 identified themselves as being neurodivergent
• 6 selected stamina, breathing, or fatigue
• 4 selected a neurological condition (including epilepsy)
• 4 selected learning, understanding, or concentrating;
• 4 selected memory
• 4 selected dexterity
• 3 had hearing impairments
• 2 had impairments to do with speech or language
• 1 had a visual impairment

Throughout our report, when referring to participants impairments or conditions, we have only used terms based on participants’ self-descriptions.

Group participants’ age brackets ranged from 18 to 65.10 participants were women (4 were men, 2 preferred not to tell us). And the majority (15) were White British. Participants lived across England and Wales.

In terms of employment status, most (11) were unable to work due to illness or disability. 4 were employed (part-time or self-employed). 1 was a full-time student.

In the second qualitative stage, we spoke with 8 of these participants again.

Universal Credit (UC)

Universal Credit (UC) is a means-tested benefit. This means it is based on a person’s income and savings. People may be eligible if they:

• are not working or are on a low income 
• are under State Pension age
• do not have savings of £16,000 or more

Disabled people who have an illness or condition that affects their ability to work may also be eligible for “health-related” elements of Universal Credit. These are called “Limited Capability for Work” (LCW) or “Limited Capability for Work and Work-Related Activity” (LCWRA). These are awarded following a Work Capability Assessment (WCA). People may be given one of these elements depending on the outcome of this assessment.

Employment and Support Allowance (ESA)

Employment and Support Allowance (ESA) is another benefit that disabled people can receive.

There are 2 types of ESA:

• New Style ESA, also called contributory ESA or contribution-based ESA
• income-related ESA

If someone has not claimed ESA before, they can only claim New Style ESA.

New Style ESA eligibility depends on someone’s age, condition and income.

They must:

• be at least 16 and under State Pension age and
• have an illness or condition that affects their ability to work

They also must be one of the following:

• a part-time employee, working less than 16 hours a week
• previously an employee or self-employed person
• a full-time student

They also need 2 full years of National Insurance contributions out of the last 3 tax years.

Income-related ESA is a “legacy benefit” that can no longer be claimed. It has been replaced by Universal Credit for new claimants who are on a low income whose ability to work is affected by disability. Many people who claimed ESA in the past are still on ESA. And are still to be moved to Universal Credit.

This report will relate to the process of the Work Capability Assessment (WCA) and the different terms that are part of it. Below is a description of the current WCA process for Universal Credit (UC) and Employment and Support Allowance (ESA).

A WCA is the process where the Department for Work and Pensions (DWP) decides if you have limited capability for work or work-related activity. This happens after your doctor has provided a fit note. There is usually paperwork then an assessment appointment.

The assessment appointment focuses on disabled people’s ability to complete paid work or work-related activity. This is using limited measures of ability to work, like:

• being able to repeatedly move for 50 metres
• moving a light but bulky object such as an empty cardboard box
• reliably completing at least 2 tasks, one after the other

Claimants are put in different groups that have different levels of conditionality. Conditionality means work-related activities a claimant will have to do in order to keep their benefit.

There are 3 possible Work Capability Assessment outcomes:

• Being put in the “Limited Capability for Work and Work-Related Activity” (LCWRA) in Universal Credit or the “Support Group” (SG) for Employment and Support Allowance (ESA). There should be no conditionality and the maximum payment.
• Being put in the “Limited Capability for Work” (LCW) group in Universal Credit (UC) or the “Work Related Activity Group” (WRAG) for Employment and Support Allowance (ESA). There is less conditionality than standard UC or Jobseeker’s Allowance (JSA) and a lower payment compared to LCWRA.
• Being found “fit for work” and not being entitled to working-age disability benefits of ESA, LCWRA or LCW .This means you only receive standard Universal Credit or the legacy benefit Jobseeker’s Allowance.

Work can be different activities or tasks that are aimed at producing purpose, value or meaning. As a concept, work is not limited to being paid. Examples of this include care work, housework or administrative work that people have to complete. Similarly, work is not limited to a specific set of skills, tools or abilities. But in many social contexts, when people talk about work they tend to mean jobs that people are paid for.

People tend to value paid work more than other types of work that might have a bigger value to society or the environment. For example, volunteering or looking after your local area. The same is true for the context of the benefit system. This focus on paid work is particularly problematic for disabled people. This is because paid jobs seem to have significant barriers and consequences if they cannot be maintained (Scope, 2023b).

The following themes describe the values and experiences the disabled people we spoke with attached to work. This related to work in general, and to work in the context of benefits in particular.  

Social views and attitudes towards work and disability

The meaning of work: motivated by the sense of worth associated with work, devalued by the lack of it 

This theme describes people’s views on work, including their motivation and the values they associate with work. It also describes the way not being able to work negatively impacts some people. Scope’s position recognises not everyone can or should work, and does not view paid work as providing more value to individuals or society.

Throughout our discussions, people have frequently talked about work as something that defined a significant part of their self-worth. Beyond the obvious financial advantages, work was seen as something people derived meaning and a sense of purpose from. Although similar meaning could be obtained from non-paid work routes, paid work seemed to hold higher social value. It was seen as a marker of independence.

This feeling appeared to be stronger for those who previously had a job they appreciated or enjoyed. Those who managed to find suitable jobs described working as an empowering and motivating experience:

The ‘non-working’ or Limited Capability for Work and Work-Related Activity (LCWRA) label as mentioned here was mostly perceived more negatively. This sense of negative judgement about not being able to work often had a negative impact on people’s self-worth and self-esteem. Some people described experiencing grief over changes to their work-related capabilities. This was especially true for those who became disabled later in life or whose impairments had changed:  

As will be discussed later, the way the “limited capability for work” benefits are structured appear to leave no space for safely trying out work. This was challenging for those who felt they would be interested in doing some work if they were given the chance.

People highlighted their lack of control over some of these circumstances. They tended to describe not being able to work as an unfortunate position:

Many were motivated but could not find paid work options to suit their access needs.

Some who have lost their jobs after becoming disabled were not used to living without work-related purpose. They were not able to work, but found no support for creating alternative goals. Or finding their individual path for meaning that is not dependent on financial income.

They described how living outside the paid work structure made them feel purposeless and unvalued:

Volunteering

In contrast to paid work, those with volunteering experience talked about the many advantages this provided. They were able to contribute and take part in meaningful activities, but without the strict schedule or pressure of paid full-time work:

Some disabled people we spoke with who were not volunteering expressed an interest in this option. As they thought it may be a more enabling option to explore their capabilities. But many had not explored this idea through fear of triggering a reassessment, and potentially being pushed into work because of it.

One participant told us she was moved to the Limited Capability for Work (LCW) after volunteering for a while. She previously had a LCWRA award. This meant she was no longer protected from activity requirements and her benefit payment was reduced. Although she had an understanding disability work coach who understood she was not yet ready for paid work, so was not pushed into paid work like others.

Viewed as a burden on employers

The view of disabled people being a burden on employers seemed very common. This was reflected in people’s experience in work and looking for work. Non-disabled job applicants appeared to be routinely favoured. Adjustments were often not offered or even considered. And people were forced out of their roles when they become disabled or when their condition deteriorates. People described a lack of enforcement of anti-discrimination and employment laws. As one participant mentioned regarding her previous work:

This was also freely expressed in various types of public discussions and social media that people were exposed to:

Being aware of this view, people were trying to navigate such discriminatory behaviours. This sometimes meant considering hiding their impairment or condition if they could:

Stigma about receiving benefits

People described encountering misinformed and dismissive attitudes around their work-related activities. At the same time, they felt an intense social pressure to move into work. Their experiences reflected a widespread lack of understanding about disability and work. Despite this, judging whether disabled people 'deserve' their benefits seemed socially acceptable. Disabled people identified the news media and social media as consistently reinforcing this practice and stigma. This adds stress to disabled people's lives:

Many therefore seemed to feel a constant need to explain or justify their benefit claiming. They tried to counter the common stigma of disabled people being ‘lazy’ and attempting to avoid work:

People felt their claiming status made others view them as ‘second-class’ citizens. Within the benefit system, the Work Capability Assessment (WCA) process has reinforced that feeling. Rather than their right, benefits appear to be viewed as something to be ‘earned’

People also felt pressure to move into employment before they were ready. Political and media rhetoric about getting people back into work seemed to contribute greatly to this pressure:

A culture of suspicion

People felt a disproportionate public focus being placed on cases of benefit fraud. Efforts to expose such cases are part of the public discourse. This leads many to associate disabled people with potentially fraudulent, criminal behaviour. This seemed to be powered by direct public communications from the DWP and ministers. Similar statements are then used by other politicians and discussions on television and social media.

This narrative often caused people to feel persecuted, surveilled and threatened:

There was a sense of these threatening messages and society’s distrust of disabled people becoming worse over time:

It has also been pointed out that official benefit fraud statistics tend to be far lower than common rhetoric would suggest (less than 3% for all benefits, see DWP, 2024a).

Some have felt that the true numbers are not getting enough attention:

The existence of a prominent National Benefit Fraud Hotline felt like it could expose disabled people to abuse. One of our participants described how someone she had a personal quarrel with had used the line to falsely report her. This resulted in her account being immediately frozen. 

The next few sections describe the findings on people’s experiences of the work-related benefit system. This includes various stages in people’s claiming process:

• the circumstances that led people to claim
• awareness and access to information before claiming
• experiences of the Work Capability Assessment itself
• experiences of engagement with the Jobcentre as current claimants, including barriers around moving into work

It is important to note that in recent years, the DWP monitors customer satisfaction through its Customer Experience Survey (CES). Some of the survey items included in the CES are parallel or similar to the ones included in our research. Its recent (as well as previous) results (DWP, 2024b) are often in considerable conflict with the ones presented in this report.

This may be due to several reasons. Crucially, the CES relied on a sample of claimants who have had contact with DWP during the last 3-month quarter for certain purposes. This may mean their sample is more likely to exclude those who have less frequent or no contact with the DWP. As we will see later, this is unlike the majority of people in our sample.

Reasons to claim

We asked people about different reasons that led them to claim work-related disability benefits. We also asked about how important each of them was to them personally.

Financial need: covering living costs, allowing time to recover

Financial need was the leading reason for people claiming work-related disability benefits. Not being able to work meant people struggled to cover their basic living essentials.

Combined with constantly increasing living costs, people found themselves needing financial support to be able to take care of themselves and their households. This motivation was more often based on general need rather than knowledge of possible payment amounts.

While the benefit amount often failed to meet their needs, it helped regain some stability and time to focus on their health:

Some of the people we spoke with also claimed Personal Independence Payment (PIP), which is meant to cover the extra cost of disability. But we know this is not always the case.

The extra costs or ‘Disability Price Tag’ for a disabled household is £1,010 a month, after benefits have been taken into account (Scope, 2024a). This figure represents the extra costs disabled households face to attain the same standard of living as non-disabled households. So for those who were also unable to work or find appropriate work, the additional LCWRA element of Universal Credit (UC) provided much needed help.

One participant lost her teaching job after she became disabled. She described how being housebound and unable to work meant her expenses increased even more:

Health reasons: too ill to work, keep working or look for work

Unsurprisingly, health considerations were one of the most common reasons for claiming work-related disability benefits. This included:

• those who have always had a condition or impairment that made it difficult to work
• those whose health or condition deteriorated
• those who became disabled at a certain point in their lives and had to stop working.

Similarly, this was either a gradual process or a sudden change. Sometimes it was the activities surrounding work that also made it harder, like using transport:

Some had experienced more complex symptoms or complicated processes to receive their diagnoses. This has made their claiming journey longer and more difficult.

For those with acquired impairments, many described the shock of suddenly not being able to work. There was a long process of understanding and accepting their new situation while trying to learn about their rights.

Many described the challenge of trying to figure out their work-related capability. This could be because their condition was fluctuating or they were still learning their limitations. They also had to manage their condition and the admin burden of disability at the same time.

Loss of work: forced out or made redundant

Some have mentioned being made to leave their jobs when they became disabled or when their conditions became worse. For some this has been made clear by employers who no longer saw them as acceptable employees. For others, it has been a more gradual process. Mentions included public and private sector jobs, and none were offered adjustments to be able to stay in their roles.

This was a particularly difficult time for many, as they were trying to manage their health and were unaware of their rights:

For many, this also meant becoming familiar with the benefit system for the first time:

Information about benefits

Where people get information and advice

People have mentioned learning about applying for benefits and receiving advice from different sources.

In some cases people did not seem to be proactively made aware of the possibility of claiming work-related disability benefits.

Most had to learn about their claiming options when they were already struggling with their health and finances. Some only found out about it coincidentally or when others mentioned it to them:

Many people have told us they struggled to find information about the benefits they were entitled to. Some have tried to receive information at the Jobcentre but were misdirected or dismissed:

Low awareness of the Work Capability Assessment process and its details

Similar to eligibility, many claimants did not have clear information about the process before applying. Many started their journey not knowing what to expect. This included details about:

• the initial claiming paperwork
• the assessment appointment
• the possible outcomes and grouping following the decision
• the different conditions for each group

Some explained they were only directed to the general option of applying, and not provided with additional information:

We found that many people who are currently claiming work-related benefits did not know about the possible outcome options or did not understand their impact before claiming. Only around 42% of people applying for UC and 54% of people applying for ESA knew about the categories they could be put in if they were found to have limited capability for work.

Assessment experiences

This section relates to people’s experiences at their assessment appointment. People’s overall opinions were more negative than positive, both in our discussions and on our surveys. Some have had a positive experience and felt lucky to have their needs acknowledged and validated. However, negative experiences were considerably more common. Some explained that although their assessment was straightforward, its emotional impact was still negative. 

Inaccessible process and appointments

Many have shared finding different elements of the WCA process difficult. Sometimes it was nearly impossible. This was due to accessibility not being considered for the various stages of the process.

Several people have mentioned the capability for work questionnaire (UC50 or ESA50) to be extremely lengthy and confusing. They said they had to seek help for completing them. People said they were not offered help completing these questionnaires at the Jobcentre. Some have mentioned that when they asked for help, they were told it was not available:

Indeed, people described getting help from Citizens Advice Bureau, friends or family instead.

The phrasing and focus of the questionnaire did not accurately capture the impact and barriers of many conditions and impairments, as one participant explained:

Some have also mentioned struggling or not being able to access:

• information about the assessment appointment (including directions on how to get to the assessment centre)
• the assessment centre itself (the environment, building, and the room)
• requests made by assessors as part of the assessment

For example, one participant is legally blind and has a hearing impairment. She shared feeling lost when no adjustments were made to aid her in finding her way at the location of the assessment. She was also called to the room verbally only and was shown things physically on a screen and asked to sign it.

This lack of accessibility was also sometimes used against claimants. This was the case for the following participant whose assessment was held in a room with a door not wide enough to fit her wheelchair:

A slow and lengthy process

Although most were accepting of this reality, for many, the WCA claiming process took several months. The process was even longer for those who:

• were unwell (spending some or much of their time in the hospital)
• awaiting diagnosis
• had to appeal on their assessment’s decisions

This was at a time where they had no income from work, or their previous work income was stopped suddenly due to the changes in their health situation.

People having to request Mandatory Reconsiderations (where decisions are reviewed) or challenging the benefit decision at a tribunal adds significant delay.

Our discussions were focused on current claimants. This means the people we spoke to in depth all eventually managed to receive an award of health-related Universal Credit. But the lack of timely systemic protection for those who need it can cause real harm.

A discouraging and degrading experience

For many people, the timing of the assessment often found them in a particularly sensitive point. Many people were uncertain and anxious about their future and their capabilities. Some were still grieving over the changes to their health. The lack of informed expectations seemed to contribute to people’s worries and fears ahead of their assessment.

The assessment situation placed people in a highly vulnerable position. Claimants found themselves powerless in front of assessors. These judgements determined a meaningful part of their future. But assessors had no personal knowledge of them and their needs. There was also a sense that assessors were trying to challenge people’s barriers and symptoms, to be able to deny or reduce their eligibility.

The assessment seemed to focus solely on restrictions, rather than skills, abilities or potential. People said this forced a grim outlook on the future and on people’s worth. This was experienced as damaging to people’s self-esteem. It was also counterproductive to their potential future work prospects.

Many have said they faced cold, uncompassionate and harsh treatment by their assessors. Some cases reached abusive levels:

Many described leaving the assessment in tears. They referred to their experience as traumatic or shared this experience led to a difficult period in terms of their mental health:

For some, assessment decisions have had a long-term impact:

No decision-making transparency, no objective records

Most claimants did not expect an accurate guide to the way WCA decisions are determined. But it appears that none of the way these decisions are made was shared with claimants at any stage. This meant people were not always able to make sense of their assessment decisions. They also could not understand exactly how their capabilities were judged. This was especially crucial if they wanted to appeal.

Currently, no objective records of assessments are made routinely available. The DWP’s current policy for recording of assessments states claimants have no legal right to a recorded assessment. The DWP has no obligation to provide them with one (DWP, 2015).  

Audio recordings can be made available when asked for in advance, but this option does not seem to be advertised broadly. Access to assessment records is normally limited to the form filled at the assessment by the assessor. This is not offered to claimants but needs to be requested. One participant told us they managed to receive a copy of this form, but struggled to understand it as much of it was redacted:

It is concerning that objective records are not available. There have been complaints on assessors' report. Several participants and survey respondents mentioned that assessors made false claims. Other times, they misrepresented what people had said on assessment records:

Assessments are generally outsourced to third-party contractors. They are profiting from conducting these assessments:

Without an objective recording, most disabled claimants do not have evidence when trying to challenge accuracy of assessments and decisions or when complaining about assessors.

Jobcentre engagement

Mutual suspicion

Claimants’ overall views of the DWP and Jobcentres were considerably more negative than positive. This is perhaps not surprising given the general lack of trust people have felt for the DWP over the years (Glover, 2019; Social Security Advisory Committee, 2020).

Lack of communication and few to no contact options

Many claimants said they had very infrequent or no contact from the DWP, Jobcentre or work coach since they started receiving work-related disability benefits. This was nearly half for those receiving Limited Capability for Work and Work-Related Activity (LCWRA). This was part of what made Jobcentre employment support difficult to access for those who wanted or needed it.

This was also true for when claimants had questions or needed benefit-related support. In our interviews and discussions, many have told us they struggled to contact the DWP or Jobcentre when they needed to:

A central communication tool is the journal. It is accessed through someone’s online Universal Credit account. This is used to update information, log required activities, and communicate about your claim. Claimants can leave messages for a work coach and receive messages back.

Many have told us they were directed to their journals with questions. Yet they received unreasonably late replies, and sometimes no replies at all:

A substantial amount of disabled people need support around their benefits. But there seems to be no service in place to support their needs as they come up and provide them with information. This means people were sometimes waiting for weeks, months or even longer for replies to their questions:

In some cases, this extreme lack of response left people in a helpless position and raised worries about sanctions:

This is also a significant barrier for those who are ready to move towards work. The difficulties with contacting the DWP or Jobcentre make it difficult to get support:

Unsupported and misguided: difficulty accessing reliable information

Alongside the issues with communication, people struggled with the content of the answers they were looking for. It seems people were often not given clear, basic information about their benefits when they started to claim. So, they had to try and find information themselves. For many, it was difficult to receive accurate and reliable information about their rights and conditions. Even if they were current claimants at the Jobcentre:

It seemed that many struggled to find accessible information. One participant described their worries after being refused help from the DWP:

Some described being misdirected, while others said they had to fight for things they knew they were eligible for. This was sometimes at a cost to people’s employment, financial or health situation. One participant, for example, was told they could not have a carer present at their job interview when they needed help to sign an expected contract:

Benefit details and permissions unclear

Following from the previously described issues, we found that a significant proportion of people were unaware or unsure about the details of their benefits. More specifically, people appear to be unsure about:

• Accurate award amount
• Work allowance: more specifically, LCWRA people were unsure about whether or not they’re allowed to work. They were also unsure how that might affect their award payments and entitlement
• If they were allowed to study while claiming

People explained they could see how much they were meant to be paid. Payment amounts are listed by element and by any other people on the claim. Deductions are also listed. But people often found these hard to understand. This means people were unable to work out if they were receiving the right amount. This made detecting underpayments very difficult.  

Disabled people receiving these benefits are allowed to work. But there are slightly different rules between each group.

One participant had been told they could not do any paid work at all. They became quite distressed during a group discussion where other participants were discussing their work while receiving Limited Capability for Work (LCW) or Limited Capability for Work-Related Capability (LCWRA):

People also shared they were not told about how the transition away from benefits would work, if their paid work took them over the work allowance:

Work coach experiences

Compliance over support

In line with people’s ratings of general views on DWP and Jobcentre support, we found only 11.3% of current claimants felt supported by work coaches.

This is likely linked to the low frequency and quality of contact people had with work coaches.

People generally felt looked down upon and inspected, and wished for a more supportive attitude:

An unempathetic, black and white approach: no individual support

An experience that was very common among people interacting with work coaches was feeling a lack of empathy. People did not feel like their individual circumstances were heard and considered. They did not feel like work coaches cared much about their goals or needs. Instead, they felt decisions were made for them based on external considerations and targets.

Only 12% said they trust work coaches to have their best interest in mind.

The binary approach that seemed to guide such decisions focused on labelling people as working or non-working only. This led to ignoring people's needs:

Only 11% said work coaches were able to make helpful suggestions based on their individual circumstances and needs.

The obligation attached to those meetings with work coaches has made such experiences feel even worse:

Highly variable level of knowledge and support

Work coaches’ lack of knowledge was one of the most frequently mentioned issues throughout our research. This mainly related to 2 types of knowledge:

• Knowledge about work and benefits
• Knowledge and understanding about disability

This also meant people had to repeatedly explain their circumstances and often upsetting barriers to someone they did not know:

Positive experiences of work coaches

Only a couple of the people we spoke with had positive relationships with work coaches. While they were uncommon, the impact it had on their experience was very meaningful:

Similarly, one participant said she was able to access disability work coaches following a move from Limited Capability for Work and Work-Related Activity (LCWRA) to Limited Capability for Work (LCW). She found this changed her experience entirely:

In contrast to most people’s experiences, this shows the difference a knowledgeable, kind and sensitive attitude from work coaches can have on disabled claimants and their claiming journey.

A significant proportion of disabled people we spoke to or surveyed told us they were interested in working now or in the future. However, the many issues in the job market and benefit system that make this difficult.

On one of our surveys, we asked people to rate several potential barriers that might make it difficult for them to work. This included moving into work, or working more than they already are.

People have also pointed out the lack of enforcement of the Equality Act 2010 and other employment laws. This meant the availability of flexible and accessible jobs remains low. And employers or other organisations can continue to discriminate, not make adjustments and otherwise penalise disabled people.

The high cost and emotional demands of legally challenging discrimination means this is out of reach for many. Even with Legal Aid funding in eligible cases. Those harmed by violations of such laws are left unprotected and powerless against it:

Some have emphasised the absurdity of the government placing the responsibility of moving into work on disabled individuals, when so little is done to properly support them and enable it:

People we spoke with also mentioned additional issues they struggled with at work. They needed adequate support to be able to maintain their employment. At the same time, there was a need to make sure any health or care commitments could be continued without harm to their health or financial situation. This needed to be in place routinely for long-term conditions or impairments, or when their health might deteriorate. Some of the support elements people mentioned needing included:

• Time off for attending appointments
• Appropriate adjustments
• Adequate Sick Pay policies for when people are not well enough to work
• Flexibility for those with caring responsibilities

Some have also pointed to barriers that could arise from external factors, namely health and social care. With inadequate social care, work or work-related activities become impossible or unsustainable for some:

Others had been waiting for a long time for planned NHS treatment or were not eligible for it in the first place. High thresholds for referrals and long waiting lists were repeatedly mentioned. Some people also had conditions or impairments which could not be improved through better access to health services. Lack of NHS help can cause extended periods of poor or worsened health and wellbeing. Some people directly linked this to the increase in those unable to sustain full-time work due to health or disability:

One participant also highlighted the added challenge of working while being an unpaid carer. This could apply to being a disabled parent of disabled children or young people. But also to having caring responsibilities for another disabled adult.

A fear-filled system: risks created by the benefit system

Risks created or worsened by the benefit system were major barriers for many considering a move into work. This seemed to be mainly due to the way the system is structured and the way it operates.

A major characteristic of the work-related benefit system is fear. Current claimants did not have a sense of being cared for or supported when they are struggling. As a result, they were continually worried about aspects of their claiming and their potential consequences. Fear was a dominant feeling associated with the system. This included fear about:

• Potentially losing your award or eligibility
• Not knowing when you may get reassessed
• Being pushed to work
• Sanctions

This added stress to people’s lives and had a negative impact on their well-being.

Worries about engaging with work-related support

The current system is set up so that any engagement towards work appears to introduce additional risks. This puts people off trying and makes thinking about support much more stressful than it should be.

This may be part of the reason why 34% of survey respondents had chosen to use support from non-DWP organisations.

Fear of being pushed to work

People worried about the way being pushed to work could influence their physical and mental health. The also worried about how they will be treated once that happens:

Those who choose to move into or towards work are doing so knowing it could pose risks to their health, wellbeing and financial situation:  

People who were self-employed were also to nervous to ask about the implications of needing to save for tax:

The threat of sanctions

Another major systemic element that created fear was sanctions. This threat was perpetuated by work coaches’ statements as well as people’s own experiences or those of others.

Sanctions often appeared to be applied in a very harsh manner. There seemed to be no consideration of circumstances or difficulties guiding sanctions. There also seemed to be no space for investigating the reasons why people failed to meet their obligations:

The speed in which they were applied has made the threat even more imminent and stressful:

This threat was perceived as so volatile that some avoided enquiring about their own situation: 

Disabled people experienced sanctions as a part of the system that felt particularly cruel and undignified. Perhaps most of all, it contributed to the lack of trust people felt for the benefit system:

A few have commented on the way this type of pressure only led the opposite of the desired outcomes:

DWP work support

Lack of information, support, and guidance

In most cases, work support available at the Jobcentre appears to be far from adequate. Of the people were surveyed who have been contacted at least once by the DWP, Jobcentre or a work coach, nearly 66% of current health-related UC or ESA claimants said they have been offered no support.

We asked about types of support that the DWP say they offer.

None of the respondents said they were offered:

• Work preparation support for parents or carers
• Help with finding suitable volunteering opportunities or voluntary work
• Help with finding suitable work experience
• Support to help you resolve any problems when you start a new job
• Support to become self-employed
• Information and advice about what sort of work you could do
• Support around starting or running your own business

These findings are inconsistent with the DWP’s formally stated list of available support services (DWP, 2024c; DWP, 2024d). This could mean that in reality, some of these services are not directly available to claimants, or simply not actively offered.

People who were interested in trying to move into work said they were missing support that would be tailored to their needs, goals and skills. They also mentioned missing a barrier-focused approach:

In cases where people had been made to leave work because of their condition, specialised support seemed especially warranted:

People mentioned they have not been actively offered information or support. This made it harder to navigate the process of trying out or moving into work. Some of those who were working were self-employed.

Often this was to manage work around their impairments and also to avoid unfair attitudes or behaviour by employers. But there seemed to be a lack of guidance for people interested in self-employment:

Another important issue several participants mentioned was the lack of more specialised support for young disabled people. Their employment position may be different as they could be coming out of education with little to no work experience. For some, their education or qualifications were disrupted due to access failures or periods of illness. For others who do have basic qualifications, the standard offer for young people may not work. In such cases, people could require additional informed guidance: 

Specific employability schemes were not always helpful or appropriate for many young people. These, however, tended to be the main offer, especially for those leaving Special Educational Needs and Disabilities (SEND) settings:

For households with disabled adults and disabled young people, the impact of poor services impacts the whole family. In some cases, specialist schemes to support transition and employability for young people have had a poor impact:

Lack of accessible training and funding opportunities

An additional barrier for moving towards work was a lack of suitable training options. There was a sense that training and courses offered through the Jobcentre are limited. This was the case for people who:

• had no or fewer qualifications
• sought professional development
• wanted or needed to move career

For higher education, Student Finance criteria is rigid and the rules about studying and claiming benefits can be strict. Apprenticeships are available to people in work and rely on a minimum of work hours.

Jobcentres could offer more skill-based training courses that lead to a qualification. Or simple funding to help people develop needed skills or retrain for specific careers. This would enable people to move towards relevant work, building on existing skills:

Issues with Access to work

Access to Work is a government grant scheme which supports disabled people in work. Access to Work might pay for:

• a British Sign Language interpreter
• extra transport costs, such as a taxi where no public transport is available
• specialist equipment

You must be in or about to start paid work to apply for it.

People have described struggling to make use of Access to Work support. It has been hard to understand:

Some have commented on the unreasonable complexity of the scheme and admin required:

Some people also described the limitations of assessments and support offered through Access to Work. Often these did not capture or address people’s main challenges at work:

Another participant who was considering a job offer where she would need a support worker, explained the workplace would not provide this for her. To be able to receive this support from Access to Work, she would need to pay the support worker herself and claim the money back later. This was not possible and so she could not take the job offer.

We have introduced and asked about different policy proposals at several stages of this study. Some of these proposals were based on proposals in the previous government’s white paper (DWP, 2023). Other proposals were from other organisations, though sometimes with significant changes. Others echoed suggested alternative solutions or were developed from what people have told us at different stages of our project.

At the end of our second survey, we asked people if they had any ideas about how the DWP could better support disabled people who want to move into or look for work. We have analysed these responses by the type of desired changes they have mentioned. The most common themes people wished for are (in order of highest frequency):

• More information and support around work (including finding suitable work opportunities, courses and training, more individualised support, adjustments help and Access to Work changes, and support while in work)
• Improved knowledge of disability among staff (including training and suggestions to have disabled people as staff or involved in DWP’s decisions)
• Removing the risk from the process of trying out work and moving into work (including allowing a grace period and changing work restrictions)
• Having the DWP work directly with employers to improve conditions and address lack of opportunities
• An empathetic approach based on listening and respect for lived experience
• Changing punitive culture, reducing pressure and accepting people’s needs, barriers and goals.
• Better communication and clarity of information
• Stop the spreading of stigma that harms disabled people and shames those who need to claim benefits
• Restore trust

All of these themes have repeated themselves throughout our discussions and survey findings.

Given the breadth of the issues people described, many problems are not addressed by existing proposals. Nor are they all covered by the newly developed proposals we presented. In this section we will therefore present the responses to each proposal, followed by the additional changes people wished for. 

In deliberative groups, we used 6 criteria that were important to disabled people. These were developed through earlier qualitative and quantitative analysis:

• Effective. How big a difference it would make at helping people into sustainable work or to increase earnings.
• Safe. How much it would help reduce the risk of trying work. Or engaging with employment support.
• Dignified. How much it would improve people’s experience of the system.
• Fair. How much fairer it would make the system feel.
• Trustworthy. How much it would help increase trust.
• Inclusive. How it positively or negatively impacts diverse disabled people.

Discussions were not limited to these criteria. But we asked about how effective, safe, dignified, fair, trustworthy or inclusive the proposals may be.

Improving or reducing assessments

Proposals to change assessments

LCWRA element and protection from sanctions to be linked to PIP or a WCA (white paper with modifications)

At an early stage of this study, we asked about the proposal for Limited Capability for Work and Work-Related Activity (LCWRA) income and protection from sanctions to only be awarded to disabled people receiving Personal Independence Payment (PIP). This idea was based on proposals in the previous government’s white paper (DWP, 2023).

There was a strong negative response from disabled people during the first qualitative stage of this research. We then moved to discuss and present another version. For this one, we added significant changes to try to address concerns raised about the original white paper proposals.

Like the white paper proposal, if someone who receives PIP claims Universal Credit (UC) then they would automatically be awarded the LCWRA element of UC. This would remove the need to go through the Work Capability Assessment.

However, in our modified proposal, people who do not receive PIP would still be able to apply for the Work Capability Assessment (WCA). In that case, they could go through the work-related assessment, like the current process.

We have also removed the part of original white paper proposal that said work coaches will decide about conditions and sanctions. Instead, on our modified proposal, all claimants would automatically be protected from sanctions.

We have presented this proposal in our survey to respondents in 2 different contexts. The first context was reducing worries about trying to work or engaging with employment support. This is because, under this modified white paper proposal, entitlement would be based on a PIP award for many people, rather than on the WCA. When asked:

• 86.9% of respondents agreed with this proposal

of which:

• 63.4% strongly agreed
• and 23.5% agreed

The second context was reducing the number of stressful assessments for many disabled people. This is because some people would not need to have a Work Capability Assessment (WCA) as well as a Personal Independence Payment (PIP) assessment. When asked:

• 86.2% of 559 respondents agreed with this proposal

of which:

•  59.6% strongly agreed
• and 29.7% agreed 

Our survey showed a broad agreement to this proposal as captured by a single statement question. On the other hand, qualitative discussions tended to view it more negatively. While the proposal had an initial appeal, longer discussions revealed considerable concerns regarding how this could be implemented.

People were unclear on how the merge of 2 different assessments that are normally meant for 2 different purposes would work. Some thought this may be another way of trying to push people into work:

Many have commented this proposal could be good in theory in terms of having one instead of 2 assessments. But, with the state and structure of the benefit system, this proposal raised serious concerns.

One participant described the main appeal of this proposal as driven by the level of distress caused by assessments:

We have asked on our survey about people's view on their PIP assessment, like we did for the WCA. Agreement levels were somewhat lower for PIP in comparison.

People have also explained that basing this on PIP posed substantial risks. PIP tended to be more readily reduced or stopped when it was reassessed. Along with waiting and appeal process times, this meant many may be left uncovered for long periods of time:

Having one assessment for both Universal Credit (UC) and Personal Independence Payment (PIP) could have a negative impact. Someone could lose both after a reassessment. Even if this was later overturned at tribunal, there would be a long period of time where people do not have the financial support they need to live:

Appropriate assessors: independent specialists (Scope)

The idea of specialist assessors was based on Scope’s previous “Disability Benefits Without the Fight” campaign (Scope, 2024b). We sought to refine it based on people’s views.

People we spoke with have said medical opinions from their professionals or records are often ignored. DWP decision-makers often overrule them and prioritise benefit assessment reports. In addition, most do not think that current assessors have the professional background to make these types of judgements. Current claimants tend to suspect that non-specialist assessors are driven by considerations that do not align with claimants’ real health situation and best interests:

People therefore appreciated the option of having more weight given to medical opinions:

We first explored the idea of involving people’s own doctors in assessments. People generally liked the option of having the views of someone who personally knows them as part of their assessment:

It also reduces the pressure to explain a significant amount of complex health and contextual information in a short period:

At the same time, a few concerns were raised that required consideration:

• High stakes: too much riding on one person’s views
• Some may not have a GP or a good relationship with their GP
• This could affect patients’ relationship or trust with their GP
• Expertise: GPs often lack knowledge and expertise in specific conditions. But not everybody has specialists or consultants
• Concerns over increased workload and limited NHS capacity
• Whether the same level of detailed evidence would be required. And if the level of required sensitive information could be reduced

Much of these concerns seemed to focus on the option of GPs involvement in particular. This has also led some to reflect on the importance of the independence of assessors to ensure more objective decisions:

We have combined the need for specialism with the element of independence and presented it on our survey. This was one of the most popular proposals with survey respondents. There was a 94.6% agreement that if there is an independent assessment, it should be conducted by a specialist in the claimants’ medical conditions. Out of this 94.6% agreement, 69.1% Strongly agreed and 25.5% agreed.

To be able to compare between different options, we have presented survey respondents with several options for who the assessor should be. When asked to choose one type of professional who should conduct assessments, disabled people seemed to have a clear preference for their own medical consultants or specialists. This was closely followed by independent medical specialists. GPs were less popular, although views varied considerably between ESA and UC claimants. The current model of independent non-specialist assessors and also social workers were very unpopular choices (less than 5% for each).

This led to the suggestion that an agreement between assessor and claimant could be sought as part of the assessment. 82% thought that the assessor and the claimant should agree the impact of somebody’s condition and their barrier to work, as part of the WCA.

A more practical and respectful approach: focus on strengths and adjustments

Most people have shared their assessments left them feeling negatively about themselves and about their future. People had to explain all of their personal circumstances while no focus was placed on systemic barriers.

Those who were interested in working therefore wished assessments could focus more on individual strengths. And what they could do with appropriate adjustments in the future:

At the same time, it is important to remember that many people are too ill to work, and their circumstances are not expected to change. People who were unable to work wished for an approach that would:

• prioritise their health
• avoid unnecessary interaction
• treat them with respect and understanding

Reduce and improve reassessments

Reassessments also appeared to be used to monitor disabled people. People felt reassessments placed them in an unnecessary risky position, without offering any focus on changes in support needs. While people agreed they were useful for short-term conditions, they seemed only partially justified for others. In most cases, they seemed completely unjustified:

A more dignified approach would therefore:

• Considerably reduce the number of reassessments according to people’s conditions (extended periods or single assessments)
• Allow a brief assessment for those previously assessed
• Introduce the option to request an assessment in case your condition improves or worsens

There was also a suggestion that people with diagnoses of specific conditions would not need to have a WCA.

Protect claimants with mandatory recordings and transparent procedures

Some have commented on the unjust and imbalanced dynamics that characterise the assessment situation. Having recordings and official transcriptions available for all without them needing to be asked for would build trust and protect claimants.

Doctors, but not diagnoses

There was a general agreement when it came to doctors’ role in assessments. But their contribution was seen to serve a protective function and add evidence. An exclusive reliance on medical diagnosis received significantly less support.

54% of respondents disagreed that Work Capability Assessments should be based on medical diagnosis only. 16% neither agreed nor disagreed.

People have mentioned periods of having limited capability without a diagnosis. Some have more complicated or rare conditions, or take a very long time to get diagnosed. Yet that does not change their needs and difficulties. Some have pointed out that some conditions are not well characterised by a focus on medical needs. Such conditions may be better evidenced by social care or support needs:

We also know that not all disabled people need or can access either medical or social care support. The social care system is under strain. Many eligible needs are not being supported. In some cases, those who are expected to contribute to their care are unable to afford this. There is also a significant burden on disabled people to understand and navigate these processes.

A complete reliance on formal support structures to validate disability is therefore not appropriate. Many people are excluded or unable to access these, but they can be protective for those who do interact.

Repair broken trust

Proposals aimed at repairing trust and abolishing punitive culture

Remove all sanctions (Scope)

People viewed systemic use of threats and fear-inducing procedures as a central issue. This impaired trust and had a negative impact on people’s health and well-being. As we have seen, this was also a major barrier for engaging with support and moving into work. Instead, people sought a more supportive and understanding approach that could encourage and motivate them:

Sanctions in particular were seen as harsh and completely unnecessary:

We asked about sanctions twice on our survey. Both times, most agreed sanctions should be removed for everyone on UC. 75% of 221 current work-related disability benefit claimants thought sanctions should be removed, to reduce the risk of being found fit for work. And 76% thought they should be removed to improve trust and engagement.

Trust was a main issue and barrier that seemed to be linked to all facets of the benefit system and disabled people’s engagement with it. Repairing trust was therefore an obvious priority for any meaningful process of change:

Nothing about us without us

Much of people’s distrust seemed to come from engaging with a system not designed with disabled people’s needs and interests in mind. One important way of repairing trust and attempting to rectify the power imbalance was therefore involving disabled people in decision-making processes. Such involvement should be implemented throughout the whole system.

On our survey, 99% agreed that if the goal is to increase fairness and trust, reforms to the benefit system should be designed in collaboration with disabled people.

Meaningful involvement was seen as a positive way of making sure people can be adequately supported. And to increase motivation for engagement. But those who have previously been part of government consultations have had discouraging experiences. Such processes often seem more tokenistic than a true effort to listen and implement changes:

More thorough and transparent procedures were seen as very important. These could help guarantee disabled people are equal partners in reform processes. And it would mean lived experience can become a central consideration to guide the deep transformation the system needs.

Additional desired changes around repairing trust

Prioritise support and accessibility for claimants

Part of what appeared to contribute to the lack of trust was a low prioritisation of basic support for claimants. Throughout their claiming journey, disabled people repeatedly struggled to access information and practical help:

People described a need for the following:

• A dedicated helpline service to offer timely support for prospective and current claimants
• Substantial improvement to journal communication
• Prioritising accessibility throughout the claiming journey, including:
• Clear and simple information about benefit-related options and processes available to all
• Accessible facilities and tools
• Accessible support options (appointments, training)

Some have also wished for an explicitly agreed link between different government departments to share information and prevent duplication.

Tackling barriers within the jobs and employment system

Proposals aimed at reducing employment barriers

Employment law enforcement (Scope)

Improving enforcement of employment laws was seen as a basic step to stopping disabled people leaving the workforce:

Enhanced and extended Statutory Sick Pay (JRF)

Entitlements such as Statutory Sick Pay (SSP) have also been raised in this context. SSP can be essential for supporting disabled people at work and preventing them falling out of employment completely. People also thought that more organisations should pay above the SSP required rate:

We presented a proposal that SSP should be increased on our survey, based on a suggestion from the Resolution Foundation (The Resolution Foundation, 2023). This proposal received good support, with 86.9% agreement.  

Additional desired changes around tackling employment barriers

Work directly with employers to improve conditions

Governments working with employers was similarly seen as a crucial step. This could allow meaningful changes to disabled people's ability to move into sustainable work. People considered the important of having continual support in place for employers. This would help them accommodate disabled staff:

Dedicated legal aid for disabled people

We have heard from many who were forced out of their jobs when they became disabled or their condition worsened. For that reason, employment law enforcement alone is not enough.

Some have raised the need to have dedicated support in place for disabled people harmed by violations of these laws:  

A list of proven disability-friendly employers

People have also wished for an available list of employers who have made adjustments and put disability-related policies in place available. They felt this could reflect the work of disability-friendly employers:

This would be in addition to the existing Disability Confident scheme, which many felt did not prove to be as helpful as they wished. Because it is a self-assessment scheme, it seemed that many organisations who advertise themselves as a Disability Confident Employer are not doing enough to recruit, retain and support disabled staff.

Reducing risks of engaging with support and trying work

Not everybody can move into work and nobody should be forced to before they are ready. Yet as we have seen, current practices created risks for those interested in trying out work as well. The following proposals and ideas aimed to make the move into work safer for those who are interested in trying.

Proposals aimed at reducing risks around moving into work

Work Transition Guarantee: protected benefit status for those trying out work (JRF with additional modifications)

The Work Transition Guarantee would require the law to say that if you move towards work (like engaging with employment support or trying a job), you cannot be reassessed and therefore cannot lose your health-related UC, protection from sanctions or your PIP for 2 years. And that people would be able to reclaim their old award straight away if they were not able to stay in work.

This suggestion aims to stop disabled people worrying that trying out work will mean they will be reassessed and lose their benefits. Or that they will become subject to more conditions that could lead to sanctions. Or that they’d be unable to reclaim.

It would not mean that people couldn’t request a reassessment if their needs changed and they wanted one sooner.

This suggestion generally received favourable responses from participants in our deliberative discussion groups. At the same time, people expressed some doubt about how this would be implemented. Some also mentioned that the risk of reassessment in this case is only delayed, rather than prevented.

On our survey, we presented each element of this proposal separately:

• 95% of current claimants agreed that disabled people whose job did not work out should be able to access their old benefit straight away, if they reclaim Universal Credit within 2 years
  • 85.9% strongly agreed
• 95% of current agreed that disabled people who engage with employment support should have their benefits protected and not be reassessed for any benefit within 2 years
  • 81.8% strongly agreed
• 95% of current agreed that disabled people who try out work should have their benefits protected and not be reassessed for any benefit within 2 years
  • 80.0% strongly agreed

Being able to reclaim if needed was similarly important to enable people to enter employment and see how it works for them:

We therefore asked about if people should keep their work-related disability benefit entitlement for 6 months after they move into work. We clarified this suggestion with information on income levels for a 6-month period. When we presented it to more respondents, it did receive a good level of agreement (81.4%).

Protect and enhance UC: changing payment amounts to reduce financial risk

This proposal was to make Universal Credit stronger and more protected for all claimants. It proposed a higher basic rate of Universal Credit. And the reduction of sanctions for everyone, regardless of whether they were disabled.

The idea behind this proposal was that improving UC for all claimants (including people without health conditions) reduces the negative consequences for disabled people. This is because if they lose their additional health-related benefit support as a result of a reassessment, the basic UC rate they are left with would be higher than the current rate. This can, ultimately, lower the risks of trying work.

This proposal received a mixed and negative reaction in our deliberative discussion groups. This was despite the reduced risk associated with it and disabled claimants’ amount remaining the same. Most thought sanctions were unfair for everyone. They thought a more appropriate basic income level to meet increased living costs was needed for all. At the same time, discussion participants were bothered by the lack of acknowledgement of disabled people’s additional costs:

We therefore added 2 variations to this question on our survey.

Disabled people getting the same overall payment but with a higher basic payment for all was less popular. With this proposal, disabled people were in effect losing the differential income.

Disabled people’s additional desired changes to reducing risk

Remove conditions for moving into work

People wished for conditions around moving into work to be removed. They felt conditions attached to their claim were unfair, unhelpful and an additional burden on their health:

Only 4% of respondents thought that there should be any conditions about getting ready or looking for work for disabled people who are getting Universal Credit.

Increasing work allowance

Currently, disabled people on Universal Credit have a ‘work allowance’. They can earn up to £404 a month before their benefits are affected (if their claim includes support for housing costs). Or up to £673 a month (if their claim does not include support for housing costs).

84.9% agreed that the ‘work allowance’ should be increased to £1,047 a month (the same as the personal tax allowance).

87.3% agreed that the ‘savings allowance’ for disabled people should be increased to be £16,000 before someone’s benefits are affected. 66.5% strongly agreed.

People had concerns about something as important as their award being taken from them due to minor mistakes. This is because of the system's tendency to make harsh and quick judgements. Some worried about inability to maintain contact due to health or other valid reasons would not be accounted for:

Additional desired changes to Jobcentre support

Listen rather than dictate: a more empathetic, personal treatment

A lack of empathy was one of the most common and noticeable issues people mentioned about their experience of engaging with contacts at the Jobcentre. People felt the often cold or unkind attitudes they experienced came from a lack of understanding and interest in their circumstances:

Instead, people wished for respectful communication based on listening and taking their personal needs into account.

Personal support and time invested to get to know people who were ready to engage were key. Many wished to be asked about their needs and to be listened to:

This would enable individualised support that meets needs, goals, skills and preferences:

People wanted more options to discuss their circumstances and what might help at different points in their lives:

People were interested in DWP support to stay in the workplace. They emphasised how receptive support that values lived experience could enable that:

Comprehensive disability training and a standardised level of service

Work coaches’ training was a very common need people mentioned. People wished for a higher level of knowledge about disability and access needs that people might have. This would allow work coaches to adequately support disabled claimants. More specifically, people wished for a more nuanced understanding. One that would acknowledge diverse needs and not make assumptions about people:

People felt an improved understanding would allow work coaches to recognise where people are in need of additional help. They could offer this help before work support, and regardless of it:  

People described becoming distressed by interactions with work coaches. They therefore spoke of the importance of being trained to speak with people who might be struggling:

Many people have mentioned experiencing a vastly different level of service and varying attitudes from different contacts. Needing to share their history and difficulties repeatedly was also challenging for some. Having a consistent contact at the Jobcentre was desirable. But only if work coaches were more knowledgeable about disability.

Many people wanted disability-specific work coaches.

This was particularly the case for those who would like to move towards work but are not well enough or ready yet.

Disability-specialist work coaches could help meet disabled people’s desire for improved staff knowledge. This would enable more effective support to claimants who were in need of information about their rights and options.

Low pressure support

Many people experienced work-related support as very stressful. Any type of pressure would not be appropriate for those uninterested or unable to work. Yet this was true for many of those who were interested in working. They felt this level of stress was counterproductive when it came to helping them try or consider a move into work. People therefore expressed a great interest in being able to receive support that was:

• optional
• delivered at slow or self-determined pace
• without pressure to achieve specific progress
• aimed at feasible and sustainable working conditions (for example, flexible, remote, part-time)

People felt this would help make the possible move into work feel safer, easier and less stressful. 

83% said that Jobcentres should be more proactive at asking people if they would like any support and offering it if desired. But not on a mandatory basis.

Practical support

Overall, the most popular options for people who wanted services through their Jobcentre were:

• appointments with disability work coaches
• information about rights and disability in the workplace
• information about the Access to Work Scheme
• information about Disability Confident employers
• training and courses that lead to qualifications

They also thought mentors would be helpful. It would be a particularly useful way of helping people who were considering work explore their options in a stress-free way:

There was also a suggestion of peer support groups as a helpful addition that could improve people’s experience:

Support with employer interactions

People described wanting much more support navigating disability with employers and potential employers.

This included help to navigate and interact in early stages of applying and interviewing. Including more practical guidance about applying for jobs as a disabled person.

People also wanted support once they had started a job. 95% felt that Jobcentre support should be available for the first 6 months after a disabled person starts a new job. And that this support should be available to both the claimant and employer.

More support around Access to Work

People have mentioned struggling with applying for or accessing the support available through Access to Work. They therefore wished for additional help for individuals to be able to use this scheme. And to help employers understand it:

Some have also felt the scheme itself needed to be simplified to make it more accessible and usable. People also wanted Access to Work to be available to those starting self-employment after receiving benefits. Without a requirement on minimum earnings of the ‘lower earnings limit’.

Accessible courses and training

People wanted choice around courses and training, as many of the standard offers did not meet their needs. Practical training linked to in-demand skills, qualifications, or suitable work opportunities.

Focused qualifications are also a way to evidence skills or abilities that are not backed up by recent work experience:

Courses and training need to be accessible and include options to be remote and self-paced.

Self-employment has benefits to many disabled people. Because of this, training and support about working for yourself was also wanted:

People also wanted the option to access training or support even if they are unable to do or find paid work. This would support people’s longer-term goals rather than just a move for everyone into full-time work.

Political and public pressure to reduce the overall amount spent on disability benefits feels more present than ever. This timing can be incredibly difficult. Many disabled people are having to face this pressure while struggling under cost of living worries. Current claimants of work-related disability benefits tend to feel stressed and monitored rather than supported.

We also know many disabled people are not currently claiming the benefits that they are eligible for (DWP, 2024e). Yet the focus of attention (and resources) seems to be efforts to cut budgets, expose cases of fraud and reassess people’s long-term conditions.

Disabled people’s biggest barriers to work are their health, lack of accessible and flexible work options, and pressure from the benefit system. Not lack of skills or motivation. These systemic and employment barriers make the move into work extremely challenging for disabled people. And often impossible for many of them.

The proposals brought forward by the previous government’s white paper (DWP, 2023) provide only very partial solutions. They do not adequately address the variety of issues that are part of disabled people’s reality and needs. Nor do they aim to use the government’s power to tackle inequality in employment.

Any solution that aims to enable disabled people to move into work must also address the widespread and severe barriers within the job market itself. The aim should be to reduce the disability employment gap (Scope, 2023b) by increasing opportunities for disabled people to get jobs and stay in work.

One of the crucial changes needed to support people into work is making sure that they are not discriminated against in the workplace. This means improving hiring practices, which need to be far more inclusive. It also means creating supportive cultures for disabled people to work in, across all areas of business. Adjustments and flexible working options are essential to this process. As is making sure that disabled people know their rights. And, importantly, that employers know their responsibilities.

An extension and improvement to Statutory Sick Pay is likewise warranted. The DWP should work directly with employers to open up employment to disabled people who might otherwise have been excluded. And better support their disabled employees. This will also help to secure the provision of equal opportunities.

As we have seen, many significant barriers can be found within the structure and function of the benefit system itself. The benefits system in its current state is not fit for purpose. Sufficient support to move into employment is not offered to many people who would like it. Others are pressured into work or engaging with work support in ways that are not appropriate for their needs. This then negatively impacts their health and well-being.

Unnecessary threats and risks that are built into the system’s function do not achieve the desired results. In fact, these threats  produce the opposite effect. These risks discourage people who are interested in working from trying to do so, and make people reluctant to engage with the DWP.

Disabled people who are interested in working need more opportunities to safely try out work. This means removing any potential financial risk and allowing space and time for learning.

Support should be accessible and optional, but never a requirement.

Similarly, sanctions should be removed entirely and reassessments considerably reduced.

There is a pressing need for an improved understanding of disability and access needs within the benefit system. Too often, it fails to provide claimants with individually appropriate support. This hurts both disabled people who cannot work, and those who are already working or want to work. This improved understanding must acknowledge and respect the fact that, for some, work is simply not an option.

The existing lack of personalisation within benefit provision means that many people are nervous about engaging with support. Therefore, they remain unsure about what may be possible for them in the future. Many disabled people want closer support before, during and after the move into work. They also want, and need, practical help and accurate advice, including information about their legal rights at work.

A more informed and dignified approach could help repair trust. This includes making all information and support accessible. It will also support people to better plan for their future and fulfil their goals.

The current Work Capability Assessment (WCA) does not measure much of disabled people’s real barriers to work. And it often excludes them from accessing benefits. It ignores people’s views on their own work capability and their ambitions around work.

It also is not linked well enough to the current job market and the type of jobs that are or should be available. Many descriptors are linked to physical jobs or tasks. As such, they do not capture barriers about being able to carry out work-related activity reliably. The descriptors also ignore the possibility of activities causing harm to people’s health.

For these reasons, the existing WCA needs to be replaced, with input from disabled people. A fairer WCA might seek evidence from independent specialists, or greater involvement from people’s own medical or care professionals.

Disabled people want change. The needed changes are vast and deep. They include the benefits system as well as the culture around it. Disabled people deserve dignified support, regardless of their work capability. Disabled people who can and want to work deserve fair and safe conditions to do so, and to be able to trust that their well-being is prioritised.

Addressing the real barriers that disabled people face will reduce hardship and distress. This will better support them and enable engagement by those who are able to work, while protecting those who cannot. And help disabled people to move into and stay in sustainable work, without fear.

Department for Work and Pensions. (2015). Employment and support allowance – Work Capability Assessment: audio recording of face-to-face assessments policy.

Department for Work and Pensions. (2020). The work aspirations and support needs of claimants in the ESA Support Group and Universal Credit equivalent.

Department for Work and Pensions. (2023). Transforming support: the health and disability white paper [white paper].

Department for Work and Pensions. (2024a). Fraud and error in the benefit system, Financial Year Ending (FYE) 2024.

Department for work and Pensions. (2024b). DWP Customer Experience Survey: Benefit Customers 2023 to 2024.

Department for Work and Pensions. (2024c). Help with moving from benefits to work.

Department for Work and Pensions. (2024d).  Jobcentre Plus support.

Department for Work and Pensions. (2024e). Unfulfilled eligibility in the benefit system: financial year 2023 to 2024 estimates.

Glover, B. (2019). Pathways from Poverty: the future of the DWP. Demos

Scope. (2023a). Disability Price Tag 2023.

Scope. (2023b). Disability in the workplace: how to retain disabled staff in employment.

Scope. (2024a). Disability Price Tag 2024: Living with the extra cost of disability.

Scope. (2024b). Disability benefits without the fight.

Social Security Advisory Committee. (2020). How DWP involves disabled people when developing or evaluating programmes that affect them.

The Joseph Rowntree Foundation. (2024). Unlocking benefits: tackling barriers for disabled people wanting to work.

The Resolution Foundation. (2023). Low Pay Britain 2023

The Work Foundation. (2023). The Disability Gap: Insecure work in the UK.

WPI Economics. (2024). Disabled people’s extra burden of essentials.

This report would not have been possible without the input of disabled people. They supported this research through their involvement in Scope’s Lived Experience Research Panel. We thank them for their time, energy and sharing their experiences with us.

We would like to thank colleagues from the Joseph Rowntree Foundation, who have worked with us closely throughout this research. In particular:

• Iain Porter. For his expertise, policy ideas and focus throughout the project.
• Dan Tomlinson. For his expertise and input in the planning and first stages of the project.

Thank you to all of our Scope colleagues who worked hard to make this research possible. Especially:

• Caleb Hayes. For his support throughout the research. Particularly with qualitative analysis and recruiting participants and prioritising their welfare.
• Ian Paynter. For his support with the project and quantitative analysis.
• Zoya Javed. For her support in the planning stages and conducting Stage 2 fieldwork.
• David Southgate and Frankie Bowyer. For their policy input throughout the drafting process.
• Dr Serena Wright. For feedback on the drafts of this report.
• Dr Leticia Veruete-Mckay and Fiona Thomson. For supporting with and confirming quantitative data.
• LC Groux-Moreau. For their help and expertise on report accessibility.
• Elisabeth Ward. For her help with report accessibility.
• Heather Reeve. For her help with chart accessibility.
• Heather Perkins. For her help with summary content.

Demographic characteristics for participants claiming UC and/or ESA (n=382)

Survey respondents for each survey, with detail of participants claiming UC health element and/or ESA and those who have had a WCA