Page 23 - Reforming Benefits Decision-Making

II. ADMINISTRATIVE DECISION-MAKING

“The administration of Philippa Day’s benefits claim was characterised by multiple
errors, some of which occurred repeatedly throughout the period of her claim….The
failure to administer the claim in such a way as to avoid exacerbating Philippa
Day’s pre-existing mental health problems was the predominant factor, save for her
severe mental illness, affecting a decision taken by Philippa Day to take an overdose
32
of her prescribed insulin on the 7th or 8th August 2019.”

2.1 The current application process for benefits often fails to correctly assess
individuals’ entitlement and does not accommodate individuals’ needs. This
Chapter examines the DWP/DfC decision making processes in relation to
making initial entitlement decisions, setting claimant commitments and
sanctions decisions. We review the procedures and processes for making first-
instance decisions to see if these can be improved so that a greater volume are
made correctly first-time round.

2.2 The proportion of successful appeals to the FTT (SSCS) remains high. In
2020/21, 75 per cent of PIP and ESA appeals and 61 per cent of UC appeals
33
were successful. In Northern Ireland 63 per cent of PIP appeals were
34
successful in 2019/20. In addition, in 2019/20, 29 per cent of PIP appeals
lodged were lapsed, meaning that the DWP changed its decision in the
35
appellant’s favour before it was heard by the Tribunal. Whilst this must of
36
course be viewed against the large volume of overall decisions made,
success rates this high indicate that there are fundamental issues with DWP

32 Her Majesty’s Assistant Coroner Clow, Regulation 28: Report to Prevent Future Deaths - Philippa
Jane Louise Day (died 16 October 2019) (February 2021), section 3.
33 Ministry of Justice, ‘Tribunal Statistics Quarterly: January to March 2021’ (10 June 2021), Main
Tables SSCS_3.
34 Northern Ireland Assembly, Official Report (November 2020). Statistics on the appeal success rate
for other benefits in Northern Ireland are not currently publicly available.).
35 DWP, ‘PIP Statistics to January 2021’ (March 2021) Table 5B: PIP experimental statistics by period
of initial decision, initial decisions following a PIP assessment, MRs and appeals. Similar statistics are
not available for ESA and UC.
36 From April 2019 to March 2020, 781152 PIP decision were made (DWP, Stat-Xplore: PIP
Clearances).

14