Unlocking benefits: Tackling barriers for disabled people wanting to work

Tackling hardship for people receiving work-related disability benefits

People receiving ‘work-related disability benefits’ – health-related Universal Credit (UC) or Employment and Support Allowance (ESA) – face unacceptable levels of hardship. A quarter of adults on health-related UC used a food bank in the last year, and a third were unable to afford to keep their house warm. This compares to 3% and 11%, respectively, for the general working-age population.

Three-quarters of adults receiving health-related UC are experiencing material deprivation. This is even higher than the two-thirds of adults receiving non-health-related UC experiencing material deprivation. This compares to a fifth for the general working-age population.

Even comparing only within families on UC where no one is in work, people receiving health-related UC have a similarly high risk of deprivation as people receiving non-health-related UC. This is despite extra health-related payments via the Limited Capability for Work and Work-Related Activity (LCWRA) element.

Scope’s latest research shows that, on average, disabled households need an additional £1,010 a month to maintain the same standard of living as non-disabled households, although this will vary according to individual circumstances.

Tackling hardship must involve improving circumstances for people receiving work-related disability benefits. With so many people being held back from participating in good jobs, this is also crucial to the Government’s objectives around economic growth and security for all.

There are 2 main routes to addressing the hardship facing people receiving work-related disability benefits. Firstly, increasing the adequacy of these benefits, which are vital lifelines for disabled people; and secondly, supporting disabled people who can work into the labour market.

The Joseph Rowntree Foundation’s (JRF) programme of work with Trussell on an Essentials Guarantee is a response to the first route. It would help ensure UC provides anyone who needs it with enough support to at least afford essentials.

This present policy report is focused on the second route. It proposes several reforms to work-related disability benefits and related employment support. JRF has designed these with input from disability equality charity Scope, informed by our new joint research published alongside this report. This involved in-depth discussions with and surveys of disabled people.

Drivers of the recent rise in work-related disability benefit caseloads

The recent spike in work-related disability benefit caseloads has propelled the issue to the top of policymakers’ concerns. Worsening population health and its interaction with structural factors are likely to be key drivers. Examples of structural factors include the condition of health-related public services (like the NHS or social care) and the labour market (such as how adapted jobs are for people with health conditions).

The cost-of-living crisis, combined with factors such as extremely inadequate basic safety net support, could also have increased the take-up of previously underclaimed work-related disability benefits. Seeking to reverse higher take-up would be regressive and worsen hardship for a group already under disproportionate pressure. Attempting to do so via changing entitlement levels would probably also be ineffective because people claim these benefits for numerous reasons. For example, they had to leave their job because they became ill and needed help covering basic living costs. Most work-related disability benefit claimants we surveyed said that, when they started their claim, they did not know it could result in extra income in addition to basic UC or did not know how much extra it was worth.

The Government should focus on the most significant barriers to work

Instead, the Government should directly address the root causes of people being on work-related disability benefits. This includes tackling the most significant barriers to work for people receiving them. These relate to ill health and the labour market, including jobs that are not accepting or supportive enough of people who become ill or are disabled.

Policy must focus on improving population health and healthcare. It needs to ensure that jobs are designed to be much more viable for disabled people and more supportive when employees become ill. This means, for example, increasing job adaptability, flexible working and changing employer attitudes towards disability.

The work-related disability benefits system and related employment support also create significant barriers to work. This is the focus of the analysis and proposals in this report.

Risks associated with moving towards work

The benefits system includes structural barriers that result in not enough disabled people who want to work feeling able to try it. Chief amongst these are the sense of insecurity and the risk of losing benefits or being made otherwise worse off because of engaging with DWP or moving into work. Almost three-quarters of work-related disability benefits recipients we surveyed said that fear of losing benefits was a significant or very significant barrier to work.

This fear has 3 key aspects: 

• fear of trying work or engaging with employment support leading to benefit reassessments, loss of Personal Independence Payment (PIP) or extra support in UC, increased conditions, or the risk of sanctions
• insecurity about trying work but then not being able to fall back on the same safety net, with the same conditions, should the job not work out
• concern that wages may not be enough to offset the withdrawal of benefits or the overall financial gain not being enough to outweigh the considerable risks.

This is exacerbated by confusion and a lack of clear communication from DWP about existing benefit rules on work. Around 60% of work-related disability benefit recipients we surveyed said either they are not allowed to work, or they are not sure if they are allowed to work. This is despite there being no theoretical limit on the amount of work that health-related UC recipients are allowed to do.

Culture of distrust, fear and negativity

The sense of insecurity and risk is underpinned by low trust in DWP and a culture of fear and negativity. This rests on a series of negative interactions with the system experienced by disabled people, including traumatic experiences of assessments. People feel these are unfair, focus on irrelevant things, and can be incredibly stressful and demeaning:

I found it a really traumatic experience, the whole process broke me a bit.

Also a factor are everyday interactions with DWP, where disabled people, often at extremely challenging points in their lives, feel they have not been treated with dignity, respect or compassion:

And it’s really, like, degrading, really, to have to be almost forced to go to those meetings, but then having those experiences every time.

Jobcentres are focused on monitoring compliance rather than understanding people’s support needs. This results in a pervading fear of sanctions and unsuitable conditions. These can also be counterproductive, potentially worsening health and increasing hardship.

The language and labels used within the work-related disability benefits system also embed a sense of being ‘written off’. Examples include phrases such as ‘limited capability for work’, ‘incapable of work’ or ‘not fit for work’. This reinforces a negative sense amongst some disabled people who want to try work of being defined by the Work Capability Assessment (WCA) as incapable of doing so.

Lack of engagement from DWP and poor employment support

These structural and cultural barriers in the system combine with a lack of proactive, positive engagement from DWP and poorly tailored employment support. Of the people we surveyed who were in the UC LCWRA group (or ESA Support Group), 30% said they had never been contacted by the DWP, a Jobcentre or a work coach since starting to receive their benefit. A further 23% said they had been contacted less than once a year.

A fresh approach to benefit reform is needed

These barriers to work in the benefit system must be addressed, alongside labour market reforms that are designed to improve the suitability and adaptability of work for disabled people. This will help ensure the entire welfare–employment system works together to support more people on work-related disability benefits into work and out of hardship.

However, plans laid by the previous Government risk worsening these barriers and increasing hardship. The new Government needs to urgently scrap these plans:

Recommendation: Do not pursue similar restrictions to the previous Government’s planned changes to the WCA ‘activities’ and ‘descriptors’ criteria from 2025. These changes would restrict extra financial support to over 400,000 disabled people making a new claim, increasing hardship with very limited employment gains.

Recommendation: Scrap the plan to make individual work coaches solely responsible for deciding if disabled people can be sanctioned. This plan would intensify fears about positively engaging with work coaches or trying work.

Recommendation: End the proposal to make receipt of PIP the sole determinant of whether extra UC support will be awarded. This proposal would not be the hoped-for silver bullet to eliminate people’s fear of losing benefits because it does not tackle the full range of fears people have about engaging with work. It would also increase hardship by excluding over 600,000 disabled people in the future from extra financial support.

Instead, the Government should take a fresh approach to benefit system reform, working alongside disabled people to put forward an alternative reform agenda from the previous Government.

Reducing the risks attached to engaging with work

Recommendation: A comprehensive ‘Work Transition Guarantee’ should be put into law. This would guarantee that if someone takes certain steps towards or starts work, then DWP cannot ask them to do a WCA or PIP reassessment for at least 18 months. It would also guarantee that if someone moves off benefits into work but needs to reclaim them within 18 months, their previous benefit status would be reinstated in full immediately, including their level of financial support and conditions. A claimant would still be able to request a reassessment if they wanted one, for example if their health condition had worsened.

This should help address the range of risks people worry about when they want to engage with support or try work. However, woefully inadequate communication of existing work-friendly aspects of UC also needs to be improved.

Recommendation: DWP should instigate a step-change in awareness of health-related UC’s existing work-friendly features. For example, UC allows people to work as much as they want while keeping the LCWRA element and ensures they are better off financially in work (with UC being only gradually withdrawn after earnings rise above a ‘work allowance’ level). UC can also be reclaimed within 6 months, with previous benefit status reinstated immediately without reassessment.

Further enhancing these features would reduce risk and increase the potential upsides of trying work.

Recommendation: The Government should increase UC’s work allowances for disabled people and extend the UC reclaim period to 18 months.

Finally, many disabled people are concerned about WCA reassessments leading to a ‘fit for work’ outcome because the basic rate of UC is so inadequate and because they would face intensive work search conditions and a high risk of being sanctioned. Moves to lessen these harsh potential consequences would reduce the risk of engaging with employment support or trying work.

Recommendation: The Government should introduce an Essentials Guarantee to ensure everyone receiving UC has a protected minimum amount of support to at least afford essentials. It should also reduce the intensity of conditionality and sanctions in non-health-related UC.

Improving trust in DWP, fixing assessments and changing culture

The Government must increase trust and change the culture of fear and negativity to improve engagement with employment support and foster more opportunities to move towards work. Reducing the stress, fear and inefficiency of assessments is crucial.

Recommendation: DWP must work with disabled people to develop a replacement for the WCA. At a minimum, the assessment should be undertaken by expert, appropriate assessors with a deep understanding of applicants’ conditions and circumstances.

We also encourage the Government to reduce the number of assessments that disabled people face. For example, a ‘dual gateway’ to work-related disability benefits could avoid the need for most disabled people on UC to undergo both a WCA and a PIP assessment.

Recommendation: The Government should explore creating a ‘dual gateway’ to work-related disability benefits. This would mean anyone receiving PIP who claims work-related disability benefits should automatically receive the LCWRA element and protection from sanctions. Crucially, people who do not receive PIP should still be able to take a reformed WCA to ensure they can still access enhanced support.

The cultural barriers caused by the unhelpful language of the work-related disability benefits system must also be removed.

Recommendation: The Government should work with disabled people to replace the existing work-related disability benefits language framework in all legislation, guidance, processes and training. Labels should not imply that someone is incapable of or should not work. The LCWRA element should be renamed and clearly conveyed as in-work or out-of-work support.

Given the currently deep trust deficit, approaches to increase engagement and employment support should look to delivery via more trusted entities and heed the counterproductive impact of sanctions on general trust.

Recommendation: The Government should offer more employment support through trusted local partners and separate this from the system of claiming benefits.

Recommendation: Any increased engagement or employment support with disabled people should be offered on a voluntary basis.

Increasing engagement and effective employment support

Most people receiving work-related disability benefits currently receive no offers of employment support from DWP, let alone support that is effective or tailored to individuals. This is despite our research finding strong demand from disabled people for the right sort of employment support offered by trusted sources and the wider evidence on the importance of helping people as early as possible if they leave employment due to ill health.

Recommendation: A serious programme of proactive engagement is needed to stay in contact with work-related disability claimants on a voluntary basis. This should include robust trials of different voluntary engagement approaches.

Recommendation: The Government should provide support to both claimants and employers, brokering workplace changes and helping employers to make them. Support on both sides should continue for the first 6 months after someone starts a new job to improve the sustainability of moves into work.

Tackling hardship must involve improving circumstances for people receiving ‘work-related disability benefits’ (health-related Universal Credit or Employment and Support Allowance) who face unacceptable hardship. With so many held back from participating in good jobs, this is also crucial to the Government’s economic objectives.

This report focuses on reforms to support disabled people who can work into the labour market. It proposes several reforms to work-related disability benefits and related employment support.

JRF has designed these with input from the disability equality charity Scope, informed by our new joint research published alongside this report. This involved in-depth discussions and surveys with disabled people.

The Joseph Rowntree Foundation (JRF) and Scope engaged with disabled people to understand their experiences of the benefit system and employment, as well as their views on a range of reform proposals aimed at improving experiences and supporting more disabled people into work.

The research included an initial phase of discussions with 16 participants with recent experience claiming health-related Universal Credit (UC), a second phase of deliberative workshops with some of these participants, and 3 surveys of a wider group of 920 disabled people. All quotes in this report are from participants in this research, and all figures that refer to survey respondents have been derived from these research surveys.

JRF has also analysed levels of hardship experienced by disabled people receiving health-related UC, using the Government’s Households Below Average Income/Family Resources Survey (HBAI/FRS) data for 2022/23 (DWP, 2024a).

This report sets out the policy implications of this research and wider evidence.

It focuses on ‘work-related disability benefits’ (often called ‘incapacity benefits’ or ‘sickness benefits’). These are means-tested benefits for people with a disability or health condition that affects their ability to work. The main one for new claimants is health-related UC. Most claimants need to go through the Work Capability Assessment (WCA), which designates them into one of 3 groups:

• Limited Capability for Work and Work-Related Activity (LCWRA): People receive an extra amount in their UC (the LCWRA element, currently worth £416 a month) in addition to UC’s standard allowance. They also have no conditionality applied, meaning they cannot be required to work, search for work, undertake work-related activity (like training courses) or attend meetings with a work coach. They therefore cannot be sanctioned.
• Limited Capability for Work (LCW): People receive no extra financial element but cannot be required to work or search for work. However, they can be required to undertake work-related activity or attend meetings, at risk of sanction.
• ‘Fit for work’: People are not eligible for health-related UC. They therefore receive non-health-related UC, with no LCWRA element and full work conditionality and sanctions.

The other main work-related disability benefit is Employment and Support Allowance (ESA). This is largely being replaced by health-related UC, although a lot of people still receive it. ESA has a similar structure to health-related UC, with the WCA determining if someone is in the Support Group (equivalent to UC LCWRA), the Work-Related Activity Group (WRAG) (equivalent to UC LCW), or is ‘fit for work’ (not eligible for ESA, and so would instead need to claim Jobseeker’s Allowance).

We do not focus on Personal Independence Payment (PIP), which is the main non-means-tested benefit to help with extra costs associated with being disabled or its predecessor, Disability Living Allowance (DLA). However, we do highlight important interactions between PIP/DLA and work-related disability benefits.

Hardship amongst disabled people is unacceptably high

People in families receiving health-related UC face extremely high levels of hardship.¹ They are much more likely to experience hardship than the general working-age population or people on UC more broadly (Figure 1). For example, a quarter of adults on health-related UC used a food bank in the last year, and a third were unable to afford to keep their house warm. This compares to 3% and 11%, respectively, for the general working-age population.

Three-quarters of adults receiving health-related UC are experiencing material deprivation, as defined by the Government’s combined measure, which includes people lacking a range of basic items because they cannot afford them. This is even higher than the two-thirds of adults receiving non-health-related UC experiencing material deprivation. This compares to a fifth for the general working-age population.

A recent spike in work-related disability benefit caseloads, after years of gradual decline, has raised them to the top of policymakers’ concerns, with worries about rising benefit spending. However, a narrow focus on caseloads would be ineffective and wrong.

The increase in caseloads has resulted primarily from a sharp rise since 2019 in the number of people who start claiming work-related disability benefits each month. This has combined with the number of people who stop claiming each month remaining low (OBR, 2024a).

Health and labour market factors

There is a range of plausible causes for this recent rise in people starting to claim work-related disability benefits, with no conclusive evidence yet on the most significant. However, worsening population health is likely an underlying driver. This includes a longer-term trend in rising rates of disability and long-term health conditions amongst the working-age population, accelerated by the Covid-19 shock. Whilst the pandemic hit many countries, UK-specific factors, such as the condition of our health-related public services (like the NHS or social care) or the labour market, could have translated it into a particularly large impact on work-related disability benefit claims.⁴

Directly addressing these underlying health and structural drivers, which are damaging to economic growth and economic security in themselves, should be the focus of policy. Getting this right would naturally result in fewer people starting to claim work-related disability benefits and a falling caseload. It is also an important way to prevent people from falling into hardship in the first place.

Our research also indicates that the main underlying reasons that people end up having to start claiming work-related disability benefits lie outside the benefit system. This is primarily in the interaction of health conditions with job-related factors, such as lack of flexible working, unhelpful employer attitudes towards disabled people and limited systems of broader support when people become ill, like occupational health, job adjustments or sick pay. These factors mean that illness leads too easily to people being forced to leave employment and becoming detached from work for too long.

Reform approaches should therefore include measures to improve population health. But they also need to accept that temporary or long-term health conditions will always exist. Ensuring our economic system is geared to this reality is crucial. This means a policy focus on ensuring our labour market and jobs are designed to be a much more viable prospect for disabled people and more supportive when employees become ill.

Benefit-related factors

It is also plausible that the recent rise in people starting to claim work-related disability benefits could have been accentuated by the shock to real incomes from the recent energy-driven inflation spike (or ‘cost-of-living’ crisis). Whilst this again was not unique to the UK, it could have combined with our historically and internationally inadequate level of basic safety net support (Bannister et al., 2023), as well as the recent intensification of conditionality for non-health-related benefits, to increase take-up of health-related benefits.⁵

The acceleration of UC rollout since 2019 could also have contributed, as UC was always anticipated to support higher benefit take-up through combining multiple benefits (health-related and non-health-related) into a single claim. There is some evidence that take-up has indeed increased amongst people with health conditions (Latimer et al., 2024; OBR, 2023). Our research also finds that Jobcentre work coaches were the main source for UC recipients finding out about taking a WCA and claiming health-related UC. This is a change compared to the legacy system, where far fewer people found out about the WCA and about claiming ESA from a work coach.⁶

To the extent that there has been higher take-up by disabled people of previously underclaimed entitlements, this is a positive outcome, even if it results from undesirable drivers. Given the levels of hardship amongst people receiving work-related disability benefits, seeking to reverse take-up would be a regressive step.

However, even if policymakers wanted to reduce the take-up of work-related disability benefits in pursuit of lowering caseloads, our research throws doubt on how effective attempts to do so via changing benefit levels alone would be. For example, cutting the value of the LCWRA element (in either real terms or relative to UC’s standard allowance) is unlikely to shift the dial on the number of people starting to claim health-related UC because people claim it for multiple reasons. Most people simply claim work-related disability benefits because they have a health condition that means they are out of work and need help covering basic living costs. But when starting a claim, people are often unaware that the WCA could result in them receiving an extra amount in addition to basic UC, or they do not know how much extra it is worth. For many, it is important to claim health-related UC to protect themselves from having unrealistic conditions imposed that could result in them being sanctioned.⁷

Finally, our deprivation analysis provides no justification based on need alone for cutting the LCWRA element in real or relative terms. Similarly, simply restricting eligibility for the LCWRA element would just pull more disabled people into hardship, with very few employment gains.

The previous Government announced short-term plans to restrict eligibility for the LCWRA element for new claimants from 2025 via changes to the WCA ‘activities’ and ‘descriptors’ criteria. These restrictions would result in over 400,000 new claimants missing out on extra support by 2028/29 (DWP, 2024b), whilst the OBR estimates they will only result in employment rising by around 15,000 (OBR, 2024b).

Although the new Government has indicated it will not be going ahead with those precise plans, it has committed to delivering a similar level of fiscal savings by bringing forward its own reforms to health and disability benefits (Reeves, 2024; The Guardian, 2024).

Recommendation: Do not pursue similar measures to the previous Government’s plans to restrict eligibility for the LCWRA element for new claimants from 2025 via changes to the WCA ‘activities’ and ‘descriptors’ criteria.

The most significant barriers to work

In addition to ill health, the most significant barriers holding disabled people back from work include inaccessible jobs that lack in health-related adaptations or support; inflexible or negative employer attitudes; and a lack of support for health conditions or related care needs. Many of these barriers are the same factors driving people out of work in the first place if they get ill.

“Too many people are having to fight battles on their own and they shouldn’t be having to and it’s beyond frustrating. I’ve seen so many people lose jobs because, yes, their conditions have worsened and I think that it’s not just unfair, it is actually illegal, but the fact that we don’t have anybody backing us up is ridiculous.”

Addressing these issues requires serious will from the Government to help change the nature of work and vastly increase job quality and good jobs. This includes increasing job adaptability and flexible working, and changing employer attitudes towards disability. JRF has published other work on policies needed to improve job quality (Woodruff et al., 2021).

Specific policies that had strong support from disabled people in our research included:

• Statutory Sick Pay (SSP) can be essential for supporting disabled people at work and preventing them from leaving employment completely. There was strong agreement that SSP should be increased from its current £116.75 a week (for up to 28 weeks) to 65% of someone’s usual weekly earnings.⁸ People also thought more employers should pay above the required SSP rate.
• Improving employment law and enforcement to prevent people from losing their jobs due to disability and ensuring employers make more disabled-friendly jobs available, such as flexible, home-based and part-time jobs.
• Government working with employers was seen as crucial to allowing meaningful changes to disabled people’s ability to move into sustainable work. This included having continual support in place for employers to help them accommodate disabled staff.

However, for people receiving work-related disability benefits, the benefits system itself and its related employment support offering also present significant barriers. Our research illuminates these in detail and indicates what is likely to be effective at addressing them and what is not.

Risk of being made worse off by engaging with employment support or trying work

Worrying about losing benefits is a key barrier for disabled people considering trying work or even engaging with meetings and employment support. Almost three-quarters of work-related disability benefit recipients we surveyed said that fear of losing benefits was a significant or very significant barrier to work.

Our research adds granular insight into what exactly disabled people mean by this. It is, in fact, multifaceted, and reforms that only address some aspects of this risk will be ineffective. These risks can be grouped into 3 main sets.

The first set of risks relates to people worrying that if they engage with the DWP, show they have taken steps towards employment or have moved into work, this could trigger a benefit reassessment because DWP will assume their health condition has improved or no longer presents challenges. Even if these steps do not trigger a new assessment, people worry they could influence the outcome of their next scheduled reassessment. There are distinct worries within this:

1. Loss of extra financial support within UC: worry that a WCA reassessment could result in loss of the LCWRA element of UC.
2. Subjection to intense conditions and sanctions: worry that a WCA reassessment could result in being found ‘fit for work’, meaning someone could be made to do things they struggle to do (such as applying for jobs that are unsuitable given their health conditions) and risk losing their UC through sanctions. This is coupled with broader concern about stress or other negative impacts on their health from more intensive requirements.
3. Loss of PIP: worry that moves towards employment could lead to a PIP reassessment that results in loss or reduction of PIP, again because DWP assumes someone’s health condition has improved, despite PIP eligibility being unrelated in theory to work capability. This point is significant because almost three-quarters of people in the LCWRA/Support Group also receive PIP/DLA.⁹

Note: Figures show, of the work-related disability benefit recipients we surveyed who said they were worried about their benefits being affected if they engage with appointments or employment support, the % who gave each of the reasons listed. Fifty recipients of work-related disability benefits who said they were worried about benefits being affected if they engaged answered this question.

The second set of risks relates to the consequences of moving into work should that job then not work out (a not unreasonable worry, given disabled people’s common experiences of being forced out of jobs due to their health conditions). People have a deep sense of insecurity about not being able to fall back on the same safety net they had before, including worry about:

1. Reduced financial support: worry that a new WCA could find them eligible for less financial support than they had received previously (for example, loss of LCWRA element).
2. More intense conditions: worry that a new WCA could find them ‘fit for work’ and thus subject to more intensive conditions than previously, with the added risk of sanctions.
3. Stressful and arduous assessment experiences: even if ultimately successful in reobtaining their previous entitlements, people worry this would take a long time and do not want to go through another hugely stressful and undignified WCA.

The third set of risks relates to worry about the immediate loss of benefit income that might result from a move into work. Some disabled people believe that their wages will not be enough to overcome the loss of benefits or that the overall financial gain will be very small, considering the risks involved. Others worry about coping during a gap in income between their benefits stopping and their first wage payment.

Note: Figures show, of the work-related disability benefit recipients we surveyed who said they were worried about their benefits being affected if they try work, the % who gave each of the reasons listed. Two-hundred and nineteen recipients of work-related disability benefits who said they were worried about benefits being affected if they tried work answered this question.

The perception of these risks is made worse by confusion and poor communication from DWP about existing rules on benefits and work. For example, around 60% of work-related disability benefit recipients we surveyed said either that they are not allowed to work or they are not sure if they are allowed to work. This is despite there being no limit on the amount of work that health-related UC recipients are allowed to do.

Similarly, existing UC rules say that starting work should not in itself result in a WCA reassessment or loss of the LCWRA element (assuming underlying health conditions have not changed). In theory, someone receiving the LCWRA element should keep it after moving into work, with their total UC payment gradually tapered away as earnings rise. Furthermore, people with LCWRA get a ‘work allowance’ in UC. This means they can earn up to £673 a month (depending on their circumstances) and keep their full UC payment, including the LCWRA element. For earnings above this, their total UC payment (including the LCWRA element) will be reduced by 55 pence for every additional £1 earned.

So, despite existing UC rules meaning that people should not be reassessed if they try work, should keep their LCWRA status and should be financially better off overall, fear is rife about the opposite happening. This is not surprising, given the lack of awareness of UC’s work-related rules we found among recipients. It represents a mass failure of communication and engagement from DWP, hobbling what is, in theory, a relatively more work-friendly UC structure than people think.

However, in addition to poor communication from DWP, people in our research suggested that at least some work coaches do not understand UC’s work-related rules themselves and that claimants’ questions about them are poorly responded to:

“So, the whole time they gave me wrong information in regards to – they kept saying you had a certain amount of work hours that you could do in a month, which isn’t correct on limited capability work-related activity. It’s a work allowance which, again, they wouldn’t give me, and then they did, they gave it to me wrong.”

Culture of mutual distrust, fear and negativity

The fear of being made worse off as a result of engaging with employment support or moving towards work is strongly underpinned by disabled people’s general lack of trust in the DWP, Jobcentres and work coaches. Half of the disabled people we surveyed had a very negative overall opinion of the DWP and Jobcentres, and a further fifth had a slightly negative opinion. This compared with 13% who had a very positive or slightly positive opinion.

This seems a deep-seated cultural issue, driven by a series of negative experiences. It includes widespread awful experiences of DWP assessments (both the WCA and PIP), when disabled people often felt assessors were trying to ‘catch them out’:

“I found it a really traumatic experience, the whole process broke me a bit.”

It also includes everyday interactions with DWP where disabled people, often at extremely challenging points in their lives, feel they have not been treated with dignity, respect or compassion:

“And it’s really, like, degrading, really, to have to be almost forced to go to those meetings, but then having those experiences every time.”

Disabled people have low trust in work coaches and think they are ineffective at tailoring support or appropriately accounting for individuals’ circumstances. Only 12% of disabled people in our survey said they trust work coaches to have their best interest in mind when supporting them around work. Only 11% said work coaches were able to make helpful suggestions tailored to their individual circumstances.

Mutual suspicion is conveyed by Jobcentres focused more on monitoring compliance with rules rather than understanding people’s support needs:¹⁰

“I think they put it on this sense of, ‘We’re watching what you do’. And it’s that sense of they’re waiting to catch you out when it’s not necessarily that you’re doing that, you’re trying to just live your life.”

This results in a pervading fear of being sanctioned:

“So, it literally feels like you could… no, walking on eggshells. You could do anything, it feels arbitrary. You could look at somebody wrong in the Jobcentre and they could accuse you of abuse and you get your benefits sanctioned. Who knows what could happen?”

More broadly, disabled people acutely feel the negative tone towards disabled benefit claimants transmitted by Governments over many years. They also see a system not designed with meaningful input from disabled people, further imbuing mistrust between people seeking support and the system responsible for providing that support. 

This mutual distrust acts as a powerful cultural barrier to positive engagement with work coaches and DWP employment support.

Other systemic factors add further cultural barriers to moving towards work. The language and labels used within the work-related disability benefits system, such as ‘limited capability for work’, ‘incapable of work’ or ‘not fit for work’, embed a negative sense amongst some disabled people of being defined by the WCA as incapable of any work, or of being ‘written off’:

“I’m coming to the end of a 6-month contract, doing some part-time work. This has been a great experience, a more positive reminder of my capability, rather than the LCWRA label. I would like to find more work to continue.”

Lack of engagement from DWP and poor employment support

Most people on work-related disability benefits we surveyed had had very little contact with Jobcentres, particularly people in the LCWRA group:

I also was just left without a work coach or anyone to be able to contact after getting put on LCWRA without warning.

Of people we surveyed who were in the UC LCWRA group (or ESA Support Group), 30% said they had never been contacted by the DWP, a Jobcentre or a work coach since starting to receive their benefit. A further 23% said they had been contacted less than once a year.

Offers of employment support were minimal, and people were unaware of the potential support available. Of the people we surveyed who said they had been contacted at least once by the DWP, a Jobcentre or a work coach since starting to receive their work-related disability benefits, two-thirds said they had not received any offers of employment-related support.

Around half of the people we surveyed receiving work-related disability benefits said they would or might be interested if the Jobcentre contacted them more regularly to offer optional meetings or employment support. And a third of the people we surveyed had used employment-related support from a source outside the DWP, such as a charity or advice agency. This implies that there is demand for employment support if the right support is offered from a trusted source.

However, even if more support were to be offered from the Jobcentre, people often do not think it will be useful. Of the survey respondents who said they might or would not be interested in more regular offers of meetings or support from the Jobcentre, around 2 in 5 said this was because they did not think it would suit their needs. However, the overall trust deficit still plays a significant role here, with almost half of these survey respondents saying they would not be interested in more regular offers from DWP sources because they do not trust them.

The benefit system barriers identified must be addressed alongside labour market reforms. This will help ensure the entire welfare–employment system works together to support more people on work-related disability benefits into work and out of hardship.

However, plans laid by the previous Government risk worsening these barriers and increasing hardship.

In addition to the short-term WCA eligibility criteria restrictions already discussed, the previous Government set out longer-term plans for work-related disability benefits in its March 2023 white paper (DWP, 2023a). These were not due to be fully implemented until at least 2029, and many important details were left still to be developed.

The white paper identified some of the same barriers to work as our research. However, our research suggests that the white paper’s approach would not be effective at resolving these barriers. If anything, it could make them worse whilst increasing hardship. Two proposals in particular would be the wrong direction for reform.

Do not make work coaches solely responsible for setting conditions and sanctions

The first wrong turn is the proposal to make individual work coaches solely responsible for deciding what conditions are attached to disabled people’s benefit claims without any safeguards. This would mean any disabled person could have their benefits sanctioned, even if asked to undertake an unsuitable work-related activity.

This would be a big change from the current situation, where anyone determined by the WCA to be in the LCWRA group cannot be sanctioned. The risk of a WCA reassessment resulting in more conditions being applied and exposing someone to sanctions is a significant fear that holds disabled people back from engaging with employment support or moving towards work. By scrapping the WCA, the white paper proposal does not reduce this risk: it simply shifts it from a formal assessment (the WCA) to a less formal decision by individual work coaches.

Given the lack of trust in work coaches amongst disabled people, this change could intensify fears about positively engaging with work coaches: people will worry that displaying work-readiness could result in their work coach deciding to apply more conditions, ultimately leading to a sanction if they cannot meet these. Disabled people we spoke to were very anxious about this prospect. As much as people hate the WCA, many saw it as at least a more independent and transparent process than individual work coach decisions.

Putting work coaches in charge of deciding whether a disabled person can be sanctioned is also likely to make the issue of broader distrust in work coaches even worse, increasing another key barrier to engagement with employment support.

Recommendation: Scrap the previous Government’s plan to make individual work coaches solely responsible for deciding if disabled people can be sanctioned.

Do not make PIP the sole determinant of extra support in UC

The second wrong turn is the proposal to replace the LCWRA element with a new ‘UC health element’ with eligibility linked directly to PIP receipt, without any alternative eligibility assessment for people who do not receive PIP. The idea was that scrapping the WCA and instead linking the extra LCWRA element to someone’s PIP award would eliminate fears that moving towards work could lead to a WCA reassessment removing their LCWRA element.

However, our research shows that this would not be the hoped-for silver bullet to eliminate people’s fear of losing benefits because it does not tackle the range of worries people have about engaging with work. For example, people are also anxious about becoming exposed to sanctions and unrealistic conditions. The proposal to shift eligibility for the extra LCWRA financial support from a WCA to PIP doesn’t address this fear at all. In fact, the white paper’s proposal to transfer decisions on who can be sanctioned from a WCA to individual work coaches will increase this fear and reduce broader trust in work coaches.

The proposal also fails to address worries about losing PIP if people move towards work. Indeed, it potentially magnifies it: linking the receipt of extra financial support within UC directly to the receipt of PIP could result in losing both elements of support simultaneously.

Many people we spoke to saw 2 separate assessments (WCA and PIP), each assessing different impacts of being disabled, as an important safeguard that reduced the risk people could be left without at least one source of health-related support at any time:

“Because so many of us either get our [PIP] claim reduced or stopped at review and the wait times are disastrous, but it just doesn’t make any sense that you’ll lose pretty much all of your money for a couple of years.”

Finally, making PIP the sole determinant of extra support in UC would increase hardship because over 600,000 disabled people in the future who would have been eligible for the LCWRA element but who do not receive PIP would miss out on extra support.¹¹

Recommendation: End the previous Government’s proposal to make receipt of PIP the sole determinant of whether extra UC support will be awarded.

Instead, the new Government should take a fresh approach to benefit system reform, working alongside disabled people to put forward its own positive changes. This is likely to be more effective at supporting disabled people into work, tackling hardship and increasing economic security. The approach needs to:

• reduce risk for disabled people who engage with employment support, or move towards work or into work
• improve trust in DWP, fix assessments and change the culture of fear and negativity
• bring a step-change in early, voluntary-based engagement and effective employment support.

One of the most effective structural changes within the benefits system the Government can make to support disabled people who want to work is to reduce the real or perceived risks associated with trying work or engaging with employment.

A comprehensive ‘Work Transition Guarantee’

Recommendation: A comprehensive ‘Work Transition Guarantee’ should be legislated for and widely communicated. It should be enforceable through a fast-track process. This would guarantee that if someone takes certain steps towards work (such as engaging with employment support) or starts work, then:

• DWP cannot ask them to do a WCA reassessment for at least 18 months
• DWP cannot ask them to do a PIP reassessment for at least 18 months
• their previous benefit status (for example, LCWRA) will be reinstated immediately (without a WCA reassessment) if they move off benefits into work but need to reclaim them within 18 months (for example, if the job didn’t work out).

A claimant would still be able to request a reassessment if they wanted one, for example if their health condition had worsened.

This proposal was very popular with disabled people with whom we discussed it (although we tested a version with a guarantee period of 2 years). Of survey respondents who were receiving work-related disability benefits, around 95% agreed with each of the 3 components of the guarantee.

The previous Government announced plans for a ‘Chance to Work Guarantee’ (DWP, 2023b). However, this was not a comprehensive guarantee. Our research found, for instance, that a guarantee is also needed to remove the fear of losing PIP. Chance to Work could also only practically be a temporary position, reliant on the broader white paper reforms going ahead in future: it was essentially clever branding for a decision to suspend almost all WCA reassessments for existing claimants from 2025, linked to planned restrictions of the WCA ‘activities’ and ‘descriptors’ criteria from 2025 and the white paper plan to scrap the WCA entirely by 2029.

Improving real and perceived work incentives

More awareness of UC’s existing work-related rules, which are more work-friendly than most people believe, would also help lower perceived risks. For example, UC allows people to work as much as they want, while keeping the LCWRA element, and ensures they are better off financially in work, due to its work allowances and taper rate. UC can also be reclaimed within 6 months of leaving it, without a reassessment and with the LCWRA element intact from day one of the reclaim.

Recommendation: DWP should instigate a step-change in awareness of health-related UC’s existing work-friendly features. This should be communicated clearly at the start of every interaction with the Jobcentre and should be a standing point in UC’s journal and statements for people on health-related UC. It will also be aided by more regular proactive contact with people in the LCWRA group (as discussed below).

Further enhancing UC’s work-friendly features would reduce risk and increase the potential upsides of trying work.

Recommendation: The Government should increase UC’s work allowances for disabled people and extend the UC reclaim period to 18 months.

Increasing work allowances was popular with disabled people in our research. Of our survey respondents who were receiving work-related disability benefits, almost 90% agreed that work allowances for disabled people on UC should be increased to the same level as the personal tax allowance (£1,047 a month).

Reducing the harsh consequences of losing work-related disability benefits 

Part of the worry about WCA reassessments leading to a ‘fit for work’ outcome arises from the harsh negative consequences of having to rely solely on non-health-related benefits. These include a basic rate of UC that falls well short of what is needed to afford essentials like food, vital household bills and travel (JRF and Trussell, 2024). They also include a very intensive work search conditionality regime for unemployed people. Anything that lessens these consequences should lower the stakes for disabled people associated with moving towards work, including:

Recommendation: An Essentials Guarantee to ensure everyone receiving UC has a protected minimum amount of support to at least afford essentials (Bannister et al., 2023).

Recommendation: Reduce the intensity of conditionality and sanctions in non-health-related UC. This should be pursued through procedural and cultural change to shift the use of sanctions towards being a last resort, lowering the number of sanctions. The severity of sanctions should also be reduced so that they never leave people destitute.

While disabled people in our research agreed that these changes were needed to improve UC for everyone, focusing on the non-health-related system provoked some anger in our discussion groups. Some participants were offended that changes to the non-health-related system were being proposed as ways to improve the lives of disabled people, rather than a focus on the big improvements needed to work-related disability benefits.

This anger was greatest when discussing alternative ways to lower the financial consequences of losing the LCWRA element. A suggestion to increase the basic rate of UC whilst reducing the LCWRA element by an equal amount (so the total UC received by someone with LCWRA remains the same) was viewed dimly. People thought this belittled the extra needs associated with health conditions that affected people’s opportunities to work. But they thought it was right that no one, with or without health conditions, should have to live on the incredibly low basic rate of support in UC:

I’d welcome, as anybody else would welcome, a higher basic rate, because you just can’t afford to live on what they give you as it is.

This view is consistent with our analysis of hardship for people receiving work-related disability benefits, which indicates a need to increase the adequacy of health-related and non-health-related UC on a similar basis, to address unacceptable hardship across the board.

Rationale for extra health-related financial support in our income safety net

It is worth briefly discussing the underlying rationale for extra health-related financial support within the income-replacement benefit safety net, which disabled people in our research tapped into. That is, whereas people might be able to survive for short periods – say, a brief spell of unemployment – on very basic subsistence-level benefits, people will need a higher level of income if they are likely to be without any earnings for longer periods. The higher rate of State Pension that has developed compared to unemployment benefit has a similar rationale. Disabled people face health-related challenges that translate into a higher likelihood of needing income support above what is needed to afford basic essentials for short periods (and it should be remembered that the basic rate of UC is even currently well below this low bar).

Of course, if the basic rate of benefit for everyone was significantly higher – say allowing a more decent standard of living including full social participation, such as JRF’s Minimum Income Standard (Davis et al., 2024) – then the rationale for extra top-ups for some groups would become less strong.

Other rationales point in a similar direction. For example, even if PIP fully covered all additional everyday living costs associated with being disabled – which evidence suggests is far from the case (Scope, 2024) – there are also extra costs associated specifically with being disabled and trying to move into or sustain a job. This was previously recognised explicitly within the benefits system, with the disability element of Working Tax Credit providing an extra amount for disabled people who were working (with similar eligibility criteria to the current LCWRA element). UC partly replicates this by theoretically allowing people to keep the LCWRA element as they move into work.

Finally, to the extent that PIP (rightly or wrongly) does not fully cover all additional costs associated with being disabled, any extra amount within the income replacement benefit system could alternatively be viewed as a targeted means-tested top-up that helps close the gap for disabled people on the lowest incomes.

Reducing the perceived risk of engaging with employment support and fostering more opportunities to move towards work also requires broader change to increase trust in DWP and reduce cultural barriers in the system.

Replacing the WCA

Reducing the stress, fear and inefficiency of assessments is a crucial component of this. Redesigning assessments with meaningful input from disabled people in the design process is the most important factor in getting this right.

Recommendation: DWP must work with disabled people to develop a replacement for the WCA.

Our research also highlighted other attributes that are likely to be needed in a new assessment:

• more use of input from experts who have some specialist knowledge of the patient’s health conditions
• more use of input from professionals who know the patient - however, consideration should be given to concerns, including the impact on the patient’s trust or relationship with their doctors, limited NHS capacity, and not having too much riding on one person’s view
• independence of assessors from DWP
• assessments based not solely on medical diagnosis but rather on how conditions (diagnosed or undiagnosed) affect disabled people’s opportunities and challenges in work
• more of an interaction between the claimant and assessor(s) - this led to the suggestion that a joint agreement between the assessor and the claimant could be sought on the impacts of somebody’s health conditions on work
• more focus on people’s strengths and what they could do with adjustments in the future.

“It’s so easy to throw people on the scrap heap when, really, they shouldn’t be assessing you to see if you can’t work. They should be assessing you to see if you can work and putting that support in place to do that.”

To reiterate, our research found a desire amongst disabled people to keep a separate assessment relating to work-related impacts of health conditions rather than trying to ignore these or combining them with the PIP assessment’s focus on extra daily living costs. This was partly due to the greater risks associated with a single high-stakes assessment affecting support linked to both aspects of need. It was also partly due to the view that the UC assessment should consider work-related criteria that the PIP assessment does not, consistent with the policy rationale discussed above.

Reducing assessments and speeding up access to extra support

Nevertheless, we explored with disabled people possible options for reducing the number of stressful assessments. One idea built on the white paper’s approach to eliminating the WCA, whilst addressing some of its flaws:

Recommendation: The Government should explore creating a ‘dual gateway’ to work-related disability benefits. This would mean anyone receiving PIP who claims work-related disability benefits should automatically receive the LCWRA element and protection from sanctions. Crucially, people who don’t receive PIP should still be able to take a reformed WCA to ensure they can still access enhanced support.

This would exploit the fact that, although PIP eligibility is not based directly on work-related factors, over three-quarters of people on UC (or legacy equivalents) who receive PIP/DLA have also been assessed as having LCWRA.¹² Practically, then, if someone on UC also receives PIP, that acts as a reasonable predictor that a WCA would deem them to have LCWRA. Relying on this predictor would remove the need for most disabled people to have to go through 2 assessments: they would be able to access the LCWRA element via either the PIP assessment or a separate work-related UC assessment but would not need to do both.

Our proposal also differs from the white paper in that it includes giving protection from sanctions to anyone receiving the LCWRA element. This is to address worries about individual work coach decisions resulting in disabled people becoming subject to the risk of sanctions.

Whilst participants in our research saw the advantages of reducing the number of assessments for many disabled people, significant concerns remained about everything riding on a single assessment and being linked directly to PIP: it would still mean that if PIP was lost for any reason (such as at a regular review), LCWRA status would simultaneously be lost. People also worried that it could expose disabled people to even greater losses if future Governments decided to change PIP eligibility criteria.

However, if combined with a comprehensive ‘Work Transition Guarantee’ that could lessen these anxieties, this option could still be worth considering. The advantages would include greatly reducing the number of WCA (or replacement) assessments, speeding up access to support, and people worrying less about benefit eligibility in the important initial phase of a health-related UC claim, allowing more focus on support people need to access work.

When our survey asked about this proposal in the context of reducing the number of stressful assessments for many disabled people, 86% of respondents agreed with it.

Replacing unhelpful labels within work-related disability benefits

Instead of the current ‘limited capability for work’ language and labels, there needs to be a positive framework that recognises health-related challenges but focuses on support, strengths and opportunities.

Recommendation: There should be a bold and strongly communicated replacement of the language framework in all legislation, rules, guidance, processes and training within the work-related disability benefit system.

The previous Government already stated its intention to take steps in this area: it announced that from 2025, the term ‘Work Preparation’ would replace LCW, and ‘Health Group’ would replace LCWRA (DWP, 2023b). However, the change needs to go much deeper.

To get this right, the Government should work with disabled people to determine the new language framework.

Labels should not imply that someone is incapable of or should not work. They should instead recognise that a disabled person is likely to face reduced opportunities in the labour market that extra support can help overcome. And that work can and should be an objective for anyone who can (although many will not be able to work right now or ever).

Groups or types of employment support available should not refer to levels of expected work-related activity (such as ‘work preparation’). Assessment outcomes should not define people as ‘fit for work’ or ‘incapable of work’. Instead, they should reflect benefit eligibility. The LCWRA element should be renamed and clearly conveyed as an additional in-work or out-of-work component of UC support.

Voluntary engagement and provision by trusted partners

There is little evidence that threatening sick or disabled people with sanctions is effective at improving their employment outcomes. However, there is evidence that it can be counterproductive, worsening people’s mental and physical health, increasing hardship (which itself can make recovery and progression towards work harder) and deterring positive engagement with employment support (Institute for Employment Studies, 2024).

Our research also finds that the threat of sanctions is undermining trust between disabled people and DWP staff (including work coaches) and that this distrust forms a strong barrier to effective engagement with employment support.

This points to a default assumption that conditionality, particularly when operationalised via a compliance-led culture with the harsh application of sanctions, should not be increased on disabled people.

Disabled people we spoke to thought that requiring all disabled people receiving UC to attend quarterly meetings with work coaches (in person, by phone or online), on a mandatory basis, would not be an effective way to support people towards work and would undermine trust further. Of our survey respondents who were receiving work-related disability benefits, 53% disagreed with this proposal. Of these, 58% strongly disagreed.

“Especially for people that are anxious already. You know, for certain people, that’s why they are on this so why make it more traumatic for them, but I would love it if it was optional.”

Recommendation: Any increased engagement and employment support for disabled people should be offered on a voluntary basis.

Measures suggested by disabled people, such as more training for work coaches on how to work with disabled people and ensuring people see the same work coach at each meeting, could start to build trust.

However, given the general and deep distrust of DWP and Jobcentres identified in our research, the best chance of positive engagement may well come with engagement and employment support being offered via more trusted entities, such as local partners. Providing as much separation as possible from the system of claiming and managing the benefit claim would also help in this regard. The new Government’s commitment to devolve employment support for disabled people to local areas is a huge and positive opportunity to operationalise this (DWP, 2024c).

Recommendation: The Government should offer more employment support through trusted local partners and separate this from the system of claiming benefits.

Alongside fixing the structural and cultural barriers to engagement and work created by the benefits system, improving the quality and relevance of employment support on offer will increase engagement.

At a basic level, however, our research finds that the Government needs to be much more proactive at reaching out to people receiving work-related disability benefits, particularly those in the LCWRA group, who currently receive very little contact. This is particularly so, given the wider evidence on the importance of supporting people as early as possible if they leave employment due to ill health (The Health Foundation, 2024; Phillips, 2024).

Of our survey respondents who were receiving work-related disability benefits, 83% agreed that Jobcentres should be more proactive at asking all disabled people what support they would like to help them into work and offering this support where desired, but not on a mandatory basis.

Recommendation: A serious programme of proactive engagement is needed to stay in contact with work-related disability claimants on a voluntary basis. This should include robust trials of different voluntary engagement approaches.

For example, as a default, Jobcentres or local partners should contact everyone receiving work-related disability benefits at least twice a year for a ‘check-in’ about their health and employment aspirations, with relevant offers of voluntary support. This could be online, by phone or in person, according to people’s needs.

The Government should undertake robust trials of different voluntary engagement approaches to build evidence on what is most effective. However, these must be undertaken within an environment where the broader structural and cultural barriers to engagement identified in our research have been addressed. Otherwise, the presence of these barriers will likely invalidate the findings of voluntary engagement trials.

Trials could be undertaken once the recommended structural policy changes have been implemented. Alternatively, they could happen in separate controlled environments where these structural barriers have been reduced. Again, the Government’s plans to devolve employment support for disabled people to local areas provide a good opportunity to do this.

The Government needs to expand access to effective, evidence-based approaches to supporting people with health conditions into employment, such as Individual Placement and Support (IPS). This should be available to people whether they are claiming benefits or not. This will help reduce the stigma associated with accessing support. It will also enable earlier access to support (for example, when someone first becomes ill but hasn’t yet navigated through the benefits system) and allow uninterrupted support as people move into work and exit the benefits system.

The previous Government started to do this, with more places announced on schemes such as Universal Support and IPS in health settings, such as NHS Talking Therapies. However, the number of available places has so far been relatively small.

Our research also indicates the types of employment support that disabled people who want to work say would be most helpful. This includes providing support for employers as well as claimants. Our participants thought employers struggle on their own to make the right adjustments or provide the right in-work support for disabled people. Of the disabled people we surveyed, 96% agreed that the DWP should work with employers to improve the availability of jobs to disabled people. This included more flexible, home-based and part-time jobs, or making adjustments like changes to working patterns or locations, or providing necessary equipment.

The desired support also includes assistance that continues (for both employee and employer) after someone starts a new job. A promising new job can become unsustainable after a challenging starting period, where further help and changes could make all the difference. Of our survey respondents, 95% agreed that Jobcentre support should be available for the first 6 months after a disabled person starts a new job, for both the claimant and employer.

Recommendation: The Government should provide support to both claimants and employers, brokering workplace changes and helping employers to make them. Support on both sides should continue for the first 6 months after someone starts a new job to improve the sustainability of moves into work.

More generally, support needs to be more tailored to individual circumstances and health conditions, and delivered with greater understanding, empathy and respect:

A kind and supportive worker who listens and understands your needs so they can provide a more tailored experience for your needs.

Being treated like a person, a human being. Having understanding, patience. Actually getting to know the person and their struggles, and giving them the right advice.

Any credible plan to tackle hardship must involve improving the circumstances of people receiving work-related disability benefits. With so many held back from participating in good jobs, this is also crucial to the Government’s objectives around economic growth and to ensure everyone has the same opportunities to access work and economic security.

The recent rise in work-related disability benefit caseloads shows the need for change is pressing. However, policymakers should not fall into the trap of narrowly focusing on caseloads and benefit spending. Instead, they should directly address underlying health and structural drivers, which are damaging to economic growth and security in themselves.

Policy must focus on improving population health and healthcare. It needs to ensure jobs are designed to be much more viable for disabled people and more supportive when employees become ill. At the same time, barriers to work in the benefit system must be addressed to ensure the entire welfare–employment system works as one to support more people on work-related disability benefits into work and out of hardship.

However, the direction set out by the previous Government risked worsening these barriers and increasing hardship. The new Government must not repeat the failed approaches of the past. Instead, it should take a fresh approach to benefit system reform, working alongside disabled people to put forward an alternative reform agenda: one that will ultimately be more effective at supporting disabled people into work, tackling hardship and increasing economic security.

Such an approach would reduce risk for disabled people who engage with employment support, move towards work or into work; it would improve trust in DWP, fix assessments and change the culture of fear and negativity; and it would bring a step-change in early, voluntary-based engagement, and effective employment support.

1. Findings on levels of hardship in this section are from JRF analysis of the latest Government survey data on household resources (DWP, 2024a). Throughout this analysis, by ‘family’, we technically mean ‘benefit unit’, which is 1 or 2 adults living together as a couple, plus any dependent children they are living with. Health-related UC means where DWP has assessed someone in the family as having LCW or LCWRA.
2. None of the differences shown in Figure 2 between people receiving health-related UC and people receiving non-health-related UC are statistically significant.
3. The poverty measure used here excludes disability benefits like PIP from household income because these benefits are designed to cover extra costs associated with being disabled. Therefore, including them in income would give a misleadingly low assessment of poverty amongst disabled people.
4. For discussion and evidence, see: BCG Centre for Growth and NHS Confederation, 2024; Judge and Murphy, 2024; Latimer et al., 2024; OBR, 2023; OBR, 2024a; The Health Foundation, 2024; Thomas et al., 2024.
5. For discussion and evidence, see: De Brouwer et al., 2023; Codreanu and Waters, 2023; OBR, 2023; OBR, 2024a; Reeves et al., 2024.
6. Of people we surveyed who were receiving health-related UC, 30% found out from a work coach that they could claim it, whilst 23% found out themselves. Of people we surveyed who were receiving ESA, 11% found out from a work coach, whilst 34% found out themselves.
7. For example, 77% of people we surveyed who received health-related UC either did not know that they could get an extra amount or did not know how much the LCWRA element was worth before they claimed. Of these, 60% were not aware of the possible extra income at all, whilst 40% knew there could be extra income but did not know how much.
8. This proposal was based on a suggestion from the Resolution Foundation (Cominetti et al., 2023).
9. JRF analysis of DWP Stat-Xplore: benefit combinations data for working-age claimants in England and Wales for February 2024.
10. For more on this theme, see: Tomlinson, 2024.
11. JRF analysis of DWP Stat-Xplore: benefit combinations data for working-age claimants in England and Wales for February 2024.
12. JRF analysis of DWP Stat-Xplore: benefit combinations data for working-age claimants in England and Wales for February 2024. This analysis has been simplified by ignoring Jobseeker’s Allowance and Income Support claims, but the number of people still receiving these legacy benefits is small, so it should not significantly affect the result.

Bannister, L. Matejic, P. Porter, I. Sands, D. Schmuecker, K. Wenham, A. Bull, R. Ferrer, I. and Hughes, A. (2023) An Essentials Guarantee: Reforming Universal Credit to ensure we can all afford the essentials in hard times

BCG Centre for Growth and NHS Confederation (2024) Improving our nation’s health: A whole-of-government approach to tackling the causes of long-term sickness and economic inactivity

Burkhauser, R.V. Daly, M.C. McVicar, D. and Wilkins, R. (2014) Disability benefit growth and disability reform in the US: Lessons from other OECD nations

Codreanu, M. and Waters, T. (2023) Do work search requirements work? Evidence from a UK reform targeting single parents

Cominetti, N. McCurdy, C. Thwaites, G. and Vieira-Marques, R. (2023) Low pay Britain 2023: Improving low-paid work through higher minimum standards

Davis, A. Blackwell, C. Ellis, W. Padley, M. Stone, J. and Balchin, E. (2024) A minimum income standard for the United Kingdom in 2024

De Brouwer, O. Leduc, E. and Tojerow, I. (2023) The consequences of job search monitoring for the long-term unemployed: Disability instead of employment?

Department for Work and Pensions (2021) Shaping future support: the health and disability green paper, evidence pack, July 2021

Department for Work and Pensions (2023a) Transforming support: The Health and Disability White Paper

Department for Work and Pensions (2023b) Government response to the Work Capability Assessment: Activities and descriptors consultation

Department for Work and Pensions (2024a) Family Resources Survey: Financial year 2022 to 2023

Department for Work and Pensions (2024b) Work Capability Assessment reform: Update to estimated number of claimants affected

Department for Work and Pensions (2024c) Back to Work Plan will help drive economic growth in every region

Fitzpatrick, A. Bramley, G. Treanor, M. Blenkinsopp, J. McIntyre, J. Johnsen, S. and McMordie, L. (2023) Destitution in the UK 2023

Institute for Employment Studies (2024) Working for the future: Final report of the Commission on the Future of Employment Support

Joseph Rowntree Foundation (2024) UK poverty 2024

Judge, L. and Murphy, L. (2024) Under strain: Investigating trends in working-age disability and incapacity benefits

Latimer, E. Pflanz, F. and Waters, T. (2024) Health-related benefit claims post-pandemic: UK trends and global context

Office for Budget Responsibility (2023) Fiscal risks and sustainability report – July 2023

Office for Budget Responsibility (2024a) Welfare trends report – October 2024

Office for Budget Responsibility (2024b) Supplementary forecast information release: Further information on work capability assessment reform at Autumn Statement 2023

Phillips, A. (2024) The earlier the better: Raising awareness of employment support for disabled people and people with health conditions

Porter, I. and Johnson-Hunter, M. (2023) Inadequate Universal Credit and barriers to work

Reeves, The Rt Hon R MP (2024) Autumn Budget 2024 speech

Reeves, A. Fransham, M. Stewart, K. Reader, M. and Patrick, R. (2024) Capping welfare payments for workless families increases employment and economic inactivity: Evidence from the UK’s benefit cap

Scope (2024) Disability price tag 2024

The Guardian (2024) Labour to bring in ‘own reforms’ to benefits system to save £3bn

The Health Foundation (2024) Towards a healthier workforce: Interim report of the Commission for Healthier Working Lives

Thomas, C. O’Halloran, J. Parkes, H. Hawkey, D. Williamson, A. Patel, P. Poku-Amanfo, E. and Quilter-Pinner, H. (2024) Our greatest asset: The final report of the IPPR Commission on Health and Prosperity

Tomlinson, D. (2024) ‘Work first’ can work better

Woodruff, L. Bestwick, M. and Campbell, C. (2021) Jobs that work: Paving the way for good jobs through participatory co-design

JRF would like to thank Scope for partnering on the underlying research with disabled people and producing the accompanying research report, and in particular Harriet Cavanagh, Orli Negri, Zoya Javed, Ian Paynter, David Southgate, Frankie Bowyer and James Taylor.

JRF would also like to thank Dan Tomlinson for his work on the project before leaving JRF.