Guidance for NHS staff on writing support letters for patients for applications for PIP or ESA.

Doctors and other NHS professionals in England are often asked to write in support of patients applying for benefits such as Personal Independence Payments (PIP) or Employment Support Allowance (ESA); which support people with disabilities and long-term health conditions.

These benefits are vital for people suffering from long-term health conditions and disabilities, offering them financial help that can significantly improve their wellbeing and quality of life. Given the critical nature of these benefits and the stringent criteria often applied during the assessment process, the letters we write can play an essential role in securing this much-needed support for our patients.

Here is some guidance on how to write a more effective and relevant letter of support based on my long experience as an NHS doctor in writing such letters.

1. Introduce yourself and describe your relationship to the patient, including how long you have known them and in what capacity. This will help establish your credibility as a reliable source of information in support of their application for a personal independence payment or another state benefit.

2. Provide a detailed description of the patient’s medical conditions, including any diagnoses they have received, how their medical conditions affect their daily life, and any symptoms they experience. Focus on the most relevant conditions to their application first. For example, if the patient is applying for PIP due to mobility problems, you should focus on their mobility impairments and how they affect their daily life and ability to work. Also include any medication they are taking and any past medical or surgical interventions.

3. If the patient is applying for Employment & Support Allowance (ESA), explain how their medical condition affects their ability to work. Describe any physical or cognitive limitations they have, or how their symptoms interfere with their ability to perform tasks required for their job. Aim to give precise descriptions of their conditions; for example if they have heart failure, what is the severity?

4. When describing how the patient’s condition impacts their daily life, focus on the activities of daily living that they have difficulty with. For example, you could mention if they have difficulty dressing, bathing, cooking, shopping, cleaning, or managing their finances. Also describe any problems the patients has in managing their health and their medical conditions.

5. Use specific examples to illustrate how the patient’s condition affects their daily life and ability to work. For example, you might describe a time when the patient experienced a symptom flare-up that prevented them from completing a task at home or attending work.

6. Emphasize the patient’s need for financial support through benefits such as PIP or ESA. Explain how this support would help them manage their condition and improve their quality of life. With the cost of living crisis, these benefits are now essential for many people.

7. Remember to keep the letter factual, polite, concise and to the point, and to focus on the patient’s medical conditions (both physical and mental health problems) and how they impact their ability to work and carry out essential daily activities.

Some doctors argue they should not be writing such letters as they detract from the time available from providing core medical services. But obtaining support from a PIP or ESA can improve a patient’s well-being, which ultimately is also beneficial for the NHS and society.

In England, the NHS is funding social prescribers to work with general practices and writing such letters of support is often delegated to these social prescribers who can take over this task from health professionals such as general practitioners and therapists.

Financial problems will have a big impact on people’ health and well-being and it is important that NHS staff do their best to support patients who have difficult financial circumstances because of their health problems.