UK Work Capability: Update on joint efforts by ME Charities to influence change in assessments

[Firestormm]

Morning

Y'all are probably aware of the ongoing work that has been taking place between several representatives of ME organisations, other groups representing fluctuating conditions (and mental health charities) and the DWP to try and change the current WCA to make it fairer and more relevant.

These - largely unsung efforts - are bearing fruit. At the recent Forward ME Group meeting, the following was revealed by way of progress:

1. WCA Evidence Based Review (EBR) – sent in by Dr Charles Shepherd

· Fluctuating conditions group (FCG) and mental health group (MHG) working well together – meeting quite regularly, including a visit to DWP to meet Mark Hoban MP on April 30 to discuss benefit concerns

· EBR Scrutiny Group is being chaired by Professor Malcolm Harrington

· Dr Paul Litchfield – Chief Medical Officer at BT – appointed in his place. Will carry out 4th and 5th reviews of WCA. FCG and MHG asked for a meeting with him when we were with Mark Hoban. Possible invite to Forward ME?

· EBR about to start in Atos examination centres in Manchester and Newcastle

· 1000 claimants with a wide variety of conditions will be assessed over the next few months – approx. 100 cases per week

· Aim to include significant numbers from those represented by FCG and MHG – especially less common conditions like PD; Booster Groups

· Participation is voluntary

· Two assessments – first is the current WCA followed by the one produced by FCG and MHG

· Fitness for work in these cases will be also be assessed by 30-40 Expert Panels consisting of doctors, occupational health experts, physiotherapists etc – nearest DWP can get to ‘Gold Standard’

· EP decisions will be quality assured by a smaller number of Quality Assurance Panels with condition specific expertise ME/CFS??

· But ……..we have concerns about some of the information and guidance being given to the Expert Panels

· Fitness to Work
· Positive: There has been movement in defining what constitutes fitness for work – must be able to work at least 16 hours per week and for majority of the time – which is based on JSA
· Concern: about the way in which various ‘reasonable adjustments’ to work could be producing an over-optimistic decision on capability to work
Eg: Use of ‘Disability Leave’ which is good practice but not legally enforceable under to 2010

Equality Act, as well as working from home
· Further concern: Not bringing in the ability to travel to/from work – still trying to get this inserted
· Aim is to publish interim report/results in August and recommendations in early 2014

14 May 2013 Forward ME Group Minutes.

So it looks to me like they will be trialling these new assessment methods, and then the results will be analysed by a host of experts.

I thought the attempt to define 'work' is also a positive move. Hadn't encountered that one before and it should be part of any assessment i.e. can this person actually work for 16 hours a week.

Of course I suppose it then means they would be looking at a 'model job'. Any thoughts?

 

[Valentijn]

Of course I suppose it then means they would be looking at a 'model job'. Any thoughts?

I think it's the usual problem: an employer doesn't want to hire someone who can work sometimes 3.2 hours per day (16 per week) under ideal conditions. I probably could work that much per day if it's 1) from home, 2) broken into half-hour chunks throughout the day with hour-long rests between, and 3) I pace so awesomely (never leave the house, cook for myself, clean up at all) that I never crash again.

And I think even mild-moderate cases will have the same problem. If they're crashing at all, they are an unreliable employee, and they'll be performing best with lots of accommodations. Why hire a likely liability when there's plenty of unemployed healthy people with the same training and skills?

 

[Simon]

Like Fire, i thought the move to define what is 'work' is a step forward. Up til now, there has been no attempt to justify the WCA in terms of real life.

 

[Esther12]

How about they calibrate it based on the actual results of their work programme?

If less than 50% of those in the WRAG group are able to find some paid employment in a year, then they should loosen the levels of disability required to qualify for support and wrag group. I think it's currently around 5%.

 

[Firestormm]

Like Fire, i thought the move to define what is 'work' is a step forward. Up til now, there has been no attempt to justify the WCA in terms of real life.

How about they calibrate it based on the actual results of their work programme?

If less than 50% of those in the WRAG group are able to find some paid employment in a year, then they should loosen the levels of disability required to qualify for support and wrag group. I think it's currently around 5%.

Apparently the 16 hours comes from something already attached to ESA (according to Dr Shepherd). I hadn't come across it before; but it gives me a better idea of what might be expected.

He also said on Facebook yesterday:

There does at least appear to be an acceptance that you have to be capable of 'working' for at least 16 hours a week on a regular basis......

Not that I would like to test this in any assessment of course: 'I can't possibly work for 16 hours a week!' It's never really come up. Must be one of those 'unwritten' 'unasked about' rules that may/may not be applied - bet you couldn't win an appeal based on it. Wouldn't know how to go about winning an appeal on it.

Edit:

Laurence Robertson, Conservative MP for Tewkesbury, tabled this question:

To ask the Secretary of State for Work and Pensions what assessment he has made of the adequacy of training in myalgic encephalomyelitis and chronic fatigue syndrome received by medical practitioners and assessors employed by Atos Healthcare to carry out work capability assessments.​

A written answer was supplied by DWP minister Mark Hoban MP on 24 June 2013. He wrote:

DWP recognises Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) as a real and potentially significantly disabling condition. The assessment of individuals with CFS/ME or any other condition is not dependent on their classification but rather on the disabling effects of the condition.
All health care professionals who undertake assessments on behalf of DWP are required to read an evidence based protocol on CFS/ME as part of their induction training. All health care professionals are required to engage in a programme of continuing medical education which includes modules on CFS.
While the role of the examining health care professional is not to diagnose they are expected to elicit clinical signs relevant to a function assessment. Features such as pain, fatigue and repeatability of symptoms are all considered.​

I would have said 'repeatability' i.e. the fluctuating degree of disability - but I think he means the same thing.