PIP/4 points scores

Reliably, in a timely fashion, repeatedly and safely

An individual must be able to complete an activity descriptor reliably, in a timely fashion, repeatedly and safely; and where indicated, using aids and appliances or with support from another person (or, for activity 10, a support dog). Otherwise they should be considered unable to complete the activity described at that level.

  • Reliably means to a reasonable standard.
  • In a timely fashion means in less than twice the time it would take for an individual without any impairment.
  • Repeatedly means completed as often during the day as the individual activity requires. Consideration needs to be given to the cumulative effects of symptoms such as pain and fatigue – i.e. whether completing the activity adversely affects the individual’s ability to subsequently complete other activities.
  • Safely means in a fashion that is unlikely to cause harm to the individual, either directly or through vulnerability to the actions of others; or to another person.
Risk and Safety

When considering whether an activity can be undertaken safely it is important to consider the risk of a serious adverse event occurring. However, the risk that a serious adverse event may occur due to impairments is insufficient – there has to be evidence that if the activity was undertaken, the adverse event is likely to occur.

Aids and appliances

The assessment will take some account of aids and appliances which are used in everyday life. In this context:

  • Aids are devices that help a performance of a function, for example, walking sticks or spectacles.
  • Appliances are devices that provide or replace a missing function, for example artificial limbs, collecting devices (stomas) and wheelchairs.
  • The assessment will take into account aids and appliances that individuals normally use and low cost, commonly available ones which someone with their impairment might reasonably be expected to use, even if they are not normally used.
  • Individuals who use or could reasonably be expected to use aids to carry out an activity will generally receive a higher scoring descriptor than those who can carry out the activity unaided.
Support dogs

We recognise that guide, hearing and dual sensory dogs are not ‘aids’ but have attempted to ensure that the descriptors capture the additional barriers and costs of needing such a dog where they are required to enable individuals to follow a journey safely.

Support from other people

The assessment will take into account where individuals need the support of another person or persons to carry out an activity – including where that person has to carry out the activity for them in its entirety. The criteria refer to three types of support:

  1. Assistance is support that requires the presence and physical intervention of another person i.e. actually doing some or all of the task in question. This specifically excludes non-physical intervention such as prompting or supervision which are defined below. To apply, this only needs to be required for part of the activity.
  2. Prompting is support provided by reminding or encouraging an individual to undertake or complete a task but not physically helping them. To apply, this only needs to be required for part of the activity.
  3. Supervision is a need for the continuous presence of another person to avoid a serious adverse event from occurring to the individual. There must be evidence that any risk would be likely to occur in the absence of such supervision. To apply, this must be required for the full duration of the activity.

Within the assessment criteria, the ability to perform an activity ‘unaided’ means without either the use of aids or appliances or assistance/prompting/supervision from another person.


Epilepsy is a marked example of a fluctuating condition where an individual can have no functional limitation one minute and considerable limitation the next. Assessment should be based on the impact this causes. Key to assessing individuals with epilepsy is the consideration of risk. Within each activity, the relevant descriptor should apply to a person with epilepsy if there is evidence that a serious adverse event is likely to occur if the person carried out the activity in that descriptor. It is essential to consider the likely effects of any seizure – type and frequency of fit, associated behaviour, the post-ictal phase and whether there is likely to be sufficient warning to mitigate any risk of danger