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Friday, 7 October 2011

Atos - status at 06-10-2011

Dear Ms               ,

A few matters arise from your note below and a few remain outstanding, so I will summarise below.  This covers correspondence with both you and your colleague Christine.  I have incidentally already read ESA214, which does not help.

I have confined my comments here to either information provided directly by your staff or material AH places in the public domain.  There is no reason therefore why you cannot address them without reference to DWP.

1.      Context: 
The “Benefit Assessment Process” is largely based on the WCA performed by Atos which has twice assessed me wrongly and required subsequent correction.  The only person that has suffered by this is me – no skin off Atos’s nose, no retribution, no financial penalties, absolutely nothing!  Even its complaint process takes so long and is shrouded in such secrecy, that my third WCA has arisen before my complaint over the second has been resolved.  It is therefore not surprising that “I continue to be dissatisfied” as you put it.  It would help if the matters I have raised were dealt with directly rather than avoided or ignored.

2.      Descriptors:
Atos describes itself as “the UK’s number one Occupational Health (OH) provider”, so it is perfectly reasonable to expect it to have a professional view/opinion on a whole range of matters related to occupational health.  As you will know, at some stage earlier this year, the descriptors were altered and being experts in the field, AH will be able to explain on what evidence and scientific basis these changes have been made.  AH will still have a professional opinion whether or not the alterations were initiated or finally agreed by DWP.

a.       One of the most conspicuous changes is the removal of any reference to bending and kneeling (first raised 22/09/2011).  At my third WCA your HCP explained that these movements are no longer considered relevant in the “modern workplace”.  She said this despite having to bend and kneel to complete the examination.  I would therefore like you to confirm:
                                                               i.      whether what she said was just her personal opinion or is a corporate view held by AH – it can only be one or the other?
                                                             ii.      In either case, precisely what corrective action will you will be taking?
                                                            iii.      What specific steps you have taken within Atos as a whole to eliminate need to bend and kneel.
                                                           iv.      What pressure is being applied to all UK employers to take similar steps and what AH is doing to promote these moves.

There are in fact other scenarios, but please do not send me any more links to generalised documents:

·         You could tell me that you cannot answer the question, meaning you do not have the requisite expertise.  If this is the case, you will of course need to change your claim about leading the UK in the area of occupational health.

·         You could just refuse to answer the question, in which case I would like to know why and who in your organisation has sanctioned the decision.  It is clearly quite a serious issue for you to dismiss claimants in this manner given your “Customer Charter” etc.

b.      The walking descriptor for one measure refers to being able to ascend/descend 2 steps.  In the context of performing a typical job, what is the specific importance of 2 steps?  Although not directly relevant to AH, you will be aware that the points associated with this “2-step” issue have been reduced from 15 to 9, indicating that it is now seen as less important in terms of limiting one’s capability.  On what basis have you reached this conclusion  i.e. what has changed?

c.       The standing and sitting descriptor has been radically overhauled.  The first “benchmark” is now 30 minutes.  (was 10 minutes) and worse-case has been reduced from 15 points to 9, so is seen as less of an issue.  Again, what evidence can you call upon, empirical or theoretical, to support this view?  If there is none, your motivation becomes quite obvious and your promise to be “fair and accurate” as expressed in your Charter is worthless.  AH presumably wishes to maintain its professional integrity, so cannot hide behind only doing what DWP tells you to do – it must have a view of its own.

3.      Assessment
Exactly what assessment an HCP does (medical or work capability) is not just semantics, but is key to a number of other issues not least of which is value for money – as you know, AH is paid from public funds.  Unfortunately, from your note below, I am now even more confused. 

Your website blog says you perform a WCA, which in line with your note below i.e.  that the HCP makes a recommendation to DWP as to whether a person is able to work or not, but your HCP was quite clear that she would NOT be making any form of recommendation, just providing a list of medical statistics based on asking questions about my day to day activities and a short physical examination.  It may be the case that DWP finally decides on benefit entitlement, but it is important to know whether Atos just provides data or a work capability recommendation.  If there is any dispute about what Ms Jephcott said at my assessment my wife will confirm my synopsis.  It was very significant at the time as her response allowed her to rebuff some questions I had about the WCA.

In addition your statement about a doctor’s aim is fundamentally wrong as you are saying that their role is complete once a diagnosis has been made and treatment administered.  If this were the case, there would be no concept of post-treatment care, God forbid.  Clearly a doctor’s objective is to return their patient to as normal a life as possible and if working is an integral part of the recovery plan doctors can be relied upon to ensure it happens as far as they can.  To suggest as you are that doctors are not as inclined to declare patients fit for work when they should, indicates that you believe they are not acting in the patients best interests.  You cannot have it both ways.

I have been through three WCAs and I can absolutely confirm that no special skills in the area of disability assessment were brought to bear.  My GP, his physiotherapist or any of the nursing staff at the practice could well have performed every task your HCP did and regularly do.  Suggesting that some special powers are required is a nonsense. 

As an aside, I have a grave concern that some of your HCPs do not have anywhere near enough clinical experience to adequately understand the massive range of conditions they will inevitably come across and to suggest that the assessment objectives are “different” and can be distilled down into a superficial WCA is disingenuous at best, fraudulent at worst.

You refer in your note to “everyday work-related activities”.  Please explain more precisely which specific parts of the HCPs assessment are “work-related”.

Work of any kind has certain common, fundamental characteristics, for example, the requirement to arrive and depart at fixed times each day.  Do you as occupational health experts in AH believe that they should feature more prominently in your assessments? 

4.      Revised WCA Handbook – version 3 Final
I believe this document was authored by Atos, although signed off by DWP, so you are well placed to comment upon its content.  It contains many assertions that instruct HCPs how to interpret certain information, which give rise to a number of questions.  Referring to just one for the time being:

“ a person who can walk around a shopping centre/supermarket is unlikely to be limited to walking less than 800 metres although consideration must be given to the speed of walking, stops and pauses etc”

·         What evidence can you provide to confirm this assumption – it has to be documented somewhere to have any credibility? 
·         It say “unlikely” not “cannot”.  What steps would you expect an HCP to take to resolve this dilemma?
·         Supermarkets vary widely in size with differing amenities.  What steps do you expect an HCP to take to ensure that the claimant fully understands the question and the consequences of their answer?

5.      HCP Standards
On Aug 13th 2011, the Guardian newspaper reported that 12 of your HCPs were under investigation by the General Medical Council.

·         Is the report correct?
·         What was the outcome – were any of the 12 re-instated?
·         Have any further cases come to light since?
·         In total how many HCP have you had cause to dismiss for some form of misconduct?
·         What specific changes have you made to your recruitment strategy?

6.      Independent Tier – outstanding
Please see my email from 27th Sept attached – 4 easy questions.

7.       Other Correspondence
Your colleague Christine is helping me with the second email attached. (dated 4/10/11).  You can ignore 3) & 4) in it as they are incorporated in point 4 above here.  1) & 2) are outstanding.
  
8.      (NEW) Appointments
You have a policy of overbooking appointments.  Do you assign a fixed time for each and if so, what is it?  If variable, what criteria are applied and how do the allotted times then vary?  My appointment was at 13:15 on 23/09/11.  How much time had you allowed?

I would like clear and point by point responses to this note.  If you feel this is not possible, I would like you to tell me why.  As I have said earlier, Atos is paid large amounts from the public purse for which it takes on certain accountabilities and responsibilities, which is what I am trying to clarify here.  I see no reason why the FoI Act is relevant – if you think it is, again you will have to explain why when everything I have raised here as  based on information you have already disclosed about Atos operations, which I am only seeking to clarify.

Some, but not all of the points here are relevant to whether or not I refer my complaint regarding my WCA in Feb 2011 to the IT, so a prompt reply from you is important.  It may seem odd to be pursuing a complaint about something that has been superseded,  but I am concerned that the failures it has revealed are endemic and therefore still need to be addressed.

Yours sincerely

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