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Incapacity certification changes

The new Employment and Support Allowance will not mean extra work for GPs, says Dr Nerys Williams.

GPs frequently fill in forms about patients' eligibility for incapacity benefit.

On 27 October the new Employment and Support Allowance (ESA), which replaces incapacity benefit and income support paid on incapacity grounds, will be introduced. The new allowance will apply across the UK and is intended to help patients with an illness or disability move into suitable work if and when they are able to do so.

The right type of work can help mental and physical problems

Little extra work for GPs
The ESA builds on the Pathways to Work programme, which has helped more than 64,000 people into work since October 2003.

While the ESA means that the forms GPs complete are changing, the workload itself should stay much the same. The ESA will not make significant changes to interactions with patients, or to the amount of paperwork (see box).

Entitlement will, for most patients, be assessed via a 'work capability assessment (WCA), carried out by healthcare professionals for the Department for Work and Pensions (DWP).

The WCA will focus on what individuals can and cannot do. It includes the new 'work-focused health-related assessment', giving patients the opportunity to discuss moving into work and identifying health-related interventions that may help.

The patient will receive a copy of the WCA from their Jobcentre Plus personal adviser and encouraged to show it to their GP.

People assessed as having some capacity for work will join a scheme called the Work-Related Activity Group. Their adviser will be able to refer them for personalised support, including employment, training or condition management to help them engage in appropriate work.

Those with a severe illness or disability (assessed as being unable to take part in work-related activity) will join the 'support group'. They will not be required to prepare for work (unless they want to) and will receive additional financial support.

The right type of work can be therapeutic for both mental and physical health problems. However, some patients may take a long time to be ready to consider working, so the ESA is designed to support them.

The intention is to enable them to realise the benefits of working by ensuring their needs are recognised and they are helped to manage their condition.

  • Dr Williams is principal occupational physician at the DWP


  • The DWP or, in Northern Ireland, the Social Security Agency, already asks you to provide information about your patients.
  • GPs will still be asked for 'statements of incapacity for work', usually on the Med 3 form, until a work capability assessment is carried out.
  • GPs may also complete an ESA113 form for patients with severe conditions who may be eligible for the ESA without face-to-face assessment.

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