DWP’s Targeted Case Review
The DWP will, as part of its anti-fraud plan, carry out a large-scale review of universal credit cases. Owen Stevens examines the Targeted Case Review.
What is happening?
DWP anti-fraud activities include a targeted case review (TCR) of universal credit (UC) cases. This is described as the most significant component of DWP’s counter fraud plan.
1Ministerial Statement UIN HCWS471, available at ; DWP, Annual Report and Accounts 2022 to 2023 (‘ARA 2022-23’), July 2023, p276, available at gov.ukThis work will build on the work already done to ‘retrospectively verify’ the 900,000 awards made while ‘easements’ on checking and verifying claim information were in place during the pandemic and identified as the ‘riskiest’ cases by the Integrated Risk and Intelligence Service (IRIS).
2Fighting Fraud in the Welfare System, DWP policy paper, May 2022, available at gov.uk; DWP, Annual Report and Accounts 2021 to 2022 (‘ARA 2021-22’), July 2022, p68, available at gov.uk; for more on IRIS, see cpag.org.uk/dwp-fraud-reviewsIntention
TCR agents will review awards for ‘incorrectness’, which may or may not be the result of fraud. A claimant must have been receiving UC for six months to be eligible for review.
3The DWP routinely refers to reviews of ‘claims’ rather than ‘awards’. This is incorrect and misleading. See cpag.org.uk/right-word-right-place; ARA 2022-23, p306.The DWP expects to act on potential incorrectness identified by IRIS. The aim, assuming funding is extended beyond 2024–25, is to conduct around 8 million reviews by the end of the TCR and that this will, by 2027–28, prevent £6.4 billion of losses that would otherwise have been incurred. The TCR budget was £28 million in 2022–23, rising to £129 million in 2023–24, and £286 million in 2024-25. The DWP’s TCR exercise will recruit 5,900 agents by March 2025.
4ARA 2022-23, pp107, 297 and 307; correspondence with the Chair of the Work and Pensions Select Committee, 11 October 2023The DWP states that ‘customers are supported to provide the right evidence, which verifies their circumstances and entitlement to claim universal credit. Our agents work closely with vulnerable customers to support them through the process’. The DWP says that overpayments will be recovered and, where appropriate, prosecution or penalty action instigated. The DWP does not record data on time taken to contact claimants whose case is being reviewed.
5ARA 2022-23, p107; freedom of information (FOI) response (ref FOI2023/59392), 31 August 2023, Progress so far
The TCR has started by reviewing the lower risk cases which entered the UC system during the pandemic, and which are still in payment.
6ARA 2021-22, p68By March 2023, the DWP had recruited 840 staff, conducted 25,000 reviews and claimed to have saved £39 million (of which £14 million related to 2022–23 expenditure).
7ARA 2022-23, p307The DWP has begun recruiting a large number of TCR staff. Over 40 per cent of staff carrying out the TCR reviews will be outsourced, with training provided by the outsourced provider. It appears that the DWP’s internal recruitment into TCR roles is causing knock-on problems in other areas of the DWP.
8Archived job advertisement, ; T Markson, ‘DWP considers outsourcing 2,500 new jobs’, Civil Service World, 31 August 2023, available at civilserviceworld.com; ‘Staffing chaos within the DWP’, Public and Commercial Services Union, 04 October 2023, available at Areas of focus
The DWP will conduct a detailed review of the major drivers of fraud and error, generating intelligence on new and emerging areas of fraud, and will look at more areas of incorrectness as it carries out the TCR. Intelligence gained will inform changes to UC policies, service design and processes.
9Fighting Fraud in the Welfare System, DWP policy paper, May 2022, para 33; ARA 2022-23, p107The DWP has stated that the TCR will help to identify incorrect awards among the self-employed and people living together as a couple, and will presumably use the TCR to target other high-risk areas, including capital and housing.
10ARA 2021-22, pp65-66; ARA 2022-23, p308The TCR will partly align with the system of conditionality, so that certain sanctioned claimants who disengage with conditionality will be expected to engage with the TCR.
11‘Cutting taxes and rewarding work’, in HM Treasury, Autumn Statement 2023, 30 November 2023, available at gov.ukBlanket approach
The DWP says that ‘[w]here incorrectness is found, claims will be corrected retrospectively’ and resulting overpayments recovered. Any such blanket approach could result in unlawfulness – for example, it would be unlawful to revise a decision where there is no statutory ground to do so. The DWP took the same blanket approach to the ‘retrospective verification’ of awards made during the pandemic, and CPAG is aware of decisions apparently taken in accordance with that blanket policy which were successfully challenged at the First-tier Tribunal without the DWP seeking to appeal further to the Upper Tribunal.
12ARA 2022-23 p107; Written evidence submitted by CPAG on the ARA 2022-23, CPAG, July 2023, Prior to any decision, if the award has been suspended advisers should consider whether the DWP is correctly using its suspension power – if not, then in these cases although there is no right of appeal, the available legal remedy is judicial review. Once an entitlement decision (eg, following suspension) has been made, claimants have a right of appeal, subject to the mandatory reconsideration requirement. Advisers assisting with revisions and appeals should ensure that they consider whether the DWP correctly applied the legislation on suspension and termination, and on revision and the effective date of supersessions.
13See cpag.org.uk/reverification-uc-awards, and Demands to Repay: the impact and legality of the DWP’s reverification of UC claims, CPAG policy briefing, available at cpag.org.ukEffectiveness
Thirty-two per cent of reviewed awards have so far been found to have contained inaccuracies, according to the DWP – which the National Audit Office (NAO) notes is similar to the level of incorrectness found in the DWP’s random sampling exercises.
14ARA 2022-23, pp307-8The DWP has identified uncertainties around assumptions on productivity rates of TCR activities and the value of overpayments detected. The DWP estimates a roughly constant rate of incorrectness identified – around 30 per cent – over the lifetime of the TCR, described by the NAO as a ‘conservative assumption’.
15HM Treasury, Autumn Statement 2022: policy costings, November 2022, p51, available at gov.uk; ARA 2022-23, p308Automation, data matching and machine learning
IRIS uses automation and data matching to identify cases to refer to the TCR. Data matching to investigate benefit fraud has caused problems and hardship in the past. It is worth noting that the TCR will make use of special category data (ie, particularly sensitive data which could include data concerning health, racial origin, etc) or data which reveals or concerns these types of data.
16FOI response (ref FOI2023/74247), 24 October 2023, . Interestingly, the TCR is a rare example of an initiative in which the DWP appears (as far as it is possible to tell, given the extensive redaction) to acknowledge some use of automated decision making (though apparently not in respect of stopping or awarding benefit) – see DPIA 2319. See also DPIA 2097, , and M Willis, 'Concentrix – lessons learned?', Welfare Rights Bulletin 255, December 2016.The DWP intends to improve its analytics to better target the TCR at awards that are more likely to be incorrect. The DWP intends to use machine learning to better target TCRs. But, although the DWP is developing and piloting new models, it seems that machine learning is not currently in use in the TCR.
17ARA 2022-23, pp304 and 307-8. ‘Analytics’ comprises a collection of activities designed to enhance DWP’s counter-fraud performance in various ways. These include work by IRIS to risk-score benefit claims and a new case management system and IT platform. The DWP has piloted models designed to prevent fraud in the key UC risk areas of people living together, self-employment, capital and housing. These pilots are currently on a very small scale: . FOI response (ref FOI2023/59392), 31 August 2023, .The NAO states that there is an inherent risk that machine-learning algorithms are biased towards selecting cases for review from vulnerable people or groups with protected characteristics.
18ARA 2022-23, p309The DWP says it is mitigating the risk of machine-learning bias by, first, ensuring that a human makes the decision and that false positives are included in the cases presented to decision makers and, second, that small-scale testing is carried out initially with analysis of any resulting bias. The DWP has committed to reporting annually on the impact of data analytics on protected groups and vulnerable claimants.
19Oral Evidence to the Public Accounts Committee, 18 September 2023, Q101, available at ; House of Commons Committee of Public Accounts report on the ARA 2022-23, November 2023, p19, available at