YOU can prevent the DWP interfering in the patient/doctor’s relationship

Courtesy of DPAC our Sister Org


The DWP has issued a new ESA65B, the form used to inform a patient’s GP of their WCA outcome.  This form which requests GPs not to send any further fit notes for ESA purposes after a claimant has been found fit for work, unless they appeal had already been at the centre of a controversy. James Harrison died 10 months after being found fit for work and after the jobcentre asked his GP not to issue further fit notes for ESA purposes. James Harrison wanted a fit note because he was too ill to attend the jobcentre appointments, but his GP refused to issue them.

The new ESA65B form which is headed ‘Help us support your patient to return to or start work’ has an added paragraph

In the course of any further consultations with [Title] [First name] [Surname] we hope you will also encourage [select] in [select] efforts to return to, or start, work.

It is all in keeping with DWP’s mantra that not only work is good for health, but also should be a ‘health outcome’. There are many reasons why this is wrong and DR Jay Watts, Consultant clinical psychologist, lists some of them:

Health professionals across the country will be horrified at this latest interference from the DWP – a move that undermines clinical expertise and threatens the safety of patients. There are a number of problems. First the letter places the expertise of DWP-funded ESA assessors above that of GPs. This is despite the fact GPs are more qualified to assess mental health, and can do so with the benefits of having known the patient for years, often decades (as opposed to in a one-off assessment). The DWP letter makes clear that they wish claimants to return to work at any cost, even if that means leaving a current occupation – an attack on the core identity of patients likely to have a damaging effect on mental health. Second, the letter states that “we know most people are better off in work”. This ignores a considerable literature showing that work can be damaging for mental health, with poor work environments a frequent trigger to mental breakdown. Economic evidence shows that rushing people back into work increases the likelihood of long-term illness. How then can it be right to encourage GPs to coerce patients back to work, a pressure likely to increase the feelings of shame, despair and anxiety at not working that have been exacerbated by the governments relentless and damaging campaign to associate worklessness with worthlessness? Third, the pressure the DWP is exerting on GPs to ‘encourage’ patients back to work, and desist from providing fit notes, is an attack on clinical expertise and the sanctity of the clinical space and clinical decision-making. Without a firm denouncement of this letter from Royal College of General Practitioners, we risk a situation where claimants will feel unwilling to make appointments with their GPs, given the level of fear the DWP and the work agenda elicits, with damaging and potentially life-threatening effects on the physical and mental health of claimants. It is vital that health professionals speak up for claimants rights, and insist that fit notes and therapeutic conversations are dictated by the needs of patients not the DWP.



You can make sure that your GP does not receive this letter and is not informed of your WCA outcome. This is sensitive personal data and the DWP needs your consent to share it as show  here in this FOI request.  There are several steps you need to take to refuse your consent:

1) You need to refuse to give your consent when you are completing your ESA50. On page 21 of the ESA50 form, under the “Other information” box you will write:

I DO NOT consent/agree to my doctor or any doctor treating me,
being informed about the Secretary of State’s
determination on
– limited capability for work
– limited capability for work-related activity
or being sent a summary of the Limited Capability for Work Assessment.

And you need to remove/strike out the text on the ESA50 form in the Declaration section page 22, that covers allowing the DWP to notify the person’s GP. The ESA50 form used for this is this form


2) Because you cannot be sure that the ESA50 form will be read by DWP, you need to write to the benefit centre which processes your claim, to inform them that you refuse to give your consent to share the WCA outcome with your GP, or any doctor. You will find a proforma letter to do so at the end of this article.


If you forgot to amend the ESA50 form in order to refuse your consent, you can still write to the DWP/benefit centre after every ESA50 form submitted and or after every WCA undertaken asking them not to share your WCA outcome with your GP.

This is heavily drawn from Frank Zola’s article on the same subject, which also provides more information and template letters to help you to refuse your consent. 

And thanks also to John Slater @AmateurFOI for his input

That should stop the DWP interfering in the doctor/patient’s relationship and destroying the trust which exists between them and also stop the DWP from exerting pressures on GPs in a way which can be detrimental for their patients.


Template letter

[Your full address]

[The date]

Department for Work and Pensions

[Address of your local JCP office]

[Enter Your National Insurance Number]

Dear Sir or Madam


RE: Consent, ESA50 and my Work Capability Assessment (WCA)


I write to confirm that I do not consent to my or any doctor being informed of any determination related to:


  1. limited capability for work
  2. limited capability for work-related activity


I am asserting my rights under the Data Protection Act (1998), as the Department requires my explicit consent to share said determination with my or any Doctor/GP, as it is my sensitive personal data.


Please write to me to acknowledge receipt of this letter and confirm that my records have been updated on the appropriate IT systems.


On your ESA50 form, a copy of which I have retained, I have removed/ struck-out the part of the declaration section that states:


“I agree to my doctor or any doctor treating me, being informed about the Secretary of State’s determination on

– limited capability for work

– limited capability for work-related activity, or

– both”


If I change my mind in the future I will write to the Department to advise it. I will not notify the Department of any change via the ESA50 form and should there be any doubt this letter should always take precedent.


Yours faithfully


6 thoughts on “YOU can prevent the DWP interfering in the patient/doctor’s relationship

  1. MarkCarlisle says:

    Me and my girlfriend both received a uc50 form for fitness for work because we are on universal credit and both are unfit for work and while I was looking thru the form it also had about the secretary of state on it so I followed exactly how the email told me to scribble it out and fill in more information so iam just writing this for others to check all forms the DWP send out to you.

  2. MarkCarlisle says:

    Well we went to the citizens advice and they filled in the forms for myself and my partner the DWP have still sent us for a health assessment and I refused to give the secretary of state and we are on universal credit I thought it would have stopped them because I also sent a letter to the job centre aswel I will let you know the outcome of the test iam taking proof that iam seeing a spine specialist and just started intense physio.

  3. MarkCarlisle says:

    I had my assessment I was asked if ive ever thought of committing suicide I even recorded it on my phone as evidence aswel of the questions she asked me and right at the end she wanted to know what it means by the do not agree with the secretary of the state on the form and I told her that I don’t agree because iam not having the person telling my doctor not to give me anymore sick notes in the future she even tried saying they don’t do that its only to ask for a letter from him my answer to that was if the DWP want a letter from my doctor I will ask him to write a letter not the other way round I will have to wait around 6 weeks for the decision.

  4. MarkCarlisle says:

    It never stopped the DWP I was still found fit for work there was no mention on the report about my carer with me it made out I could walk 200 meters without any help when I use a walking aid she only seen me walk a couple of meters and I had to keep stopping.

  5. MarkCarlisle says:

    The DWP are now claiming to have lost the uc60 form after I wrote on I do not agree to the secretary of state they also used my ex girlfriends medical records against my own by saying I claim to have these medical problems but when I attended I had total different problems. The DWP have already messed the courts about they sent me and my caseworker the files for the court but sends total different paperwork to the court last year so it got adjourned and still waiting. Then 9 weeks ago I got a phone call about they adjourned my court case even when myself and case worker never received a court date they tried doing it over the phone without us knowing they said it’s adjourned and they are sending letter and 9 weeks later myself and my case worker have not received the letter they even told my case worker the same and my case worker said she has never seen or heard about anybody who has been so badly treated by the DWP the way Ive been treated. I’ve had two spine injections what has not worked my disk has collapsed and my spine has got DDD.

  6. MarkCarlisle says:

    Hi just a update about the universal credit and my court case I was really dreading this case because it was all done telephone but ism pleased to say after fighting the DWP for two and half years I have won my case to be put on ESA I was awarded the maximum 15 points needed. So anybody who is having to fight the DWP don’t give in keep fighting that’s what the DWP hate people who fight against them I was even asked to drop my case by a work coach when I refused they made my life hell but I stayed strong and never gave up.

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