Research and analysis

Executive summary

Published 7 October 2024

In 2022, the Department for Work and Pensions (DWP) commissioned Basis Social, an independent research agency, to carry out research with health and disability benefit claimants to understand how the use of specialism in health assessments may improve the assessment process. This research was commissioned to provide DWP with evidence of the potential impact different forms of specialist intervention may have on claimants’ experience of assessment processes. In this research, specialism is defined, in the broad sense, as Healthcare Professionals (HCPs) who can use targeted skills and knowledge around a specific condition group because of their professional background or training provided by DWP. It is important to note, that although the term ‘specialist’ is referenced throughout this report, at the time of publication, the term ‘specialist’ is no longer used to refer to assessors in the context of Personal Independence Payment (PIP).  

The research comprised of 30 participants taking part in one-hour, online in-depth interviews which included participants listening to, discussing, and comparing two, partial, mock assessments. All participants were in receipt of PIP and/or Universal Credit/Employment and Support Allowance (UC/ESA) and had been through a disability benefit assessment process in the past twelve months. The sample was selected across three health condition areas: ‘think and feel differently’ (including mental health needs, learning difficulties), ‘sense differently’ (including blind and partially sighted individuals) and ‘other’ (including complex health challenges, chronic pain). The mock assessments explored four types of specialism: static resource (for example, case studies, handbooks), specialist support (for example, HCPs with condition focussed experience available to provide advice), specialist HCP training, and recruited specialists (for example, HCP specialists from NHS).  

Overall, the interviews showed that participants were, generally, in favour of specialisation. Participants highlighted the importance of feeling understood, listened to and supported by their assessor, and being able to freely discuss the complexities of their individual case. Specialism was viewed as a way of improving the assessor’s ability to understand health conditions and their functional impacts on daily life. Similarly, greater specialism led participants to report that they would feel more at ease during their health assessments, as it helped build trust and confidence.  

In some cases, participants reported that they would be willing to wait longer in order to be matched with a specialist. Moreover, some participants were willing to compromise on the mode in which the assessment was conducted to guarantee being seen by a specialist, for example having an online or telephone assessment instead of face-to-face. In general, participants showed preference for online or telephone assessments, however, this was dependent on the type of health condition the participant had. For instance, mobility conditions were believed to be better suited for in-person assessments as it was felt that it was important for the assessor to see how the condition presents in real life.  

Knowing the assessor was an HCP with years of experience and had reviewed and understood their case was satisfying for participants. It was also viewed positively when assessors introduced their specialism at the start of the health assessment. Although this was seen to build rapport, when the assessor’s specialism was over-emphasised, it had a negative impact, with some participants doubting the assessor’s credibility and ability to individualise the assessment.  

The positive findings regarding the assessment introduction demonstrates that there are alternative routes that can be taken to improve claimant confidence in health assessments, beyond explicitly matching claimants to assessors with condition specific skills and backgrounds.