Sarah Radcliffe Policy & Campaigns Manager, NAT PIP, benefits changes & HIV Tri-borough HIV forum conference 18 March 2015

Who are NAT? The UK’s HIV policy and campaigning charity (since 1987). Our goals: Tri-borough conference

Overview Tri-borough conference What is coming What you can do about it What NAT is doing about it

PIP basics Tri-borough conference Personal Independence Payment (PIP) Gradually replacing Disability Living Allowance (DLA) Extra-costs benefits (not income-replacement), tax-free ‘Daily living’ and ‘mobility’ components - each paid at 2 rates (‘standard’ and ‘enhanced’) Fixed-term awards (most 2-5 year)

Tri-borough conference 9.4% of all people accessing HIV care in 2014 also received DLA Of the 7,680 recipients, 50% on higher rate care and 77% on higher rate mobility Majority receive both care and mobility components.

PIP assessment Tri-borough conference ‘Functional’ (NOT medical) assessment Ability to carry out set activities (tick box/ points) “safely, reliably, repeatedly and in a reasonable time period” Most will have face-to-face assessment with Atos or Capita, in addition to sending own evidence Special rules for people with terminal diagnosis (<6months)

Tri-borough conference THRESHOLDS Standard rate: 8 points Enhanced rate: 12 points

PIP award Tri-borough conference Daily living Standard:£54.45 / week Enhanced:£81.30 / week Mobility Standard: £21.55 / week Enhanced: £56.75 /week PASSPORTED BENEFITS!

Tri-borough conference

PIP roll-out Tri-borough conference All new claims will be PIP (not DLA) DLA claimants in specific postcodes are re-assessed IF: A fixed-term award is coming to an end There has been a change in circumstances reported They are turning 16 (‘natural reassessment’) All long-term awards will be re-assessed from October 2015 onwards (‘managed reassessment’) - must meet new PIP criteria to be paid award in future

PIP interventions Tri-borough conference Successful claimants subject to additional review part-way through a fixed-term claim Claimant will be sent the ‘PIP 2’ evidence form again NAT is fighting this policy in coalition with broader disability organisations Contact with any

PIP – what you can do Tri-borough conference Start planning now - make time Consider activities list and scores – be realistic Evidence gathering – NAT/NHIVA guides Budgeting support Reconsideration and appeals Tell NAT!

PIP – what NAT is doing Tri-borough conference Campaigns work during development stage Delay roll-out for long-term awards Safety/reliability/reasonable standard criteria ‘HIV insight reports’ for Atos and Capita Independent Review of PIP DWP implementation stakeholder forum Opposing ‘interventions’ policy Information for plwh and their support organisations/clinics

ESA basics Tri-borough conference Employment and Support Allowance (ESA) For people who can’t work due to disability or long-term serious health problems Work-related activity (WRAG) and support groups ‘Contributory’ or ‘income-based’ – depending on NI payments Contributory WRAG limited to 12 months’ payment

ESA assessment - WCA Tri-borough conference Work Capability Assessment (WCA) Functional assessment using activities/descriptors/points Almost all claimants will have face-to-face assessment with Maximus (some support group claims decided ‘on paper’) Fluctuation SHOULD be taken into account by assessor, BUT safety/reliability/repeatability not written into regs as with PIP ‘majority of the time’ test tends to be used

‘Non-functional descriptor’ Tri-borough conference “A claimant is suffering from some specific disease or bodily or mental disablement and, by reasons of such disease or disablement there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work/ work-related activity” (and this risk cannot be controlled through treatment and/or reasonasble workplace adjustments)

ESA award Tri-borough conference Work-related activity group: up to £72.40 a week (less for <25s) - some activity requirements (NOT required to job search) Support group : up to £ a week (less for <25s) -no activity requirements Reviewed within a few years (new assessment)

ESA – what you can do Tri-borough conference Focus on FUNCTION and workplace impact of symptoms - not specific diagnosis – when helping clients Get key Drs/nurses on-side early for evidence – NAT/NHIVA guides Keep a diary of fluctuation Remember the non-functional descriptor Know the rules on mandatory reconsideration/ appeals and time limits

ESA – what NAT is doing Tri-borough conference Report on initial impact (2010) 5 Independent Reviews (Harrington/Litchfield) Evidence Based Review of the WCA Semi-structured interview approach Engaging with Maximus (new provider) on training and roll-out

Resources Tri-borough conference PIP factsheet for PLWH ESA factsheet for PLWH Guide to benefits evidence for clinicians (with NHIVA) Guide to benefits evidence for PLWH (with NHIVNA)

Contacts NAT (National AIDS Trust) APPGH&A