Guidance

Guidance for health and disability assessment providers carrying out face-to-face assessments during COVID-19

Updated 15 August 2022

Applies to England, Scotland and Wales

1. Introduction

1.1 Purpose of the document

1.1.1 This document has been produced for the Department for Work and Pensions’ (DWP) health and disability assessment providers – Centre for Health and Disability Assessments (CHDA), Capita and Independent Assessment Services (IAS) – and the DWP Assessment Centres.

1.1.2 It draws on existing published sources including national infection protection and control and other public health material, and guidance from the Department for Business, Energy and Industrial Strategy (BEIS) and Health and Safety Executive (HSE). The Department has consulted with the Department of Health and Social Care (DHSC), UK Health Security Agency (UKHSA) and HSE and taken into consideration comments provided by Cabinet Office, Scottish and Welsh Government officials, public health bodies in Scotland and Wales and the Department’s Chief Medical Officer.

1.1.3 The document sets out minimum standards for the physical building measures, safe systems of working and personal protective measures that must be in place at Assessment Centres for the purposes of face to face health and disability assessments. As such, the document reflects the Department’s national approach, referencing published sources for England and generally uses terminology common across England. The Department recognises the Scottish and Welsh equivalents and provides links to relevant published sources of guidance throughout and in Annex B (“Key guidance resources”). The guidance will be kept under review to ensure the Department’s approach remains aligned with published government, public health and HSE guidance.

1.1.4 It is essential that the standards outlined are followed to minimise the risk of infection and help protect claimants and Provider personnel – both healthcare professionals (HCPs) undertaking the face to face assessments and non-clinical staff involved in running the Assessment Centre operation. The safety and protection of everyone working in or attending an Assessment Centre is of paramount importance to the Department.

1.2 Risk assessment

1.2.1 The Department is taking a risk-based approach in the standards set for Assessment Centre safety; risks have been assessed in line with published HSE and Working Safely guidance – links in 1.2.6 below.

1.2.2 Limiting transmission of the COVID-19 virus requires a range of infection prevention and control measures, which can be considered as a hierarchy of risk controls.

1.2.3 The Department has identified reasonable and practical measures to control and manage COVID-19 risk in the Assessment Centre environment. Such measures will help prevent the introduction of infection and control and limit the transmission of infection. The control of exposure at source, including adequate ventilation systems and effective environmental decontamination will physically reduce potential exposure to infection.

1.2.4 Applying these preventative measures in line with the hierarchy of controls, routinely and systematically, should reduce the COVID-19 risk to the lowest reasonably practicable level. DWP has outlined when the final level in the hierarchy of controls be required – use of personal protective equipment (PPE) in Annex A.

1.2.5 In line with health and safety guidance and business as usual practices, risk assessments should be kept under review to ensure that risks identified are up to date and controls in place are still relevant.

1.2.6 Further information about risk assessment can be found at:

• HSE guidance: Managing risks and risk assessments at work
• Government guidance for England: Reducing the spread of respiratory infections, including COVID-19, in the workplace
• Government guidance for Scotland: Coronavirus (COVID-19): safer workplaces and public settings
• Government guidance for Wales: Public health guidance for employers, businesses and organisations: coronavirus

1.3 Structure of the document

1.3.1 This document maps the claimant journey through the Assessment Centre from entering the building, the reception and waiting room environments, moving around the site, the assessment room itself and leaving the building. It also includes details of information claimants will receive in advance of their assessment and what they should take into account before the appointment.

1.3.2 For each element of the journey through the Assessment Centre, the guidance describes the physical and personal protective measures to make sites COVID-19- secure and ensure the safety of Provider staff and claimants.

1.3.3 As mentioned at 1.2.4 Annex A includes detailed guidance on the assessment room environment in ‘Guidance for healthcare professionals undertaking face-to-face assessments for Industrial Injuries Disablement Benefit (IIDB), Work Capability Assessment (WCA) and Personal Independence Payment (PIP)’. This section of the guidance sets out the measures to ensure the safety of healthcare professionals and claimants in the assessment room.

1.4. Estates arrangements

1.4.1 Physical measures for front of house settings were developed in partnership with DWP Estates based on those in place in the DWP Jobcentre Plus environment and DWP provided detailed plans for the installation of social distancing measures, including example floor plans and signage for the Assessment Centres.

The Department acknowledges that the estates arrangements differ between Providers, and similarly there are differences in landlord arrangements (for example, some sites are shared with the Department; some with other businesses; and others are stand-alone Assessment Centres). Therefore, the Department accepts that it will not have been possible for physical COVID-19 precautionary measures to be replicated exactly in all sites.

1.4.2 As we continue to move to a ‘Living with Covid’ environment, activity is underway to remove signage and floor markings across DWP Estates. Some signage will remain and is outlined in this document, particularly in assessment rooms and toilets.

1.4.3 The over-riding requirement is to ensure that the broad principles and minimum standards described in this document relating to physical measures are applied in the most appropriate way. DWP Contract Management and Partner Delivery Account Team colleagues will discuss assurance arrangements separately.

2. Claimant Journey

2.1 Prior to assessment

2.1.1 Appointment Letter: Claimants invited to a face to face assessment will receive additional information with their invitation letter.

2.1.2 The appointment letter will highlight claimants should not attend their appointment if, at the time of the assessment, they, or anyone coming to the assessment with them:

• have symptoms of COVID-19 - see 2.1.4 below; or
• have tested positive for COVID-19

2.1.3 Claimants will be referred to guidance in England, Scotland or Wales, which include information about the requirements for staying at home and avoiding contact with people in certain circumstances.

2.1.4 Symptoms of coronavirus (COVID-19) in adults can include:

• a high temperature or shivering
• a new, continuous cough
• a loss or change to your sense of smell or taste
• shortness of breath
• feeling tired or exhausted
• an aching body
• a headache
• a sore throat
• a blocked or runny nose
• loss of appetite
• diarrhoea
• feeling sick or being sick

and either:

• they have a high temperature
• they do not feel well enough to go to work or do their normal activities

Claimants should try to stay home and avoid contact with other people if they have symptoms of COVID-19.

More information is available on the NHS website.

2.1.5 If they cannot attend their appointment for the reasons outlined above, claimants are advised to contact the Assessment Provider to rearrange.

2.1.6 The additional information also states that claimants must not bring children to the assessment. They are asked to contact the Provider if they cannot make childcare arrangements so that the Provider can consider the best way to carry out the assessment.

2.1.7 The additional information will recommend claimants (and companions where present) wear a face covering when attending the Assessment Centre unless a reason not to applies. Government guidance on face coverings is available online for England, Scotland or Wales.

2.2. Entering the Assessment Centre

2.2.1 Hand sanitiser: Hand sanitiser will be provided at the entrance of the site, to be used by claimants and companions on entering the building. The security guard (if there is one), site staff or Provider staff are responsible for reminding claimants, and companions where present, to use the hand sanitiser provided on entering the Assessment Centre.

2.3 Reception/waiting area

2.3.1 Waiting area: Claimants are requested not to arrive more than 10 minutes early for their assessment.

2.3.2 Reception screens: Screens may be in place at the designated signing in desk/reception counter in all Assessment Centres. These screens (with or without audio holes) assist in providing a safer environment for reception staff without the need for them to wear face coverings or additional PPE.

2.3.3 Document handover: Where claimants need to provide documents (for example, evidence of identity or medical condition information), these should be submitted in line with Providers’ specific processes. Hand sanitiser should be available for claimants to use before passing documents over and again on receiving them back.  Provider staff are also advised to hand sanitise before handling the documents and after passing the documents back to the claimant. 

2.3.4 Confirming symptoms: Claimants and companions, where present, will be asked to provide information relating to symptoms in 2.1.4 above.

2.3.5 Where the Provider has concerns about the claimant/companion having or potentially having the virus in light of information provided or symptoms displayed, they should be requested to leave the Assessment Centre and advised to follow NHS advice on what to do next. The Provider should follow their business as usual guidance for re-arranging the appointment.

2.3.6 Where the opinion of the claimant or companion differs to the opinion of Provider personnel as to the presence of symptoms, the opinion of the Provider will take precedence, taking into account published guidance on symptoms as 2.1.4 above refers.

2.3.7 The Department recognises that there will be different guidance relating to cleaning across the different parts of Provider estate. Providers are advised to follow the relevant cleaning guidance in place for their Assessment Centres where a claimant has presented with suspected or confirmed case of COVID-19. The principles for cleaning following a suspected or confirmed case are detailed in 3.1.3 below.

2.4 Getting to the assessment room

2.4.1 Circulation areas: Circulation areas within sites will be managed by the security guard (if there is one), site staff or Provider staff. Arrangements may differ as recognised in earlier parts of this document.

2.5 In the assessment room

2.5.1 Signage: Signage will be in place on assessment room doors to indicate if the room is in use.

2.5.2 Hand sanitiser: The Provider should ensure there is hand sanitiser in the assessment room for the HCP to use between assessments. Where the assessment room has a sink in it, normal hand washing can be undertaken instead. There is no requirement for hand sanitiser for claimants to use in the assessment room as it will be available at reception and entry/exit points to the building.

2.5.3 Assessment: PIP and WCA assessments will be no-touch. IIDB assessments will continue as normal (but see 2.5.4 below).

2.5.4 PPE and face coverings: The ‘Guidance for Health Care Professionals Undertaking Face-to-Face Assessments’ for Industrial Injuries Disablement Benefit (IIDB), Work Capability Assessment (WCA) and Personal Independence Payment (PIP)’ (Annex A) sets out PPE requirements for IIDB that should be worn and highlights that PPE use for all other assessments is at HCP discretion. Claimants, companions (where present) and the HCPs should keep face coverings on throughout their time in the Assessment Centre if they have chosen to wear one.

2.5.5 Terminating an assessment: If the healthcare professional has concerns about the claimant/companion having or potentially having the virus in light of information provided or symptoms displayed during the assessment itself, the assessment should be terminated and steps taken in line with 2.3.5 – 2.3.6 above.

2.5.6 Providers should follow the relevant guidance for their Assessment Centres in relation to cleaning following a suspected or confirmed case (see 3.1.3 below).

2.6 Exiting the assessment room/centre

2.6.1 Exiting the assessment room: HCPs will ensure the corridor is clear before the claimant leaves the room.

2.6.2 Hand sanitiser: Hand sanitiser will be provided at the site exit for claimants to use. The security guard (if there is one), site staff or Provider staff are responsible for reminding claimants, and companions where present, to use the hand sanitiser provided when exiting the Assessment Centre.

2.6.3 Exiting the site: Provider staff should ensure that the claimant and companions leave the building promptly to minimise the number of people in the Assessment Centre at any one time.

3. Additional Information

3.1 Cleaning

3.1.1 Standard additional cleaning

3.1.1.1 Additional cleaning is no longer required at all sites, and all sites are to revert to pre-pandemic cleaning measures that were in place prior to the pandemic. It is recognised, however, that exact cleaning arrangements may differ in line with different Provider estates settings.

3.1.2 Within the assessment room

3.1.2.1 As stated at 3.1.1.1, Providers are to return to pre-pandemic cleaning regimes therefore there is no longer a requirement to ensure that high frequency touchpoints and areas that the claimant has had prolonged contact with, receive a touchpoint clean unless there has been a suspected or confirmed case – see 3.1.3 below.

3.1.3 Specific cleaning if a suspected or confirmed case

3.1.3.1 The guidance below is relevant if there is a suspected case of COVID-19 and/or where a claimant or their companion has tested positive for the virus recently and where:

• they are currently in the Assessment Centre; or
• their appointment has taken place in the previous 72 hours.

3.1.3.2 Information that there has been a positive COVID-19 test result could be advised by the claimant themselves on the day of the assessment or subsequently.

3.1.3.3 Public areas where a symptomatic person has passed through and spent minimal time, but which are not visibly contaminated with body fluids, such as corridors, can be cleaned thoroughly as normal.

3.1.3.4 All surfaces that the symptomatic person has come into contact with should be cleaned and disinfected, including all potentially contaminated and frequently touched areas, such as toilets, door handles, telephones and grab rails in corridors and stairwells (targeted touchpoint cleaning).

3.2 Business continuity plans

3.2.1 Providers should follow their existing business continuity plans for actions to take in the event of a site closure and the subsequent need to cancel appointments.

3.3 PPE and face coverings for clinical and non-clinical staff

3.3.1 The most effective methods of preventing the transmission of COVID-19 are still regular hand hygiene and good respiratory hygiene. HSE guidance is that where these measures are robustly and systematically applied within a hierarchy of risk control principles, the risk of disease transmission will be significantly reduced.

3.3.2 PPE: The ‘Guidance for Health Care Professionals Undertaking Face-to-Face Assessments’ for Industrial Injuries Disablement Benefit (IIDB), Work Capability Assessment (WCA) and Personal Independence Payment (PIP)’ (Annex A) sets out the PPE requirements to be worn by HCPs for IIDB assessments. It also outlines where HCPs have discretion over wearing PPE for all other benefit assessments.

3.3.3 Where PPE is to be used, it is important that staff understand how to put it on and remove it safely. Providers should ensure this is reflected in relevant upskilling material/sessions. Information quick guides/posters are available online:

• Guide to donning and doffing PPE
• Taking of personal protective equipment (PPE) Standard Infection Control Precautions

3.3.4 Protective screens at reception points provide a safer environment for staff without the need for them to wear additional PPE.

3.4 Disposal of PPE and face coverings

3.4.1 Before and after PPE or face coverings are put on and removed, the wearer should wash their hands or use hand sanitiser.

3.4.2 Used face coverings or PPE, such as gloves, should be disposed of as follows:

• In the ‘black bag’ waste bin
• Do not put them in a recycling bin as they cannot be recycled through conventional recycling facilities.

3.4.3 Used face coverings or PPE, such as gloves, do not need to be:

• Put in an extra bag
• Stored for a time before throwing them away.

3.4.4 Waste does not need to be segregated unless an individual in the setting shows symptoms of, or tests positive for, COVID-19.

3.4.5 Personal waste from individuals with symptoms of COVID-19 and waste from cleaning of areas where they have been (including PPE, disposable cloths and used tissues):

• Should be put in a plastic rubbish bag and tied when full
• The plastic bag should then be placed in a second bin bag and tied
• This should be put in a suitable and secure place and marked for storage

3.4.6 This waste should be stored safely and should not be placed in communal waste areas until the waste has been stored for at least 72 hours.

3.4.7 If the individual undertakes a COVID-19 tests and the result is reported as negative, this waste can be disposed of immediately with the normal waste.

3.4.8 If COVID-19 is confirmed, this waste should be stored for at least 72 hours before disposal with normal waste.

3.5 Air conditioning/ventilation

3.5.1 In line with the UK Health and Safety Agency on ventilation and air conditioning, Providers will consider ways to maintain and increase the supply of fresh air in assessment rooms; for example, by opening windows and doors (unless fire doors), where this is possible and does not risk claimant privacy/confidentiality/safety.

3.5.2 Most types of air conditioning system will be used as normal. Where a centralised ventilation system that removes and circulates air to different rooms is in place, the recirculation setting will be turned off, replaced with a fresh air supply setting.

3.5.3 Estate management should assess whether there are any sites that present a risk in terms of air conditioning.

3.6 Toilets

3.6.1 Toilets inside premises should be kept open.

3.6.2 Providers should take the following steps:

• Use signs and posters to build awareness of: good handwashing technique; the need to increase handwashing frequency; the need to avoid face touching; and the need to cough or sneeze into a tissue that is binned safely, or into your arm if a tissue is not available
• To enable good hand hygiene, ensure suitable handwashing facilities (including running water and liquid soap) and suitable options for drying (either paper towels or hand driers) are available
• Keep the facilities well ventilated; for example, by fixing doors open where appropriate
• Put up a visible cleaning schedule and keep it up to date and visible

Annex A: Guidance for healthcare professionals undertaking face-to-face assessments for Industrial Injuries Disablement Benefit (IIDB), Work Capability Assessment (WCA) and Personal Independence Payment (PIP)

This guidance assumes that the estate is COVID-secure i.e. optimal hand hygiene, cleaning and surface decontamination, adequate ventilation and other measures where appropriate.

This guidance refers to additional measures necessary within the assessment room during a face-to-face assessment.

1. Assessments should not proceed if a claimant displays any symptoms of
COVID-19 e.g.

• a high temperature
• a new, continuous cough
• a loss or change to sense of smell or taste
• shortness of breath
• feeling tired or exhausted
• an aching body
• a headache
• a sore throat
• a blocked or runny nose
• loss of appetite
• diarrhoea

• feeling sick or being sick

  and either:

• they have a high temperature
• they do not feel well enough to go to work or do their normal activities

If a claimant starts to display symptoms during an assessment, the assessment should be terminated and the claimant advised to leave the Assessment Centre and follow NHS advice on what to do next. The claimant should be advised that the assessment will be rearranged.

2. For all benefit assessments claimants (and companions where present) are recommended to wear a face covering.

3. Claimants must be assessed (and companions allowed with them in the assessment room) whether or not they are wearing a face covering.

4. Providers’ risk assessments (see section 1.2 in the main document) should consider all factors on a case by case basis to determine if:

• additional reasonably practicable measures should be adopted by the HCP; or
• an alternative mode of assessment is appropriate/possible.

5. For all benefit assessments, except IIDB, it is at HCP discretion as to whether a face mask is worn. If a HCP wears a face mask, this should, as a minimum requirement, be a fluid-resistant (Type IIR) surgical mask. This should be safely removed and discarded after each assessment.

6. Should the Provider/HCP deem that reasonably practicable measures referred to in paragraph 4 above involve wearing a higher medical grade mask, Providers should ensure these are purchased through DHSC central procurement.

7. The HCP may wear additional eye or face protection e.g. a visor or goggles if necessary. As in paragraph 4 above, the use of these should be based on assessment of risk and should be worn if blood and/or body fluid contamination to the eyes or face is anticipated or likely (e.g. in close contact IIDB assessments).

Note: Current evidence is that visors alone do not offer adequate protection. The addition of face coverings or masks in an enclosed space offers further protection.

8. For WCA and PIP the assessment will be no-touch.

9. For IIDB:

a) The HCP will wear a fluid-resistant (Type IIR) surgical mask.

b) The HCP will be required to wear additional PPE when directly assessing and examining a claimant.

c) Additional PPE will consist of:

• Single use disposable gloves; and
• Single use disposable plastic apron

10. For all other assessments:

a) The HCP is not required to wear additional PPE but can do so at their own discretion

b) Like IIDB, additional PPE will consist of:

• Single use disposable gloves; and
• Single use disposable plastic apron

11. All PPE to be safely donned, doffed and disposed of (as described in paragraph 3.3.3 of the main document).

12. See also 3.4 Disposal of PPE in the main document.

Annex B: Key guidance resources [Note: this is not an exhaustive liost]

General:

COVID-19 symptoms

People with symptoms of a respiratory infection

Risk assessment and controls

Working safely during the coronavirus outbreak

Reducing the spread of respiratory infections, including COVID-19, in the workplace

Coronavirus (COVID-19) – Advice for workplaces - hse.gov.uk

Living safely with respiratory infections including COVID-19 - www.gov.uk

Guide to donning and doffing PPE: Droplet Precautions

Taking off personal protective equipment (PPE) - standard infection control precautions

Information relating to Scotland, Wales and Northern Ireland

Scotland

Scottish Government website

Public Health Scotland

Health Protection Scotland

Wales

Welsh Government website

Public Health Wales

Northern Ireland

nidirect website

Public Health Northern Ireland