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

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

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

4. 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)

5. 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.

6. 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)

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

8. 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!

9. Tri-borough conference

10. 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

11. 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 sarah.radcliffe@nat.org.uk with any examplessarah.radcliffe@nat.org.uk

12. 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!

13. 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

14. 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

15. 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

16. ‘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)

17. 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 £108.15 a week (less for <25s) -no activity requirements Reviewed within a few years (new assessment)

18. 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

19. 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

20. 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) http://www.lifewithhiv.org.uk/

21. Contacts www.nat.org.uk @NAT_AIDS_Trust NAT (National AIDS Trust) sarah.radcliffe@nat.org.uk APPGH&A