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Saturday, 8 September 2012

WCA - A call for evidence - Year 3 Independent Review

The Work Capability Assessment – A Call for Evidence: Year 3 Independent Review – Questions

Question 1

a) Have you had more than one WCA?

b) Was your most recent WCA:
(Please select only one)
·         A reassessment of an existing Incapacity Benefit (IB) award?
·         A new claim for Employment and Support Allowance (ESA)?
·         A repeat (second or third) WCA having already been awarded Employment and Support Allowance?
If you answered YES to Question 1a), please go to Question 2
If you answered NO to Question 1a), please go to Question 9

Question 2

Please tell us where you live in Great Britain
(Please select only one)
1.    South East England
2.    South West England
3.    North East England
4.    North West England
5.    Midlands
6.    Scotland
7.    Wales

Question 3

Were you assessed for:
(Please select only one)
1.    A mental, intellectual or cognitive condition or disability
2.    A physical health condition or disability
3.    Both

Question 4

What was the outcome of your award?
1.    Found fit for work (for the 3rd consecutive time)
2.    Work related activity
3.    Support group


Question 5 (communications)

a) Thinking about the start of your claim, were there any changes in the telephone contact between you and DWP between your first and your most recent WCA?
(Please select only one)
·         There has been an improvement
·         It was not as good
·         There was no change – equally disinterested.

b)  Between your first and your last WCA, did you notice any changes to the written communications which DWP sent you?
(Please select only one)
·         There has been an improvement
·         It was not as good
·         There was no change – certainly not of any consequence.

c)  The ESA50 form has been amended; please can you tell us if you think:
(Please select only one)
·         There has been an improvement
·         It was not as good.  Changes to descriptors were completely unjustified and were simply intended to cut points.
·         There was no change
Please use this space to tell us anything that is relevant to communications during the WCA process
Frankly dreadful.  The DWP notification that my ESA had been stopped was slow coming and arrived AFTER I had obtained a copy of the ESA85, so I knew what was coming.  It effectively stopped my ESA retrospectively – i.e. 3 weeks before the date of the notification.
There was no phone call to explain the decision at any point and I had to chase DWP around to find out what was going on.  They admitted receiving but completely ignoring the detailed letter of complaint I had sent to Atos when making their decision.  It was only through pressing during these phone calls that I unearthed the “hypothetical wheelchair” deception used to assess mobility and the inconsistencies around it.  I was and still am staggered that this trick is deemed acceptable.

Question 6 (face to face assessment)

a) Was there a notable difference between your first and your most recent face to face assessment?
·         First was better – still not good, but better than the two that followed, primarily because it was a doctor not a nurse.
·         Last was better
·         There was no difference
Please use the space below us to tell us anything else that you think is relevant to the face to face assessment
For my last WCA, the HCP could not have been less interested.  She made not note of the information I had taken with me, had clearly not completed the file-work thoroughly and was not at all conversant with the consequences of my condition & treatment.
Through minimal research it became apparent that this was not her main source of income, which perfectly explained her overall approach and attitude.
She made no attempt to follow even the most basic instructions in the WCA handbook.

Question 7 (decision making)
a) Since your last WCA, did you notice a difference in the way in which the outcome of your WCA was communicated to you by a decision maker?
(Please select only one)
·         There has been an improvement
·         It was not as good.  Although the message was broadly the same, DWP staff were far more aggressive and dismissive in dealing with my challenges.
·         There was no change

b) If you provided additional evidence in support of your claim (e.g. from a GP, consultant or support worker), was this evidence taken fully into account by the decision maker?
(Please select only one)
·         Evidence was considered and it changed the original decision
·         Evidence was considered and it did not change the original decision
·         Evidence was supplied but not reconsidered.  She ignored it completely and did not even record that I had brought it with me.
·         Not applicable
Please use the space below us to tell us anything else that you think is relevant to the decision making process
See below.  You have to start by working out what the REAL decision points are and who is best qualified to make them.
There is not one single area where DWP claims to have made improvements that they can support with any hard evidence whatsoever – it is all just intuitively wishful thinking.

Question 8 (Organisations)N/A

This section should only be completed if you are responding on behalf of an organisation. The call for evidence has been designed specifically with the experiences of the claimant in mind but the Department is aware that organisations may also want to contribute to the call for evidence. Please use this section to comment on the experiences that people you represent have been experiencing since the introduction of Professor Harrington’s recommendations. You are asked to describe each part of the process, using bullet points to summarise the individual parts of the process. Any further evidence should be given at question 11.


Face to face assessment

Decision Making

Fairness and Effectiveness


Question 9

Overall, how fair do you feel that the assessment was?
The latest was totally unfair as shown by a successful appeal, now three times over.  They did not even take the trouble to check my WCA case history and learn from previous mistakes.

Question 10

Overall, how effective do you feel that the process was?
Totally ineffective.  Setting aside whether or not the WCA is fit for purpose, it application and control is poor, which is why there are so many mistakes.  Everyone talks about right-first-time decisions, but nobody troubles to measure it – ridiculous.  HCPs don’t follow the handbook. Atos managers/auditors are unable/unwilling to see when this is the case.

Looking forwards

Question 11

What one thing (if any) would you change about the WCA to make the system better for people claiming ESA?
You have to look at a person’s ability to survive in employment and hold down a job, NOT just their ability to do random pieces of work.  All employers depend on staff reliability and this is precisely the thing that many disabled people struggle to guarantee.  The concept of “general work” is meaningless. Change the name WCA to J(ob)CA.
Please use the space below to give us your comments.

Question 12

Is there anything else, relevant to the WCA, that you would like to tell us about?
Please use the space below to give us your comments.
Much of this is simply good management practice.
·      If GPs haven’t provided quite the right perspective on capability to work, retrain/re-educate them so they do, don’t take it out of their hands altogether, if only on the grounds of cost.  What better place could there be to conduct my assessment than at my GP’s practice – he has EVERYTHING to hand – even a second opinion if he needs it.  10,000 practices, 40,000 GPs – you do the math – a handful of WCAs per week on average:  Barely noticeable in relation to workload.
·      DWP should at least be open and honest with claimants.  Their whole approach is born out of the belief that we are all benefit scroungers and are intent on fraudulently obtaining money.  They therefore have to employ a variety of underhand tricks and subterfuge to establish the ”truth” – or the truth as they would like it to be.  The hypothetical wheelchair scenario when assessing mobility is shameful.
The picture here appears in a DWP publication and says it all.  The document contains 8 images with 17 faces portrayed, which carefully ensure all races are represented.  Given the high correction cost, documents like this are always very diligently proof-read and checked in great detail prior to mass production.  Of the 17 faces, the one on the left here is the ONLY one with a sad expression.  It was not therefore an accident or oversight, but done this way for a reason.  There are only two possible interpretations of the message they are attempting to convey:

1.    All claimants are on the fiddle and this one knows they have just been found out
2.    This claimant knows the assessment is wrong and they will now have their benefit stopped and will have to fight for a year to get it back.

DWP would hardly promote its own errors, so option 1 here is the logical interpretation
The fact that I occasionally visit a supermarket does NOT prove I can repeatedly walk 800m and the fact I can drive for 15 mins does NOT mean I can propel a wheelchair.  They suggest that there is scientific evidence to support both propositions, but this is a lie.

·      Why on earth does nobody measure the right-first-time rate when it is by a long way the most important performance measure?  What would you prefer – a wrong decision communicated sensitively, or a right decision communicated a bit abruptly?  It’s all about priorities!  The old cliché “if you don’t measure it, you can’t manage it” is true.
There are standard statistical techniques to measure the success of any discrimination process, most of which have a valuable place here with the WCA.  It is a long way from rocket science – just good management practice.
·      What is regarded as an acceptable error rate – 1 in 10? 1 in 100?  We need to know and agree what we are aiming for.  Until we do, we cannot be sure that current process is capable of delivering it and even if we do, we’ll never know and there is no point in continuing to seek something that is unattainable.
·      You cannot proactively manage anything if you have to wait 9 months to be sure your data is correct.  Quickly get the Tribunal queue down to see more clearly where the problems are and be in a position to act quickly and see the results of any changes quickly.
·      The Paralympics recognises that in many cases sports have to be modified or indeed created to allow disabled people give of their best.  What’s so different about the job market?  We must place the horse before the cart – be sure that suitable jobs are available first.
·      If DWP can legitimately countermand my GP’s recommendation it MUSTR accept full responsibility for my health and well-being thereafter, which includes the consequences of a wrong decision whatever they might be.  Authority without corresponding accountability is a well know recipe for disaster.
·      DWP’s standards of integrity can be demonstrated by its approach to the audio recording trial.  Never have I seen such a poorly managed project progresses under such obvious sufferance.  Clearly DWP doesn’t want it and has been doing its level best to scupper the idea since ‘Day 1’.  The present tactic it to deliberately suppress demand so that it can kick the idea out on the basis that there isn’t any and the whole thing is not cost effective.  Even Atos could see the reality, but let’s not forget that this need is a result of justifiable mistrust which needs to be eliminated NOT accommodated.
·      Where is the original risk analysis – the one that examined in detail the potential consequences of making wrong decisions?  There is not one – again shameful.  The ends DO NOT always justify the means and the level of collateral damage we have seen is simply not acceptable – people have died.  Imagine the outcry if the same cavalier approach was taken in the justice system – the huge downside risk is the very reason we do not have capital punishment – we do not say that killing the odd person wrongly is the price one has to pay . . . .
The best processes achieve consensus early on, so everyone has the same objective thereafter.  Being borne out of mistrust, the current WCA process is highly adversarial which inevitably generates conflict, misunderstandings, errors and cost.  It the HCP has done a fair and thorough job and can genuinely say that their recommendation is in my best interests, why can’t we discuss the result BEFORE I leave and sign it off?  Of course not as easy as it sounds, but worth thinking about. 
Any suggestion that it is not in my best interest raises a whole host of questions . . . . .
·      The confusion over quite who can & should do what between an Atos HCP & DWP DM in itself causes errors through confusion.  The DM decides if I am to receive ESA or not – on the surface purely an administrative decision.  But, it is a direct result of me being deemed fit for work or not, so who makes that decision?  It can’t be the DM as the DM has no medical training and the assessment is largely medically based.  It can’t be the HCP otherwise they are in reality determining my benefit entitlement.  So who?  The current attempt at job definitions fudges the issue and creates a DM role that is not really necessary if you have trust and confidence in the HCP – easier if they are public rather than private sector employed.  Sadly, in 2008 we through the baby out with the bathwater.
·      Outsourcing is hardly a new commercial concept, but DWP does not yet understand that whilst you can outsource the service itself, you cannot outsource or side-step the accountability for successful delivery.  It cannot even guarantee that at the time of a WCA the Atos HCP’s qualifications are wholly up to date, despite stating that this is an absolute prerequisite for approval.

There are many other side issues too numerous to list here.  Everything I have said is (unlike the equivalent DWP claim) genuinely evidence-based, largely through the use of FoI requests.  What DWP cannot say is often as revealing as its confessions.


Anonymous said...

Why do you write such protracted blogs? Do you think anyone reads them? Or is it a kind of therapy? With such literary capacity, I think you would be a very valuable asset in many public sector organisations

Tia Junior said...

Dear Anonymous,

Why do you ask rhetorical questions? Reading them is of course optional and as far as I am aware, they do no harm. It's a bit like people complaining about poor TV programmes - all they have to do it use the "off" switch and at least with my blog, there is no charge.

Clearly not with you, but with over 16,000 "hits" some at least have struck a chord.

I agree with you completely, anyone with a modicum of common sense and integrity would indeed be valuable within the public sector.

Why do you choose to remain anonymous? DWP secret service?