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Tuesday, 16 April 2013

GPs' PIP Report

This is the form GPs have been told to use for PIP assessments' reports. For each completed form the GP will get £33.

Your Report

Patient’s name & National Insurance Number

Date when patient last seen by a health professional
/ /

Where and by whom

Please record relevant information based on your knowledge of the patient and their medical records.
Please write down facts rather than opinion. We require an objective report - please only include information about symptoms that are recorded in the patient’s records and information about disabling effects that you or another healthcare professional have directly observed.
It may be helpful to your patient to enclose any relevant correspondence contained in their file – for example, recent consultant letters or letters from a Community Mental Health Team. Please ensure that any third party information is removed. Third party information is any sensitive information that refers to someone other than the patient – for example, the patient’s family.
Please complete all sections as fully as possible but write “not known” if appropriate. “Not known” can be helpful.
Relevant information is anything that relates to health conditions or disabilities which impact on the patient’s functional ability.

1. Disabling conditions
Please list conditions or impairments which affect the patient’s functional ability.

2. History of condition(s). Include details of any relevant special investigations

3. Symptoms and variability
This is especially helpful in conditions that fluctuate. It should be based on information in the clinical record. Include both day-to-day and longer-term fluctuations. Include the frequency and duration of exacerbations. Please also specify if the condition is well controlled.

4. Relevant clinical findings
Entitlement is based on the impact of the individual’s impairment or health condition(s) on their everyday life. Please provide details of examination findings related to the severity or impact of any health conditions or impairments.

5. Treatment – Current, planned, response and prognosis
Please provide details of drug and non drug treatment and aids and appliances used (prescribed or, if known, non-prescribed). Please specify frequency of treatment and, for medication, dose as relevant.

6. Effects of the disabling condition(s) on day to day life

7. Does the patient have a history of threatening or violent behaviour?

No Yes Don’t know

8. Could your patient travel to an assessment centre by public transport or taxi?

Yes No Don’t know

9. Additional information
Use this section if there was insufficient space in one of the previous boxes OR to add important relevant factual information that has not been written in the body of the report. Do not use the section to provide an opinion.

I understand that, in certain circumstances, this report will be released to my patient, their legal representative and any authority deciding an appeal in relation to their entitlement to benefit. I also understand that the only information that can be withheld is medical evidence that would be harmful to the person’s health.

Your signature

Name in capitals


The comment by one GP says the form is illegal.



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The Tough Tenor (when I could walk)!

In a Mellotone

In a Mellotone
Ah sweet Youffff