Friday, September 20, 2019
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‘Misleading’ DWP letter sent to GP’s risks ‘endangering’ patient health

Welfare Weekly recently reported that the DWP has been sending letters to GPS, seemingly instructing them not to support disabled with sick notes while they appeal benefit entitlement decisions.

The Work and Pensions Select Committee has today published letters from GP unions, which warn that the DWP’s instruction to GP’s risks “endangering” the health of vulnerable benefit claimants.

The DWP letter advises GP’s not to provide sick notes (aka ‘fit notes’) to patients found ‘fit for work’ following a face-to-face medical assessment for Employment and Support Allowance (ESA).


Campaigners protest against government welfare changes. Photo: Paula Peters

It has also been revealed that DWP ministers ordered changes to the standard-issue letter to remove references that made it clear to GPs they may have to issue a medical statement if their patient wished to appeal against a WCA decision.

The DWP responded by saying this was not intended to dissuade GPs from issuing ‘fit notes’. However, medical experts say the letter is still “misleading” and threatens patient relationships with their GP’s.

The Royal College of General Practitioners (RCGP) told the Work and Pensions Committee: “Without a fit note from their GP, claimants who are awaiting the outcome of their appeal will not be able to receive ESA.

“They would therefore have to seek Universal Credit or Jobseekers Allowance, and subsequently try and meet the work-seeking requirements of those benefits, potentially endangering their health in the process.

“As such the College is deeply concerned about the potential impact of this on doctors and their relationships with potentially vulnerable patients.”

The DWP has insisted that medical associations signed off on the controversial letter. However, this claim that has been disputed by both the British Medical Association (BMA) and RCGP.

“While the BMA may act in an advisory capacity it does not have the authority to clear, approve or otherwise sign off any DWP correspondence or policies and would see this as being clearly outside of our remit”, they said in a letter to the Work and Pensions Commiteee.


“At a meeting with the DWP and RCGP a BMA representative was given sight of the ESA65B amended letter. The BMA considers that sight of this letter was for the purposes of information sharing and did not agree or otherwise sign off the content of the letter.”

Photo: Paula Peters

The RCGP said: “We are aware that the Department claims that ‘The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016’.

“However, there is some ambiguity about what was said in the referenced meeting with the DWP. Since the DWP did not keep any written records of what was said at this meeting, we are unable to provide further clarity.”

They added: “Since these changes were made, significant evidence has come to light about the negative impact that these changes have had in relation to patient care, leading to some patients being denied fit notes by their doctors.

“We are concerned that the current wording of ESA65B does not sufficiently clearly indicate that there are circumstances in which GPs may need to continue to issue fit notes for their patients.

“It is essential that communication with GPs is as clear as possible, to uphold the high levels of trust that exist between GPs and their patients. As a minimum we would want to see the wording of the ESA65B letter urgently changed to its previous wording.”

A DWP spokesperson said: “We have regular discussions with the BMA and RCGP to ensure we deliver effective support to disabled people and those with health conditions.


“The wording of this letter was discussed as part of these meetings, as both organisations confirm, as was the release of the final letter.

“Of course, we recognise the concerns of GPs which is why we are discussing a revised letter with the BMA and RCGP and have issued clear guidance for GPs in the meantime.”

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