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Daily living - Activity 3: Managing therapy or monitoring a health condition

Activity 3 considers a claimant’s ability to: (i) appropriately take medications in a domestic setting that are prescribed or recommended by a registered doctor, nurse or pharmacist; (ii) monitor and detect changes in a health condition; and (iii) manage therapeutic activities that are carried out in a domestic setting that are prescribed or recommended by a registered doctor, nurse, pharmacist or healthcare professional regulated by the Health Professions Council. As with all the other activities, a claimant is to be assessed as satisfying a descriptor only if they can do so reliably.

Descriptors

The descriptors for Activity 3 are -

  1. Either - (i) does not receive medication or therapy or need to monitor a health condition; or (ii) can manage medication or therapy or monitor a health condition unaided. 0 points
  2. Needs any one or more of the following - (i) to use an aid or appliance to be able to manage medication; (ii) supervision, prompting or assistance to be able to manage medication; (iii) supervision, prompting or assistance to be able to monitor a health condition. 1 point
  3. Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week. 2 points
  4. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 3.5 but no more than 7 hours a week. 4 points
  5. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 7 but no more than 14 hours a week. 6 points
  6. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 14 hours a week. 8 points

Source: Part 2 of Schedule 1 to the Social Security (Personal Independence Payment) Regulations 2013 (SI.No.377/2013) as amended (with effect from 16 March 2017) by regulation 2 of the Social Security (Personal Independence Payment) (Amendment) Regulations 2017 (SI.No.194/2017), and Part 2 of Schedule 1 to SR.No.217/2016 in Northern Ireland as amended (with effect from 20 April 2017) by regulation 2 of the Social Security (Personal Independence Payment) (Amendment) Regulations 2017 (SR.No.69/2017).

NB - in Scotland, adult disability payment is replacing personal independence payment and the descriptors are found in Part 2 of Schedule 1 to the Disability Assistance for Working Age People (Scotland) Regulations 2022 (SSI.No.54/2022).

 

Definitions

Terms used in the PIP descriptors are defined in regulations and, in relation to Activity 3, are -

  • “aid or appliance” - (a) means any device which improves, provides or replaces [the claimant's] impaired physical or mental function; and (b) includes a prosthesis; 
  • “assistance” means physical intervention by another person and does not include speech; 
  • “manage medication” means take medication, where a failure to do so is likely to result in a deterioration in [the claimant's] health;
  • "manage therapy" means undertake therapy, where a failure to do so is likely to result in a deterioration in [the claimant's] health;
  • “medication” means medication to be taken at home which is prescribed or recommended by a registered - (a) doctor; (b) nurse; or (c) pharmacist; 
  • “monitor a health condition” means - (a) detect significant changes in [the claimant's] health condition which are likely to lead to a deterioration in [the claimant's] health; (b) take action advised by a - (i) registered doctor; (ii) registered nurse; or (iii) health professional who is regulated by the Health Professions Council, without which [the claimant's] health is likely to deteriorate;
  • “prompting” means reminding, encouraging or explaining by another person; 
  • “supervision” means the continuous presence of another person for the purpose of ensuring [the claimant's] safety; 
  • “therapy” means therapy to be undertaken at home which is prescribed or recommended by a - (a) registered - (i) doctor; (ii) nurse; or (iii) pharmacist; or (b) health professional regulated by the Health Professions Council; but does not include taking or applying, or otherwise receiving or administering, medication (whether orally, topically or by any other means), or any action which, in [the claimant's] case, falls within the definition of “monitor a health condition”;
  • “unaided” means without - (a) the use of an aid or appliance; or (b) supervision, prompting or assistance. 

Source: Regulation 2 of and Part 1 of Schedule 1 to the Social Security (Personal Independence Payment) Regulations 2013 (SI.No.377/2013) as amended (with effect from 16 March 2017) by regulation 2 of the Social Security (Personal Independence Payment) (Amendment) Regulations 2017 (SI.No.194/2017), and regulation 2 of and Part 1 of Schedule 1 to SR.No.217/2016 in Northern Ireland as amended (with effect from 20 April 2017) by regulation 2 of the Social Security (Personal Independence Payment) (Amendment) Regulations 2017 (SR.No.69/2017).

See also DWP guidance on Activity 3 in section 2.3 of the Personal Independence Payment assessment guide for assessment providers.

NB - in Scotland, adult disability payment is replacing personal independence payment and the definitions are found in regulation 2 of and Part 1 of Schedule 1 to the Disability Assistance for Working Age People (Scotland) Regulations 2022 (SSI.No.54/2022). See also Social Security Scotland guidance in Daily living component activity 3 for ADP - managing therapy or monitoring a health condition.

Case law

Commentary: the effect of [2016] UKUT 530 (AAC), in which Judge Mesher held that the definition of therapy includes treatment which consists of the monitoring of health and administration of medication, has been reversed by amendments to the PIP regulations from 16 March 2017 so that where a claimant needs supervision, prompting or assistance to be able to manage medication and monitor a health condition, this will only satisfy descriptor 3(b) and not any higher scoring descriptor. The amended definition of therapy from 16 March 2017 also excludes assistance applying topical medication so that [2015] UKUT 622 (AAC) is also no longer applicable.

The pre-2017 definition of therapy was also going to be considered by a three-judge panel of the Upper Tribunal on 21 May 2018 in a test case (concerning two cases, one of which had been determined by Judge Jacobs - [2015] UKUT 681 (AAC) - that has since been judged to be defective and set aside under the Upper Tribunal’s review powers and removed from the Upper Tribunal website as a result). However, the Secretary of State withdrew her appeal prior to the scheduled hearing, accepting that she was in error for excluding treatment which consists of the monitoring of health and administration of medication from the definition of therapy. She has also confirmed that she will need to review past claims to identify claimants who may have been underpaid as a result of her error.

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