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New Approach to UK Benefits Assessments

Discussion in 'General ME/CFS News' started by Bob, Sep 1, 2011.

  1. Bob

    Bob

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    I'd like to find out more about this. Has anyone seen any more info on it?

    I don't anything about this new approach to benefits assessments - I only know what I've read in this article.

    Here are some of the main points that I've picked out of the article...


    Spot checks on sick benefit staff ordered to be 'nicer'
    31 August 2011 Last updated at 18:22
    http://www.bbc.co.uk/news/uk-politics-14738007

    The coalition government asked Prof Harrington to review the test after complaints from disabled people, doctors, and charities that people were wrongly being found capable of working and losing benefit money as a result and that 40% of decisions were being overturned on appeal.

    Prof Harrington, a former professor of occupational health at the University of Birmingham, concluded there were serious problems with the assessment process and made a series of recommendations to improve it - all of which were accepted by ministers.

    The test is carried out by assessors from private firms - but the final decision on their fitness to work and which benefits people should receive as a result is taken by Job Centre staff.

    Employment Minister Chris Grayling recently told a Commons Select Committee that the medical assessment, conducted by healthcare firm Atos, has been "downgraded" in importance.

    Prof Harrington said the medical test was not the "be all and end all" but he stressed that claimants had to make sure that all corroborative evidence in their case was made available to be considered.

    The changes to the test would give greater authority to Job Centre staff, he added, to make their own decisions rather than just "rubber stamp" the outcome of the medical tests.

    They collect all the information from the claimant, they ask the claimant who is their preferred health care advisor.

    They collect the ATOS assessment, they bring it all together, and before they make a decision, they contact the claimant and say 'this is what I'm going to do, have you got any other information you want me to consider?'
     
  2. ukxmrv

    ukxmrv Senior Member

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    The problem for me is that the DWP didn't "consider" the evidence that I provided them with and even at the Tribunel stage my evidence was not "considered". They had very fixed beliefs and simply did not belive what was in the reports from a reputed NHS consultant.

    Obaining evidence can be very hard and very expensive for the patient. I was just lucky that I had some medical reports written for another purpose. I had no consulant who would write reports for free.
     
  3. Bob

    Bob

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    That was how I thought it worked, but the article suggests that this has now changed. I don't know how accurate the article is.

    Yes, that part worries me as well... It's a lot of hard work and effort to collate information and evidence... Especially when a patient is very ill... It seems that we will need to be expert patients to present our medical case... I hope they will provide us with professional advocates.
     
  4. Esther12

    Esther12

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    I don't have any real evidence related to my illness... other than that it definitely started with glandular fever. All the rest is personal testimony, and they can believe me or not. It's so frustrating being forced to play these stupid games. Luckily my GP is a nice guy. Not sure how much help that will be though.
     
  5. ukxmrv

    ukxmrv Senior Member

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    When I had my problems with DLA I noted that although I had specificied on the form the name of the medical expert that they should approach for some more information the DWP never did this.

    Putting the onus on the patient is going to be very expensive for us. Many ME patients do not have a consultant who will write a report or even a consultant who believes that ME is a physical disease.
     
  6. oceanblue

    oceanblue Guest

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    This comes from Prof Harrington's report which came out some time ago. Essentially he found that DWP 'Decision Makers' were just rubber-stamping the findings of the ATOS assessors, rather than treating it as one line of evidence. Harrington recommended that the 'Decision Makers' should be just that, judging the evidence from the applicant and any submitted medical evidence, as well as the ATOS findings. This recommendation was accepted - whether or not it makes any difference remains to be seen. I'll find out in the next few months.
     
  7. currer

    currer Senior Member

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    Hi,
    I used to work as a benefit advisor for DLA.

    Generally the claimant needs supporting medical evidence from a GP or consultant to back up a claim for benefit.
    The higher levels of benefit require a consultant report as a GP does not have sufficient status to swing the decision on DLA for example.

    It always was that supporting evidence could be sent in - maybe they tried to change this when they made the test harder and just relied on the ATOS report. So it looks to me as if they have just gone back to the earlier arrangement.
    Certainly, the medical report by the examining doctor was always inadequate, and someone with ME always needed extra evidence to clarify their level of disability as this always seemed to escape the notice of the doctor.
    Some people used to read out pre-written statements, (as our memories are bad,) or give extra evidence to the examining doctor.

    Remember most claimants will have huge medical files on their disability, operation notes etc. PWME usually have nothing to prove they are ill. Evidence is required. You can offer to pay a GP for a report as this job is not part of their NHS contract.

    You need firm statements on how you are affected in walking and daily care needs. This has to go down on paper.
     
  8. Firestormm

    Firestormm

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    Bob,

    Not sure what you are asking here. I did transcribe the Radio 4 programme if it helps?

    Professor Harrington is now engaging in his continuing review of the assessment process. This is what he said about visiting Job Centres (not 'spot checks' as part of any 'system' but for his own personal benefit to see if the changes promised are actually happening):

    BBC Radio 4 You and Yours Wednesday 31 August 2011

    iPlayer: http://www.bbc.co.uk/iplayer/console/b013q355

    05.09

    Linda McAuley: The man with the job of sorting out a controversial new test used to decide who will get sickness benefit has told this programme that he plans to make unannounced visits to Job Centers.

    Job Centers are the first port of call for anyone who wants to claim the new Employment and Support Allowance, Professor Malcolm Harrington will do the spot checks to see if changes hes already asked for are happening; and well be talking to him in a minute.

    But first our own Disability Specialist Caroline Atkinson has a bit of background on it, Carolyn:

    Caroline: Well the new benefit, Employment and Support Allowance, was brought in in 2008 and it replaced three other incapacity benefits. Now the way people are assessed for it has been really controversial and the Coalition agreed that it wanted to sort things out and it asked Professor Harrington to investigate.

    Its controversial because lots of people who insisted they were too ill to work, were being told they were Fine, and they lost their money, got less money, or they were told simply to Get a job. And weve had people contacting us on You and Yours, for example, with relatives assessed as being Fit for Work who died shortly afterwards as they were about to appeal.

    Now a more typical example though, could be somebody like Jenny Fletcher who has severe depression, and a number of physical disabilities, back in April I went to Portsmouth where she was having her Work Capability Assessment: thats the test you have to have. She previously failed two others, but one had been overturned and shed won the other on appeal.

    Now I waited outside the building for an hour and three-quarters, while she went inside with her Community Psychiatric Nurse and when she came out it had not gone well

    Jenny Fletcher [clearly upset]: We were told the assessment when we got in would be half-an-hour and when we got in the assessment he said No, its going to be at least an hour and a quarter. So weve just been messed around

    Caroline: All in all youre no further down the route?

    Jenny: No further down the route and feeling very angry as well as all the stress. Im just so wound-up now.

    Caroline: I spoke to Jenny again earlier this morning. I spoke to her to find out the latest

    Jenny: I eventually had my assessment on June 9. I didnt get any immediate response from the DWP. Six weeks later, all I had was a letter confirming my benefit. No reference to the assessment. So I asked for the medical report [from the Atos assessment] and I eventually go it.

    Caroline: And you have enough points so youve been put in deemed unable to work at the moment?

    Jenny: Ive been put into the Work Related Group. I am happy to have got enough points, but going through the report in detail I am not happy that the depression was the major thing that got me enough points to be declared Unfit for Work I think it was my other health problems [that should have been taken into account] and that really worries me.

    Caroline: Jenny Fletcher. Now charities and support groups up and down the UK have been extremely worried about this test as weve been reporting on the programme in Glasgow a GP who was noticing that some of her patients who she considered Too ill to work were going for the test and then were being told they were fine.

    Dr Margaret McCartney decided to investigate and she went off to a recruitment evening for new assessors they can be doctors, they can be nurses or physiotherapists and she wanted to find out more about how the tests are carried out.

    Shes written up her findings for the British Medical Journal and she told me why she took action

    Dr Margaret McCartney: I had noticed that I had been getting some reports through basically saying that my patients were no longer going to be entitled to benefits. On the basis of their recent medical assessment and I was surprised by some of these reports, and also perturbed.

    At that point I decided to just to do a little background reading and find out really what was going on and how these decisions were being made because it wasnt something I felt was concordant with my knowledge of the patients.

    Caroline: Now getting the tests right is crucial, not least because since April around 1.7 million on the old Incapacity Benefit have started being called in to see if they qualify to claim the Employment and Support Allowance. And in fact there are now 11,000 assessments roughly being carried out each month. But the criticisms do keep on coming.

    The Department for Work and Pensions Select Committee is less than impressed, it published a report earlier in the Summer saying the test is causing fear and anxiety amongst claimants and they say it leaves people saying the Governments only objective is to save money.

    Now the tests are done by a company called Atos under contract to the Department for Work and Pensions the doctors regulator the General Medical Council confirmed to me this morning, that there are currently 10 investigations going on at the moment relating to 8 doctors employed by Atos and that 2 of those cases directly relate to their work for Atos.

    Now the Government say there are listening, and listening intently, not least because at the moment around 40% of people who take their case to Appeal Win. And that figure is often higher if people are represented.

    At the Lib Dem conference next month they may end up debating a motion brought by Liberal Youth about the Work Capability Test but at the moment the Coalition is relying on Professor Malcolm Harrington, hes on Year Two of a Five Year Review and he wants to know from listeners what their experience has been. You have until Friday September 16 to get in touch and the details of how to do that are on our website.

    10.33

    Linda: Caroline Atkinson thank you. Well Professor Malcolm Harrington is here in the studio with me now. Professor Harrington you are going to spend some time hanging around in Job Centres, why?

    Professor Malcolm Harrington: Well, partly because, although I visited a number in the course of the first year and the second year, and this year Ive been to Aberdeen where the new IB [Incapacity Benefit] roll-out occurred; Ive also been to Plymouth twice, but I didnt want people to think I only went there when I went along and everyone knew I was coming and everything was fine because they would wouldnt they?

    So I got permission from the Department to give me a list of potential major sites say in the Southern England, just for logistical purposes, and I said I just want to turn up. I just want to go there for an hour, have a word with the manager and ask the decision makers, Have things changed for you? Is it better than it was? and if its not, Why isnt it?.

    Linda: Because you asked for a number of changes, didnt you? Youre not confident I take it that they are being implemented

    Professor: Theyve all been accepted. Every one

    Linda: By the Government though?

    Professor: By the Government. It is now DWP policy to implement all the changes from the first year recommendations. That includes the ones relating to Atos because Atos are under contract to the DWP and so that will happen on that basis

    Linda: So changes to the test, Atos should be looking at. What should be happening at the Job Centres then?

    Professor: They should be less mechanistic and more human about the way in which they handle people

    Linda: Nicer to people?

    Professor: Nicer to people. Theyve changed the telephone system, theyve changed the words they use from the call centre, theyve changed the wording on the letters. Theres more opportunity to have a dialogue with the claimant and so now the claimant is now told early on what it is they expect to have happen.

    And most importantly of all I want to emphasise to your listeners, is that the Atos test if I may call it that is not the be all and end all of this assessment. Its only part of it, its not even the major part now.

    The really important thing is for the claimant to make sure all the corroborative evidence they want to be considered in their case is made available.

    Linda: Because at the beginning they did the test and assessed you didnt they? Without looking at any corroborative evidence? Am I right?

    Professor: You cant guarantee that at the Atos assessment they will look at corroborative evidence. Some of them do some of them dont. But theres a very important person in this whos called the Decision Maker. And the Decision Maker needs to make decisions. And up until now a lot of them have been rubber-stamping the Atos assessment.

    What I want to have happen and they are being trained to do this and the ones I have spoken to really like the fact of being empowered they are now in the centre of this. They collect all the information from the claimant. They ask the claimant who is their preferred healthcare advisor. They collect the Atos assessment.

    They bring it all together and then they make a decision. And before they make that decision they contact the claimant and say, Look this is what I am going to do. Have you got any other information you want me to consider? Now that I think will be a fairer and more effective assessment and should involve less people going to appeal, because they feel they have had a decent deal.


    Linda: Now you are asking for evidence. Who is it in particular you want to hear from? Because you have been suggesting these changes havent you, theres no point taking evidence from people who were assessed ages ago, is there really?

    Professor: No. Youre absolutely right. And I think the point that Caroline made earlier is the fact that looking at what happened to people in April, probably is not relevant any more.

    Now I dont expect this to have occurred right throughout the county, I had a number of meetings with the major charities and support groups earlier this month; and some of them said Yes I have seen some changes and others I think more circumspectly and more reasonably said, No but I expect them to come and some are just saying Nothings happening. Now it could be that nothings happening because, nothings happening it hasnt been rolled-out to that particular part of the country but if itsby the end of the year we are not seeing some positive effects I would be astonished! Because it is happening.

    The training is taking place and quite frankly, the people who are doing it want to do it. I mean some of my recommendations have actually been improved by being rolled out by the JCP [Job Centre Plus] and there are now saying, Well why dont we do this? I think this is a better way and I said terrific!

    Linda: Professor Harrington, thanks very much for coming in and there is a link to your website Gathering information on our website. We asked the Government for a contribution. They say, as Professor Harrington has just said, We are committed to ensuring the Work Capability Assessment is fair and accurate.

    Thats why we will keep it under independent review for five years to make sure its working properly. We have accepted all the suggestions made by Professor Harrington in his First Review, and we are looking forward to receiving his Second Review later on in the year.

    These reforms are vital and they will allow us to help those who can work, into work and to continue to support those who cannot.
     
  9. Bob

    Bob

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    Thanks very much Firestormm. I'll read your text this evening.

    I haven't heard or read anything else about the change in approach to making assessments for benefits, so I was just after more info.

    To my knowledge, in recent times, the assessment decisions have been purely based on the ATOS examination, but this now appears to have changed.

    Thanks again for the extra info.
     
  10. justy

    justy Donate Advocate Demonstrate

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    Purely anecdotal but a couple of months ago i was asked to send in another medical form for ATOS, this then ususally leads to a medical which i have always passed (for ESA never tried to claim DLA) this time though i have not been asked in for another medical and have had a letter from the job centre saying how much my ESA will be for the next 6 months. I dont know if this means they arent always doing medicals but this time i really went to town on the form and stated over and over that whilst i could do most things once i couldnt do them repeatedly.
    All the best! Justy x
     
  11. Bob

    Bob

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    Thanks Justy. That's helpful. Your situation sounds similar to mine.
     
  12. Firestormm

    Firestormm

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    I have submitted the ESA50 Questionnaires and had no medical at times. Though mainly I have had the medical and then hear nothing unless I 'fail'.

    This happened in February, and I appealed. I won the appeal yesterday. Not really a cause for celebration is it? Hard to know what to call it really. 'Justice'?

    Anyway, there are parts of the process I would like to see changed on top of what I have read from Harrington to date, and I will be submitting a proposal to him shortly.

    The link to do this is contained in this article from the Guardian: 6 September: http://www.guardian.co.uk/society/2011/sep/06/no-turning-back-work-capability-assessment?INTCMP=SRCH
     
  13. Esther12

    Esther12

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    Yes! Even if it shouldn't be. I'm celebrating for you - sorry you had to go through so much trouble for it though.
     
  14. Firestormm

    Firestormm

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    Thanks Esther12.

    I am afraid the pressure the CAB are under (as my advocates) for those who don't know was the main reason it all took so long - from February until yesterday (with one postponement at my instigation). Too much shirking of responsibility by the Government onto the Third Sector if you ask me - not to mention legal aid budget cuts - grumble grumble...
     
  15. Esther12

    Esther12

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    I'm filling in forms on my own at the moment - I've had new medical news this week which means I may have to re-do loads... the deadline's approaching, I've not got advocates.

    I'm doing a bad job, perhaps because I resent the stupidity of the system and my need to conform to it. I need to start being smarter about it.
     
  16. Firestormm

    Firestormm

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    This for an appeal then Esther? Either way I do wish you luck. Shouldn't have to of course but with this system it does come it handy. Have you had any support?
     
  17. Esther12

    Esther12

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    My initial application. I feel so certain that I'll be turned down up to a tribunal appeal that it's robbed me of all motivation with the form. A bit lazy and stupid... ah well. Hopefully it will go okay. Ta.
     

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