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Wednesday, 12 September 2012

WCA Audio Recording - Project management at its very best

The exchange below stemmed from an FoI request and took a staggering 6 months to get some straight answers

WCA Audio recordings (2)
22nd March 2012
Dear Department for Work and Pensions,

In 2011, a trial was undertaken and recently Chris Grayling has confirmed that it was successful and the facility is now available on demand nationwide.  Please provide me with a copy of the following, all of which would have been produced before implementation commenced.
1)        The risk analysis
2)        The risk register
3)        The impact assessment
4)        If they are not available, who authorised implementation without them?

23rd  April 2012

In response to Qs 1, 2 & 3 the decision was taken that as the Audio Recording pilot scheme was considered to be an interim solution that there was no requirement for detailed impacting or the undertaking of risk analysis. The Pilot scheme was put in place to allow consideration of the potential volumes of requests and recording methods, to therefore ensure that an appropriate solution to the recording of medical assessments was found.  In answer to Q 4 this decision was taken by Atos Healthcare and the Head of DWP Medical Services – Commercials.
23rd  April 2012
Dear Department for Work and Pensions,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Department for Work and Pensions' handling of my FOI request 'WCA Audio Recording (2)'.  I would be grateful if you would ensure this is passed to a manager who has the ability to see how absurd the DWP response is.

Issue of audio recordings is high profile and a specific recommendation from Professor Harrington. This nprofessional & haphazard approach is therefore a serious letdown to him and his team.

The pilot scheme was established to determine the best solution to a problem. Only once the final solution is known, can any other temporary fix be described as “interim”. It is simply impossible to set out to establish an interim answer to anything without knowing what the anything is!!!

On this basis, the decision to waive the three key processes was clearly unjustified and fundamentally wrong. An IA was VITAL as the potential consequences of this trail are immense and could spread through the not only JCP, but the TS too. Its omission was therefore a serious dereliction of duty. For the record, Atos has NO part to play in the decision anyway – accountability and responsibility sit EXCLUSIVELY with DWP.

There are likewise a number of serious risks – lengthening the WCA for example and to ignore them is an equally serious dereliction of duty.

The (unexplained) limitations imposed on the trial rendered it totally incapable of assessing true demand, so this suggestion is not only completely at odds with other FoI responses and information published, it is simply fabricated.

The response to another FoI request states that the report and all the associated documents will be available on 04/05/2012. In will be interesting to see how well considered and professionally produced it is.
 
 DATE 21 May 2012

At the time of your request, the Audio Recording Pilot had ended and an interim solution was in place whilst the Department was considering the evaluation. As this was considered an interim solution there was no detailed impacting or risk analysis undertaken. I apologise that the previous response implied that the actual pilot was the interim solution and for any confusion that may have arisen.
Since the request under review was made, the full evaluation report has become available using the following link: http://www.dwp.gov.uk/policy/welfare-reform/employment-and-support/wca-independent-review/year-one/
In reviewing your request I uphold the decision of the Freedom of Information Officer in part and have added information where appropriate. I am therefore satisfied now that all the information that DWP are able to supply to you has been supplied.
29 May 2012

Dear Department for Work and Pensions,

Please pass this on to the person who conducts Freedom of Information reviews.  I am writing to request an internal review of Department for Work and Pensions’ handling of my FOI request 'WCA Audio Recording (2)'.

I’m sorry, but you are hedging the issue.

1)  The report published by Atos is 12 months old and includes a number of questions that it feels need to be answered before a full roll-out can take place. Over the past 12 months what information has DWP produced that addresses these questions?

2)  If as you say DWP has been “evaluating” the pilot, what conclusions has it so far drawn, given it has already had 12 months?

3)  To what timetable is DWP working to produce a definitive statement of what it regards as the final solution, bearing in mind it has had 12 months already?

4)  At what point will the statutory requirements for risk & impact analyses plus a risk register be produced?

5)  DWP will have a defined project plan to ensure the evaluation is completed on time and comprehensively includes all of the relevant issues. Please provide a copy.

6)  Who is DWP “owns” this evaluation and the subsequent implementation – i.e. has direct accountability for the success of both.

7)  Is any form of consultation planned and if so, at what point?

Can I respectfully remind you of the overarching requirements of Article 19 of the Universal Declaration of Human Rights embodied within UK legislation (Principles 1 – 3 particularly) adherence to which would have offered this information voluntarily. All I am seeking is a clear understanding of DWP’s real attitude to this piece of work and how enthusiastically it intends to pursue it - the impression you are giving is that you have no enthusiasm, little interest and are actively engineering its failure.
11th Sept 2012

In response to Q 1 the questions in Section 8 relate to national rollout. No final decision has been made about this. The answers to these questions have therefore not been formally considered and are therefore not available.

In reply to Qs 2, 3, 4 & 5 DWP are developing criteria in order to evaluate the success of the current approach which will take into account factors such as value for money and the value it adds to the Work Capability Assessment process. Therefore no conclusions have been reached and the information is not available. A timetable and a project plan will be produced as part of the evaluation process which will include the undertaking of risk and impact nalyses.
In answer to Q 6 the evaluation of the pilot scheme is owned by the DWP Health and Wellbeing Directorate.
In response to Q 7 there has been no decision taken in relation to this point.

Summary
Having seen the Atos report from the trial published in June 2011, it rather looks like Atos set it up in reasonably good faith albeit without much thought and rigour, so that the dilemmas that subsequently arose were entirely predictable.  It would have helped if Prof Harrington had provided more guidance and continual reminders as to why the idea ever arose in the first place.
The shameful organisation within DWP is apparent from this last response dated 11th September.  In essence DWP has done nothing to constructively take this forward for a year and a half and even now can only offer faint promises for unspecified dates in the future.
It is bad enough being screwed by a group of so-called public servants but twice as painful when it is done so inefficiency that it costs a lot and achieves nothing.

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?
YES

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.

Communications

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
or,
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.

WCA Audio Recording - an enquiry to Atos

To:  Atos Customer Services

Dear Sir,

In your “Pilot Evaluation Report”, you state:

The results of the pilot indicate that there are (sic) a significant proportion of clients who would welcome the opportunity to have their assessment recorded”  and

“There is increasing demand for recording of assessments and currently there is no easy process to offer this and we estimate AH receives around 1-2 requests / day. Therefore is a need to make recordings more readily available on request. “

And finally, “Our recommendation would be that recording should be become routine as it is in a call centre or for example – NHS direct. “

However, on your website you now state: “Due to minimal take-up during the pilot, we only have a limited number of recording devices available”.
Why are you now misrepresenting the results of the trial and why have you so drastically changed your position on the usefulness of the facility to the point where you now only offer it on a hit and miss basis?  Surely this will result in discrimination – some claimants will have the benefit of a recording, others will not, which if they decide to appeal the DWP decision, places them at a huge disadvantage.
I look forward to hearing your explanation.
Yours faithfully