Consolidated Report on the application by the United Kingdom on ILO Conventions Nos 12, 17, 19, 24, 25, 42, 102 & the European Code of Social Security, 2021
Table of Contents
List of applicable legislation
II - 6. Objectives of Medical Care
II - 7. Promotion of the general health service
II - 9. Minimum duration of Benefit
II - 10. Suspension of Benefit
II- 11. Right of complaint and appeal
II - 12. Financing and Administration
List of applicable legislation
III - 4. Level and Calculation of Benefit
III - 6. Minimum duration of Benefit
III - 8. Suspension of Benefit
III - 9. Right of complaint and appeal
List of applicable legislation
IV – 4. Level and Calculation of Benefit
IV - 6. Minimum duration of Benefit and Waiting Period
IV – 8. Right of complaint and appeal
IV - 9. Financing and Administration
List of applicable legislation
V - 4. Level and Calculation of Benefit
V - 9. Right of complaint and appeal
V - 10. Financing and Administration
Part VI. Employment Injury Benefit
List of applicable legislation
VI - 1. Contingencies and regulatory framework
VI – 3. Definition of Occupational Diseases
VI - 8. Financing and Administration
List of applicable legislation
VII - 6. Level and Calculation of Benefit
VII - 8. Suspension of Benefit
VII – 9. Right of complaint and appeal
VII - 10. Financing and Administration
Part VIII. Maternity benefit = not accepted
Part IX. Invalidity benefit = not accepted
List of applicable legislation
X - 4. Level and Calculation of Benefit
X – 9. Right of complaint and appeal
X - 10. Financing and Administration
Part XI. Standards to be complied with by periodical payments
Part XII. Equality of treatment of non-national residents
XIII – 1. Suspension of benefit
XIII – 2. Right of complaint and appeal
XIII – 3. Financing and Administration
Annex 1: Responses to requests for further information
Annex 2: Supplementary information on the UK’s response to the Covid-19 pandemic
Part I. General provisions
The Part I “General provisions” comprises the following explanatory and procedural clauses:
§ Articles 1-6 C102
§ Articles 1-6 ECSS
LEGISLATION
Great Britain and Northern Ireland: Separate, but corresponding, schemes of Social Security operate in Great Britain and Northern Ireland. Reciprocal arrangements between the two ensure that the schemes effectively operate as a single system. The law governing Social Security in Great Britain was amended during the reference period by the measures listed below. Corresponding legislation came into effect in Northern Ireland as listed after the GB measures. Benefit levels are maintained in parity with Great Britain and all rates quoted therefore apply equally.
Copies of the original text of Acts, Regulations and Orders can be viewed at the Government’s website[1]. Statutory Instruments (SIs) and Statutory Rules (SRs) can be traced by their year of publication and SI/SR Number quoted below. The complete Law on Social Security, as it currently applies in Great Britain, as amended and updated, is published as the “Blue Volumes” and is now available online via the Department for Work and Pensions’ website[2]. Guidance on how to navigate the respective volumes is also available there. Corresponding Social Security legislation that has effect in Northern Ireland can be viewed at the Department for Communities website[3].
Universal Credit Northern Ireland Flexibilities: During discussions on the implementation of Universal Credit (UC) in Northern Ireland, the then Minister for Social Development secured payment flexibilities under Universal Credit for NI claimants. It was agreed that: (1) twice monthly payments will be available to all households as the default, with monthly payments available on request; and (ii) managed payment of the housing element of Universal Credit direct to the landlord will be available to all, with a direct payment to the household available on request to those who meet the criteria.
Scotland:Competence for the administration of eleven UK social security benefits, approximately 15 per cent of the UK’s total social security spending, was devolved to Scottish Ministers by the Scotland Act 2016. The Social Security (Scotland) Act 2018[4] (‘the Act’), received Royal Assent on 1 June 2018 and is the statutory framework under which regulations for each devolved form of assistance will be made. The Act also confers a power on Scottish Ministers to ‘top up’ benefits reserved to the UK. The Act allows Scottish Ministers to determine the person to whom, or the time when, Universal Credit is paid. This has resulted in the Universal Credit Scottish choices, a policy developed by the Scottish Government and delivered by the Department for Work and Pensions on their behalf, allowing claimants in Scotland to choose to receive their Universal Credit award twice monthly and to have the housing element of their award paid directly to their landlord.
Wales: Social Security is not devolved to the Welsh Government.
Acts of Parliament
Primary legislation relevant to the benefits covered by the Report and introduced during the reference period includes:
·
·
2020
- Coronavirus Act 2020
· https://www.legislation.gov.uk/ukpga/2020/7/contents/enacted
· Social Security (Up-rating of Benefits) Act 2020
· https://www.legislation.gov.uk/ukpga/2020/23/contents/enacted
Statutory Instruments
An alphabetical list of all current secondary legislation, i.e. Regulations and Orders in the form of Statutory Instruments, is available via the link below[5].
All secondary legislation can be viewed via links in the chronological bookmarks in the left hand side-bar of the list.
The rates of Social Security benefits payable under the respective Parts of the Code were increased during the reference period by the following instruments:
· 2017
· The Social Security Benefits Up-rating Order 2017 (SI 2017 No 260 NI Equivalent SR 2017 No 56)
· The Social Security Benefits Up-rating Order (NI) 2017( SR 2017 No. 56)
· The Social Security Benefits Up-rating (No. 2) Order (NI) 2017 (SR 2017 No. 187)
· The Social Security (2017 Benefits Up-rating) Regulations (Northern Ireland) 2018 (SR 2018 No. 57)
·
2018
· The Social Security Benefits Up-rating Order 2018 (SI 2018 No 281 NI Equivalent SR 2018 No 58)
· The Social Security Benefits Up-rating Order (NI) 2018 (SR 2018 No. 58)
· The Social Security Benefits Up-rating (No. 2) Order (NI) 2018 (SR 2018 No. 167)
· The Social Security (2018 Benefits Up-rating) Regulations (Northern Ireland) 2019 (SR.2019 No. 48)
2019
· The Social Security Benefits Up-rating Order 2019 (SI 2019 No 480 NI Equivalent SR 2019 No 58)
· The Social Security Benefits Up-rating Order (NI) 2019 (SR 2019 No. 58)
· The Social Security Benefits Up-rating (No. 2) Order (NI) 2019 (SR 2019 No. 188)
2020
· The Social Security Benefits Up-rating Order 2020 (SI 2020 No 234 NI Equivalent SR 2020 No 40)
· The Social Security Benefits Up-rating Order (NI) 2020 (SR 2020 No. 40)
·
2021
· The Social Security Benefits Up-rating Order 2021 (SI 2021 No 162 NI Equivalent SR 2021 No 82)
· The Social Security Benefits Up-rating Order (NI) 2021 (SR 2021 No. 82)
The following instruments are of relevance to the report:
2017
· The Social Security (Scottish Infected Blood Support Scheme) Regulations 2017 (SI 2017 No 329)
· The Social Security (Infected Blood and Thalidomide) Regulations 2017 (SI 2017 No 870, NI Equivalent SR 2017 No 219)
2018
· The Universal Credit and Jobseeker’s Allowance (Miscellaneous Amendments) Regulations (Northern Ireland) 2018 (S.R. 2018 No 187)
· The Housing Benefit and Universal Credit Housing Costs (Executive Determinations) (Amendment) Regulations (Northern Ireland) 2018 (S.R. 2018 No. 209)
· The Social Security (Treatment of Arrears of Benefit) Regulations 2018 (SI 2018 No 932)
· Agricultural Wages (Wales) Order 2019 (SI 2019 No 511 (W 118))
· The Universal Credit (Transitional Provisions) (SDP Gateway) (Amendment) Regulations 2019 {SI 2019 No.10} (Northern Ireland) 2019 (SR 2019 No. 2)
· The Universal Credit (Managed Migration Pilot and Miscellaneous Amendments) Regulations 2019 {SI 2019 No.1152} (Northern Ireland) 2019 {SI 2019 No.152}
· The Universal Credit (Restrictions on Amounts for Children and Qualifying Young Persons) (Transitional Provisions) (Amendment) Regulations (Northern Ireland) 2019 (SR 2019 No. 3)
· The Welfare Reform Act 2012 (Commencement No. 31 and Savings and Transitional Provisions and Commencement No. 21 and 23 and Transitional and Transitory Provisions (Amendment)) Order 2019 (SI 2019 No. 37)
· The Welfare Reform Act 2012 (Commencement No. 31 and Savings and Transitional Provisions (Amendment)) Order 2019 (SI 2019 No. 935)
· The Social Security (Income-related Benefits) (Updating and Amendment) (EU Exit) Regulations 2019
2020
· The Employment and Support Allowance and Universal Credit (Coronavirus Disease) Regulations 2020 {SI 2020 No 289]
· The Social Security (Coronavirus) (Further Measures) Regulations 2020 [SI 2020 No. 371]
· The Employment and Support Allowance (Transitional Provisions) (Amendment) Regulations 2020 [SI 2020 No 102]
· The Housing Benefit (Transitional Provision) (Amendment) Regulations 2020 [SI 2020 No 288]
· The Employment and Support Allowance and Universal Credit (Coronavirus) Regulations (Northern Ireland) 2020 (SR 2020 No. 33)
· The Employment and Support Allowance and Housing Benefit (Transitional Provisions) (Amendment) Regulations (Northern Ireland) 2020 (SR2020 NO. 45
· The Social Security (Coronavirus) (Further Measures) Regulations (Northern Ireland) 2020(SR 2020 No 53)
· The Social Security (Coronavirus) (Prisoners) Regulations (NI) 2020 (SR 2020 No. 63)
· The Social Security (Income and Capital) (Miscellaneous Amendments) Regulations (Northern Ireland) 2020 (SR 2020 No 108)
· The Universal Credit (Persons who have attained state pension credit qualifying age) (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 119)
· The Universal Credit (Great Britain Reciprocal Arrangements) Regulations (Northern Ireland) 2020 (SR 2020 No. 129)
· The Universal Credit (Persons of Northern Ireland – Family Members) (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 130)
· The Statutory Sick Pay (Coronavirus) (Suspension of Waiting Days and General Amendment) (No.2) Regulations (Northern Ireland) 2020 SR 2020 No. 134
· The Social Security (Income-related Benefits) (Persons of Northern Ireland-Family Members) (Amendment ) Regulations (NI) 2020 (SR 2020 No. 149)
· The Statutory Sick Pay (General) (Coronavirus Amendment) (No. 5) Regulations (Northern Ireland) (2020 SR 2020 No 167)
· The Statutory Sick Pay (General) (Coronavirus Amendment) (No. 6) Regulations (Northern Ireland) (2020 SR 2020 No. 186)
· The Employment and Support Allowance and Universal Credit (Coronavirus (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 217)
· The Universal Credit (Earned Income) (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 226)
· The Social Security (Coronavirus) (Further Measures) (Amendment) and Miscellaneous Amendment Regulations (Northern Ireland) 2020 (SR 2020 No.242)
· The Statutory Sick Pay (General) (Coronavirus Amendment) (No. 7) Regulations (Northern Ireland) (2020 SR 2020 No 351) The Social Security (Coronavirus) (Prisoners) Regulations 2020 [ SI 2020 No 409]
· The Social Security (Coronavirus) (Prisoners) Amendment Regulations 2020 [SI 2020 No 1156]
· The Social Security (Coronavirus) (Further Measures) Amendment Regulations 2020
· Social Security, Child Benefit and Child Tax Credit (Amendment) (EU Exit) Regulations 2020
· The Scottish Child Payment Regulations 2020 (SSI 2020 no 351)
2021
· The Universal Credit (Transitional Provisions) (Claimants previously entitled to a severe disability premium) Amendment Regulations 2021 {SI 2021 No.4} (Northern Ireland) 2021(SR 2021 No. 2)
· The Social Security (Coronavirus) (Miscellaneous Amendments) Regulations 2021 [SI 2021 No 476]
· Universal Credit (Extension of Coronavirus Measures) Regulations 2021 (S.I. 2021/313)
· The Universal Credit (Transitional Provisions) (Claimants previously entitled to a severe disability premium) (Amendment) Regulations (Northern Ireland) 2021 (SR 2021 No. 2)
· The Housing Benefit and Universal Credit Housing Costs (Executive Determinations) (Modification) Regulations (Northern Ireland) 2021 (SR 2021 No. 14)
· The Housing Benefit (persons who have attained the qualifying age for state pension credit)(Amendment) Regulations (Northern Ireland) (SR 2021 No 70
· The Loans for Mortgage Interest (Amendment) Regulations (Northern Ireland) 2021 (SR 2021 No. 28)
· The Universal Credit (Extension of Coronavirus Measures) Regulations (Northern Ireland) 2021 (SR 2021 No. 67)
· The Social Security (Coronavirus) (Miscellaneous Amendments) Regulations (Northern Ireland) 2021 (SR 2021 No. 105)
· The Housing Benefit and Universal Credit (Care Leavers and Homeless) (Amendment) Regulations (Northern Ireland) 2021 SR 2021 No. 118
Part II. Medical Care
The United Kingdom has accepted the obligations resulting from Part II of C102 and Part II of the ECSS.
Information provided below applies across Great Britain and Northern Ireland, except in instances where it is indicated that Scotland has different legislation or policies in place.
List of applicable legislation
· National Health Service Act 2006[6]
· Health and Social Care Act 2012[7]
· The Care Act 2014[8]
· Public Bodies (Joint Working) (Scotland) Act 2014[9]
· Mental Health (Care and Treatment) (Scotland) Act 2003[10]
II – 1. Regulatory framework
Article 7. C102 and ECSS
Each Member (Contracting Party) for which this Part of this Convention (Code) is in force shall secure to the persons protected the provision of benefit in respect of a condition requiring medical care of a preventive or curative nature in accordance with the following Articles of this Part.
Basic principle: tax financed National Health Service for all residents.
Secretary of State
The Secretary of State for Health and Social Care has ultimate responsibility for the provision of a comprehensive health service in England and ensuring the whole system works together to respond to the priorities of communities and meet the needs of patients.
The Secretary of State works through the Department of Health and Social Care to provide strategic direction for the NHS and wider health and care system and holds all of the national bodies to account for their operational and financial performance, thereby ensuring that the different parts of the system work properly together.
The Secretary of State has to fulfil a number of duties that are set out in law, including: the promotion of a comprehensive health service; to have regard to the need to reduce health inequalities between the people of England; and to have regard to the NHS Constitution. These duties, and others, are fulfilled through relationships with other bodies and the Secretary of State’s performance with regard to his or her duties is covered in his/her annual report. The Secretary of State, and all public bodies in the healthcare system, must also comply with the public sector equality duty in the Equality Act 2010.
Department of Health and Social Care
The Department of Health and Social Care’s purpose is to help people live better for longer. It leads, shapes and funds health and care in England, making sure people have the support, care and treatment they need, with the compassion and dignity they deserve. The Department, on behalf of the Secretary of State, acts as ‘system steward’ – it is the only body with oversight over the whole health and care system, and it works to ensure the health and care system operates effectively to meet the needs of people and their communities.
The Department of Health and Social Care is responsible for strategic leadership of both the health and social care systems.
NHS England is an executive non-departmental public body, sponsored by the Department of Health and Social Care.
Healthcare in Scotland
The Scottish Government aims to provide high quality healthcare services that focus on prevention, early intervention and supported self-care management. This means people will be treated and stay at home where possible, and when a hospital admission is required, they will be seen and discharged as swiftly as it is safe to do so.
Scotland is comprised of 14 territorial Health Boards covering all regions of Scotland, with eight national boards which provide specific support such as education, improvement and ambulance services. In addition, through the Public Bodies (Joint Working) (Scotland) Act 2014, there are 31 Integration Authorities (more detail on those below).
Health and Social Care Integration in Scotland
A review of progress with integration was undertaken by the Ministerial Strategic Group for Health and Community Care (MSG) and published in February 2019. The review highlighted findings from a recent national audit report on integration, which outlined that integration can work within the current legislative framework and is already working well in some places, but there are significant barriers to delivering integration. Extensive work is underway to deliver the review’s 25 practical proposals, which set a challenging and ambitious agenda for Integration Authorities, NHS Boards and Local Authorities, working with key partners, including the third and independent sectors to increase the pace and effectiveness of integration by March 2020.
Further information about health and social care integration is available on the Scottish Government Health and Social Care Integration page (www.gov.scot) and the Health and Social Care Scotland website (www.hscscotland.scot).
II - 2. Contingencies covered
Article 8. C102 and ECSS
The contingencies covered shall include any morbid condition, whatever its cause, and pregnancy and confinement and their consequences.
The NHS Constitution[11] establishes the principles and values of the NHS, setting out rights which patients, public and staff are entitled to ensure that the NHS operates fairly and effectively. This means that any patient in need of medical care and attention receives this from the NHS regardless of the morbid condition such as self-inflicted incidents that led to the person seeking medical assistance in the first instance.
NHS Constitution: ‘The service is designed to improve, prevent, diagnose and treat both physical and mental health problems with equal regard. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.’
II - 3. Persons protected
§1(c) Article 1 C102, §1(f) Article 1 ECSS
The term wife means a wife who is maintained by her husband.
Article 9. C102 and ECSS
The persons protected shall comprise:
(a) prescribed classes of employees, constituting not less than 50 per cent of all employees, and also their wives and children; or
(b) prescribed classes of the economically active population, constituting not less than 20 per cent of all residents, and also their wives and children; or
(c) prescribed classes of residents, constituting not less than 50 per cent of all residents.
The NHS provides a comprehensive service, available to all.
Access to NHS services is based on clinical need, not an individual’s ability to pay. NHS services are free of charge, except in limited circumstances sanctioned by Parliament.
GP and nurse consultations in primary care, treatment provided by a GP and other primary care services are free of charge to all, whether registering as an NHS patient, or as a temporary patient, which is when the patient is in the area for more than 24 hours and less than 3 months.
For secondary care services, the UK’s healthcare system is a residence-based one, which means entitlement to free healthcare is based on living lawfully in the UK on a properly settled basis for the time being.
The measure of residence that the UK uses to determine entitlement to free NHS healthcare is known as ‘ordinary residence’. This requires non-EEA nationals subject to immigration control to also have the immigration status of indefinite leave to remain.
Individuals who are not ordinarily resident in the UK may be required to pay for their care when they are in England. However, some services and some individuals are exempt from payment.
II - 4. Types of Benefit
§1. Article 10. C102 and ECSS
The benefit shall include at least:
(a) in case of a morbid condition,
(i) general practitioner care, including domiciliary visiting;
(ii) specialist care at hospitals for in patients and out patients, and such specialist care as may be available outside hospitals;
(iii) the essential pharmaceutical supplies as prescribed by medical or other qualified practitioners; and
(iv) hospitalisation where necessary; and
(b) in case of pregnancy and confinement and their consequences,
(i) pre natal, confinement and post natal care either by medical practitioners or by qualified midwives; and
(ii) hospitalisation where necessary.
Information on NHS services:
· Primary Care (including general practitioner care): https://www.england.nhs.uk/primary-care/
· Urgent and Emergency Care: https://www.england.nhs.uk/urgent-emergency-care/Hospital services: https://www.nhs.uk/using-the-nhs/nhs-services/hospitals/
· Pharmacies: https://www.nhs.uk/using-the-nhs/nhs-services/pharmacies/
· Maternity care: https://www.nhs.uk/conditions/pregnancy-and-baby/antenatal-midwife-care-pregnant/
· Postnatal care: https://www.nhs.uk/conditions/pregnancy-and-baby/you-and-your-baby-postnatal-period/
Statistics
Details of Statistics & data collections can be viewed via the following link:
https://digital.nhs.uk/data-and-information
Domiciliary visiting
In England, GPs provide primary medical services under contracts with NHS England. Under these arrangements, GP practices are required to provide services to patients at their home where, in the GP’s opinion, the patient’s medical condition requires them to be seen by a GP and it would be inappropriate for the patient to go to the GP practice.
The practice also has the option of treating a patient at alternative premises, as have been agreed with NHS England, or another place in the practice area.
Further information can be found in Schedule 3 of The NHS (General Medical Services Contracts) Regulations 2015 – SI2015/1862 http://www.legislation.gov.uk/uksi/2015/1862/pdfs/uksi_20151862_en.pdf
Similar provisions are also contained in the regulations relating to the provision of primary medical services in Wales, Scotland and Northern Ireland – links to relevant legislation is included below for reference.
Links to regulations applying to the provisions in Wales, Scotland and Northern Ireland are:
Wales: Schedule 6, paragraph 3, of The National Health Service (General Medical Services Contracts) (Wales) Regulations 2004 – SI 2004/478 (W.48)
http://www.legislation.gov.uk/wsi/2004/478/pdfs/wsi_20040478_en.pdf
Scotland: Schedule 6, paragraph 4, of The National Health Service (General Medical Services Contracts (Scotland) Regulations 2018 – SI 2018/66
http://www.legislation.gov.uk/ssi/2018/66/pdfs/ssi_20180066_en.pdf
Northern Ireland: Schedule 5, paragraph 3, of The Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) – SI 2004/140
http://www.legislation.gov.uk/nisr/2004/140/pdfs/nisr_20040140_en.pdf
Pre-natal, confinement and post-natal care
The National Health Service Act 2006(www.legislation.gov.uk/ukpga/2006/41/pdfs/ukpga_20060041_en.pdf)
The National Health Service Act 2006 places a duty on the Secretary of State with regard to maternity care, this legislation covers pre-natal, confinement and postnatal care.
The provisions in the Health and Social care Act 2012 (http://www.legislation.gov.uk/ukpga/2012/7/pdfs/ukpga_20120007_en.pdf ) ensure that these functions continue. Clauses 9 and 10 are the provisions which ensure that the services and facilities for the care of pregnant women, breastfeeding women and young children required to be provided now in accordance with section 3(1)(d) of the 2006 Act, would continue to be provided as a part of the health service.
Midwifery and maternity services are regulated activities. Information on midwifery regulation is available from the Nursing and Midwifery Council https://www.nmc.org.uk/about-us/policy/projects-were-involved-in/changes-to-midwifery-regulation/
Scotland
In Scotland, the National Health Service (Scotland) Act 1978 Act applies. The relevant sections are sections 38 and 38A. Section 38 places a duty on the Scottish Ministers to make arrangements to such extent as they consider necessary for the care (including in particular dental and medical care) of expectant mothers and nursing mothers and of young children.
National Health Service (Scotland) Act 1978 (legislation.gov.uk)
II - 5. Cost-sharing
§2. Article 10. C102 and ECSS
The beneficiary or his breadwinner may be required to share in the cost of the medical care the beneficiary receives in respect of a morbid condition; the rules concerning such cost-sharing shall be so designed as to avoid hardship.
The National Health Service (NHS) is a comprehensive service available to all, free at the point of use and based on clinical need, not the ability to pay.
Payment of doctor
For hospital treatment:
Treatment is free to those people who are ordinarily resident in the UK or exempt from charges under the NHS (Charges to Overseas Visitors) Regulations 2011. Anyone else is liable for the full cost of any treatment provided.
Ordinarily resident
For the purpose of eligibility to free NHS hospital treatment, being Ordinarily Resident means: An individual living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, whether of short or long duration. Non-EEA nationals who are subject to immigration control must additionally have indefinite leave to remain (ILR) in the UK in order to be ordinarily resident in the UK.
Patient charges
No charge to patients ordinarily resident in the UK or charge-exempt overseas visitors, except where the patient asks for special amenities or for extra treatment which is not clinically necessary.
Scotland
In Scotland, the relevant regulations are the National Health Service (Charges to Overseas Visitors) Regulations 1989. Medical treatment, including hospital treatment, is provided by Health Boards on the NHS in Scotland by virtue of the Functions of Health Boards (S) Order 1991. Section 36 of the 1978 Act places Ministers under a duty to provide (to such extent as they consider necessary to meet all reasonable requirements) accommodation, specifically hospital accommodation and premises other than hospitals at which facilities are available for any of the services provided under the 1978 Act and medical, nursing and other services whether in such accommodation or premises or in the home of the patient or elsewhere.
Boards are required to provide health services (as specified in the 1991 Order) to persons who are ordinarily resident in the Health Board area and to persons who reside ordinarily outside the UK but who are in the HB area. For A&E services Boards must provide/ secure the provision of A&E for all persons in the Board area.
Healthcare charges, including charges for maternity services apply to overseas visitors, who are not included in the exempt services or persons listed in the Scottish overseas visitors charging regulations, or where they are not covered by reciprocal healthcare arrangements (both with the EEA and other parts of the world).
However, Scottish policy is that because of the severe health risks associated with conditions such as eclampsia and pre-eclampsia, maternity services, even in early pregnancy, should always be considered to be immediately necessary treatment and must not be withheld if the woman is unable to pay in advance. No woman must ever be denied, or have delayed, maternity services due to charging issues.
Dental care
There are three standard charging bands for NHS dental treatment in England delivered in primary care (high street dentists and community dental services) – Band A - £23.80, Band B - £65.20 or Band C - £282.80 depending on treatment required for the 2020/21 financial year.
There is no charge for NHS dental treatment for:
· women who are pregnant, or who have had a baby in the preceding 12 months, when the course of treatment starts;
· people under 18; or those aged 19 or under and in full-time education
· people and their partners who are receiving Income-related Employment and Support Allowance (ESA), Income Support or Income-based Jobseekers’ Allowance, Universal Credit or Pension Credit Guarantee Credit;
· people named on an NHS Tax Credit Exemption Certificate or a valid HC2 certificate; and
· Adults on a low income may be able to get help with the cost of treatment through the NHS Low Income Scheme
In-patients receiving dental treatment in an NHS hospital from the hospital dentist are exempt from dental charges. Patients receiving outpatient care from a hospital dentist are exempt from the standard NHS dental charges but charges may be applied for dental appliances such as dentures.
In Wales the three equivalent standard charging bands for the 2020/21 financial year are as follows: Band A - £14.70, Band B - £47.00 and Band C - £203.00. There are also additional exemptions for those people under 25 years of age or over 60 years of age to receive a free dental check-up.
Pharmaceutical products
Charge of GBP 9.35 per prescribed item.
An annual (or 3 months) prescription prepayment certificate can be bought which offers considerable savings to those who need regular medication. The cost of the certificate is GBP 108.10 (England) for one year and GBP 30.25 (England) for 3 months.
There is no charge for the following exemption categories:
§ Age: A patient is entitled to a free NHS prescription if they are under 16, aged 16-18 and in full time education, aged 60 or over
§ Income-based benefits: a patient is entitled to free NHS prescriptions if they are included in award for income support, income-based jobseeker’s allowance, income-related employment and support allowance. If a patient is receiving one of these benefits, their partner and any dependent young people under 20 are also entitled to free NHS prescriptions.
§ Pension Credit: A patient is entitled to free NHS prescriptions if they or their partner receives Pension Credit Guarantee Credit or Pension Credit Guarantee Credit with Savings Credit.
§ Universal credit: To be entitled to claim help with their health costs, a patient must be receiving Universal Credit, either as a single person or as a member of a couple, and:
a) for the last complete assessment period the patient and their partner (if they have one) had either no earnings or net earnings of £435.00 or less. Or;
b) for the last complete assessment period a patient and their partner (if they have one) had either no earnings or net earnings of £935.00 or less and had a child element included in their award or had limited capability for work. A patient would also be entitled if they were a dependent child or qualifying young person of someone who meets specified criteria.
§ Tax credits: A patient is entitled to free NHS prescriptions if their annual family income used to work out their tax credits is £15,276 or less and they receive either child tax credit, working tax credit and child tax credit paid together or working tax credit including a disability element.
§ Pregnant women and those who have had a baby in the past 12 months
§ Low income (including students and pensioners): A patient can get free NHS prescriptions if they have a valid HC2 certificate. These certificates are issued to people who qualify for full help with health costs through the NHS Low Income Scheme.
§ People who receive war pension scheme or Armed Forces Compensation Scheme payments: A patient can get free NHS prescriptions if they have a valid war pension exemption certificate and their prescription is for their accepted disability.
There is no charge for a NHS prescription that has been prescribed by an NHS Wales healthcare professional and has been dispensed in Wales.
Prosthesis, spectacles, hearing-aids
Vouchers available to help with purchase of spectacles for certain groups: to children under 16 or under 19 and still in full-time education, or people (and their partner) getting income-related Employment and Support Allowance (ESA) or Income Support or income-based Jobseeker’s Allowance or Pension Credit Guarantee Credit or receiving Universal Credit or Tax Credits and meeting qualifying conditions, or those on a low income and named on a valid HC2 (full help) or HC3 (partial help) certificate and those who require complex lenses.
No charge for NHS sight tests for the above categories, plus people aged 60 or over, those registered blind or partially sighted, those diagnosed with diabetes or glaucoma, those aged 40 or over and the brother, sister, parent or child of a person diagnosed with glaucoma, and those advised by an ophthalmologist that they are at risk of glaucoma. Others pay privately but may be entitled to help with costs if in receipt of a HC3 partial help certificate.
Hospital Eye Service patients get free sight tests and possible help towards the cost of glasses or contact lenses. War Pensioners can claim back the cost of treatment (for their accepted disability).
Prosthesis, sight testing, spectacles and hearing aids. No charge for provision and fitting of National Health Service appliances.
Scotland
Dental care
NHS dental examinations are free in Scotland.
The criteria for exemption from NHS dental charges is the same across the UK. However, for those who are required to pay; in Scotland a patient will pay 80% of the cost of their NHS dental treatment up to a maximum of £384 per course of treatment.
Eye care
NHS eye examinations are free in Scotland to anyone ordinarily resident in the UK or who is in one of the categories for exemption from NHS charges set out in the NHS (Charges to Overseas Visitors) (Scotland) Regulations 1989. This ensures there is no financial barrier for such people accessing eye care in the community.
Optical vouchers to help with the cost of purchasing spectacles or contact lenses are available to eligible people, including:
children aged under 16; people aged under 19 and in qualifying full-time education; people who require complex lenses; people (and their partner) receiving Income-related Employment and Support Allowance (ESA), Income Support, Income-based Jobseeker’s Allowance (JSA) paid on its own or with contribution-based JSA, Pension Credit Guarantee Credit paid on its own or with Savings Credit, Universal Credit and meeting qualifying conditions; people who are entitled to, or named on, a valid NHS Tax Credit exemption certificate; people who are on a low income and named on a valid HC2 (full help) or HC3 (partial help) certificate.
Pharmaceutical products
Prescription charges were abolished in Scotland in 2011.
II - 6. Objectives of Medical Care
§3. Article 10. C102 and ECSS
The benefit provided in accordance with this Article shall be afforded with a view to maintaining, restoring or improving the health of the person protected and his ability to work and to attend to his personal needs.
As stated above, the Department of Health and Social Care’s purpose is to help people live better for longer. It leads, shapes and funds health and care in England, making sure people have the support, care and treatment they need, with the compassion and dignity they deserve.
Introduction to the NHS Constitution:
‘The NHS belongs to the people.
It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.’
II - 7. Promotion of the general health service
§4. Article 10. C102 and ECSS
The institutions or Government departments administering the benefit shall, by such means as may be deemed appropriate, encourage the persons protected to avail themselves of the general health services placed at their disposal by the public authorities or by other bodies recognised by the public authorities.
See under Part II-1. Regulatory framework.
Public Health England
Public Health Englandare an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. Providing government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. It has responsibility for the following;
· making the public healthier and reducing differences between the health of different groups by promoting healthier lifestyles, advising government and supporting action by local government, the NHS and the public
· protecting the nation from public health hazards
· preparing for and responding to public health emergencies
· improving the health of the whole population by sharing our information and expertise, and identifying and preparing for future public health challenges
· supporting local authorities and the NHS to plan and provide health and social care services such as immunisation and screening programmes, and to develop the public health system and its specialist workforce
· researching, collecting and analysing data to improve our understanding of public health challenges, and come up with answers to public health problems
UK Health Security Agency (UKHSA)
Formally established on 1 April 2021 as an Executive Agency of the Department of Health and Social Care, the new UK Health Security Agency (UKHSA) is England’s permanent standing capacity to prepare for, prevent and respond to threats to the population’s health.
UKHSA brings together Public Health England’s (PHE) highly established health protection expertise with the significantly increased capacity for testing, contact tracing and outbreak management and the associated data, insight and analytical capability and intelligence capability to strengthen health protection across the UK and enhance our current COVID-19 response. The UKHSA will be the nation’s public health security agency, operating as an integral part of the public health system. The UKHSA will prevent, investigate, mitigate and respond to all infectious diseases and other hazards to health. This includes: emergency response and preparedness to deal with the most severe incidents at national and local level; all infectious diseases including pandemics, endemic, high-consequence, vaccine-preventable, resistant, healthcare associated, new and emerging diseases; environmental threats, radiation, chemicals and other threats to health; and local health protection teams to deal with infections and other hazards to health.
To protect operational continuity, the transition of responsibilities and capabilities from PHE into the new Agency will take place during 2021, with the UKHSA fully operational from October 2021. Until this date, PHE will continue to deliver its existing functions.
Public Health Scotland
Public Health Scotland is Scotland’s lead national agency for improving and protecting the health and wellbeing of all of Scotland’s people.
Our vision is of a Scotland where everybody thrives. Our focus is on increasing healthy life expectancy and reducing premature mortality. To do this, we use data, intelligence and a place based approach to lead and deliver Scotland’s public health priorities.
The scale of the challenge is so great that no one organisation or profession can address it alone. But together, we can. We are jointly sponsored by COSLA and the Scottish Government and collaborate across the public and third sectors.
Public Health Wales
With support from our staff, partners and the people of Wales, Public Health Wales has developed a long term strategy covering 2018-30. It brings together seven strategic priorities which are intrinsically linked and together help us achieve our purpose: Working to Achieve a Healthier Future for Wales.
This strategy will enable us to focus on how we can best work with our partners to have maximum impact in improving health and wellbeing and reducing health inequalities in Wales.
Our seven priorities are:
· Influencing the wider determinants of health
· Improving mental well-being and resilience
· Promoting healthy behaviours
· Securing a healthy future for the next generation
· Protecting the public from infection and environmental threats to health
· Supporting the development of a sustainable health and care system focused on prevention and early intervention
· Building and mobilising knowledge and skills to improve health and well-being across Wales
Public Health Agency (Northern Ireland)
The Public Health Agency (PHA) was established under Section 12 (1) of the Health and Social Care (Reform) Act (Northern Ireland) 2009, and is an arms length body of the Department of Health in Northern Ireland.
The overall aim for the PHA is to improve the health and social well-being of the population and the quality of care provided, and to protect the population from communicable disease or emergencies or other threats to public health. As well as the provision or securing of services related to those functions, the PHA will commission or undertake programmes of research, health awareness and promotion etc. This aim is delivered through three core functions of the PHA:
- securing the provision of and developing and providing programmes and initiatives designed to secure the improvement of the health and social well-being of and reduce health inequalities between people in Northern Ireland,
- protecting the community (or any part of the community) against communicable disease and other dangers to health and social well-being including dangers arising on environmental or public health grounds or arising out of emergencies; and
- providing professional input to the commissioning of health and social care services which meet established quality standards and which support innovation.
The PHA also has a general responsibility for promoting improved partnership working with local government and other public sector organisations to bring about real improvements in public health and social well-being on the ground and anticipating the new opportunities offered by community planning.
II - 8. Qualifying period
§1(f) Article 1 C102, §1(i) Article 1 ECSS
The term qualifying period means a period of contribution, or a period of employment, or a period of residence, or any combination thereof, as may be prescribed.
Article 11. C102 and ECSS
The benefit specified in Article 10 shall, in a contingency covered, be secured at least to a person protected who has completed, or whose breadwinner has completed, such qualifying period as may be considered necessary to preclude abuse.
See part II 3 and 5
II - 9. Minimum duration of Benefit
Article 12. C102 and ECSS
The benefit specified in Article 10 shall be granted throughout the contingency covered, except that, in case of a morbid condition, its duration may be limited to 26 weeks in each case, but benefit shall not be suspended while a sickness benefit continues to be paid, and provision shall be made to enable the limit to be extended for prescribed diseases recognised as entailing prolonged care.
There is no time limit for which a patient can access NHS care in England. In exceptional circumstances, a hospital may seek a court order to discharge a patient who does not want to be discharged, when they are medically fit. Such situations are very rare however, and this is handled on a case by case basis by the trust. Similarly, there are no prescribed time limits for access to medical care in Wales.
II - 10. Suspension of Benefit
Article 69. C102, Article 68. ECSS
A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed:
(a) as long as the person concerned is absent from the territory of the Member;
(b) as long as the person concerned is maintained at public expense, or at the expense of a social security institution or service, subject to any portion of the benefit in excess of the value of such maintenance being granted to the dependants of the beneficiary;
(c) as long as the person concerned is in receipt of another social security cash benefit, other than a family benefit, and during any period in respect of which he is indemnified for the contingency by a third party, subject to the part of the benefit which is suspended not exceeding the other benefit or the indemnity by a third party;
(d) where the person concerned has made a fraudulent claim;
(e) where the contingency has been caused by a criminal offence committed by the person concerned;
(f) where the contingency has been caused by the wilful misconduct of the person concerned;
(g) in appropriate cases, where the person concerned neglects to make use of the medical or rehabilitation services placed at his disposal or fails to comply with rules prescribed for verifying the occurrence or continuance of the contingency or for the conduct of beneficiaries;
Entitlement to NHS services is centred on the UK’s residency-based healthcare system. Both Ordinarily Resident and Non-Ordinarily Resident persons are able in law to access the NHS. The UK system does not involve a periodical payment to cover treatment; treatment is free at the point of access. Furthermore, UK legislation does not make provision for suspension of medical services in the circumstances covered by the Code.
Non-Ordinarily Resident visitors, however, will be subject to a charge for NHS secondary care services, unless an exemption from a charge category applies to them or the treatment accessed. Where a charge applies, treatment that a clinician considers “non-urgent”, which means it should wait until the date at which the visitor can reasonably be expected to depart the UK, will be withheld unless payment is provided in full. Immediately necessary or urgent treatment which a clinician considers should not wait until the date the visitor can reasonably be expected to depart the UK will not be withheld even if payment is not provided. If an individual is entitled to NHS care, access to treatments will be subject to the treatments and services that are available locally as well as the eligibility criteria set for these services. In specific circumstances, NHS treatment can be suspended if the treating clinician believes it is medically inappropriate to continue treatment for a patient, this occurs on a case by case basis with decisions made on the basis of medical appropriateness.
II- 11. Right of complaint and appeal
Article 70. C102, Article 69. ECSS
1. Every claimant shall have a right of appeal in case of refusal of the benefit or complaint as to its quality or quantity.
2. Where in the application of this Convention (Code) a government department responsible to a legislature is entrusted with the administration of medical care, the right of appeal provided for in paragraph 1 of this article may be replaced by a right to have a complaint concerning the refusal of medical care or the quality of the care received investigated by the appropriate authority.
3. Where a claim is settled by a special tribunal established to deal with social security questions and on which the persons protected are represented, no right of appeal shall be required.
Should a person wish to complain about any aspect of NHS care, treatment or services, they have the right to do this under the NHS constitution and can do so by following the complaints procedure at their local NHS (i.e. hospital, GP surgery, etc.).
II - 12. Financing and Administration
Article 71. C102, Article 70. ECSS
1. The cost of the benefits provided in compliance with this Convention (Code) and the cost of the administration of such benefits shall be borne collectively by way of insurance contributions or taxation or both in a manner which avoids hardship to persons of small means and takes into account the economic situation of the Member (Contracting Party) and of the classes of persons protected.
2. The total of the insurance contributions borne by the employees protected shall not exceed 50 per cent of the total of the financial resources allocated to the protection of employees and their wives and children. For the purpose of ascertaining whether this condition is fulfilled, all the benefits provided by the Member (Contracting Party) in compliance with this Convention (Code), except family benefit and, if provided by a special branch, employment injury benefit, may be taken together.
3. The Member (Contracting Party) shall accept general responsibility for the due provision of the benefits provided in compliance with this Convention (Code), and shall take all measures required for this purpose; it shall ensure, where appropriate, that the necessary actuarial studies and calculations concerning financial equilibrium are made periodically and, in any event, prior to any change in benefits, the rate of insurance contributions, or the taxes allocated to covering the contingencies in question.
Article 72. C102, Article 71. ECSS
1. The Member (Contracting Party) shall accept general responsibility for the proper administration of the institutions and services concerned in the application of the Convention (Code).
2. Where the administration is not entrusted [to an institution regulated by the public authorities or – C102] to a Government department responsible to a legislature, representatives of the persons protected shall participate in the management, or be associated therewith in a consultative capacity, under prescribed conditions; national laws or regulations may likewise decide as to the participation of representatives of employers and of the public authorities.
See under Part XIII-3-
The most up-to-date information on healthcare expenditure can be found here: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2018#how-health-care-in-the-uk-is-financed
NHS Funding Act
On 16 March 2020, the NHS Funding Act came into force after it received Royal Assent. The Act enshrines in law an extra £33.9 billion in cash terms every year by 2023/24 for the NHS to transform care.
It includes a ‘double-lock’ commitment that places a legal duty on both the Secretary of State and the Treasury to uphold this minimum level of NHS revenue funding over the 4 years to 2023/24.
Since this announcement other pledges made include:
· £1.5 billion in 2020/21 for hospital maintenance, eradicating mental health dormitories, enabling hospital building, and improving Accident & Emergency capacity.
· £9.4 billion for 2021/22, including £4.2 billion for NHS operational capital investment and £559 million for DHSC, NHS technology and AI.
· This also includes the first year of a £5.4 billion multi-year commitment until 2024-25 to support the delivery of 40 new NHS hospitals and over 70 NHS hospital upgrades.
· This is on top of £63 billion made available in 2020/21 and £29 billion in 2021/22 to help health services tackle coronavirus.
Scotland’s Health and Social Delivery Plan
In support of the Delivery Plan, the Health and Social Care Medium Term Financial Framework, published on 4 October 2018, sets out five areas of activity to reform, improve and achieve better value from health and social care services, to ensure continued delivery of a financially balanced and sustainable Health and Social Care system.
Part III. Sickness Benefit
The United Kingdom has accepted the obligations resulting from C24, C25, Part III of C102 and Part III of the ECSS.
Information provided below applies across Great Britain and Northern Ireland, except in instances where it is indicated that Scotland has different legislation or policies in place.
List of applicable legislation
For a full list of legislation, see: https://www.legislation.gov.uk/uksi/social%20security
Universal Credit Regulations 2013 and ‘Welfare Reform and Work Act 2016 http://www.legislation.gov.uk/ukdsi/2013/9780111531938/contents http://www.legislation.gov.uk/ukpga/2016/7/contents/enacted
Universal Credit Regulations (Northern Ireland) 2016 and Welfare Reform and Work (Northern Ireland) Order 2016
http://www.legislation.gov.uk/nisr/2016/216/contents/made
http://www.legislation.gov.uk/nisi/2016/999/contents
III - 1. Regulatory framework
Article 1. C24
Each Member of the International Labour Organisation which ratifies this Convention undertakes to set up a system of compulsory sickness insurance which shall be based on provisions at least equivalent to those contained in this Convention.
Article 1. C25
Each Member of the International Labour Organisation which ratifies this Convention undertakes to set up a system of compulsory sickness insurance for agricultural workers, which shall be based on provisions at least equivalent to those contained in this Convention.
Article 13. C102 and ECSS
Each Member (Contracting Party) for which this Part of this Convention (Code) is in force shall secure to the persons protected the provision of sickness benefit in accordance with the following Articles of this Part.
Financial Support for employed individuals unable to work due to sickness or incapacity is available in the form of Statutory Sick Pay (SSP). SSP is paid by the employer from the fourth day or first day if due to COVID-19, for up to a maximum of 28 weeks, and in the same way and at the same time as an employee’s normal wages. If SSP ends, an employee can claim Universal Credit or New Style Employment and Support Allowance depending on circumstance.
Employment and Support Allowance is available for those who require additional financial support or for those who do not qualify for Statutory Sick Pay.
New style Employment and Support Allowance (NS ESA) is available to individuals who have a disability or health condition that affects how much they can work for. Individuals are able to claim NS ESA with or instead of UC.
Universal Credit
The UK welfare system is made up of social security benefits and social assistance measures that together provide a welfare safety net protecting the most vulnerable in society. Universal Credit (UC) is a universal social assistance measure that supports those who can work into work by providing a minimum level of income, and cares for those who cannot work, in line with the UK’s view that work is the most effective route out of poverty. For the purposes of the Code it is considered a social assistance benefit. UC replaces the previous complex system of six main benefits (Income-based Jobseeker’s Allowance, Income-related Employment and Support Allowance, Income Support, Working Tax Credit, Child Tax Credit, Housing Benefit) with one simple monthly payment, the same way that many working people are paid.
Universal Credit supports people who are on a low income or out of work and helps to ensure that they are better off in work than on benefits. It provides claimants with the support they need to prepare for work, move into work, or to earn more if already in work. In return, claimants make a Claimant Commitment following a conversation with their work coach. The Claimant Commitment sets out what the claimant has agreed to do to prepare for and look for work, or to increase their earnings if already employed. It is based on the claimant's personal circumstances and is reviewed and updated on a regular basis.
Universal Credit Northern Ireland
Section 87 of the Northern Ireland Act 1998 (“the 1998” Act”) places a places a statutory duty on the Minister for Communities and the Secretary of State for Work and Pensions to consult with one another with a view to securing a single social security system for the United Kingdom. Section 88 of the 1998 Act makes provision for financial adjustments to support the maintenance of these parity arrangements.
Underpinning the parity principle is the argument that, as people in Northern Ireland pay the same rates of income tax and National Insurance contributions as people in Great Britain, they are entitled to the same rights and benefits paid at the same rate.
Universal Credit Scottish Choices
Sections 29 and 30 of the Scotland Act 2016 allow Scottish Ministers to introduce flexibilities in relation to Universal Credit (UC) with regard to the person to whom, and the time when, UC is to be paid, and to vary the amount of housing costs paid to people in receipt of UC. Since 4 October 2017, people in Scotland have had the choice to receive their UC award either monthly or twice monthly and to have the housing costs in their UC award paid directly to their landlord in both the privately and socially rented sectors. These are known as the UC Scottish choices.
The Department for Work and Pensions (DWP) delivers the UC Scottish choices on behalf of the Scottish Government. The UC Scottish choices give people more choice and control over UC payments, as well as helping safeguard tenancies and preventing the build-up of rent arrears. The Scottish Government has committed to abolish the bedroom tax at source within the UC system. On 19 September 2017 it was announced that the Scottish and UK Governments had agreed a solution to abolish the bedroom tax in UC, in a way which would not be limited by any interaction with the benefit cap. Those affected will receive one UC payment that includes both the main UC award, and the additional Scottish Government funding.
The Scottish Government also intends to introduce split payments of UC to give everyone access to an independent income and to promote equality in the welfare system, and is currently actively working with the DWP to develop options for how this could be delivered.
III - 2. Contingency covered
Article 14. C102 and ECSS
The contingency covered shall include incapacity for work resulting from a morbid condition and involving suspension of earnings, as defined by national laws or regulations.
The contingency covered complies with this article.
III - 3. Persons protected
§1. Article 2. C24
The compulsory sickness insurance system shall apply to manual and non-manual workers, including apprentices, employed by industrial undertakings and commercial undertakings, out-workers and domestic servants.
§1. Article 2. C25
The compulsory sickness insurance system shall apply to manual and non-manual workers, including apprentices, employed by agricultural undertakings.
Article 15. C102 and ECSS
The persons protected shall comprise:
(a) prescribed classes of employees, constituting not less than 50 per cent of all employees; or
(b) prescribed classes of the economically active population, constituting not less than 20 per cent of all residents; or
(c) all residents whose means during the contingency do not exceed limits prescribed in such a manner as to comply with the requirements of Article 67.
Universal Credit
Universal Credit (UC) is a universal social assistance measure that supports those who can work into work, and cares for those who cannot work by providing a minimum level of income, in line with the UK’s view that work is the most effective route out of poverty. There are five basic conditions of entitlement to Universal Credit: to be 18 years or over (with some exceptions); to be under Pension Credit age (with some exceptions); to be a resident of Great Britain; to not be in full-time education (with some exceptions); and to have accepted a claimant commitment.
Lower age limit
The lower age limit for entitlement to Universal Credit is usually 18 years. This is because 16 and 17 year olds should usually be in education or training and be supported by their parents. Where appropriate, Universal Credit provides financial support for most 16 and 17 year-olds via the child element awarded to their parents. However, there are exceptional circumstances where 16 and 17 year olds can claim Universal Credit in their own right. There is no direct entitlement to Universal Credit for children under the age of 16. If one member of a couple is ineligible for Universal Credit because they are under the age of 18 years, then they are not included in the calculation of entitlement. However, any capital, income or earnings that they have is still taken into account.
16 and 17 year olds can claim Universal Credit in their own right if they
• are responsible for a child (lone parents or couples);
• are sick or disabled with limited capability for work, or providing medical evidence and waiting to be assessed – they do not already need to have been awaiting a WCA at the point of claiming Universal Credit;
• have regular and substantial caring responsibilities for a severely disabled person;
• are pregnant and it is 11 weeks or less before the expected week of confinement, or were pregnant and it is 15 weeks or less since the date of confinement;
• have no parent, or cannot live with their parent(s), or, in specific circumstances are not supported by their parent(s).
Upper age limit
The upper age limit for Universal Credit is the qualifying age for Pension Credit. The qualifying age for Pension Credit is linked to the State Pension age for women. As the State Pension age for men and women equalised in December 2018, Pension Credit qualifying age is now the same as State Pension age for both genders (currently 66). The Pension Credit qualifying age will continue to rise in line with the further State Pension age increases.
Before 15 May 2019, couples with one person above and one person below Pension Credit qualifying age (“mixed age couples”) were able to choose to claim either Pension Credit (and/or Housing Benefit for pensioners) or the appropriate working-age income-related benefit. Since 15 May 2019 new claims for Pension Credit and Housing Benefit for pensioners have been restricted to couples where both members are above the Pension Credit qualifying age. Mixed age couples who were already claiming Pension Credit and/or Housing Benefit for pensioners immediately before the change are not affected for as long as they remain entitled to either benefit. Accordingly, entitlement to Pension Credit may also still be granted to these couples if they are in receipt of pension age Housing Benefit and vice versa.
Those couples not eligible for these pensioner benefits may qualify for Universal Credit, subject to satisfying the capital, income and other entitlement conditions. As Universal Credit is designed to incentivise and reward paid work, this will ensure that the working age partner receives the right support and incentives to move into work and, where appropriate, they are required to meet work related conditions. Any Universal Credit work-related requirements will only apply to the partner below State Pension age. The upper age limit for Universal Credit will in such cases therefore be attained once both members of the couple have reached the qualifying age for Pension Credit.
The change to the eligibility conditions for mixed-age couples was enacted by paragraph 64 of Schedule 2 to the Welfare Reform Act 2012, and brought into force with effect from 15 May 2019 by the Welfare Reform Act 2012 (Commencement No. 31 and Savings and Transitional Provisions and Commencement No. 21 and 23 and Transitional and Transitory Provisions (Amendment)) Order 2019 (Statutory Instrument 2019 no. 37).
Corresponding Northern Ireland legislation is paragraph 53 of Schedule 2 to the Welfare Reform (Northern Ireland) Order 2015 and the Welfare Reform (Northern Ireland) Order 2015 (Commencement No. 13 and Savings and Transitional Provisions and Commencement No. 8 and Transitional and Transitory Provisions (Amendment)) Order 2019 (SR 2019 No. 4).
Since 25 November 2020 claimants receive a payment of Universal Credit for the entire monthly assessment period in which state pension credit qualifying age is reached, so in effect a run-on of Universal Credit past that age, helping to smooth the transition between working age and pension age benefits. For mixed-age couples this applies when the younger partner reaches State Pension Credit qualifying age.
This change was made in the Universal Credit (Persons who have attained state pension credit qualifying age) (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 119).
Resident in Great Britain
Universal Credit is intended for people who are living in Great Britain. Except for certain limited categories of people, a person meets the entitlement condition if they are: present in Great Britain; have a qualifying right to reside; and are factually habitually resident in the United Kingdom, the Channel Islands, Isle of Man, or the Republic of Ireland (known as the ‘Common Travel Area’).
In certain circumstances, an adult whose particular form of employment means they are working abroad, is to be treated as still resident for Universal Credit purposes. This includes ‘Crown Servants’ (UK Government workers) and members of the armed forces who are posted to work outside Great Britain, provided they were habitually resident in the UK before they were posted abroad.
Where a claimant has an award of Universal Credit, we allow a temporary period of absence abroad of up to one month for any reason. We also allow a longer period of up to six months temporary absence abroad for reasons of medical treatment or in the case of mariners and people working on continental shelf operations. During this time Universal Credit is payable as normal.
There is corresponding provision for people living in Northern Ireland (Universal Credit Regulations (Northern Ireland) 2016).
Reciprocal arrangements between Great Britain and Northern Ireland are designed to co-ordinate, to the extent agreed, the respective legislations; creating in effect, a single system of social security across the United Kingdom. They ensure that recipients of certain specified benefits do not experience a break in claim as a result of moving from one jurisdiction to the other and are entitled to benefits on the same basis as other people in the relevant jurisdiction. This existing arrangement was extended to apply for Universal Credit.
If one member of a couple is ineligible for Universal Credit because their immigration status means they cannot claim public funds, then they are not included in the calculation of entitlement. However, any capital, income or earnings that they have is still taken into account.
Since 24 August 2020 family members of people of Northern Ireland granted limited leave to enter or remain under the EU Settlement Scheme (EUSS) as the family member of a person of Northern Ireland would have access to Universal Credit if the person of Northern Ireland was in a comparable position to an EEA national exercising a qualifying EU treaty right in the UK.
This change was made in the Universal Credit (Persons of Northern Ireland – Family Members) (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 130).
Education: Exclusions and Exemptions
The majority of people in full-time education are not entitled to Universal Credit. However, exceptions are made where students have additional needs that are not met through the student support system. Treatment of student income under Universal Credit broadly mirrors that in income-related Employment and Support Allowance, Housing Benefit, Income Support and income-based Jobseeker’s Allowance which safeguards fairness whilst also ensuring simplification of the benefit system.
A person in full time education can claim Universal Credit if they are:
• living with their partner and the partner is eligible for UC
• responsible for a child, either as a single person or as a couple if both are students.
• disabled and entitled to Attendance Allowance (AA) Disability Living Allowance (DLA), Personal Independence Payment (PIP) or Armed Forces Independence Payment (AFIP) and have limited capability for work
• in ‘non-advanced education’ (for example studying for A levels or a BTEC National Diploma), are 21 or under and don’t have parental support on the date of claim to Universal Credit
Any student loan paid to meet living costs is subject to a £110 disregard in each Assessment Period, equivalent to that provided under Legacy Benefits. Any reduction is only for living costs as loans or grants for other things, such as tuition fees or books, are fully disregarded.
Claimant Commitment
All claimants make a Claimant Commitment as a condition of entitlement. Couples living in the same household make a joint claim for Universal Credit and each have their own Claimant Commitment. Where a claimant is physically or mentally unable to accept a Claimant Commitment and this is unlikely to change, or it would be unreasonable to expect them to do so due to terminal illness, we will waive the requirement to accept a Claimant Commitment.
Restrictions on Entitlement
There is no entitlement to Universal Credit where a person is:
· a member of a religious order fully maintained by their order;
· a prisoner (except to the extent that support is provided for a temporary period for housing costs where period in custody is likely to be less than six months); or
· serving a sentence of imprisonment and detained in hospital.
These exclusions apply because these categories of people are maintained from other sources and therefore have no need to rely on benefits. These rules broadly mirror current rules in the income-related benefits.
Apprenticeships
People aged 18 or over on apprenticeships will be eligible for Universal Credit if they satisfy the normal conditions of entitlement. Young people aged 16 and 17 will not normally be able to claim Universal Credit, but there are some limited exceptional circumstances where they may do so, for example where they themselves are responsible for a child, have limited capability for work or are without parental support.
The Social Security (Coronavirus) (Further Measures) Regulations 2020 [SI 2020 No. 371] which came into force on 30 March 2020, amended The Employment and Support Allowance and Universal Credit (Coronavirus Disease) Regulations 2020 such that the treating of a person as having limited capability for work now applies only to claims for Employment and Support Allowance and not to claims for Universal Credit.
https://www.legislation.gov.uk/uksi/2020/371/contents
Corresponding Northern Ireland legislation is the Employment and Support Allowance and Universal Credit (Coronavirus) Regulations (Northern Ireland) 2020 (SR 2020 No. 33).
These regulations were amended by the Employment and Support Allowance and Universal Credit (Coronavirus) (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 217) to extend the period to 14 months from 13 March 2020.
These regulations were further amended by the Social Security (Coronavirus) (Miscellaneous Amendments) Regulations (Northern Ireland) 2021 (SR 2021 No. 105) to extend the period to 20 months from 13 March 2020.
Coronavirus and self-employed
Those who are gainfully self-employed and whose net earnings for any assessment period are below a set amount, they are treated as if they had earnings equivalent to the minimum income floor (MIF) when calculating entitlement to universal credit for that period. During the pandemic outbreak the MIF which is an assumed level of income, has been suspended to 31 July 2021 meaning that only actual earnings are taken into account when calculating universal credit entitlement, and self-employed claimants are able to access support on more generous terms.
.
The following exceptions apply:
(a) before 1 February 2019, UC wasn’t available where a person wished to claim benefits for more than 2 children;
(b) no claim could be made for UC on or after 16 January 2019 by a single claimant who, or joint claimants either of whom (i) had been within the past month, entitled to an award of an existing benefit that included a severe disability premium, and (ii) in cases where the award ended during that month, had continued to satisfy the conditions for eligibility for a severe disability premium. This restriction was lifted from 27 January 2021 and former recipients of the severe disability premium are now able to make a claim to UC from that date; and
(c) neither the legislation nor the UC platform currently permit claims from people who do not have a GB postcode, so if a “frontier worker” (i.e. a person who works in GB but lives in another country) attempts to claim UC, they are signposted to claim a legacy benefit instead.
People in receipt of income-related ESA, or income-based JSA at any time before UC became available in their particular area, will remain in receipt of these ‘legacy’ benefits, as long as they continue to meet the relevant conditions of entitlement, until their awards migrate to UC.
UC is not replacing two benefits: contribution-based JSA or contributory ESA. These remain and can be paid alongside or separately to UC where appropriate.
The following table summarises which claimant categories are eligible for which benefits:
|
Claimant category |
Legacy (non-UC) or UC? |
Legacy housing benefit or UC? |
|
Above working age |
N/A |
Legacy housing benefit |
|
Working age since before UC |
Income-related ESA+JSA |
Legacy housing benefit |
|
Working age since start of UC |
Contrib. ESA+JSA |
UC |
|
Working age since start of UC |
UC |
UC |
|
Working age in temporary/ supported accommodation |
UC |
Legacy housing benefit |
Legacy benefit changes (updates) since July 2019:
Mixed Age Couples
Income Related ESA
Before the roll-out of UC Full Service across Great Britain, a mixed age couple (MAC) (where one partner has not yet reached State Pension age) could previously claim income-related ESA (ESA(IR)) via a claim from one partner in the couple - the “lead claimant” - who fulfils the conditions of entitlement, and claims for their partner as a dependent.
Due to a policy change which took effect from 15 May 2019, MACs are no longer able to claim Pension Credit until both members of the couple have reached State Pension age. This means they need to claim the appropriate working age benefit instead, usually Universal Credit (UC), where eligible.
To address this, article 8(2)(a)(iii) of the Welfare Reform Act 2012 (Commencement No. 31 and Savings and Transitional Provisions and Commencement No. 21 and 23 and Transitional and Transitory Provisions (Amendment)) Order 2019, as inserted by article 2(4) of the Welfare Reform Act 2012 (Commencement No. 31 and Savings and Transitional Provisions (Amendment)) Order 2019 (S.I. 2019/935), extended the eligibility of the older member of a mixed age couple for ESA(IR) – but only in these limited circumstances – beyond State Pension age, and until both members of the couple are of pensionable age or they undergo managed migration to UC (MM), whichever occurs first.
Income-based JSA
Before the roll-out of UC Full Service across Great Britain, a mixed age couple (MAC) (where one partner has not yet reached State Pension age could previously claim income-based JSA (JSA(IB)) via a claim from one partner in the couple - the “lead claimant” - who fulfils the conditions of entitlement, and claims for their partner as a dependent.
Due to a policy change which took effect from 15 May 2019, MACs are no longer able to claim Pension Credit until both members of the couple have reached State Pension age. This means they will need to claim the appropriate working age benefit instead, usually UC, where eligible.
To address this, article 8(2)(a)(ii) of the Welfare Reform Act 2012 (Commencement No. 31 and Savings and Transitional Provisions and Commencement No. 21 and 23 and Transitional and Transitory Provisions (Amendment)) Order 2019, as inserted by article 2(4) of the Welfare Reform Act 2012 (Commencement No. 31 and Savings and Transitional Provisions (Amendment)) Order 2019 (S.I. 2019/935), extended the eligibility of the older member of a mixed age couple for JSA(IB) – but only in these limited circumstances - beyond State Pension age, and until both members of the couple are of pensionable age or they undergo managed migration to UC (MM), whichever occurs first.
Corresponding NI legislation: the Welfare Reform (Northern Ireland) Order 2015 (Commencement No. 13 and Savings and Transitional Provisions and Commencement No. 8 and Transitional and Transitory Provisions (Amendment)) Order 2019 (SR 2019 No. 4 (c. 1)) and the Welfare Reform (Northern Ireland) Order 2015 (Commencement No. 13 and Savings and Transitional Provisions (Amendment)) Order 2019 (SR 2019 No. 107 (c. 4)).
The Social Security (Coronavirus) (Further Measures) Regulations 2020 (SI 2020/371)[12]. This change provides that people do not lose their entitlement to JSA if they are infected with coronavirus, self-isolating or caring for a child who is infected or self-isolating. This provision treats such claimants as not having limited capability for work and excludes periods of sickness or self-isolation due to Covid from the maximum permitted number of sickness periods applicant to recipients of old style or new style JSA. The regulation supports the Government’s intention to provide additional support that helps both individuals and the wider economy arising from the COVID-19 outbreak and applies until 31 August 2021.
The Social Security (Coronavirus) (Further Measures) Regulations (Northern Ireland) 2020(R 2020 No 53). These regulations provide for period in which a person who is infected or contaminated with coronavirus disease, in isolation or caring for a child or qualifying young person in their household who is so infected or contaminated or is in isolation to be disregarded for the purposes of calculating the number of occasions of a period of sickness. By not counting any period during which a person is infected or contaminated with coronavirus disease, in isolation or caring for a child or qualifying young person in their household who is so infected or contaminated or is in isolation, any such period will not count towards a period of sickness and so a person will not lose entitlement to jobseeker's allowance because of coronavirus disease. This regulation applied for a period of 8 months from 13 March 2020.
The Social Security (Coronavirus) (Further Measures) (Amendment) and Miscellaneous Amendment Regulations (Northern Ireland) 2020 (SR 2020 No.242). This amendment extended the periods of sickness in respect of Coronavirus regulation to 12 May 2021
The Social Security (Coronavirus) (Miscellaneous Amendments) Regulations (Northern Ireland) 2021 (SR 2021 No. 105). This amendment extended the periods of sickness in respect of Coronavirus regulation to 31 August 2021
Housing Benefit
Before the roll-out of UC Full Service across Great Britain, a mixed age couple (MAC) (where one partner has not yet reached State Pension age) could previously claim Housing Benefit (HB), if they needed help to pay their housing costs. If the working age member of the couple was in receipt of JSA(IB), Income Support or ESA(IR) they could receive HB awarded under the working age HB regulations. If the older member was receiving Pension Credit or no benefits were in payment, they received HB awarded under the pension age HB regulations.
Due to a policy change which took effect from 15 May 2019, MACs are no longer able to claim Pension Credit or pension age HB until both members of the couple have reached State Pension age. This means they need to claim Universal Credit (UC) for help with their housing costs, where eligible.
People receiving pension age HB on 14 May 2019 continue to receive it unless there is a change in their circumstances which ends their claim and they aren’t also entitled to Pension Credit.
Contributory (now known as New Style ESA (NS ESA)) and income-related ESA
The Employment and Support Allowance and Universal Credit (Coronavirus Disease) Regulations 2020[13]. This change provides that people who are infected or contaminated with Coronavirus disease, in isolation in line with Government advice, or caring for a child or qualifying young person who is a member of the person's household and is infected or in isolation in line with Government advise, and who meet the standard conditions of entitlement, are treated as having limited capability for work. The change also removes the standard 7 waiting days at the start of these ESA claim. These urgent Regulations were brought into force with immediate effect to provide immediate support for people following Government advice to isolate and are designed to remove the need for face to face contact with those who are self-isolating or who may have contracted the virus. These Regulations originally applied for 8 months from 13 March 2020. They have subsequently been extended for 6 Months from 13 November 2020[14] and a further 6 months from 13 May 2021[15]. They will expire on 12 November 2021.
The Employment and Support Allowance (Transitional Provisions) (Amendment) Regulations 2020[16] . These Regulations removed the end date of 5 April 2020 for ESA transitional additions (TA) from the Employment and Support Allowance (Transitional Provisions, Housing Benefit and Council Tax Benefit) (Existing Awards) (No.2) Regulations 2010. DWP introduced ESA for new claimants with a health condition or disability from 27 October 2008. Migration of the existing awards of incapacity benefits (Incapacity Benefit, Severe Disablement Allowance and Income Support on disability grounds) to ESA began in April 2011. Claimants whose award of ESA was lower than their previous award when converted to ESA, were awarded a TA equal to that difference. Legislation provided for termination of TA when the amount was reduced to nil, when the person ceases to be entitled to ESA or 5 April 2020 (whichever occurred first). This change maintained the policy position in respect of TA, which is that cases converted to ESA are transitionally protected. Rather than make further assumptions as to when TA will be eroded to nil, we removed the end date for TA. TA will continue to be terminated when they are reduced to nil or when the person ceases to be entitled to ESA. In the case of income-related ESA, TA will also terminate when the case is migrated to Universal Credit. Claimants will have their existing rate of income-related ESA, including any TA in payment, protected when migrated to UC.
Corresponding Northern Ireland legislation is the Employment and Support Allowance and Universal Credit (Coronavirus) Regulations (Northern Ireland) 2020 (SR 2020 No. 33).
These regulations were amended by the Employment and Support Allowance and Universal Credit (Coronavirus) (Amendment) Regulations (Northern Ireland) 2020 (SR 2020 No. 217) to extend the period to 14 months from 13 March 2020.
These regulations were further amended by the Social Security (Coronavirus) (Miscellaneous Amendments) Regulations (Northern Ireland) 2021 (SR 2021 No. 105 to extend the period to 20 months from 13 March 2020.
Contribution-based JSA
The Social Security (Coronavirus) (Further Measures) Regulations 2020 (SI 2020/371)[17]. This change provides that people do not lose their entitlement to JSA if they are infected with coronavirus, self-isolating or caring for a child who is infected or self-isolating. This provision treats such claimants as not having limited capability for work and excludes periods of sickness or self-isolation due to Covid from the maximum permitted number of sickness periods applicant to recipients of old style or new style JSA. The regulation supports the Government’s intention to provide additional support that helps both individuals and the wider economy arising from the COVID-19 outbreak and applies until 31 August 2021.
The Social Security (Coronavirus) (Further Measures) Regulations (Northern Ireland) 2020(R 2020 No 53). These regulations provide for period in which a person who is infected or contaminated with coronavirus disease, in isolation or caring for a child or qualifying young person in their household who is so infected or contaminated or is in isolation to be disregarded for the purposes of calculating the number of occasions of a period of sickness. By not counting any period during which a person is infected or contaminated with coronavirus disease, in isolation or caring for a child or qualifying young person in their household who is so infected or contaminated or is in isolation, any such period will not count towards a period of sickness and so a person will not lose entitlement to jobseeker's allowance because of coronavirus disease. This regulation applied for a period of 8 months from 13 March 2020.
The Social Security (Coronavirus) (Further Measures) (Amendment) and Miscellaneous Amendment Regulations (Northern Ireland) 2020 (SR 2020 No.242). This amendment extended the periods of sickness in respect of Coronavirus regulation to 12 May 2021
The Social Security (Coronavirus) (Miscellaneous Amendments) Regulations (Northern Ireland) 2021 (SR 2021 No. 105) This amendment extended the periods of sickness in respect of Coronavirus regulation to 31 August 2021
Legacy housing benefit
The Housing Benefit (Transitional Provision) (Amendment) Regulations 2020[18]. (Northern Ireland equivalent is SR 2020 No. 45)This change removes the 5 April 2020 end date for Employment and Support Allowance (ESA) transitional additions (TA) from the Housing Benefit Regulations 2006, thereby maintaining unity between the Housing Benefit (HB) and ESA regulations in relation to ESA TA, and ensure claimants entitled to a TA who are in receipt of HB and have a TA included in their HB award will not lose this from 5 April 2020, The Employment and Support Allowance (Transitional Provisions) (Amendment) Regulations 20202 (the “TP Regulations”) came into force on 27 February 2020. They made changes to ESA legislation to remove the end date of 5 April 2020 for the TA payable to claimants who were converted from incapacity benefits to ESA. The purpose of the TA is to compensate for any difference in award as a result of the conversion. These Regulations removed the TA end date, allowing the TA to continue until naturally eroded to nil, the ESA claim is closed or, in the case of income-related ESA, claimants are migrated to Universal Credit. The HB regulations provide for a TA to be added to a claimant's applicable amount where the claimant or the claimant's partner has had an award of benefit converted to ESA in accordance with Regulations or is appealing a decision not to convert an award to ESA. Contributory ESA is taken into account as income under HB regulations but to ensure that claimants do not see a decrease in their income, amounts equivalent to the ESA components are included in the HB award. Where an ESA claimant has a TA this is also reflected in their HB award. Those entitled to income-related ESA are passported to maximum eligible HB.
Housing costs for those individuals in Supported Housing or Temporary Accommodation where the relevant criteria set out in legislation is met, will continue to be funded through Housing Benefit. There have not been any changes to Housing Benefit regulations in respect of either Supported Housing or Temporary Accommodation since July 2017.
Tax credits
See part VII for details related to Working Tax Credit and Child Tax Credit.
Timetable for the move to UC (from legacy):
Regulations to commence the move to UC of existing benefit claimants who have had no change in circumstances came into force in July 2019. Initially we will be conducting a pilot of up to 10,000 claimants that will be moved to UC. The pilot began in Harrogate on 24th July 2019. Due to the Covid-19 pandemic the pilot was temporarily suspended and the government is currently assessing when it will recommence. The government will report on its findings to Parliament and bring forward legislation for the wider roll out of managed migration. Before the Covid-19 pandemic, it had been announced that the move to Universal Credit of all existing claimants will be completed by September 2024. The government is also assessing the impact of suspending the pilot on the date of completion.
The Government has given a commitment that no one who is moved to UC as part of the managed migration process will have a lower level of entitlement to UC than had been the total level of their entitlement to their existing benefits at the point that they move. Where necessary we will provide transitional protection as part of the UC award to ensure that this is the case.
III - 4. Level and Calculation of Benefit
Article 16. C102 and ECSS
1. Where classes of employees or classes of the economically active population are protected, the benefit shall be a periodical payment calculated in such a manner as to comply either with the requirements of Article 65 or with the requirements of Article 66[19].
2. Where all residents whose means during the contingency do not exceed prescribed limits are protected, the benefit shall be a periodical payment calculated in such a manner as to comply with the requirements of Article 67; [provided that a prescribed benefit shall be guaranteed, without means test, to the prescribed classes of persons determined in accordance with Article 15. a or b - ECSS].
Universal Credit
Universal Credit is social assistance provided for those who have limited means. While it is important to protect the incentive to save for claimants on low earnings, people with substantial capital must take responsibility for their own support. All income, savings and capital either in the UK or abroad of the individual or couple, must be taken into account when calculating the adjusted award for UC. UC broadly follows the capital rules from legacy means-tested benefits e.g. Income Support and extends them to the customer group who would previously have claimed Tax Credits. People with capital of £16,000 or more who are entitled to Tax Credits before migrating to UC will have transitional protection to protect their entitlement to benefit for a year. The upper capital limit is £16,000. Beyond that point the claimant(s) will not be entitled to UC. Capital of £6,000 and under will be disregarded completely.
Universal Credit also improves work incentives by introducing a smoother, more transparent reduction of benefits at a consistent and predictable rate when people move into work and increase their earnings. A single taper of 63 per cent per £1 is applied as earnings rise and some claimants will also receive a work allowance, depending on their circumstances.
Universal Credit payment is made up of a standard allowance and any extra amounts that apply, for example if an individual:
· has children
· has a disability or health condition which prevents them from working
- needs help paying their rent
As part of the UK Government’s strategy of supporting people affected by Covid-19, a temporary uplift of £86.67 per month/£20 a week to the Universal Credit standard allowance has been in place since the start of the pandemic to provide extra financial support to those experiencing the most financial disruption and avoid a drop in income whilst various restrictions remain in place. This uplift has been extended until September 2021.
Calculation of the level of social assistance
For the purposes of establishing the level of social assistance received, in the form of Universal Credit, by the standard beneficiary in accordance with Article 67 of the Code the reference wage has been calculated as the median gross weekly earning (excluding overtime) for full-time male employees who are classified as typical of unskilled labour selected in accordance with the provisions of the Article 66 (4)(b) and 66 (5) . The 2020 reference wage reflects the 2020 Annual Survey of Hours and Earnings (ASHE) median wage for a male employee under classification SOC 91[20]. For the purposes of the calculation of the level of social assistance, the reference wage for the 2020/21 financial year is £387.60 per week or £1679.60 per month.
Due to its status as a social assistance measure that supports those who can work into work, and cares for those who cannot work by providing a minimum level of income, the calculation of the Universal Credit award takes into account a number of variables that are not accounted for in the Code such as the level of savings and the housing costs of the standard beneficiary. Universal Credit is also awarded on a monthly rather than a weekly basis. To account for these differences, the amount of Universal Credit payable to the standard beneficiary has been calculated for a number of scenarios and the figures provided for a monthly award. Note exact UC entitlement depends on the characteristics of each household – e.g. households can receive more than the amounts below if they have a Limited Capability for Work Related Activity, Disabled Child or have childcare costs etc.
(1) Couple over 25 with 2 children, not working, with no savings and no rent – replacement rate of 76%
a. UC Award: £1,116
b. Child Benefit award: £153
a. Net Income: £1,269
(2) Couple over 25 with 2 children over 25, not working, with no savings and the lowest Local Housing Allowance rate (£104pw) – replacement rate of 99%
a. UC Award: £1,514
b. Child Benefit award: £153
c. Net Income: £1,667
(3) Couple over 25 living in London, with 2 children, not working, no savings, highest Local Housing Allowance rate (£442pw) – replacement rate of 114% (14% higher than the reference wage)
a. UC Award: £1,764
b. Child Benefit award: £153
c. Net Income: £1,917
III - 5. Qualifying period
§2. Article 3 C24 and C25
The payment of this benefit may be made conditional on the insured person having first complied with a qualifying period and, on the expiry of the same, with a waiting period of not more than three days.
§1(f) Article 1 C102, §1(i) Article 1 ECSS
The term qualifying period means a period of contribution, or a period of employment, or a period of residence, or any combination thereof, as may be prescribed.
Article 17. C102 and ECSS
The benefit specified in Article 16 shall, in a contingency covered, be secured at least to a person protected who has completed such qualifying period as may be considered necessary to preclude abuse.
Statutory Sick Pay
Statutory Sick Pay is subject to 3 waiting days, or from day 1 if it is COVID-19 related and the absence is for four days or more.
New Style Employment and Support Allowance
Individuals claiming New Style Employment and Support Allowance are normally subject to 7 waiting days or day 1 if it is COVID-19 related.
New Style Job Seekers Allowance
Individuals claiming New Style Job Seekers Allowance are normally subject to 7 waiting days.
Universal Credit
There is no qualifying period of contributions for Universal Credit.
Details on the waiting period
All claimants are eligible for Universal Credit from the first day they claim it, (subject to satisfying the conditions of entitlement), as we have removed the 7 days some had to wait prior to 14 February 2018. Claimants can also apply to get a Universal Credit payment to cover up to 1 month before they started their claim - this is called 'backdating'. The claimant (or both claimants if a couple) need a good reason for not claiming earlier. Payments are made retroactively.
It is not possible to award a Universal Credit payment as soon as a claim is made, as the assessment period must run its course before the award of Universal Credit can be calculated. Advances are in place to ensure financial support is available as soon as possible, with most claimants able to request an advance of up to 100% of the monthly amount they are due to receive.
We continue to pay Housing Benefit and other DWP legacy benefits for two weeks when people move to Universal Credit. . We also continue to pay Universal Credit for the entire monthly assessment period in which state pension credit qualifying age is reached, in effect a run-on of Universal Credit past that age, helping to smooth the transition between working age and pension age benefits.
We assess and pay Universal Credit monthly. It is paid in arrears for each calendar month. Universal Credit is paid in a single monthly sum which helps households plan their budget, easing the transition to work.
Northern Ireland:Universal Credit is paid twice monthly in Northern Ireland.
Where a claimant receives two payments in one assessment period we reallocate a calendar monthly payment reported via Real Time Information to a different Universal Credit assessment period where it is necessary to maintain a regular payment cycle. Only one set of earnings will be taken into account in each assessment period rather than 2 sets of earnings. This will also enable certain claimants to benefit from any applicable work allowance in each assessment period.
III - 6. Minimum duration of Benefit
§1. Article 3. C24 and C25
An insured person who is rendered incapable of work by reason of the abnormal state of his bodily or mental health shall be entitled to a cash benefit for at least the first twenty-six weeks of incapacity from and including the first day for which benefit is payable.
Article 18. C102 and ECSS
The benefit specified in Article 16 shall be granted throughout the contingency, except that the benefit may be limited to 26 weeks in each case of sickness, [in which event it – C102] need not be paid for the first three days of suspension of earnings.
Statutory Sick Pay
Statutory Sick Pay is paid for up to 28 weeks.
Employment and Support Allowance
Within Employment and Support Allowance there are two groups, work-related activity group which is payable for 365 days or the support group which has no time limit.
New Style Job Seekers Allowance
New Style Job Seekers Allowance is payable up to 6 months
Universal Credit
There is no limit to how long UC can be paid. It is paid for the duration of the need.
II - 7. Medical Care
Article 4. C24 and C25
1. The insured person shall be entitled free of charge, as from the commencement of his illness and at least until the period prescribed for the grant of sickness benefit expires, to medical treatment by a fully qualified medical man and to the supply of proper and sufficient medicines and appliances.
2. Nevertheless, the insured person may be required to pay such part of the cost of medical benefit as may be prescribed by national laws or regulations.
3. Medical benefit may be withheld as long as the insured person refuses, without valid reason, to comply with the doctor's orders or the instructions relating to the conduct of insured persons while ill, or neglects to make use of the facilities placed at his disposal by the insurance institution.
Article 5. C24 and C25
National laws or regulations may authorise or prescribe the grant of medical benefit to members of an insured person's family living in his household and dependent upon him, and shall determine the conditions under which such benefit shall be administered.
See information under Part II. Medical Care
III - 8. Suspension of Benefit
§3§4. Article 3. C24 and C25
3. Cash benefit may be withheld in the following cases:
(a) where in respect of the same illness the insured person receives compensation from another source to which he is entitled by law; benefit shall only be wholly or partially withheld in so far as such compensation is equal to or less than the amount of the benefit provided by the present Article;
(b) as long as the insured person does not by the fact of his incapacity suffer any loss of the normal product of his labour, or is maintained at the expense of the insurance funds or from public funds; nevertheless, cash benefits shall only partially be withheld when the insured person, although thus personally maintained, has family responsibilities;
(c) as long as the insured person while ill refuses, without valid reason, to comply with the doctor's orders, or the instructions relating to the conduct of insured persons while ill, or voluntarily and without authorisation removes himself from the supervision of the insurance institutions.
4. Cash benefit may be reduced or refused in the case of sickness caused by the insured person's wilful misconduct.
Article 69. C102, Article 68. ECSS
A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed--
(a) as long as the person concerned is absent from the territory of the Member;
(b) as long as the person concerned is maintained at public expense, or at the expense of a social security institution or service, subject to any portion of the benefit in excess of the value of such maintenance being granted to the dependants of the beneficiary;
(c) as long as the person concerned is in receipt of another social security cash benefit, other than a family benefit, and during any period in respect of which he is indemnified for the contingency by a third party, subject to the part of the benefit which is suspended not exceeding the other benefit or the indemnity by a third party;
(d) where the person concerned has made a fraudulent claim;
(e) where the contingency has been caused by a criminal offence committed by the person concerned;
(f) where the contingency has been caused by the wilful misconduct of the person concerned;
(g) in appropriate cases, where the person concerned neglects to make use of the medical or rehabilitation services placed at his disposal or fails to comply with rules prescribed for verifying the occurrence or continuance of the contingency or for the conduct of beneficiaries;
Claimant Commitment
All claimants must accept a Claimant Commitment as a condition of entitlement. Couples living in the same household make a joint claim for Universal Credit and each have their own Claimant Commitment. Claimants’ obligations are recorded in one place, clarifying both what people are expected to do in return for benefits and support, and exactly what happens if they fail to comply. If a claimant disagrees with any work search or availability requirements detailed in their Claimant Commitment, then they can ask for it to be reviewed by another Work Coach. The Claimant Commitment should be revised on an on-going basis to clearly record the expectations placed upon a claimant and the consequences (sanctions) of any failure to comply. A personalised Claimant Commitment is drawn up by the Work Coach often as the output of a face-to-face discussion with the claimant. The initial Claimant Commitment is usually accepted as part of the normal claims process. If a claimant refuses to accept their Claimant Commitment, then they are not entitled to Universal Credit. As Universal Credit is a household benefit, if either adult in a couple refuses to accept their Claimant Commitment, then the claim for the other adult also ends.
Where a claimant refuses to accept their Claimant Commitment, we allow a short ‘cooling off’ period to give the claimant the opportunity to reconsider their decision and the impact on the household claim.
In exceptional circumstances, where a claimant is unable to accept a Claimant Commitment, we can remove the requirement to do so. This may include, for example, claimants who have an appointee or someone acting on their behalf, claimants who are incapacitated in hospital and exceptional emergency situations. Where the claimant is physically or mentally unable to accept a Claimant Commitment and this is unlikely to change, or it would be unreasonable to expect them to do so due to terminal illness, we will waive the requirement to accept a Claimant Commitment.
The Claimant Commitment and the process of acceptance have been designed to support robust monitoring and drive higher compliance with requirements. The Claimant Commitment helps focus a claimant on their work related requirements, including where appropriate, proactive, work-search that treats looking for work as a full time activity and sets the right foundation ahead of Universal Credit’s smoother, clearer, and more stable incentives to work.
In November 2019, the UK Government reduced the maximum length of a high level sanction from 3 years to 6 months.
In Northern Ireland the maximum length of a high level sanction was reduced from 18 months to 6 months.
III - 9. Right of complaint and appeal
See under Part XIII-2, Part III-7
Article 9. C24, Article 8. C25
A right of appeal shall be granted to the insured person in case of dispute concerning his right to benefit.
Complaints and appeals processes
If a claimant is not happy with the service provided they may wish to make a complaint. They can contact their local Jobcentre plus or make an online complaint. https://www.gov.uk/government/organisations/department-for-work-pensions/about/complaints-procedure
The last published figures on claimant satisfaction with UC were for 2018/19 – which showed ‘79% of claimants are satisfied with their experience in Universal Credit’. This compares with a satisfaction level of 81% for all benefits administered by DWP.
III - 10. Financing and Administration
Article 6. C24 and C25
1. Sickness insurance shall be administered by self-governing institutions, which shall be under the administrative and financial supervision of the competent public authority and shall not be carried on with a view of profit. Institutions founded by private initiative must be specially approved by the competent public authority.
2. The insured persons shall participate in the management of the self-governing insurance institutions on such conditions as may be prescribed by national laws or regulations.
3. The administration of sickness insurance may, nevertheless, be undertaken directly by the State where and as long as its administration is rendered difficult or impossible or inappropriate by reason of national conditions, and particularly by the insufficient development of the employers' and workers' organisations.
Article 7. C24 and C25
1. The insured persons and their employers shall share in providing the financial resources of the sickness insurance system.
2. It is open to national laws or regulations to decide as to a financial contribution by the competent public authority.
Article 71. C102, Article 70. ECSS
1. The cost of the benefits provided in compliance with this Convention (Code) and the cost of the administration of such benefits shall be borne collectively by way of insurance contributions or taxation or both in a manner which avoids hardship to persons of small means and takes into account the economic situation of the Member (Contracting Party) and of the classes of persons protected.
2. The total of the insurance contributions borne by the employees protected shall not exceed 50 per cent of the total of the financial resources allocated to the protection of employees and their wives and children. For the purpose of ascertaining whether this condition is fulfilled, all the benefits provided by the Member (Contracting Party) in compliance with this Convention (Code), except family benefit and, if provided by a special branch, employment injury benefit, may be taken together.
3. The Member (Contracting Party) shall accept general responsibility for the due provision of the benefits provided in compliance with this Convention (Code), and shall take all measures required for this purpose; it shall ensure, where appropriate, that the necessary actuarial studies and calculations concerning financial equilibrium are made periodically and, in any event, prior to any change in benefits, the rate of insurance contributions, or the taxes allocated to covering the contingencies in question.
Article 72. C102, Article 71. ECSS
1. The Member (Contracting Party) shall accept general responsibility for the proper administration of the institutions and services concerned in the application of the Convention (Code).
2. Where the administration is not entrusted [to an institution regulated by the public authorities or – C102] to a Government department responsible to a legislature, representatives of the persons protected shall participate in the management, or be associated therewith in a consultative capacity, under prescribed conditions; national laws or regulations may likewise decide as to the participation of representatives of employers and of the public authorities.
Universal Credit
Information on the financing of Universal Credit can be found in the Business Case: https://www.gov.uk/government/publications/universal-credit-programme-full-business-case-summary/universal-credit-programme-full-business-case-summary#the-financial-case
Part IV. Unemployment benefit
The United Kingdom has accepted the obligations resulting from Part IV of C102 and Part IV of the ECSS.
List of applicable legislation
Welfare Reform Act 2012, Universal Credit Regulations 2013 and ‘Welfare Reform and Work Act 2016
https://www.legislation.gov.uk/ukpga/2012/5/contents/enacted
http://www.legislation.gov.uk/ukdsi/2013/9780111531938/contents http://www.legislation.gov.uk/ukpga/2016/7/contents/enacted
The Welfare Reform (Northern Ireland) Order 2015, Universal Credit Regulations (Northern Ireland) 2016 and ‘Welfare Reform and Work (Northern Ireland) Order 2016
https://www.legislation.gov.uk/nisi/2015/2006/contents
http://www.legislation.gov.uk/nisr/2016/216/contents/made
http://www.legislation.gov.uk/nisi/2016/999/contents
IV - 1. Regulatory framework
Article 19. C102 and ECSS
Each Member (Contracting Party) for which this Part of this Convention (Code) is in force shall secure to the persons protected the provision of unemployment benefit in accordance with the following Articles of this Part.
See information under Part III-1.
Article 20. C102 and ECSS
The contingency covered shall include suspension of earnings, as defined by national laws or regulations, due to inability to obtain suitable employment in the case of a person protected who is capable of,and available for, work.
See information under Part III-2.
Article 21. C102 and ECSS
The persons protected shall comprise:
(a) prescribed classes of employees, constituting not less than 50 per cent of all employees; or
(b) all residents whose means during the contingency do not exceed limits prescribed in such a manner as to comply with the requirements of Article 67.
See information under Part III-3.
IV – 4. Level and Calculation of Benefit
Article 22. C102 and ECSS
1. Where classes of employees are protected, the benefit shall be a periodical payment calculated in such manner as to comply either with the requirements of Article 65 or with the requirements of Article 66.
2. Where all residents whose means during the contingency do not exceed prescribed limits are protected, the benefit shall be a periodical payment calculated in such a manner as to comply with the requirements of Article 67. [provided that a prescribed benefit shall be guaranteed, without means test, to the prescribed classes of employees determined in accordance with Article 21.a. - ECSS]
See under Part III-4.
§1(f) Article 1 C102, §1(i) Article 1 ECSS
The term qualifying period means a period of contribution, or a period of employment, or a period of residence, or any combination thereof, as may be prescribed.
Article 23. C102 and ECSS
The benefit specified in Article 22 shall, in a contingency covered, be secured at least to a person protected who has completed such qualifying period as may be considered necessary to preclude abuse.
See under Part III-5.
IV - 6. Minimum duration of Benefit and Waiting Period
Article 24. C102 and ECSS
1. The benefit specified in Article 22 shall be granted throughout the contingency, except that its duration may be limited
(a) where classes of employees are protected, to 13 weeks within a period of 12 months, [or to 13 weeks in each case of suspension of earnings - ECSS]; or
(b) where all residents whose means during the contingency do not exceed prescribed limits are protected, to 26 weeks within a period of 12 months; [provided that the duration of the prescribed benefit, guaranteed without means test, may be limited in accordance with sub‑paragraph a of this paragraph - ECSS].
2. Where national laws or regulations provide that the duration of the benefit shall vary with the length of the contribution period and/or the benefit previously received within a prescribed period, the provisions of paragraph 1 of this article shall be deemed to be fulfilled if the average duration of benefit is at least 13 weeks within a period of 12 months.
3. The benefit need not be paid for a waiting period of the first seven days in each case of suspension of earnings, counting days of unemployment before and after temporary employment lasting not more than a prescribed period as part of the same case of suspension of earnings.
4. In the case of seasonal workers the duration of the benefit and the waiting period may be adapted to their conditions of employment.
See under Part III-6.
Article 69. C102, Article 68. ECSS
A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed--
(a) as long as the person concerned is absent from the territory of the Member;
(b) as long as the person concerned is maintained at public expense, or at the expense of a social security institution or service, subject to any portion of the benefit in excess of the value of such maintenance being granted to the dependants of the beneficiary;
(c) as long as the person concerned is in receipt of another social security cash benefit, other than a family benefit, and during any period in respect of which he is indemnified for the contingency by a third party, subject to the part of the benefit which is suspended not exceeding the other benefit or the indemnity by a third party;
(d) where the person concerned has made a fraudulent claim;
(e) where the contingency has been caused by a criminal offence committed by the person concerned;
(f) where the contingency has been caused by the wilful misconduct of the person concerned;
(h) in the case of unemployment benefit, where the person concerned has failed to make use of the employment services placed at his disposal;
(i) in the case of unemployment benefit, where the person concerned has lost his employment as a direct result of a stoppage of work due to a trade dispute, or has left it voluntarily without just cause; and
See under Part III-8.
IV – 8. Right of complaint and appeal
IV - 9. Financing and Administration
See under Part III-10.
Part V. Old-age Benefit
The United Kingdom has accepted the obligations resulting from Part V of C102 and Part V of the ECSS.
List of applicable legislation
Aside from annual orders to protect pensions from inflation there has been no significant further state pensions legislation since the Pensions Act 2014.
See under Part I. General provisions. Articles 1-6. C102 and ECSS.
V - 1. Regulatory framework
Article 25. C102 and ECSS
Each Member (Contracting Party) for which this part of this Convention (Code) is in force shall secure to the persons protected the provision of old‑age benefit in accordance with the following Articles of this Part.
Legislative changes
The Pensions Act 2014 introduced the new State Pension for people reaching state pension age on or after 6 April 2016, radically simplifying state pension provision.
Qualification for the new state pension is based on an individual’s National Insurance record, with a minimum qualifying period of 10 years usually required to receive any pension. In steady state, the full rate of the new State Pension (previously referred to as the single-tier pension) is based on 35 qualifying years of National Insurance contributions or credits. Transitional arrangements are in place for those who have qualifying years before 6 April 2016.
State Second Pension
The State Second Pension (also known as additional State Pension) ended in April 2016 and with it the ability to contract out of the State Second Pension. Up until this point some people were contracted out of the State Second Pension into a private or workplace pension. While the additional State Pension has ended it will remain in payment, to those with entitlement who reached state pension age before 6 April 2016. A proportion of an additional State Pension can be inherited by surviving wives, husbands and civil partners beyond April 2016.
Northern Ireland
Northern Ireland measures corresponding to the Pensions Act 2014 were approved by the Northern Assembly on 11 May 2015. The measures include the introduction, in 2016, of a single-tier State Pension designed to reduce the complexity of the current system, support the introduction of workplace pension reform and pay a higher weekly amount than the current State Pension. The new system recognises pre-2016 National Insurance contributions so that individuals are not disadvantaged and builds on the existing range of National Insurance credits awarded to those who have had care responsibilities.
Pension Credit
In February 2019, an additional amount payable to those with responsibility for a child or qualifying young person (QYP) was introduced into Pension Credit. This coincided with the closure of Child Tax Credit to new claims, and provided continuity of support for those over State Pension age who are not able to access Universal Credit. In 2021/22, the amount is £65.10 for a first child/ QYP born before 6 April 2017, and £54.60 for each subsequent child/QYP. Additional amounts are available for disabled children.
From May 2019, a change to the entitlement conditions for couples took effect, restricting access to Pension Credit to couples where both partners have reached the qualifying age. Before May 2019, couples where only one member had reached the qualifying age (“mixed age couples”) could choose to claim either the applicable working-age income related benefit (now Universal Credit), or Pension Credit. Mixed age couples not eligible for Pension Credit may qualify for Universal Credit, subject to satisfying the capital, income and other entitlement conditions. This change is intended to ensure that the same work incentives apply to the working-age member of the couple as to other people of the same age.
V - 2. Contingency covered
Article 26. C102 and ECSS
1. The contingency covered shall be survival beyond a prescribed age.
2. The prescribed age shall be not more than 65 years or such higher age [that the number of residents having attained that age is not less than 10 per cent of the number of residents under that age but over 15 years of age - ECSS] as may be fixed by the competent authority with due regard to the working ability of elderly persons in the country concerned
3. National laws or regulations may provide that the benefit of a person otherwise entitled to it may be suspended if such person is engaged in any prescribed gainful activity or that the benefit, if contributory, may be reduced where the earnings of the beneficiary exceed a prescribed amount and, if non-contributory, may be reduced where the earnings of the beneficiary or his other means or the two taken together exceed a prescribed amount.
State Pension age
Under the Pensions Act 2011 State Pension age for women increased gradually from 60 to 65 between 2010 and 2018. Between 2018 and 2020, State Pension age increased from 65 to 66 for both men and women. The State Pension age will increase from 66 to 67 between 2026 and 2028 under the Pensions Act 2014. The timing of the increase from 67 to 68 remains set to happen between 2044 to 2046 as set out in the Pensions Act 2007. The changes in State pension age reflect increasing longevity in society and make the State Pension affordable in the long term.
The Pensions Act 2014 contains a framework for further changes to state pension age through a regular review by Government.
As part of the review process, the Government is required to commission a report from the Government Actuary’s Department looking at the implications of life expectancy data for State Pension age. The legislation also requires Government to commission a further independent report covering other relevant factors. This may include variations in life expectancy between socio-economic groups, and the wider economic context at the time of a review. All reports prepared as part of the review must be published.
The Government will publish a report on their review of the state pension age every 6 years. The first review was published on 19th July 2017.[21]
Northern Ireland
Under the Pensions Act (Northern Ireland) 2012, State Pension age for men and women was equalised at age 65 in October 2018. State Pension age increased incrementally to reach age 66 by October 2020. The State Pension age will increase from 66 to 67 between 2026 and 2028 under the Pensions Act (Northern Ireland) 2015. The timing of the increase from 67 to 68 remains set to happen between 2044 to 2046 as set out in the Pensions Act (Northern Ireland) 2008.
V - 3. Persons protected
Article 27. C102 and ECSS
The persons protected shall comprise:
(a) prescribed classes of employees, constituting not less than 50 per cent of all employees; or
(b) prescribed classes of the economically active population, constituting not less than 20 per cent of all residents; or
(c) all residents whose means during the contingency do not exceed limits prescribed in such a manner as to comply with the requirements of Article 67.
The persons protected are those with at least 10 qualifying years of National Insurance contributions or credits. This means they were either:
· working and paying National Insurance
· getting National Insurance Credits, for example for unemployment, sickness or as a parent or carer
· paying voluntary National Insurance contributions
The Office for National Statistics estimate that there were 42.7m people aged 16 to 65, and 12.0m aged 66 or greater in the UK in July 2021. The State Pension age (Spa) was still increasing from 65 to 66 in July 2020 so some 65 year olds would have been above SPa. DWP estimates that around 10% of people aged 65 in July 2020 would be above SPa. This leads to an estimate of 42.5m people aged between 16 and SPa and 11.9m people over SPa.
So we estimate that the number of people aged over SPa in 2021 is approximately 28.2% of the number of people over 15 years of age and under SPa.
The chart below shows how the estimate varies each year through to 2070 under the legislated SPa timetable and under the proposals outlined in the 2017 review.
V - 4. Level and Calculation of Benefit
Article 28. ECSS
The benefit shall be a periodical payment calculated as follows:
(a) where classes of employees or classes of the economically active population are protected, in such a manner as to comply either with the requirements of Article 65 or with the requirements of Article 66;
(b) where all residents whose means during the contingency do not exceed prescribed limits are protected, in such a manner as to comply with the requirements of Article 67.
Title I of RF/C102/ECSS (Article 66).
Please state the amount of the wage of the ordinary adult labourer wage (standard wage).
£387.60 per week.
TITLE III of RF/C102/ECSS (Article 66), according to which the standard beneficiary is a man with a wife of pensionable age.
Amount of benefit granted during the time basis.
The new State Pension was introduced for people reaching State Pension age from 6 April 2016. The full rate of the new State Pension for 2021/22 was £179.60 a week. Individuals who did not make National Insurance contributions or get National Insurance credits before 6 April 2016 will receive the full rate if they accrue 35 qualifying years. If they accrue 30 qualifying years, they will receive 30/35ths of the full amount, £153.94 a week in 2020/21 rates. A standard beneficiary of a man and a wife both of pensionable age, who have 30 qualifying years each and did not make National Insurance contributions or get National Insurance credits before 6 April 2016, would receive £307.88 a week in 2021/22 rates. Note that it is currently not possible to accrue 30 qualifying years and to have not made National Insurance contributions or received National Insurance credits before 6 April 2016 – the figure is for illustrative purposes only. For individuals who did make National Insurance contributions or get National Insurance credits before 6 April 2016, there are transitional arrangements which mean that individuals could receive less or more than the full rate of the new State Pension, depending on their individual circumstances.
People above State Pension age who are on a low income may be entitled to Pension Credit. Pension Credit is a non-contributory, income-related benefit that can provide a minimum weekly income for pensioner households of £177.10 for a single person or £270.30 for a couple (at 2021/22 rates), by topping up their other income, if any, to that amount. These minimum amounts – known as the “standard minimum guarantee” – can be increased to include additional amounts for specified circumstances, including where the pensioner is severely disabled, is providing care for a severely disabled person, or is responsible for a dependent child or young person in full-time education or training.
Amount of family allowance, payable during employment, for a period equal to the time basis.
£155.05
Family allowances, payable during employment and the contingency, (where applicable) comprise £21.15 Child Benefit for the eldest qualifying child, £14 for the second qualifying and Child Tax Credit of £119.90 in respect of both children.
UK policy is that each individual should build up a qualifying year for every year that they contribute to UK society: https://www.gov.uk/national-insurance-credits/eligibility
Sum of Old-Age Benefit and family allowance payable during contingency per cent of sum of standard wage and family allowance payable during employment.
79% (without family benefit), 119% with family benefit
TITLE V of RF/C102/ECSS (Article 66), according to which the beneficiary is a woman employee.
Amount of benefit granted during the time basis.
Amount of Old-Age Benefit per cent of the standard wage, payable during the contingency, for a period equal to the time basis.
40% based on new State Pension with 30 qualifying years, 46% based on Pension Credit standard minimum guarantee.
V - 5. Adjustment of benefits
§10 Article 65, §8 Article 66. C102 and ECSS
The rates of current periodical payments in respect of old age, employment injury (except in case of incapacity for work), invalidity and death of breadwinner, shall be reviewed following substantial changes in the general level of earnings where these result from substantial changes in the cost of living.
Pension uprating
The Consumer Prices Index is the Government’s preferred measure for the indexation of benefits and tax credits. The full rate of the basic and new State Pensions must be increased each year by at least the rise in earnings. The “triple lock” is a government commitment to increase the full rates of the basic and new State Pensions by the highest of: average weekly earnings; prices; or 2.5%. Additional elements of the basic and new State Pensions will continue to be uprated by the growth in prices. These include State Earnings Related Pension Scheme (SERPS), State Second Pension (S2P), increments for deferral, Graduated Retirement Benefit and new State Pension protected payments.
Additional Pension is different to the basic State Pension, because people can contract out of it into occupational or private schemes. It has only ever been uprated by prices, in line with the indexation arrangements for second tier pensions generally. To increase Additional Pension by more than prices would put it out of kilter with occupational and private pension schemes.
For the purposes of the 2021/22 uprating, 2.5% was the highest of the three triple lock benchmarks, meaning that:
- the New State Pension (for those reaching State Pension age on or after 6 April 2016) is £179.60 per week in 2021/22 (up from £175.20 in 2020/21)
- the Basic State Pension (the core amount in the old State Pension system) is £137.60 per week in 2021/22 (up from £134.25 in 2020/21).
The triple lock commitment does not apply to Pension Credit, but the Pension Credit standard minimum guarantee must also be increased at least in line with earnings. In 2021/22 it rose by 1.9%, an increase of £3.35 for a single pensioner (matching the cash increase in the basic State Pension) and £5.10 for a couple. Uprating of the other components of Pension Credit is discretionary but in practice they are uprated in line with prices.
V - 6. Qualifying period
§1(f) Article 1 C102, §1(i) Article 1 ECSS
The term qualifying period means a period of contribution, or a period of employment, or a period of residence, or any combination thereof, as may be prescribed.
Article 29. C102 and ECSS
1. The benefit specified in Article 28 shall, in a contingency covered, be secured at least:
(a) to a person protected who has completed, prior to the contingency, in accordance with prescribed rules, a qualifying period which may be 30 years of contribution or employment, or 20 years of residence; or
(b) where, in principle, all economically active persons are protected, to a person protected who has completed a prescribed qualifying period of contribution and in respect of whom while he was of working age, the prescribed yearly average number of contributions has been paid.
2. Where the benefit referred to in paragraph 1 of this article is conditional upon a minimum period of contribution or employment, a reduced benefit shall be secured at least:
(a) to a person protected who has completed, prior to the contingency, in accordance with prescribed rules, a qualifying period of 15 years of contribution or employment; or
(b) where, in principle, all economically active persons are protected, to a person protected who has completed a prescribed qualifying period of contribution and in respect of whom, while he was of working age, half the yearly average number of contributions prescribed in accordance with paragraph 1.b of this Article has been paid.
3. The requirements of paragraph 1 of this Article shall be deemed to be satisfied where a benefit calculated in conformity with the requirements of Part XI but at a percentage of ten points lower than shown in the Schedule appended to that Part for the standard beneficiary concerned is secured at least to a person protected who has completed, in accordance with prescribed rules, ten years of contribution or employment, or five years of residence.
4. A proportional reduction of the percentage indicated in the Schedule appended to Part XI may be effected where the qualifying period for the benefit corresponding to the reduced percentage exceeds ten years of contribution or employment but is less than 30 years of contribution or employment; if such qualifying period exceeds 15 years, a reduced benefit shall be payable in conformity with paragraph 2 of this Article.
5. Where the benefit referred to in paragraphs 1, 3 or 4 of this Article is conditional upon a minimum period of contribution or employment, a reduced benefit shall be payable under prescribed conditions to a person protected who, by reason only of his advanced age when the provisions concerned in the application of this Part come into force, has not satisfied the conditions prescribed in accordance with paragraph 2 of this Article, unless a benefit in conformity with the provisions of paragraphs 1, 3 or 4 of this Article is secured to such person at an age higher than the normal age.
Qualification for the new state pension is based on an individual’s National Insurance record, with a minimum qualifying period of 10 years usually required to receive any pension. For someone with no National Insurance record prior to 6 April 2016, the full rate of the new State Pension (previously referred to as the single-tier pension) will be based on 35 qualifying years of National Insurance contributions or credits.
Transitional arrangements are in place for those who have qualifying years before 6 April 2016, which take someone’s previous National Insurance contributions into account and mean that people could receive less or more than the full rate, depending on their National Insurance record.
V -7. Duration of Benefit
Article 30. C102 and ECSS
The benefits specified in Articles 28 and 29 shall be granted throughout the contingency.
Once eligible, the new State Pension is payable for the rest of the person’s life.
V - 8. Suspension of Benefit
Article 69. C102, Article 68. ECSS
A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed:
(a) as long as the person concerned is absent from the territory of the Member;
(b) as long as the person concerned is maintained at public expense, or at the expense of a social security institution or service, subject to any portion of the benefit in excess of the value of such maintenance being granted to the dependants of the beneficiary;
(c) as long as the person concerned is in receipt of another social security cash benefit, other than a family benefit, and during any period in respect of which he is indemnified for the contingency by a third party, subject to the part of the benefit which is suspended not exceeding the other benefit or the indemnity by a third party;
(d) where the person concerned has made a fraudulent claim;
(g) in appropriate cases, where the person concerned neglects to make use of the medical or rehabilitation services placed at his disposal or fails to comply with rules prescribed for verifying the occurrence or continuance of the contingency or for the conduct of beneficiaries;
Social Security Contributions and Benefits Act 1992
Section 113. Disqualification and suspension
(1) Except where regulations otherwise provide, a person shall be disqualified for receiving any benefit under Parts II to V of this Act, and an increase of such benefit shall not be payable in respect of any person as the beneficiary’s wife, husband or civil partner, for any period during which the person:
(a) is absent from Great Britain; or
(b) is undergoing imprisonment or detention in legal custody.
(2) Regulations may provide for suspending payment of such benefit to a person during any period in which he is undergoing medical or other treatment as an inpatient in a hospital or similar institution.
(3) Regulations may provide for a person who would be entitled to any such benefit but for the operation of any provision of this Act [the Administration Act or Chapter II of Part I of the Social Security Act 1998] to be treated as if entitled to it for the purposes of any rights or obligations (whether his own or another’s) which depend on his entitlement, other than the right to payment of the benefit.
Corresponding Northern Ireland legislation: the Social Security Contributions and Benefits (Northern Ireland) Act 1992 – section 113.
V - 9. Right of complaint and appeal
See under Part XIII-2
V - 10. Financing and Administration
See under Part XIII-3
Financing principle: contributions and state guarantee.
Part VI. Employment Injury Benefit
The United Kingdom (UK) is unable to accept Part VI of the European Code of Social Security because UK law and practice are not compatible with the requirements of Article 34 2(b) and (e). These exceptions apart, the requirements of Part VI are met by the provisions in the UK scheme which ensure that all employed workers (‘employed earners’) are compulsorily protected against employment injury and disease.
The position remains unchanged. Prescription charges and the costs of dental treatment are borne by recipients of industrial injuries benefits on the same basis as they are borne by people receiving other state benefits. This is at variance with the requirement of Article 34 that persons suffering employment related injury should not contribute to their cost of medical care.
List of applicable legislation
Great Britain
The Pneumoconiosis etc. (Workers’ Compensation) Act 1979
Part 5 SSCA 1992
Part 4 Child Maintenance and Other Payments Act 2008
Mesothelioma Act 2014
The Social Security (Industrial Injuries) (Prescribed Diseases) Regulations 1989 SI 1985/967
The Pneumoconiosis etc. (Workers' Compensation) (Payment of Claims) Regulations 1988 SI 1988/668
The Mesothelioma Lump Sum Payments (Claims and Reconsiderations) Regulations 2008 SI 2008/1595
The Mesothelioma Lump Sum Payments (Conditions and Amounts) Regulations 2008 SI 2008/1963
The Welfare Reform Act 2012 – Part 3 – Industrial Injuries Benefit
The Diffuse Mesothelioma Payment Scheme Regulations 2014 SI 2014/916
The Diffuse Mesothelioma Payment Scheme (Levy) Regulations 2014 SI 2014/2904
Northern Ireland
Pneumoconiosis, etc., (Workers' Compensation) (Northern Ireland) Order 1979
Part 5 Social Security Contributions and Benefits (Northern Ireland) Act 1992
Mesothelioma, etc., Act (Northern Ireland) 2008
The Social Security (Industrial Injuries) (Prescribed Diseases) Regulations (Northern Ireland) 1986 SR 1986 No. 179
The Pneumoconiosis, etc., (Workers' Compensation) (Payment of Claims) Regulations (Northern Ireland) 1988 SR 1988 No. 242
The Mesothelioma Lump Sum Payments (Claims and Reconsiderations) Regulations (Northern Ireland) 2008 SR 2008 No. 353
The Mesothelioma Lump Sum Payments (Conditions and Amounts) Regulations (Northern Ireland) 2008 SR 2008 No. 354
Statutory Instruments
2017
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations (Northern Ireland) 2017 S.R. No.68
https://www.legislation.gov.uk/nisr/2017/68/contents
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) (No. 2) Regulations (Northern Ireland) 2017 S.R. No. 186
https://www.legislation.gov.uk/nisr/2017/186/contents
- The Social Security (Industrial Injuries) (Prescribed Diseases) (Amendment) Regulations (Northern Ireland) 2017 S.R. No. 45
https://www.legislation.gov.uk/nisr/2017/45/contents/made
2018
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations (Northern Ireland) 2018 S.R. No. 59
https://www.legislation.gov.uk/nisr/2018/59/contents
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) (No. 2) Regulations (Northern Ireland) 2018 S.R. No. 168
https://www.legislation.gov.uk/nisr/2018/168/contents
- The Social Security (Industrial Injuries) (Prescribed Diseases) (Amendment) Regulations (Northern Ireland) 2018 S.R. No. 151
https://www.legislation.gov.uk/nisr/2018/151/contents/made
· Conditions and Amounts) (Amendment) Regulations (Northern Ireland)
http://www.legislation.gov.uk/nisr/2019/47/pdfs/nisr_20190047_en.pdf
(Northern Ireland)
· Conditions and Amounts) (Amendment) Regulations (Northern Ireland) 2018
http://www.legislation.gov.uk/nisr/2018/55/pdfs/nisr_20180055_en.pdf
http://www.legislation.gov.uk/nisr/2018/59/contents
Amounts) (Amendment No. 2) Regulations (Northern Ireland)
2019
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations (Northern Ireland) 2019 S.R. No. 57
https://www.legislation.gov.uk/nisr/2019/57/contents
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) (No. 2) Regulations (Northern Ireland) 2019 S.R. No. 187
https://www.legislation.gov.uk/nisr/2019/187/contents
- The Social Security (Industrial Injuries) (Prescribed Diseases) (Amendment) Regulations (Northern Ireland) 2019 S.R. No. 204
https://www.legislation.gov.uk/nisr/2019/204/contents/made
https://www.legislation.gov.uk/uksi/2019/1241/made
2020
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations (Northern Ireland) 2020 S.R. No. 36
https://www.legislation.gov.uk/nisr/2020/36/contents/made
- The Pneumoconiosis etc. Workers' Compensation) (Payment of Claims) (Amendment) Regulations (Northern Ireland)2020 S.R. No. 26
https://www.legislation.gov.uk/nisr/2020/26/contents/made
https://www.legislation.gov.uk/uksi/2020/244/contents/made
2021
- The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations (Northern Ireland) 2021 S.R. No. 59
https://www.legislation.gov.uk/nisr/2021/59/contents/made
- The Pneumoconiosis etc. Workers' Compensation) (Payment of Claims) (Amendment) Regulations (Northern Ireland)2021 S.R. No. 55
https://www.legislation.gov.uk/nisr/2021/55/contents/made
VI - 1. Contingencies and regulatory framework
Article 1. C12
Each Member of the International Labour Organisation which ratifies this Convention undertakes to extend to all agricultural wage-earners its laws and regulations which provide for the compensation of workers for personal injury by accident arising out of or in the course of their employment.
The position remains as previously described. Agricultural workers are not covered by a special system of social insurance. They are covered by the general Industrial Injuries Benefits schemes in operation in Great Britain and Northern Ireland respectively and that cover all employed earners. The provisions described in the concurrent Reports in respect of Conventions No. 17 (Accident) and No. 42 (Occupational Diseases) apply equally to agricultural workers, for the reference period.
Article 1. C17
Each Member of the International Labour Organisation which ratifies this Convention undertakes to ensure that workmen who suffer personal injury due to an industrial accident, or their dependants, shall be compensated on terms at least equal to those provided by this Convention.
§1 Article 1. C42
Each Member of the International Labour Organisation which ratifies this Convention undertakesto provide that compensation shall be payable to workmen incapacitated by occupational diseases, or, in case of death from such diseases, to their dependants, in accordance with the general principles of the national legislation relating to compensation for industrial accidents.
The regulations set out in the list of applicable legislation modify the provisions described in previous reports by, amongst other things, up-rating the various benefits and making changes to the list of prescribed diseases (PDs).
Outline of the UK IIDB scheme
The industrial injuries disablement benefit scheme (IIDB) has its statutory basis in the Social Security Act 1975 and subsequent statutory instruments, as well as the Social Security Contributions and Benefits Act 1992. The scheme is administered by the Department for Work and Pensions (DWP). The benefit provides compensation for disablement due to loss of faculty. It does not take into account economic losses due to an injury when determining the level of compensation. To be eligible under the scheme, it needs to be demonstrated that the injury or disease is work related. This is achieved with a schedule of prescribed diseases for which work causation is assumed, provided pre-defined exposure criteria are met. Work relatedness can also be demonstrated by showing that a specific work related incident has resulted in the injury or the disease. The levels of compensation for amputations, loss of vision, disfigurement and for noise induced hearing loss (NIHL) are defined by statutory instruments. Whilst there exists case law and guidance for other injuries, this is not based on statute law, and therefore considered not as robust as the statutory tables for the purpose of assessing disablement under the IIDB scheme.
VI - 2. Persons protected
Articles 2. C17
1. The laws and regulations as to workmen’s compensation shall apply to workmen, employees and apprentices employed by any enterprise, undertaking or establishment of whatsoever nature, whether public or private.
2. It shall nevertheless be open to any Member to make such exceptions in its national legislation as it deems necessary in respect of:
(a) persons whose employment is of a casual nature and who are employed otherwise than for the purpose of the employer’s trade or business;
(b) out-workers;
(c) members of the employer’s family who work exclusively on his behalf and who live in his house;
(d) non-manual workers whose remuneration exceeds a limit to be determined by national laws or regulations.
There has been no change to the scope of application since the last report. All employed earners are covered by the IIDB Scheme.
VI – 3. Definition of Occupational Diseases
Article 2. C42
Each Member of the International Labour Organisation which ratifies this Convention undertakes to consider as occupational diseases those diseases and poisonings produced by the substances set forth in the Schedule appended hereto, when such diseases or such poisonings affect workers engaged in the trades, industries or processes placed opposite in the said Schedule, and result from occupation in an undertaking covered by the said national legislation.
|
List of diseases and toxic substances |
List of corresponding trades, industries and processes |
|
Poisoning by lead, its alloys or compounds and their sequelae. |
§ Handling of ore containing lead, including fine shot in zinc factories. § Casting of old zinc and lead in ingots. § Manufacture of articles made of cast lead or of lead alloys. § Employment in the polygraphic industries. § Manufacture of lead compounds. § Manufacture and repair of electric accumulators. § Preparation and use of enamels containing lead. § Polishing by means of lead files or putty powder with a lead content. § All painting operations involving the preparation and manipulation of coating substances, cements or colouring substances containing lead pigments. |
|
Poisoning by mercury, its amalgams and compounds and their sequelae. |
§ Handling of mercury ore. § Manufacture of mercury compounds. § Manufacture of measuring and laboratory apparatus. § Preparation of raw material for the hatmaking industry. § Hot gilding. § Use of mercury pumps in the manufacture of incandescent lamps. § Manufacture of fulminate of mercury primers. |
|
Anthrax infection. |
§ Work in connection with animals infected with anthrax. § Handling of animals carcasses or parts of such carcasses including hides, hoofs and horns. § Loading and unloading or transport of merchandise. |
|
Silicosis with or without pulmonary tuberculosis, provided that silicosis is an essential factor in causing the resultant incapacity or death. |
Industries or processes recognised by national law or regulations as involving exposure to the risk of silicosis. |
|
Phosphorous poisoning by phosphorous or its compounds, and its sequelae. |
Any process involving the production, liberation or utilisation of phosphorous or its compounds. |
|
Arsenic poisoning by arsenic or its compounds, and its sequelae. |
Any process involving the production, liberation or utilisation of arsenic or its compounds. |
|
Poisoning by benzene or its homologues, their nitro- and amido-derivatives, and its sequelae. |
Any process involving the production, liberation or utilisation of bezene or its homologues, or their nitro- or amido-derivatives. |
|
Poisoning by the halogen derivatives of hydrocarbons of the aliphatic series. |
Any process involving the production, liberation or utilisation of halogen derivatives of hydrocarbons of the aliphatic series designated by nationals laws or regulations. |
|
Pathological manifestations due to: § a) radium and other radioactive substances; § b) X-rays. |
Any process involving exposure to the action of radium, radioactive substances, or X-rays. |
|
Primary epitheliomatous cancer of the skin. |
Any process involving the handling or use of tar, pitch, bitumen, mineral oil, paraffin, or the compounds, products or residues of these substances. |
There has been no change since the last report.
Article 5. C17
The compensation payable to the injured workman, or his dependants, where permanent incapacity or death results from the injury, shall be paid in the form of periodical payments; provided that it may be wholly or partially paid in a lump sum, if the competent authority is satisfied that it will be properly utilised.
Article 7. C17
In cases where the injury results in incapacity of such a nature that the injured workman must have the constant help of another person, additional compensation shall be provided.
§2 Article 1. C42
The rates of such compensation shall be not less than those prescribed by the national legislation for injury resulting from industrial accidents. Subject to this provision, each Member, in determining in its national law or regulations the conditions under which compensation for the said diseases shall be payable, and in applying to the said diseases its legislation in regard to compensation for industrial accidents, may make such modifications and adaptations as it thinks expedient.
Cash benefits paid due to employment injury
Permanent disability:
Industrial injuries disablement benefit (social insurance):If the insured is assessed with a 100% disability, £182.90 a week (as of April 2021) is paid from the 15th week after the work-related accident occurred or the occupational disease began[22].
Partial disability: The benefit varies from £36.58 a week (as of April 2021) for an assessed degree of disability of 20% to £164.61 a week (as of April 2021) for an assessed degree of disability of 90% if aged 18 or older[23].
Constant-attendance allowance: If the insured requires the constant attendance of others to perform daily functions, £146.40, £109.80, £73.20 or £ 36.60 a week is paid as of April 2021 depending on attendance needs[24].
See under Part X-2-Survivors benefits
Articles 5. C17, Article 1. C42
Level of benefits
1. Examples of weekly rates of Disablement Benefit, and associated increases payable during the period under consideration are shown below:
|
From April |
2017/2018 (£) |
2018/2019 (£) |
2019/2020 (£) |
2020/2021 (£) |
2021/22 (£)[25] |
|
Disablement 100% |
169.70 |
174.80 |
179.00 |
182.00 |
182.90 |
|
Disablement 20% |
33.94 |
34.96 |
35.80 |
36.40 |
36.58 |
|
Reduced Earnings Allowance* (maximum rate) |
69.90 |
69.90 |
71.60 |
72.80 |
73.16 |
|
Retirement Allowance (maximum) |
17.48 |
17.48 |
17.90 |
18.20 |
18.29 |
|
Constant Attendance Allowance (maximum) |
139.80 |
139.80 |
143.20 |
145.60 |
146.40 |
|
Exceptionally Severe Disablement Allowance |
69.90 |
69.90 |
71.60 |
72.80 |
73.20 |
*Reduced Earnings Allowance is not payable in respect of accidents or diseases arising on or after 1 October 1990.
VI – 5. Benefits in kind
Article 9. C17
Injured workmen shall be entitled to medical aid and to such surgical and pharmaceutical aid as is recognised to be necessary in consequence of accidents. The cost of such aid shall be defrayed either by the employer, by accident insurance institutions, or by sickness or invalidity insurance institutions.
§1. Article 10. C17
1. Injured workmen shall be entitled to the supply and normal renewal, by the employer or insurer, of such artificial limbs and surgical appliances as are recognised to be necessary: provided that national laws or regulations may allow in exceptional circumstances the supply and renewal of such artificial limbs and appliances to be replaced by the award to the injured workmen of a sum representing the probable cost of the supply and renewal of such appliances, this sum to be decided at the time when the amount of compensation is settled or revised.
2. National laws or regulations shall provide for such supervisory measures as are necessary, either to prevent abuses in connection with the renewal of appliances, or to ensure that the additional compensation is utilised for this purpose.
Supply and renewal of artificial limbs and surgical appliances
The NHS will supply the appropriate prosthetic device to meet the clinical needs of the patient regardless as to the reason for amputation.
In respect of pharmaceutical products outside the hospital, the position continues to be that prescription charges and the costs of dental treatment are borne by recipients of industrial injuries benefits on the same basis as they are borne by people receiving other state benefits. Assistance may be available for example, because of receipt of a qualifying income-related benefit, because of specified conditions related to age or health. These costs will be reviewed in March 2023.
http://www.nhs.uk/NHSEngland/Healthcosts/Pages/Prescriptioncosts.aspx
In respect of pharmaceutical products outside the hospital the position is that all Health Service prescriptions dispensed in Northern Ireland are free of charge for everyone.
https://www.nidirect.gov.uk/articles/help-with-health-costs
Article 6. C17
In case of incapacity, compensation shall be paid no later than as from the fifth day after the accident, whether it be payable by the employer, the accident insurance institution, or the sickness insurance institution concerned.
Financial support for individuals unable to work due to sickness or incapacity for employment is provided for all employees either through Occupational Sick Pay or Statutory Sick Pay. More details on Statutory Sick Pay can be found here.
Universal Credit or Employment and Support Allowance is available for those who require additional financial support or for those who do not qualify for Occupational or Statutory Sick Pay. Further information on these benefits is contained elsewhere in this report.
Statutory Sick Pay is subject to 3 waiting days, unless related to COVID-19, which is paid from day 1 provided the absence is for 4 days or more. Industrial Injuries Disablement Benefit may also become payable for accidents 90 days from the date the accident occurred. This period is to allow for the possibility that the condition of the individual will improve, and to understand the full impact of the accident on the claimant’s disablement. There is no similar period for industrial diseases.
Compensation is paid by central government with the exception of Occupational and Statutory Sick Pay which are paid by employers.
VI - 7. Insolvency of employer
Article 11. C17
The national laws or regulations shall make such provision as, having regard to national circumstances, is deemed most suitable for ensuring in all circumstances, in the event of the insolvency of the employer or insurer, the payment of compensation to workmen who suffer personal injury due to industrial accidents, or, in case of death, to their dependants.
For the Industrial Injuries Scheme, eligibility requires that at the time of the accident or disease exposure, the individual must have been engaged in employed earners employment, i.e. they should have been an employee at the time of accident/exposure. There is no requirement for the employer to be solvent at the time of a claim to the Industrial Injuries Scheme. Claims are paid on a no fault basis so employer liability need not be proven. Awards are paid for the duration of the disablement which could be anything that the healthcare professional deems appropriate; including life awards.
VI - 8. Financing and Administration
Article 8. C17
The national laws or regulations shall prescribe such measures of supervision and methods of review as are deemed necessary.
§2. Article 10. C17
National laws or regulations shall provide for such supervisory measures as are necessary, either to prevent abuses in connection with the renewal of appliances, or to ensure that the additional compensation is utilised for this purpose.
The total amount of Industrial Injuries Benefits Annually Managed Expenditure for the financial year ending each March (GB £ million, nominal terms) was as follows[26]:
|
2017 |
2018 |
2019 |
2020 |
2021 |
|
861 |
840 |
838 |
831 |
721 (forecast) |
The costs of estates, IT support, central services and the administrative costs of actually paying the benefit are not available. Since the previous reporting period, there have been further developments on administration. During the reporting period the number of processing sites was increased to three regional centres, covering the whole of Great Britain.
The cost of Industrial Injuries benefits (IIB) in Northern Ireland for the financial years ending March were as follows: (in £GB thousands):
|
2017 |
2018 |
2019 |
2020 |
2021 |
|
29,419 |
29,291 |
29,886 |
30,347 |
29,811 (forecast) |
* Since 2016 IIB is administered along with Employment and Support Allowance and separate specific administration costs for IIB are not identifiable.
The Industrial Injuries Scheme in Great Britain is administered by the Department for Work and Pensions, through two dedicated regional Industrial Injuries Benefit delivery centres. The Industrial Injuries Scheme in Northern Ireland is administered by the Department for Communities.
ILO Convention 19
Separate, but corresponding, schemes of Social Security are operated in Great Britain and Northern Ireland. Reciprocal arrangements between the two ensure that the schemes effectively operate as a single system. For ease of reference the legislation introduced during the reference period and of relevance to this Convention is listed below. Corresponding legislation has effect in Northern Ireland and is likewise listed. Benefit levels and dates of commencement are maintained in parity with Great Britain and all rates quoted therefore apply equally.
The complete law on Social Security, as it currently applies in Great Britain, including copies of the text of Acts, Regulations and Orders can be view at the Government’s website[27]. Statutory Instruments (SIs) can be traced by their year of publication and SI Number quoted, via the same website. Guidance on how to navigate the respective volumes is also available there. Corresponding Social Security legislation that has effect in Northern Ireland can be viewed at the Department for Communities in Northern Ireland website[28].
The following regulations modify the provisions described in previous reports by, amongst other things, up-rating the various benefits and making changes to the list of prescribed diseases (PDs). Otherwise the position remains as previously described.
The Social Security (Industrial Injuries) (Prescribed Diseases) Amendment Regulations 2019
https://www.legislation.gov.uk/uksi/2019/1241/made
The Social Security (Industrial Injuries) (Prescribed Diseases) (Amendment) Regulations (Northern Ireland) 2019 S.R. No. 204
https://www.legislation.gov.uk/nisr/2019/204/contents/made
The Pneumoconiosis etc. (Workers’ Compensation) (Payment of Claims) (Amendment) Regulations 2021
https://www.legislation.gov.uk/uksi/2021/271/made
The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations 2020
https://www.legislation.gov.uk/uksi/2020/244/contents/made
The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations 2021
https://www.legislation.gov.uk/uksi/2021/270/contents/made
The Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations (Northern Ireland) 2021
https://www.legislation.gov.uk/nisr/2021/59/contents/made
The above mentioned legislation is administered by Department for Work and Pensions (GB) and the Department for Communities (NI).
The Pneumoconiosis etc. Workers' Compensation) (Payment of Claims) (Amendment) Regulations (Northern Ireland)2021 S.R. No. 55
https://www.legislation.gov.uk/nisr/2021/55/contents/made
Part VII. Family Benefit
The United Kingdom has accepted the obligations resulting from Part VII of C102 and Part VII of the ECSS.
List of applicable legislation
· The Child Maintenance and other payments Act 2008
https://www.legislation.gov.uk/ukpga/2008/6/contents
· Tax Credits Act 2002
http://www.legislation.gov.uk/ukpga/2002/21/pdfs/ukpga_20020021_en.pdf
· The Scottish Child Payment Regulations 2020 (SSI 2020 no 351)
The Scottish Child Payment Regulations 2020 (legislation.gov.uk)
VII - 1. Regulatory framework
Article 39. C102 and ECSS
Each Member (Contracting Party) for which this Part of this Convention (Code) is in force shall secure to the persons protected the provision of family benefit in accordance with the following Articles of this Part.
Her Majesty’s Revenue and Customs (HMRC) is the Department responsible for Child Benefit and non-Universal Credit related tax credits.
Child Benefit is generally payable to all persons who have responsibility for a child, regardless of means. Child Benefit is a non-contributory benefit and is not treated as taxable income.
As of January 2013, claimants may be liable to a tax charge called the 'High Income Child Benefit Charge'. Being liable for this charge does not affect entitlement to Child Benefit for a child. The High Income Child Benefit Charge is a tax charge which applies to anyone with an income of over £50,000 if they, or their partner, is in receipt of Child Benefit. The charge increases gradually for those with incomes between £50,000 and £60,000 and is equal to one per cent of a family’s Child Benefit for every extra £100 of income that is over £50,000 each year. Where income exceeds £60,000, the tax charge is equal to the amount payable in Child Benefit. Alternatively, claimants affected by the High Income Child Benefit charge have the option to opt-out of receiving Child Benefit, thereby ceasing their payments, which means that they are not subject to the tax charge.
Child Tax Credit (CTC) is a means-tested form of support for families (with children) who are in or out of work and living in the UK.
Working Tax Credit (WTC) provides financial support, on top of earnings for in-work households with low incomes who are living in the UK. This is paid to families with or without children. WTC provides support to in-work households on low incomes and additional support is available for disabled workers. It is payable to the person who is working. The “childcare element” of WTC is paid directly to the main carer of the child or children along with Child Tax Credit. Further information on eligibility for tax credits and how awards are calculated is published in leaflet WTC 2 entitled A Guide to Child Tax Credit and Working Tax Credit.
From 6 April 2021, if a claimant is entitled to Working Tax Credit, whether on its own or in addition to Child Tax Credit, and their family’s annual income is below £6,565 they will get the maximum amount of all the elements that they qualify for. If income is over that threshold, the maximum amount will be reduced by 41 pence for every pound of income over the threshold.
Universal Credit is replacing tax credits. It has been successfully rolled out across the whole of the UK by the Department for Work and Pensions in Great Britain, and Department for Communities in Northern Ireland. From 1 February 2019, HMRC has not accepted any new claims for tax credits unless an exception applies.
Where a claim to Universal Credit is made by a tax credits recipient, their tax credits award is ended. Tax credits customers under state pension age will typically move to Universal Credit if they have a relevant change of circumstances such as a change in household make-up or loss of employment leading to a need for out of work support.
Scotland
Scottish Child Payment (SCP) is a means tested form of support for families (with children) in or out of work resident in Scotland. Eligible families must be in receipt of a qualifying UK benefit (child element of Universal Credit or Child Tax Credit). SCP was introduced in February 2021 and is currently paid at a rate of £40 every 4 weeks to eligible families for each child under the age of 6. It is administered by Social Security Scotland, an agency of the Scottish Government. The Scottish Government intends to extend eligibility to children under the age of 16 by the end of 2022.
Article 40. C102 and ECSS
The contingency covered shall be responsibility for the maintenance of children as prescribed.
§h Article 1. ECSS
the term “child” means a child under school leaving age or under 15 years of age, as may be prescribed.
Child Benefit is paid to those responsible for children (aged under 16) or qualifying young people. The latter includes those:
a. in full-time non-advanced education or (from April 2006) on certain approved vocational training courses and who are under 19, or are aged 19 and have been on the same course since their 19th birthdays.
b. entered for future external examinations, or are in the period between leaving education and the week containing the first Monday in September and are not in work.
c. aged under 18 who have moved directly from full-time education to being registered for work or training with the Careers service or with Connexions.
Article 41. C102 and ECSS
The persons protected shall comprise, [as regards the periodical payments specified in Article 42 - ECSS]:
(a) prescribed classes of employees, constituting not less than 50 per cent of all employees; or
(b) prescribed classes of the economically active population, constituting not less than 20 per cent of all residents.
[(c) all residents whose means during the contingency do not exceed prescribed limits – C102].
The number of families receiving Child Benefit in the UK for the years covered by this Report are contained in the following table:
The Number of Child Benefit recipients – August each year:
|
UK (figures in ‘000s) |
|
|
2017/18 |
7,377 |
|
2018/19 |
7,326 |
|
2019/20 |
7,282 |
|
2020/21 |
7,211 |
Note: UK totals include foreign nationals and not known.
The number of families receiving Child Tax Credit in the UK for the year 2018/19 was 3.3 million, comprising some 6.1 million children.
The Child and Working Tax Credits statistics: finalised annual awards - 2018 to 2019 statistics can be found by following the link below:
See Part III of this report for figures on Universal Credit (UC).
Child Tax Credits
|
Average number of families in receipt of CTC and children for whom CTC is being claimed for CTC 2014/15 – 2019/20[29] |
||||||||||||||||||
|
Thousands |
||||||||||||||||||
|
2014-15 |
2015-16 |
2016-17 |
2017-18 |
2018-19 |
||||||||||||||
|
Families |
3,921 |
3,804 |
3,646 |
3,443 |
3,017 |
|||||||||||||
|
Children |
7,459 |
7,299 |
7,070 |
6,718 |
6,092 |
|||||||||||||
Prior to this policy change, the family element of CTC (£545) was protected so long as household income did not exceed the second income threshold, which for most claimants was £40,000. Once household income exceeded £40,000, then the CTC family element was tapered away at a rate of 41p for every pound earned over this amount. Once this second income threshold was removed, the family element was no longer protected and tapered away once all other elements were removed. This primarily affected households that were only claiming the family element of CTC and had relatively higher household incomes.
Article 42. C102 and ECSS
The benefit shall be:
(a) a periodical payment granted to any person protected having completed the prescribed qualifying period; or
(b) the provision to or in respect of children of food, clothing, housing, holidays or domestic help; or
(c) a combination of (a) and (b).
The Child Tax Credit annual rates for the period of this Report.
|
Child Tax Credit |
From April 2017 |
From April 2018 |
From 2019 |
From 2020 |
From 2021 |
|
Family element[30] |
545 |
545 |
545 |
545 |
545 |
|
Child element[31] |
2,780 |
2,780 |
2,780 |
2,830 |
2,845 |
|
Disabled child element[32] |
3,175 |
3,275 |
3,355 |
3,415 |
3,435 |
|
Severely disabled child element[33] |
1,290 |
1,325 |
1,360 |
1,385 |
4,825 |
|
Income thresholds and withdrawal rates |
|||||
|
First income threshold |
6,420 |
6,420 |
6,420 |
6,530 |
6,565 |
|
First withdrawal rate (per cent) |
41 |
41 |
41 |
41 |
41 |
|
Second withdrawal rate (per cent) |
|||||
|
First threshold for those entitled to CTC only |
16,105 |
16,105 |
16,105 |
16,385 |
16,480 |
|
Income increase disregard |
2,5000 |
2,500 |
2,500 |
2,500 |
2,500 |
|
Income disregard |
2,500 |
2,500 |
2,500 |
2,500 |
2,500 |
Child Benefit weekly rates for the period of this Report
|
From |
Child Benefit |
|
April 2017 |
£20.70 eldest child |
|
£13.70 each other child |
|
|
April 2018 |
£20.70 eldest child |
|
£13.70 each other child |
|
|
April 2019 |
£20.70 eldest child |
|
£13.70 each other child |
|
|
April 2020 |
£21.05 eldest child |
|
£13.95 each other child |
|
|
April 2021 |
£21.15 eldest child |
|
£14.00 each other child |
§1(i) Article 1. C102/ECSS
The term qualifying period means a period of contribution, or a period of employment, or a period of residence, or any combination thereof, as may be prescribed.
Article 43. ECSS
The benefit specified in Article 42 shall be secured at least to a person protected who, within a prescribed period, has completed a qualifying period which may be one month of contribution or employment, or six months of residence, as may be prescribed.
Article 43. C102
The benefit specified in Article 42 shall be secured at least to a person protected who, within a prescribed period, has completed a qualifying period which may be three months of contribution or employment, or one year of residence, as may be prescribed.
Eligibility to Child Benefit
Only one person can get Child Benefit for a child.
You normally qualify for Child Benefit if you’re responsible for a child under 16 (or under 20 if they stay in approved education or training) and you live in the UK.
You’ll usually be responsible for a child if you live with them or you’re paying at least the same amount as Child Benefit (or the equivalent in kind) towards looking after them. In these cases, we would usually need to see evidence of expenditure towards the child’s upbringing.
Examples of contributions are:
· money
· clothes
· birthday and Christmas presents
· food
· pocket money
Eligibility to Child Tax Credit
Child Tax Credit has been available to individuals who are responsible for a child and:
· have a right to reside in the UK
· pay National Insurance contributions in the UK
Eligibility to Child Benefit and CTC for those coming to the UK from abroad can be found at the following links:
https://www.gov.uk/child-benefit-move-to-uk
https://www.gov.uk/tax-credits-if-moving-country-or-travelling/moving-to-the-uk
Eligibility for Scottish Child Payment
Only one person can get SCP. Eligibility is based on being resident in Scotland, in receipt of a qualifying UK benefit and having responsibility for a child or children under the age of 6.
VII - 6. Level and Calculation of Benefit
Article 44. C102 and Protocol to the ECSS
The total value of the benefits granted in accordance with Article 42 to the persons protected shall be such as to represent:
[(a) 3 per cent. of the wage of an ordinary adult male labourer, as determined in accordance with the rules laid down in Article 66, multiplied by the total number of children of persons protected; - C102 ] or
(b) 1.5 per cent. of the said wage, multiplied by the total number of children of all residents.
HMRC produces figures for total expenditure on Tax Credit and Child Benefit in the “HMRC Tax Receipts and National Insurance Contributions for the UK”, which can be found at the following the link :
https://www.gov.uk/government/statistics/hmrc-tax-and-nics-receipts-for-the-uk
Expenditure data for tax credits and Child Benefit from 1999/2000 to 2020/21 can be found on the right hand side of the HM Revenue and Customs expenditure table. This figure covers both Working Tax credit (WTC) and CTC.
Total UK child benefit expenditure in 2020-21 was £11.496bn. Based on a reference wage of £387.60 per week, (annual - £20,155 x 1.5% = £302.33) and taking the Office for National Statistic’s child population estimates of 14.19m UK children as a proxy, the amount the UK would need to spend in order to be in compliance with the Code is £4.29bn, which the UK’s expenditure for Child Benefit alone exceeds.
Scottish Child Payment
Between 15 February and 31 March 2021, the total value of Scottish Child Payments issued was £3.6 million.
Article 45. ECSS
Where the benefit consists of a periodical payment, it shall be granted throughout the contingency.
Child Benefit is paid every four weeks for the duration of the period of eligibility.
VII - 8. Suspension of Benefit
Article 69. C102, Article 68. ECSS
A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed--
(a) as long as the person concerned is absent from the territory of the Member;
(b) as long as the person concerned is maintained at public expense, or at the expense of a social security institution or service, subject to any portion of the benefit in excess of the value of such maintenance being granted to the dependants of the beneficiary;
(c) as long as the person concerned is in receipt of another social security cash benefit, other than a family benefit, and during any period in respect of which he is indemnified for the contingency by a third party, subject to the part of the benefit which is suspended not exceeding the other benefit or the indemnity by a third party;
(d) where the person concerned has made a fraudulent claim;
https://www.gov.uk/child-benefit-for-children-in-hospital-or-care
Child Benefit for children in hospital or care
Child Benefit payments might be affected if the child goes into:
- care for more than 8 weeks
- hospital or ‘residential care’ for more than 12 weeks
Residential care is accommodation paid for by local councils, usually because the child has a mental or physical disability. This is different to ‘care’.
After 8 or 12 weeks
Usually, recipients are no longer entitled to Child Benefit after the time limit. There are exceptions to this rule, for example:
- for children in care - if they spend at least 24 hours a week at home
- for children in a UK hospital or residential care - if the recipient is regularly spending money on them
- for children in hospital abroad - if the recipient is back in the UK and regularly spending money on them.
The recipient’s money will only count if they are married or civil partnered and living together.
Child Benefit if the child lives with someone else
An individual will usually get Child Benefit for 8 weeks after the child goes to live with someone else (e.g. a friend or relative), if nobody else claims. It can continue for longer if the individual makes contributions to the child’s upkeep.
The Child Benefit Office will tell individuals if they get another claim for the child. They will help with decisions regarding who should claim if the individual cannot decide for themselves.
Contributions to upkeep
Payments could continue for more than 8 weeks if the individual contributes to the child’s upkeep by the same amount or more than the Child Benefit payment.
Upkeep includes clothes, presents, food and pocket money and financial contributions to provide the child with somewhere to live.
Tax credits
Payments of tax credits can be suspended in cases where insufficient information has been provided by the customer (for example, they did not provide a home address or a bank account) or where the outcome of a court decision on entitlement is pending. The full circumstances where payments of tax credits can be suspended (or postponed) are set out in Regulation 11 of The Tax Credits (Payment by the Commissioners) Regulations 2002.
VII – 9. Right of complaint and appeal
See under Part XIII-2
VII - 10. Financing and Administration
See under Part XIII-3
Part VIII. Maternity benefit = not accepted
Laws and regulations do exist to provide benefit cover for pregnancy. Protection is provided under a compulsory scheme, in addition employers may operate a contractual maternity pay scheme.
Laws and Regulations introduced during the reporting period
https://www.legislation.gov.uk/uksi/2020/600/contents/made
The Maternity Allowance, Statutory Maternity Pay, Statutory Paternity Pay, Statutory Adoption Pay, Statutory Shared Parental Pay and Statutory Parental Bereavement Pay (Normal Weekly Earnings etc.) (Coronavirus) (Amendment) Regulations 2020 SI No 450.
https://www.legislation.gov.uk/uksi/2020/450/contents/made
Scope
All pregnant working women earning on average at least £30 or more a week are eligible for maternity benefits.
State Maternity Allowance (MA)
MA is financed from employer and employee contributions to the National Insurance Fund.
a) Rates during the reporting period are as follows (£):
2019/20 2020/21 2021/22
MA (Standard Rate) £148.68 £151.20 £151.97
Note: The rate of MA is based on a woman’s average weekly earnings. MA is paid at the lower of a standard rate or 90% of the woman’s average earnings.
Statutory Maternity Pay (SMP)
SMP is earnings related for the first six weeks and set at 90% of average weekly earnings with no upper limit.
Week 7 onwards 2019/20 2020/21 2021/22
Standard weekly rate £148.68 £151.20 £151.97
b) Other resources are not taken into account.
c) Levels of benefit are reviewed annually as part of the uprating process.
The Maternity Allowance, Statutory Maternity Pay, Statutory Paternity Pay, Statutory Adoption Pay, Statutory Shared Parental Pay and Statutory Parental Bereavement Pay (Normal Weekly Earnings etc.) (Coronavirus) (Amendment) Regulations 2020 were introduced in April 2020.
The purpose of the instrument was to prevent an employee from experiencing disadvantage in relation to the above family-related statutory payments and Maternity Allowance as a result of their being placed on temporary leave under the Coronavirus Job Retention Scheme (“the CJRS”).
The amendments ensured that an employee’s eligibility for family-related statutory pay and their earnings-related rate of Statutory Maternity Pay, Maternity Allowance or Statutory Adoption Pay is the same as it would have been had they not been furloughed.
Part IX. Invalidity benefit = not accepted
Protection is provided under a compulsory insurance scheme.
Laws and Regulations introduced during the reporting period
1. Scope
The position on scope of persons covered remains as previously described.
2. Conditions for entitlement to benefit
The contingencies of Part III and IX of the Code are now covered by Employment and Support Allowance (ESA). ESA replaced Incapacity Benefit (IB) and Income Support (IS), paid on grounds of incapacity, for new claimants from 27 October 2008. All existing IB and IS claims are to be reassessed for ESA.
Following the introduction of Universal Credit (UC), ESA Regulations 2013 replaced the ESA Regulations 2008, effectively removing all references to income-related ESA, and re-introducing ESA as a contributory benefit only.
Once UC is fully introduced, income-related ESA will be absorbed into UC and ESA will exist separately as a contributory benefit only.
The United Kingdom has accepted the obligations resulting from Part X of C102.
List of applicable legislation
· Social Security Contributions and Benefits Act 1992
http://www.legislation.gov.uk/ukpga/1992/4/pdfs/ukpga_19920004_en.pdf
· Pensions Act 2014
http://www.legislation.gov.uk/ukpga/2014/19/contents/enacted
Northern Ireland
· Social Security Contributions and Benefits (Northern Ireland) Act 1992
https://www.legislation.gov.uk/ukpga/1992/7/contents
· Pensions Act (Northern Ireland) 2015
https://www.legislation.gov.uk/nia/2015/5/contents
See under Part I. General Provisions. Articles 1-6.
Article 59. C102M
Each Member (Contracting Party) for which this Part of this Convention (Code) is in force shall secure to the persons protected the provision of survivors' benefit in accordance with the following Articles of this Part.
Basic principles
Compulsory social insurance scheme for the active population (employees and self-employed) financed by contributions providing lump sum Bereavement Payment, and flat-rate Widowed Parent's Allowance.
Article 60. C102
1. The contingency covered shall include the loss of support suffered by the widow or child as the result of the death of the breadwinner; in the case of a widow, the right to benefit may be made conditional on her being presumed, in accordance with national laws or regulations, to be incapable of self-support.
2. National laws or regulations may provide that the benefit of a person otherwise entitled to it may be suspended if such person is engaged in any prescribed gainful activity or that the benefit, if contributory, may be reduced where the earnings of the beneficiary exceed a prescribed amount, and, if non contributory, may be reduced where the earnings of the beneficiary or his other means or the two taken together exceed a prescribed amount.
Types of benefits
Bereavement Support Payment (social insurance): A lump sum of £2,500 plus £100 a month is paid for up to 18 months; £3,500 plus £350 a month is paid for up to 18 months if the widow(er) is pregnant or is entitled to receive child benefit.
Widowed Parent's allowance*: Up to £122.55 a week as of April 2021 is paid to a widowed parent entitled to child benefit for at least one dependent child.
Guardian's allowance:£18.00 a week (£18.00 a week as of April 2021) is paid for each child.
* This benefit is not available to claimants for deaths that occurred after April 2017.
Legislative provisions
The provisions relating to Bereavement Benefits are to be found in Part II of the Social Security Contributions and Benefits Act 1992 as follows:
Widowed Mother’s Allowance and Widow’s Pension: See sections 36A to 39, which apply only to cases where the death occurred before 9 April 2001;
Section 36A
(1) Sections 37 to 39 and section 40 below apply only in cases where a woman’s husband has died before the appointed day, and section 41 below applies only in cases where a man’s wife has died before that day.
(2) Sections 39A to 39C below apply in cases where a person’s spouse [or civil partner] dies on or after the appointed day, but section 39A also applies (in accordance with subsection (1)(b) of that section) in cases where a man’s wife has died before that day.
(3) In this section, and in sections 39A and 39B below, “the appointed day” means the day appointed for the coming into force of sections 54 to 56 of the Welfare Reform and Pensions Act 1999.
Section 37
(1) A woman who has been widowed shall be entitled to a widowed mother’s allowance at the rate determined in accordance with section 39 below if her late husband satisfied the contribution conditions for a widowed mother’s allowance specified in Schedule 3, Part I, paragraph 5 and either:
(a) the woman is entitled to child benefit in respect of a child [or qualifying young person] falling within subsection (2) below; or
(b) the woman is pregnant by her late husband; or
(c) if the woman and her late husband were residing together immediately before the time of his death, the woman is pregnant as the result of being artificially inseminated before that time with the semen of some person other than her husband, or as the result of the placing in her before that time of an embryo, of an egg in the process of fertilisation, or of sperm and eggs.
(2) A child [or qualifying young person] falls within this subsection if one of the conditions specified in section [77(5)] below is for the time being satisfied with respect to the child [or qualifying young person] and the child [or qualifying young person] is either:
(a) a son or daughter of the woman and her late husband; or
(b) a child [or qualifying young person] in respect of whom her late husband was immediately before his death entitled to child benefit; or
(c) if the woman and her late husband were residing together immediately before his death, a child [or qualifying young person] in respect of whom she was then entitled to child benefit.
(3) The widow shall not be entitled to the allowance for any period after she remarries [or forms a civil partnership], but, subject to that, she shall continue to be entitled to it for any period throughout which she satisfies the requirements of subsection (1)(a),(b) or (c) above.
(4) A widowed mother’s allowance shall not be payable:
(a) for any period falling before the day on which the widow’s entitlement is to be regarded as commencing for that purpose by virtue of section 5(1)(k) of the Administration Act;
(b) for any period during which she and a man to whom she is not married are living together as husband and wife [or
(c) for any period during which she and a woman who is not her civil partner are living together as if they were civil partners.
Section 38
(1) A woman who has been widowed shall be entitled to a widow’s pension at the rate determined in accordance with section 39 below if her late husband satisfied the contribution conditions for a widow’s pension specified in Schedule 3, Part I, paragraph 5 and either:
(a) she was, at the husband’s death, over the age of 45 but under the age of 65; or
(b) she ceased to be entitled to a widowed mother’s allowance at a time when she was over the age of 45 but under the age of 65.
(2) The widow shall not be entitled to the pension for any period after she remarries [or forms a civil partnership], but, subject to that, she shall continue to be entitled to it until she attains [pensionable age].
(3) A widow’s pension shall not be payable:
(a) for any period falling before the day on which the widow’s entitlement is to be regarded as commencing for that purpose by virtue of section 5(1)(k) of the Administration Act;
(b) for any period for which she is entitled to a widowed mother’s allowance;
(c) for any period during which she and a man to whom she is not married are living together as husband and wife, [or
(d) for any period during which she and a woman who is not her civil partner are living together as if they were civil partners.
(4) In the case of a widow whose late husband died before 11th April 1988 and who either:
(a) was over the age of 40 but under the age of 55 at the time of her husband’s death; or
(b) is over the age of 40 but under the age of 55 at the time when she ceases to be entitled to a widowed mother’s allowance, subsection (1) above shall have effect as if for “45” there were substituted “40”.
Section 39
(1) The weekly rate of
(a) a widowed mother’s allowance, widow’s pension.
(b) a widow’s pension,
shall be determined in accordance with the provisions of [6,7sections 44 to [45B]] below as they apply in the case of a Category a retirement pension, but subject, in particular, to the following provisions of this section and section [146] below.
(2) In the application of [2,3sections 44 to [45B]] below by virtue of subsection (1) above:
(a) where the woman’s husband was over pensionable age when he died, references in those sections to the pensioner shall be taken as references to the husband, and
(b) where the husband was under pensionable age when he died, references in those sections to the pensioner and the tax year in which he attained pensionable age shall be taken as references to the husband and the tax year in which he dried.
(3) […]
(4) Where a widow’s pension is payable to a woman who was under the age of 55 at the time when the applicable qualifying condition was fulfilled, the weekly rate of the pension shall be reduced by 7 per cent. of what it would be apart from this subsection multiplied by the number of years by which her age at that time was less than 55 (any fraction of a year begin counted as a year).
(5) For the purposes of subsection (4) above, the time when the applicable qualifying condition was fulfilled is the time when the woman’s late husband died or, as the case may be, the time when she ceased to be entitled to a widowed mother’s allowance.
(6) In the case of a widow whose later husband died before 11th April 1988 and who either:
(a) was over the age of 40 but under the age of 55 at the time of her husband’s death; or
(b) is over the age of 40 but under the age of 55 at the time when she ceases to be entitled to a widowed mother’s allowance, subsection (4) above shall have effect as if for “55” there were substituted “50”, in both places where it occurs.
Widowed Parent’s Allowance: sections 39A and 39C, for deaths occurring between 9 April 2001 and 5 April 2017. The contribution conditions are detailed in para 5 of Schedule 3.
Section 39A
(1) This section applies where:
(a) a person whose spouse [or civil partner] dies on or after the appointed day is under pensionable age at the time of the spouse’s [or civil partner’s] death, or
(b) a man whose wife died before the appointed day:
(i) has not remarried before that day, and
(ii) is under pensionable age on that day.
(2) The surviving spouse [or civil partner] shall be entitled to a widowed parent’s allowance at the rate determined in accordance with section 39C below if the deceased spouse [or civil partner] satisfied the contribution conditions for a widowed parent’s allowance specified in Schedule 3, Part I, paragraph 5 and
(a) the surviving spouse [or civil partner] is entitled to child benefit in respect of a child [or qualifying young person] falling within subsection (3) below;
(b) the surviving spouse is a woman who either:
(i) is pregnant by her late husband, or
(ii) if she and he were residing together immediately before the time of his death, is pregnant in circumstances falling within section 37(1)(c) above or
(c) the surviving civil partner is a woman who:
(i) was residing together with the deceased civil partner immediately before the time of the death, and
(ii) is pregnant as the result of being artificially inseminated before that time with the semen of some person, or as a result of the placing in her before that time of an embryo, of an egg in the process of fertilisation, or of sperm and eggs.
(3) A child [or qualifying young person] falls within this subsection if one of the conditions specified in sections [77(5)] below is for the time being satisfied with respect to the child [or qualifying young person] and the child [or qualifying young person] is either:
(a) a son or daughter of the surviving spouse [or civil partner] and the deceased spouse [or civil partner]; or
(b) a child [or qualifying young person] in respect of whom the deceased spouse [or civil partner] was immediately before his or her death entitled to child benefit; or
(c) if the surviving spouse [or civil partner] and the deceased spouse [or civil partner] were residing together immediately before his or her death, a child [or qualifying young person] in respect of whom the surviving spouse [or civil partner] was then entitled to child benefit.
(4) The surviving spouse shall not be entitled to the allowance for any period after she or he remarries [or forms a civil partnership], but, subject to that, the surviving spouse shall continue to be entitled to it for any period throughout which she or he:
(a) satisfied the requirements for subsection (2)(a) or (b) above; and
(b) is under pensionable age.
(4A) The surviving civil partner shall not be entitled to the allowance for any period after she or he forms a subsequent civil partnership or marries, but, subject to that, the surviving civil partner shall continue to be entitled to it for any period throughout which she or he:
(a) satisfies the requirements of subsection (2)(a) or (b) above; and
(b) is under pensionable age.
(5) A widowed parent’s allowance shall not be payable:
(a) for any period falling before the day on which the surviving spouse’s [or civil partner’s] entitlement is to be regarded as commencing by virtue of section 5(1)(k) of the Administration Act;
(b) for any period during which the surviving spouse [or civil partner] and a person of the opposite sex to whom she or he is not married are living together as husband and wife [or
(c) for any period during which the surviving spouse or civil partner and a person of the same sex who is not his or her civil partner are living together as if they were civil partners.
Section 39C
(1) The weekly rate of a widowed parent’s allowance shall be determined in accordance with the provisions of section 44 to [45AA] [and Schedule 4A] below as they apply in the case of a Category A retirement pension, but subject, in particular, to the following provisions of this section and section [46] below.
(2) The weekly rate of a bereavement allowance shall be determined in accordance with the provisions of section 44 below as they apply in the case of a Category A retirement pension so far as consisting only of the basic pension referred to in subsection
(3)(a) of that section, but subject, in particular, to the following provisions of this section.
(3) In the application of sections 44 to [45AA] [and Schedule 4A] or (as the case may be) section 44 below by virtue of subsection (1) or (2) above:
(a) where the deceased spouse [or civil partner] was over pensionable age at his or her death, references in those [provisions] to the pensioner shall be taken as references to the deceased spouse [or civil partner], and
(b) where the deceased spouse [or civil partner] was under pensionable age at his or her death, references in those [provisions] to the pensioner and the tax year in which he attained pensionable age shall be taken as references to the deceased spouse [or civil partner]and the tax year in which he or she died.
(4) Where a widowed parent’s allowance is payable to a person whose spouse [or civil partner] dies after [5th October 2002], the additional pension falling to be calculated under sections 44 to [45AA] [and Schedule 4A] below by virtue of subsection (1) above shall be one half of the amount which it would be apart from this subsection.
Where a bereavement allowance is payable to a person who was under the age of 55 at the time of the spouse’s [or civil partner’s] death, the weekly rate of the allowance shall be reduced by 7 per cent. of what it would be apart from this subsection multiplied by the number of years by which that person’s age at that time was less than 55 (any fraction of a year being counted as a year).
§1(c) Article 1 C102
The term wife means a wife who is maintained by her husband.
Article 61. C102
The persons protected shall comprise:
(a) the wives and the children of breadwinners in prescribed classes of employees, which classes constitute not less than 50 per cent of all employees; or
(b) the wives and the children of breadwinners in prescribed classes of the economically active population, which classes constitute not less than 20 per cent of all residents; or
(c) all resident widows and resident children who have lost their breadwinner and whose means during the contingency do not exceed limits prescribed in such a manner as to comply with the requirements of Article 67.
See under Part X-2
X - 4. Level and Calculation of Benefit
Article 62. C102
The benefit shall be a periodical payment calculated as follows:
(a) where the wives and children of breadwinners in classes of employees or classes of the economically active population are protected, in such manner as to comply either with the requirements of Article 65 or with the requirements of Article 66;
(b) where all resident widows and resident children whose means during the contingency do not exceed prescribed limits are protected, in such a manner as to comply with the requirements of Article 67.
Title I of RF/C102/ECSS (Article 66).
Please state the amount of the wage of the ordinary adult labourer wage (standard wage).
£387.60
Title IV of RF/C102/ECSS (Article 66), according to which the standard beneficiary is a widow with two children.
· Amount of Survivors’ Benefit granted during the time basis
£122.55 (basic Widowed Parent’s Allowance)
· Amount of family allowance, payable during employment, for a period equal to the time basis.
£155.18
Family allowances, payable during employment and the contingency, (where applicable) comprise £21.15 Child Benefit for the eldest qualifying child, £14.00 for the second qualifying and Child Tax Credit of £120.03 in respect of both children. From April 2003 Child Tax Credits replaced Child Dependency Increases payable with State Pension.
· Sum of Survivors’ Benefit and family allowance payable during contingency per cent of sum of standard wage and family allowance payable during employment.
Sum of Survivors’ Benefit and family allowance: £277.73, 66% of the sum of standard wage and family allowance payable during employment (£422.75, standard wage plus Child Benefit)
TITLE V of RF/C102/ECSS (Article 66), according to which the beneficiary is a woman employee.
· Amount of benefit granted during the time basis.
A childless woman employee may be eligible for benefits such as UC.
· Amount of Survivors’ Benefit per cent of the standard wage, payable during the contingency, for a period equal to the time basis.
§10 Article 65, §8 Article 66. C102
The rates of current periodical payments in respect of old age, employment injury (except in case of incapacity for work), invalidity and death of breadwinner, shall be reviewed following substantial changes in the general level of earnings where these result from substantial changes in the cost of living.
See under Part V-5
§1(f) Article 1 C102
The term qualifying period means a period of contribution, or a period of employment, or a period of residence, or any combination thereof, as may be prescribed.
Article 63. C102
1. The benefit specified in Article 62 shall, in a contingency covered, be secured at least:
(a) to a person protected whose breadwinner has completed, in accordance with prescribed rules, a qualifying period which may be 15 years of contribution or employment, or 10 years of residence; or
(b) where, in principle, the wives and children of all economically active persons are protected, to a person protected whose breadwinner has completed a qualifying period of three years of contribution and in respect of whose breadwinner, while he was of working age, the prescribed yearly average number of contributions has been paid.
2. Where the benefit referred to in paragraph 1 of this article is conditional upon a minimum period of contribution or employment, a reduced benefit shall be secured at least:
(a) to a person protected whose breadwinner has completed, in accordance with prescribed rules, a qualifying period of five years of contribution or employment; or
(b) where, in principle, the wives and children of all economically active persons are protected, to a person protected whose breadwinner has completed a qualifying period of three years of contribution and in respect of whose breadwinner, while he was of working age, half the yearly average number of contributions prescribed in accordance with subparagraph (b) of paragraph 1 of this Article has been paid.
3. The requirements of paragraph 1 of this Article shall be deemed to be satisfied where a benefit calculated in conformity with the requirements of Part XI but at a percentage of ten points lower than shown in the Schedule appended to that part for the standard beneficiary concerned is secured at least to a person protected whose breadwinner has completed, in accordance with prescribed rules, five years of contribution, employment or residence.
4. A proportional reduction of the percentage indicated in the Schedule appended to Part XI may be effected where the qualifying period for the benefit corresponding to the reduced percentage exceeds five years of contribution or employment but is less than 15 years of contribution or employment; a reduced benefit shall be payable in conformity with paragraph 2 of this Article.
5. In order that a childless widow presumed to be incapable of self-support may be entitled to a survivor's benefit, a minimum duration of the marriage may be required.
To qualify for WPA the deceased spouse must satisfy both the 1st and 2nd contribution conditions.
Condition 1
They must either:
- have had one qualifying year since 6 April 1975 which is derived from the actual payment of Class 1, 2, or 3 NI contributions
- or have paid 50 flat-rate contributions at any time before 6 April 1975.
Condition 2
For the standard basic rate (100 per cent) of WPA, the late spouse/civil partner must have had qualifying years for about 90 per cent of the years in their working life. If they had fewer qualifying years than the number needed for the standard basic rate a smaller basic rate will be paid, provided that the number of their qualifying years was at least a quarter of the number needed. Qualifying years for the 2nd contribution condition can be made up of paid Class 1,2,3 or credits or a mixture of paid contributions and credits.
Article 64. C102
The benefit specified in Articles 62 and 63 shall be granted throughout the contingency.
Widowed parent's allowance (social insurance): Weekly pension paid as long as widow or widower or surviving civil partner has dependent child under 16 (under 19 if in non-advanced full-time education).The allowance ceases upon remarriage or cohabitation.
Article 69. C102
A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed:
(a) as long as the person concerned is absent from the territory of the Member;
(b) as long as the person concerned is maintained at public expense, or at the expense of a social security institution or service, subject to any portion of the benefit in excess of the value of such maintenance being granted to the dependants of the beneficiary;
(c) as long as the person concerned is in receipt of another social security cash benefit, other than a family benefit, and during any period in respect of which he is indemnified for the contingency by a third party, subject to the part of the benefit which is suspended not exceeding the other benefit or the indemnity by a third party;
(d) where the person concerned has made a fraudulent claim;
(e) where the contingency has been caused by a criminal offence committed by the person concerned;
(f) where the contingency has been caused by the wilful misconduct of the person concerned;
(j) in the case of survivors' benefit, as long as the widow is living with a man as his wife.
Payment stops once the survivor is no longer eligible for Child Benefit, they reach State Pension age, or if they remarry, enter into a civil partnership or start cohabiting with another person.
If the recipient remarries they cannot re-qualify for benefit, even if they are subsequently divorced. A widow or widower who remarries and whose second spouse dies can only become entitled to benefit if the second spouse made sufficient National Insurance contributions; no account is taken of the first spouse’s contributions record.
Where a person lives with someone else as husband, wife or civil partner but is not legally married to them or not in a legal civil partnership, benefit is suspended but is reinstated if they stop cohabiting.
X – 9. Right of complaint and appeal
See under Part XIII-2
X - 10. Financing and Administration
See under Part XIII-3
Part XI. Standards to be complied with by periodical payments
Article 66. C102 and ECSS
1. In the case of a periodical payment to which this Article applies, the rate of the benefit, increased by the amount of any family allowances payable during the contingency, shall be such as to attain, in respect of the contingency in question, for the standard beneficiary indicated in the Schedule appended to this Part, at least the percentage indicated therein of the total of the wage of an ordinary adult male labourer and of the amount of any family allowances payable to a person protected with the same family responsibilities as the standard beneficiary.
2. The wage of the ordinary adult male labourer, the benefit and any family allowances shall be calculated on the same time basis.
3. For the other beneficiaries, the benefit shall bear a reasonable relation to the benefit for the standard beneficiary.
4. For the purpose of this Article, the ordinary adult male labourer shall be:
(a) a person deemed typical of unskilled labour in the manufacture of machinery other than electrical machinery; or
(b) a person deemed typical of unskilled labour selected in accordance with the provisions of the following paragraph.
5. The person deemed typical of unskilled labour for the purpose of subparagraph (b) of the preceding paragraph shall be a person employed in the major group of economic activities with the largest number of economically active male persons protected in the contingency in question, or of the breadwinners of the persons protected, as the case may be, in the division comprising the largest number of such persons or breadwinners; for this purpose, the international standard industrial classification of all economic activities, adopted by the Economic and Social Council of the United Nations at its Seventh Session on 27 August 1948, and reproduced in the Annex to this Convention, or such classification as at any time amended, shall be used.
6. Where the rate of benefit varies by region, the ordinary adult male labourer may be determined for each region in accordance with paragraphs 4 and 5 of this Article.
7. The wage of the ordinary adult male labourer shall be determined on the basis of the rates of wages for normal hours of work fixed by collective agreements, by or in pursuance of national laws or regulations, where applicable, or by custom, including cost-of-living allowances if any; where such rates differ by region but paragraph 6 of this Article is not applied, the median rate shall be taken.
8. The rates of current periodical payments in respect of old age, employment injury (except in case of incapacity for work), invalidity and death of breadwinner, shall be reviewed following substantial changes in the general level of earnings where these result from substantial changes in the cost of living.
Article 67. C102 and ECSS
In the case of a periodical payment to which this Article applies:
(a) the rate of the benefit shall be determined according to a prescribed scale or a scale fixed by the competent public authority in conformity with prescribed rules;
(b) such rate may be reduced only to the extent by which the other means of the family of the beneficiary exceed prescribed substantial amounts or substantial amounts fixed by the competent public authority in conformity with prescribed rules;
(c) the total of the benefit and any other means, after deduction of the substantial amounts referred to in subparagraph (b), shall be sufficient to maintain the family of the beneficiary in health and decency, and shall be not less than the corresponding benefit calculated in accordance with the requirements of Article 66;
(d) the provisions of subparagraph (c) shall be deemed to be satisfied if the total amount of benefits paid under the Part concerned exceeds by at least 30 per cent. the total amount of benefits which would be obtained by applying the provisions of Article 66 and the provisions of:
(i) Article 15 (b) for Part III;
(ii) Article 27 (b) for Part V;
(iii) Article 55 (b) for Part IX;
(iv) Article 61 (b) for Part X.
|
Part |
Contingency |
Standard Beneficiary |
Percentage |
|
III |
Sickness |
Man with wife and two children |
45 |
|
IV |
Unemployment |
Man with wife and two children |
45 |
|
V |
Old age |
Man with wife of pensionable age |
40 |
|
VI |
Employment injury: |
||
|
Incapacity of work |
Man with wife and two children |
50 |
|
|
Invalidity |
Man with wife and two children |
50 |
|
|
Survivors |
Widow with two children |
40 |
|
|
VIII |
Maternity |
Woman |
45 |
|
IX |
Invalidity |
Man with wife and two children |
40 |
|
X |
Survivors |
Widow with two children |
40 |
Standard Reference Wage
For the purposes of Article 66 Code the reference wage is £387.60 per week, being the median gross weekly earning (excluding overtime) for full-time male employees who are classified as typical of unskilled labour selected in accordance with the provisions of the Article 66 (4)(b) and 66 (5). This figure is from the Annual Survey of Hours and Earnings (ASHE) 2020.[34]
The best match for this criterion is SOC 2010 Sub-Major Group 91 (Elementary Trade and Related Occupations).
Part XII. Equality of treatment of non-national residents
The UK has ratified the obligations resulting from Part XII of C102
§1(b) Article 1 C102, §1(e) Article 1 ECSS
The term residence means ordinary residence in the territory of the Member and the term resident means a person ordinarily resident in the territory of the Member.
Article 68. C102
1. Non-national residents shall have the same rights as national residents: Provided that special rules concerning non-nationals and nationals born outside the territory of the Member may be prescribed in respect of benefits or portions of benefits which are payable wholly or mainly out of public funds and in respect of transitional schemes.
2. Under contributory social security schemes which protect employees, the persons protected who are nationals of another Member which has accepted the obligations of the relevant Part of the Convention shall have, under that Part, the same rights as nationals of the Member concerned: Provided that the application of this paragraph may be made subject to the existence of a bilateral or multilateral agreement providing for reciprocity.
In common with many nations, the UK’s social security and welfare provisions are primarily for those who are lawfully resident and settled in the UK. Temporary migrants and those in the UK without lawful status are generally subject to a no recourse to public funds (NRPF) condition which prevents them from accessing some benefits and services.
Not all temporary migrants are subject to an NRPF condition, including refugees and those granted humanitarian protection.
In order be eligible to access certain benefits and other support and assistance, non-British citizens will need to be living in the UK (for example having indefinite permission to stay or enter or having a no time limit on their stay) and are not subject to an NRPF condition.
Departments that administer benefits operate residence tests to assess the entitlement of individuals to access certain benefits and services. As part of these tests, most applicants for income-related benefits must demonstrate that they are ordinarily or habitually resident in the UK, even if they have lawful status. This is also true of British citizens.[35]
Contributory Benefits
Entitlement to contributory benefits is not dependent on nationality; anyone, regardless of nationality, who has paid sufficient national insurance contributions can access these benefits.
Health
The measure of residence that the UK uses to determine entitlement to free NHS healthcare is known as ‘ordinary residence’.
Individuals who are not ordinarily resident in the UK may be required to pay for their care when they are in England.
Part XIII. Common provisions
XIII – 1. Suspension of benefit
See under Parts II to X of the Consolidated Report
XIII – 2. Right of complaint and appeal
Article 70. C102, Article 69. ECSS
1. Every claimant shall have a right of appeal in case of refusal of the benefit or complaint as to its quality or quantity.
2. Where in the application of this Convention (Code) a government department responsible to a legislature is entrusted with the administration of medical care, the right of appeal provided for in paragraph 1 of this article may be replaced by a right to have a complaint concerning the refusal of medical care or the quality of the care received investigated by the appropriate authority.
3. Where a claim is settled by a special tribunal established to deal with social security questions and on which the persons protected are represented, no right of appeal shall be required.
Health
Complaint and redress – NHS: https://www.gov.uk/government/publications/the-nhs-constitution-for-england/how-do-i-give-feedback-or-make-a-complaint-about-an-nhs-service.
Benefits
Information on benefits appeals can be found here.
The Welfare Reform Act of 2012, effective from April 2013, was introduced to ensure that more disputes involving Department for Work and Pensions (DWP) decisions could be resolved without the need for referral to Her Majesty’s Courts and Tribunals Service (HMCTS). DWP is committed to preventing disputes, reducing the escalation of disputes, resolving disputes and learning from disputes.
DWP will reconsider all decisions before an appeal. If someone disputes a decision, they will need to ask DWP to reconsider the decision before they can appeal to HMCTS. This is known as “mandatory reconsideration”. The aim is to make sure that people understand the decision and to encourage people to provide additional evidence earlier in the process. Resolving disputes without the need for an appeal should also help ensure that people receive the right decision earlier in the process.
Appeals are to be made directly to HMCTS. After DWP has reconsidered a decision, if someone still disputes the decision and wishes to appeal, they must send their appeal directly to HMCTS. This is known as “direct lodgement”. It brings the process for Social Security and child maintenance appeals into line with other major tribunal jurisdictions handled by HMCTS.
DWP must return appeal responses to HMCTS within 28 calendar days in benefits cases, and within 42 calendar days in child maintenance cases.
Corresponding provision is made in the Northern Ireland Welfare Reform (NI) Order 2015.
Legislation
The Tribunals, Courts and Enforcement Act 2007; http://www.legislation.gov.uk/ukpga/2007/15/contents
The Tribunal Procedure (First-tier Tribunal) (Social Entitlement Chamber) Rules 2008; http://www.legislation.gov.uk/uksi/2008/2685/contents/made
The Tribunal Procedure (Upper Tribunal) Rules 2008; http://www.justice.gov.uk/downloads/tribunals/general/upper-tribs-rules.pdf
The Social Security and Child Support (Decisions and Appeals) Regulations 1999; http://www.legislation.gov.uk/uksi/1999/991/contents/made
The Universal Credit, Personal Independence Payment, Jobseeker’s Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations 2013. http://www.legislation.gov.uk/uksi/2013/381/contents/made
The Social Security and Child Support (Decisions and Appeals) Regulations (Northern Ireland) 1999 SR 1999 No. 162
http://www.legislation.gov.uk/nisr/1999/162/contents/made
The Universal Credit, Personal Independence Payment, Jobseeker’s Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations (Northern Ireland) 2016 SR 2016 No. 221
http://www.legislation.gov.uk/nisr/2016/221/contents/made
Right to be represented and assisted before relevant courts and tribunals, including access to funding
From 1 April 2013 the Legal Aid, Sentencing and Punishment of Offenders Act 2012 http://www.legislation.gov.uk/ukpga/2012/10/contents/enacted removed most welfare benefits cases from the scope of legal aid for appeal to the First-tier Tribunal (it should be noted that before the change it was only available at the advice stage and not for representation at the hearing). However, it has been retained for advice on welfare benefit appeals to the Upper Tribunal, and advice and legal representation for onward appeals to the Court of Appeal and Supreme Court.
Under rule 11 of The Tribunal Procedure (First-tier Tribunal) (Social Entitlement Chamber) Rules 2008, claimants can appoint a person to represent them before a First-tier Tribunal; similar provision is made in rule 11 of The Tribunal Procedure (Upper Tribunal) Rules 2008.
Practical procedures
The Government’s Gov.UK website sets out clear and concise instructions on to how to apply for legal aid. https://www.gov.uk/legal-aid/overview
Right to be able to challenge malpractices by social security administration before competent inspection and supervisory bodies and to request their intervention
The Department has a formal complaints procedure both for complaints and expressions of dissatisfaction with DWP policy, administration or members of staff.
DWP does its utmost to ensure that, where possible, all such complaints are resolved in house. Each of the DWP’s five customer serving business units has its complaints procedures, with a commitment to respond within two weeks by either accepting the complaint, with details of what is being done to put matters right, or, if not accepted, giving reasons why. If not satisfied, the complaining customer can request a review by a more senior staff member. DWP has an online complaints service mechanism for these purposes.
Northern Ireland
Mandatory Reconsiderations
Article 107 of the Welfare Reform (Northern Ireland) Order 2015 contains the power for mandatory reconsideration regulations.
Article 13 of the Social Security (NI) Order 1998 (S.I. 1998/1506 (NI 10)) makes provision for an individual to appeal to the Tribunal if they are dissatisfied with a decision made by the Department for Communities. An individual has one month from the date they are notified of the mandatory reconsideration outcome to appeal a decision.
Scottish redeterminations, appeals and complaints
Any determination made by Social Security Scotland can be challenged, with or without further evidence, and the challenge will be considered independently and afresh by a dedicated team separate from the original case manager in a process known as re-determination. If an applicant is still dissatisfied with the outcome of the re-determination, an appeal can be made to the independent First-tier Tribunal for Scotland. A new specialist Social Security Chamber has been created in the Scottish Tribunals system for the purpose of hearing these appeals.
Provisions relating to re-determinations appear in ss41-45 of the Act (www.legislation.gov.uk/asp/2018/9/part/2/chapter/3/crossheading/redetermination-by-the-scottish-ministers/enacted). The timescales for re-determinations are set out in regulations relative to the form of assistance in question. For Best Start Grant and Funeral Support Payment, an individual has 31 calendar days to request a re-determination and Social Security Scotland has 16 working days to carry it out.
Ss46-49 (www.legislation.gov.uk/asp/2018/9/part/2/chapter/3/crossheading/appeal-against-the-scottish-ministers-determination/enacted) provide a right for an individual to appeal to the Tribunal if they are dissatisfied with a re-determination, or if the re-determination has not been carried out within the prescribed timescales. An individual has 31 calendar days from the date they are notified about the outcome of a re-determination to make an appeal. If an individual makes an appeal after the 31 days, Social Security Scotland will forward on the appeal and relevant information to the Tribunal within 7 days, which will then decide whether to accept the late request.
The Scottish Government has committed to providing Short-term Assistance (STA) where Social Security Scotland has made a decision to reduce or stop an on-going entitlement and that decision is subject to a request for re-determination or an appeal. Short-term assistance will in effect maintain the amount paid to an individual at its original level until that individual’s re-determination rights and appeal rights to the First-Tier Tribunal for Scotland have been exhausted. The policy intention is to ensure that an individual is not discouraged from challenging a decision or from accessing administrative justice by having to manage, for a period, with a reduced income. Short-term Assistance has no equivalent in the DWP system.
As a public body in Scotland, Social Security Scotland’s complaints process complies with the Scottish Public Services Ombudsman’s (SPSO) complaints handling procedure. The SPSO procedure requires a 2-stage internal complaints process that aims to resolve complaints at the first point of contact if possible. A client can choose to provide their details or make the complaint anonymously.
XIII – 3. Financing and Administration
Article 71. C102, Article 70. ECSS
1. The cost of the benefits provided in compliance with this Convention (Code) and the cost of the administration of such benefits shall be borne collectively by way of insurance contributions or taxation or both in a manner which avoids hardship to persons of small means and takes into account the economic situation of the Member (Contracting Party) and of the classes of persons protected.
2. The total of the insurance contributions borne by the employees protected shall not exceed 50 per cent of the total of the financial resources allocated to the protection of employees and their wives and children. For the purpose of ascertaining whether this condition is fulfilled, all the benefits provided by the Member (Contracting Party) in compliance with this Convention (Code), except family benefit and, if provided by a special branch, employment injury benefit, may be taken together.
3. The Member (Contracting Party) shall accept general responsibility for the due provision of the benefits provided in compliance with this Convention (Code), and shall take all measures required for this purpose; it shall ensure, where appropriate, that the necessary actuarial studies and calculations concerning financial equilibrium are made periodically and, in any event, prior to any change in benefits, the rate of insurance contributions, or the taxes allocated to covering the contingencies in question.
Article 72. C102, Article 71. ECSS
1. The Member (Contracting Party) shall accept general responsibility for the proper administration of the institutions and services concerned in the application of the Convention (Code).
2. Where the administration is not entrusted [to an institution regulated by the public authorities or – C102] to a Government department responsible to a legislature, representatives of the persons protected shall participate in the management, or be associated therewith in a consultative capacity, under prescribed conditions; national laws or regulations may likewise decide as to the participation of representatives of employers and of the public authorities.
Financing
For UK Government tax and National Insurance Contributions receipts, see: https://www.gov.uk/government/statistics/hmrc-tax-and-nics-receipts-for-the-uk.
For benefits expenditure, including a detailed breakdown of expenditure by benefit, see: https://www.gov.uk/government/publications/benefit-expenditure-and-caseload-tables-2020.
· RF/C102/ECSS: please state to which extent responsibility has been assumed by the Member for the provision of benefits.
· No changes. RF/C102/ECSS: please indicate the principal changes that have been made during the period covered by the reports as regards benefit:
Benefits have been increased annually as provided for in the Social Security Benefits Up-rating Orders. See https://www.legislation.gov.uk/uksi/2021/162/contents/made
· RF/C102/ECSS: please indicate the principal changes that have been made during the period covered by the reports as regards rates of contribution:
Full details of National Insurance contribution rates can be found here: https://www.gov.uk/government/publications/rates-and-allowances-national-insurance-contributions/rates-and-allowances-national-insurance-contributions.
Rates of income tax can be found here: https://www.gov.uk/income-tax-rates.
· RF/C102/ECSS: please state whether the necessary actuarial studies and calculations concerning the financial equilibrium are made periodically. Where this has not already been done, please forward the results of any such studies and calculations.
Please see https://www.gov.uk/government/publications/report-to-parliament-on-the-2020-re-rating-and-up-rating-orders.
Administration
The Department of Health and Social Care (DHSC) supports ministers in leading the nation’s health and social care to help people live more independent, healthier lives for longer.
DHSC is a ministerial department, supported by 29 agencies and public bodies.
The Department for Work and Pensions (DWP) is responsible for welfare, pensions and child maintenance policy. As the UK’s biggest public service department it administers the State Pension and a range of working age, disability and ill health benefits to around 20 million claimants and customers.
DWP is a ministerial department, supported by 15 agencies and public bodies.
Her Majesty’s Revenue and Customs(HMRC) is the Department responsible for Child Benefit and non-Universal Credit related tax credits.
Social Security Scotland
Social Security Scotland is a new executive agency of the Scottish Government, set up to ensure that Scottish social security payments are managed correctly and fairly. The way these payments are administered is directed by the Principles in the Act and the commitments in the Social Security Charter.
The Agency’s first priority is to ensure the safe and secure transition of all devolved benefits to the 1.4 million people who may be relying on this support currently. In May 2018, it was estimated that from 2021/22 the value of the payments made by Social Security Scotland would be in the region of £3.5 billion per year. The interim Corporate Plan (available at www.socialsecurity.gov.scot/what-we-do/corporate-publications/corporate-plan) sets out the agency’s strategic objectives.
Headquartered in Dundee, the agency also has a base in Glasgow, and staff recruitment and identification of additional operational locations is currently ongoing. As of 31 March 2019, the agency employed a total of 404 staff: 232 in Dundee and 152 in Glasgow, with a further 20 staff employed in the local delivery of services. As of the end of June 2018 it is currently delivering the Carer’s Allowance Supplement, the Best Start Grant Pregnancy and Baby Payment, Best Start Grant Early Years Payment and Best Start Grant School Age Payment, with the Young Carer’s Grant and Funeral Expense Payment scheduled for delivery in autumn 2018.
More information is available at www.socialsecurity.gov.scot/.
Annex 1: Responses to requests for further information
Q1. The Committee takes note of this information and requests the Government to continue to provide information on the state of implementation and on the effective population coverage of the UC.
Timetable for the move to UC (from legacy):
As reported previously, the move to Universal Credit of all existing claimants will be completed by September 2024.
The Government has given a commitment that no one who is moved to UC as part of the managed migration process will have a lower level of entitlement to UC than had been the total level of their entitlement to their existing benefits at the point that they move. Where necessary we will provide transitional protection as part of the UC award to ensure that this is the case.
There were 4.9 million households on Universal Credit in November 2020. This is an increase of 2.2 million since March 2020.[36]
Q2. While taking note of the above, the Committee maintains that a person who should otherwise have the right to a benefit for meeting the qualifying conditions set out in Parts III and IV of the Code should not be deprived of such right due to someone else’s failure to fulfil such conditions, in line with Article 68 of the Code. In order to assess the practical implications of the Claimant’s Commitment’s requirement on the effective provision of UC benefits, the Committee requests the Government to provide information on the number of cases in which a claimant who would have otherwise met the conditions for entitlement to UC benefit was denied such entitlement due to the failure of another adult in the same household to accept a Claimant Commitment.
This information is not collated centrally, nor published, so not available.
Q3. The Committee requests the Government to continue providing information in the next report on the number of cases where sanctions were applied in case of refusal by a claimant to take up employment which does not match the criteria set out in section 97(4) of the Universal Credit Regulations of 2013 and section 95 of the Universal Credit Regulations (Northern Ireland) of 2016, and on the duration of reduction periods. The Government is also requested to consider withholding such sanctions during the first 26 weeks of benefit payment and to provide information on the measures taken or envisaged to this effect.
Statistics on sanctions up to January 2021 can be found here.
As stated in our report last year, claimants are not sanctioned for refusing to take up unsuitable employment.
Where a claimant has a strong track record of previous employment, work coaches can agree to limit their work search and availability requirements to jobs that are similar in nature and/or carry a similar level of pay to their previous occupation. This is called a permitted period. The work coach must be satisfied that the claimant has reasonable prospects of obtaining paid work and these limitations are only applied for up to a maximum of three months.
Once the permitted period is over, we expect claimants to take all reasonable steps to look for work. Conditionality means that we can work together with a claimant to generate a productive reciprocal relationship with the shared aim of getting claimants into work, or getting them more/better paid work. Where a claimant refuses to apply for or start a suitable job that has been discussed with their work coach, a referral for a sanction should be considered.
Universal Credit is based on a strong system of support and an agreed relationship where both sides endeavour to do the best they can to achieve positive work outcomes and prevent a slide into welfare dependency. We have robust evidence that the support our work coaches give claimants is effective at helping them into work. On average they find work almost two weeks more quickly than they would have done in the absence of any appointments with their work coach.
Q4. The Committee takes due note of the information provided by the Government and requests the Government to continue providing information on the number of mandatory reconsiderations and appeals lodged by the UC claimants with the number of initial decisions which have been overturned as a result of mandatory reconsiderations and appeals.
In 2020-21 there were 116,100 Universal Credit (UC) Mandatory Reconsiderations (MR) registered and 124,800 UC MRs completed. Of the UC MRs completed. In 38% of cases, the original decision was revised.[37]
In 2020-21 there were 11,800 UC appeals lodged and 20,500 appeals cleared. Of the 15,600 UC appeals cleared at a hearing, in 61% of cases the decision was revised in favour of the customer.[38]
These figures cover the period of the coronavirus (COVID-19) pandemic.
Q5. Committee of Ministers requests the Government to provide further information with regard to Articles 70(3) and 71(2) of the Code, General responsibility of a State for due provision of benefits and proper administration, concerning the, the Committee of Ministers hopes that the Government will consider reducing the five-week assessment and processing time for payment of the UC benefit as soon as possible with a view to avoiding hardship for the persons protected who are essentially persons with small means;
The Universal Credit assessment period and payment structure are fundamental parts of the design.
Universal Credit is a calendar monthly assessed benefit that is paid monthly in arrears. Claimants will receive a single household payment to go towards their household needs. This approach reflects the world of work, where the majority of all employees receive wages monthly.
The assessment period runs for a full calendar month from the date of entitlement and the Universal Credit pay date will be within seven calendar days after the end of the initial assessment period. Subsequent pay dates will be the same each month.
This payment structure is to ensure that we can accurately assess a claimant’s earnings over the course of the month and then up to a week afterwards to allow for the processing of payment to the claimant.
It is not possible to award a Universal Credit payment as soon as a claim is made as the assessment period must run its course before the award of Universal Credit can be calculated.
Removing the Initial Assessment Period would involve a complete change to the design of Universal Credit. This would require major resource and significant system development to facilitate such a change. For these reasons, our priority remains ensuring that claimants get the financial support they need in an accurate and timely way through Universal Credit.
Nobody has to wait for a payment in Universal Credit. New Claims Advances are the claimant’s benefit paid early, allowing claimants to access up to 100% of their estimated Universal Credit payment upfront. With a Universal Credit Advance, claimants receive an additional Universal Credit payment, resulting in 25 payments over 2 years, rather than 24.
This system is robust and ensures that no-one ‘with small means’ need suffer any hardship.
Q6. The Committee takes due note of this information, and requests the Government to provide information on the outcome of the review of the State Pension age scheduled for 2023, at the latest.
The Government will provide information on the review in our report following completion of the review.
Q7. The Committee therefore requests the Government to provide in the future such model calculations on the basis of the Pension Credit (without adding family allowances), in accordance with Article 67 of the Code
We have provided calculations on this basis in the main body of the UK 2021 report. We would point out that in 20-21, the replacement rate for the new State Pension is 40%, thus meeting the requirements of the Code without taking Pension Credit into account.
Annex 2 – supplementary information on the UK’s response to the Covid-19 pandemic
Social security measures
The UK’s primary focus throughout this health emergency has been to ensure that basic income protection is available to people affected by Covid-19.
The UK’s Chancellor of the Exchequer announced an unprecedented series of measures to support businesses and their employees to mitigate the impact of COVID-19.
A 1.7% benefit up-rating was implemented in April 2020, ending the benefits freeze, and the state pension rose by 3.9%, as per the triple lock, reflecting the substantial rise in average earnings in the UK in 2019.
The standard allowance in Universal Credit was temporarily increased by £86.67 per month for 12 months (equivalent to £20 per week) on top of the planned annual uprating. This additional increase meant that claimants received up to an additional £1,040, depending on their circumstances. In March 2021, the Government announced a six-month extension of the temporary £20 a week increase in Universal Credit.
The UK increased the local housing allowance rates for Universal Credit and housing benefit claimants, so they now cover the lowest 30% of local rents; and the Government increased the national maximum caps, so claimants in inner and central London should also see an increase in their housing support payments.
In 2020, the Government suspended all face-to-face assessments for sickness and disability benefits to protect vulnerable people (and assessment center staff) from unnecessary risk of exposure to Covid-19. During the pandemic the Department for Work and Pensions continued to assess people on paper evidence where possible, and introduced telephone assessments. In line with the latest public health guidance and adhering to strict safety protocols, the Department started reintroducing face-to-face assessments for health and disability benefits from May 2021.
Employment and Support Allowance
We made changes to Employment and Support Allowance (ESA) in response to the COVID-19 outbreak. These included:
· treating all ESA claimants who satisfy the conditions of entitlement and are suffering from COVID-19 or who are required to self-isolate in line with government guidance or caring for a child (or qualifying young person) who falls into either of those categories, including clinically extremely vulnerable individuals who have been advised by the NHS to ‘shield’ because they are at high risk of severe illness, as having limited capability for work, without the requirement to provide a fit note or to undergo a Work Capability Assessment from day one of the claim; and
· removed waiting days for these claims, meaning ESA will be payable from day one of the claim, subject to the claimant satisfying the normal conditions of entitlement.
These changes came into force on 13 March 2020 and have been extended until 12 November 2021.
Jobcentres
Jobcentres have remained open to support our most vulnerable claimants throughout this health emergency providing a service, in accordance with Public Health England and Devolved Government guidelines on social distancing, to vulnerable claimants unable to access our services through digital/telephony channels.
The Department for Work and Pensions is currently completing a programme of implementing safety measures across our Jobcentres, allowing us to extend our face to face service. We remain open for those who need us but will continue to minimise the requirement for customers to travel to our Jobcentres, conducting the majority of interactions digitally or by phone.
Conditionality
With the outbreak of Covid-19, the Government took the decision to suspend the requirement for face-to-face Jobcentre Plus appointments temporarily for all claimants in Universal Credit, New Style Job Seekers Allowance (JSA) and Employment and Support Allowance (ESA), old-style JSA and ESA, and Income Support. They continued to receive benefits as normal and they were not sanctioned for not taking part in appointments with Jobcentres.
A review has now taken place and, in line with other government decisions to ease lockdown measures, it has been agreed that a return to conditionality and expectations of work availability and work related activity for those who are able and expected to look for and prepare for work is appropriate.
As Covid-19 continues to impact both the actions of employers and employees and those looking and preparing for work, work related requirements set will be flexible and responsive to any on-going changes, including considering these where a claimant is unable to meet all of their commitments but have done all that they reasonably can.
Covid-19 measure: Prisoners on Temporary Release
In March 2020, as part of the Government’s strategy of supporting people affected by Covid-19, the Ministry of Justice made provision for the temporary release of prisoners, where necessary, to prevent the spread of Covid-19 on the prison estate. This measure was further extended in November 2020. The Ministry of Justice anticipates the continued need of the scheme in appropriate cases. The Department has responded to that, by extending the removal of restrictions which otherwise prevent prisoners on temporary release from claiming means tested benefits until 31st August 2021. This allows continuity in providing the same financial support to these prisoners, whilst on temporary release, as other comparable claimants of these benefits, which helps these individuals weather the financial impacts arising from the Covid-19 outbreak.
Jobseeker’s Allowance
In March 2020, we introduced a temporary easement to Jobseeker’s Allowance (JSA) in response to the COVID-19 outbreak establishing regulatory provision to treat a person who is infected, self-isolating or caring for a child who is infected with Covid-19 or self-isolating as not having ‘limited capability for work’ for the purposes of entitlement conditions to JSA. Any such period of sickness is excluded from the calculation of the maximum permitted number of sickness periods applicable to a person whilst in receipt of legacy JSA or new style JSA. Claimants are not expected to carry out their work search requirements or participate in interviews under such circumstances. The regulation supports the Government’s intention to provide additional support that helps both individuals and the wider economy arising from the COVID-19 outbreak and applies until 31 August 2021.
[2]http://www.dwp.gov.uk/publications/specialist-guides/law-volumes/the-law-relating-to-social-security/
[11] https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england
[19] See under Part XI. Standards to be complied with by periodical payments.
[20]https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandworkinghours/datasets/occupation4digitsoc2010ashetable14
[29] https://www.gov.uk/government/statistics/child-and-working-tax-credits-statistics-provisional-awards-april-2021
[30] From 6th April 2017, for families where the oldest child was born after 6th April 2017 Family Element was not payable.
[31] From 6th April 2017 the “two child limit” was introduced.
[32] The disabled child and severely disabled child are not separate elements. They are the same element paid at two rates.
[33] The disabled child and severely disabled child are not separate elements. They are the same element paid at two rates.
[34]https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandworkinghours/datasets/agegroupbyoccupation2digitsocashetable20
[35] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/970377/public-funds-guidance-v17.0-gov-uk.pdf
[36] https://www.gov.uk/government/statistics/universal-credit-statistics-29-april-2013-to-14-january-2021/universal-credit-statistics-29-april-2013-to-14-january-2021#:~:text=There%20were%204.9%20million%20households,2.7%20million)%20in%20March%202020.
[37] Figures are for Great Britain. Completed MRs exclude those withdrawn or cancelled. Based on unpublished data from the Universal Credit Full Service system. It may be subject to future revision.
[38] Figures are for Great Britain and are provisional. Published by the Ministry of Justice in Tables SSCS_1, SSCS_2 and SSCS_3 in “Tribunal Statistics Quarterly: January to March 2021”, available here: https://www.gov.uk/government/statistics/tribunal-statistics-quarterly-january-to-march-2021/tribunal-statistics-quarterly-january-to-march-2021