Request

Table B of Sch 1 to the National Health Service (Travelling Expenses and Remission of Charges) Regulations 2003 provides for amendments to the standard Income Support criteria when calculating requirements as they apply to the Low Income Scheme. Amendments include a substituted reg 11 an additional reg 11A (1)(b) and (2)(d)(iii) which effectively creates an additional category of entitlement to the disability premium irrespective of claims where a claimant has been "incapable of work and has been incapable of work for a continuous period of not less than 28 weeks",

1) I would be grateful if you could, provide copies of guidance:

a) with regard to the way in which this criteria is assessed

b) as to what evidence of "incapacity" in deemed acceptable normally

2) If only fit/sick noted provided to employers/DWP are accepted as proof of "Incapacity" what is the legal basis for this definition

3) Over the last year for which records are available how many awards of the disability premium have been made where the applicant:

a)was not

b) was

in receipt of Personal Independence Payment, Attendance Allowance, Disability Living Allowance, Employment and Support Allowance or Limited Capability for Work in respect of a Universal Credit claim.

Only if this is possible within the budget allocated to this task, please provide this information for the 5 boroughs of The Tees Valley Combined Authority (Darlington, Hartlepool, Middlesbrough, Redcar & Cleveland and Stockton-on-Tees)

Response

Question 1

Under Section 21 of the FOIA we are not required to provide information in response to a request if it is already reasonably accessible to you.

The information you requested is available at https://opendata.nhsbsa.net/dataset/foi-03079

You can find the information on the “R - Claims Assessment Manual v67” document at the bottom of the weblink.

The relevant section in the manual is Section 1.054.

Please see the following link to view the section 21 in full - https://www.legislation.gov.uk/ukpga/2000/36/section/21

Question 2

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA.

The assessment of incapacity for work, acceptable evidence, and the legal basis for such determinations fall under the remit of the Department for Work and Pensions (DWP). Similarly, statistical data on awards of the disability premium and related benefit entitlements is also held by DWP.

They can be contacted at the following address:

By email

Email: freedom-of-information-request@dwp.gov.uk

By post

Freedom of Information requests

Department for Work and Pensions

Caxton House

Tothill Street

London

SW1H 9NA

United Kingdom

Question 3

The NHSBSA does hold the requested information; however, we estimate that the cost of compliance with the request would exceed the appropriate limit under section 12 of the FOIA.

We estimate that the cost of complying with your request would exceed the non-central Government limit of £450. The limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 and represents the estimated cost of one person spending 18 hours in determining whether the NHSBSA holds the information, and locating, retrieving, extracting and checking the information.

Please see the following calculations which sets out the estimated cost for compliance with this request:

We would need to manually interrogate each record to see how many awards of the disability premium have been made.

148,545 claims submitted for the financial year of 2025/2026 × 5 minutes (on average) per record = 742,725 minutes (12,378 hours)

Please be advised that due to the way that the information is held by the NHSBSA, it is not possible to submit a refined request under the appropriate limit.

Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.

Reusing the data and copyright

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2025” This information is licenced under the terms of the Open Government Licence:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.