Source · Select Committees · Public Accounts Committee
Recommendation 24
24
Rejected
Fifteen percent of initial PIP benefit decisions are revised or overturned on appeal
Conclusion
As part of the Programme, the Department wants to ensure that the new service provides “getting the decision right the first time more of the time”. It recognised this may mean it needs to spend “more time up front to get the decision right the first time”.47 When claimants are unhappy with the initial benefit decision they have the opportunity to appeal through a mandatory consideration and then ultimately to a tribunal. Between April 2018 and March 2022, the Department made 2.1 million initial decisions about applications for PIP, of which 0.5 million claimants raised a mandatory reconsideration. Around 15% of the initial decisions where the claimant was not awarded full amount of PIP payment were later revised – either by the Department through mandatory reconsideration or by being overturned at appeal.48 The Cystic Fibrosis Trust reported that sufferers who it had supported through the tribunal process had their case decided in their favour.49
Government Response Summary
The government explicitly disagrees with the committee's implied recommendation regarding 'right first time' decisions and overturn rates. It states it has started publishing new HTP MI quarterly and already publishes overturn rates in PIP Official Statistics, and will look to include equivalent measures in future HTP publications.
Government Response
Rejected
HM Government
Rejected
The government disagrees with the Committee’s recommendation. On 19 December 2023, the department published the first in a new series of HTP MI. Publication of this MI will continue quarterly in line with the PIP Official Statistics release schedule. This release includes monthly information on the number of referrals to the Health Transformation Area (HTA). As the programme and underlying data systems mature, the department will be able to evolve this publication to report against KPIs and underlying performance metrics. Health assessments are conducted on the same legislative basis and same clinical standards across providers. The department will keep under review what data can be published on performance of the existing providers and is currently designing the publication strategy for when new FAS contracts are in place from Autumn 2024. The department already publishes overturn rates at Mandatory Reconsideration (MR) and appeal in the PIP Official Statistics and will look to include equivalent measures within future HTP statistical publications once the service is suitably developed and robust, and where publishing will provide a representative picture of the HTP’s progress.